Organizing and Evaluating Performance Improvement
Within 326 Chapter 15 Organizing and Evaluating Performance Improvement licat Check Your Understanding 15.4………….. 9 papian the n 1. Kevin is a member of the PI team at a local hospital. As part of his PI team duties, he is tasked with presenting the PI team’s quality data to the hospital’s board of directors. He is currently presenting this information through numerous spreadsheets and graphs, but because of the volume of data that the board must review, Kevin feels that the board is overwhelmed by the amount of data presented to them. Kevin is looking for a solution to provide this information to the board in a more succinct man- ner. Recommend a tool for Kevin and his PI team and provide rationale for your recommendation. sked at alled to 2. Argue why it is critical for hospitals to utilize a peer review process. Case St Wh Case Study…. . . . ………….. When a large regional medical center became part of an integrated delivery system that had a cen- tral board of directors, the medical center’s board began to struggle with its revised role. The new organizational environment included several outpatient clinics, multispecialty physician practices, and an insurance entity. Many of the current board members had served the organization since the medical center was built, and board activities always had been performed in a certain way. The administration rigidly con- trolled board meetings. Board members did not ask questions and routinely approved committee reports. The reports covered topics such as the organization’s financial status and future financial plans, physician E credentialing, care quality monitoring, new policies, and plans for a new hospital A new board member with a healthcare background was appointed after extensive screening and a per- sonal interview with the executive committee. She was not part of the local business power structure, and the administration was concerned that her appointment might not be a wise move. During her first board meeting, two very interesting reports were given. One report detailed some reengineering projects. One of these involved redesigning nursing staffing patterns. This redesign decreased the number of registered nurses (RNs), and replaced them with licensed practical nurses (LPNs) and certified nursing assistants (CNAs). The current quality report documented a very high quality of care and positive patient satisfaction surveys. Data excerpted from this report can be seen in the "1st Quarter" column of table 15.1. Given that this was her first board meeting, the new board member remained silent and did not ask questions. Table 15.1. Case study data Quality Performance Measure 1st Quarter | 2nd Quarter Medication errors 3.20% 10.42% Patient falls 4.21% 8.56% Cesarean sections 14.21% 17.87% Rate of vaginal births after C-section 18.27% 15.72% Healthcare Associated infections 1.78% 4.85% X-ray discrepancies 0.15% 0.21% Patient Satisfaction Measure 1st Quarter 2nd Quarter Overall service 40.52% 20.74% Overall clinical 86.72% 70.82% Overall quality of service 45.40% 22.34% Food 30.56% 32.54% Overall cleanliness 85.89% 83.26%
Review Questions 327 whin four months, the new nursing staffing pattern had been launched, Data excerpted from the dicators report presents to the board can be seen in the "2nd Quarter" column of table 15.1. Amie giving the data presented by the nurse administrator, the new board member was very concernedsite led to ask if the varies in the quality report, which show a negative trend, were for the nursing do the new nursing staring Patterns. The administrator reported that there was a direct correlation. whiter initiated discussion among other board members who were accustomed to using quality indicat Their businesses. This was the first substantive board-level discussion that the new board member liar seen. One board member mber wanted to know whether any data had been gathered from patient focus groups her board member asked whether the average length-of-stay data had increased, and someone else and about a cost-benefit analysis of the new staffing patterns. Following the usual process, the chair alled for approval of the report and presentation of the next item on the agenda Case Study Questions What changes or patterns do you see in the data? What remedies might be suggested for any problems? 2. Has the CEO carried out his or her responsibility for educating the board? Why or why not? 9. Depending on the answer to question 2, what strategies would you recommend at this point? 4. What quality data should be reported and utilized by this board of directors? . Given this administration’s style and leadership approach, do you think the minutes of the board meeting reflect actual board meeting discussions? Review Questions 1. This group has ultimate responsibility for maintaining the quality and safety of patient care provided by its healthcare organization. a. Board of directors b. Executive team c. Nursing leadership d. State board of licensure 2. Using the four reasons why healthcare organizations evaluate their performance improvement plan, provide an example of how this evaluation might occur in each section. 3. Governance, management, and employed staff are key to a healthcare organization’s success as they work together to identify community needs and pursue organizational goals. Provide an example of how each of these key groups might accomplish this 4 Medical staff standing committees are organized to review specific aspects of patient care services. List two of these areas. 5. Why are organization-wide strategic planning and planning for performance improvement interre- lated activities?
1. What changes or patterns do you see in the data? What remedies might be suggested for any problems?
2. Has the CEO carried out his or her responsibility for educating the board? Why or why not?
3. Depending on the answer to question 2, what strategies would you recommended at this point?
4. What quality data should be reported and utilized by this board of directors?
5. Given this administration’s style and leadership approach, do you think the minutes of the board meetings reflect actual board meeting discussions?
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