Adjustments to Transitions in Health Care Delivery
Adjustments to Transitions in Health Care Delivery
Consider what you’ve learned so far about the transition from volume- to value-based reimbursement. Different organizations will respond to the impact of this change in various ways. Based on its actions, an organization may flourish, or it may fail as its reimbursement decreases. As reimbursement methodology changes, institutions must adapt.
To prepare for this Assignment:
Read Case 5: Middleboro Community Hospital in this week’s Learning Resources, and consider the actions taken by this organization. Review data tables regarding their case mix (top DRGs), Patient Days, and CMS Core Measures. These metrics address both qualitative and quantitative measures in this organization.
The Assignment:
Write a brief, 2-page executive summary of the impact of the transition from volume-based to value-based health care. Specifically, address how this change in reimbursement methodology impacts operational requirements and how it can be implemented. Recommend at least two adjustments to operations which may position the organization for success under value-based health care.
MMHA6700 Healthcare Operations Management
Week 3 Assignment
High Reliability in Health Care – Long-Term Care
There are three imperative steps that need to be taken. The first is a strong commitment by leadership to this very high level of safety and quality. The leadership must set the goal and example for everyone in order to achieve high reliability. The second is to embed all of the principles and practice of a culture of safety throughout the organization which emphasizes trust, reporting of unsafe conditions, and highly effective improvement over time. The third step is to utilize powerful Robust Process Improvement tools like Six Sigma, Lean, and change management to create near perfect processes, similar to the tools that we see in industries like commercial aviation today, and sustain very high levels of safety over long periods of time.
—Dr. Mark R. Chassin
These three steps: commitment by leadership, development of a culture of safety, and the use of process improvement tools, are the core recommendations made by Dr. Chassin, the president of The Joint Commission and the president of the Joint Commission Center for Transforming Healthcare. A first step in identifying whether these recommendations are being met is to compare elements of an organization to criteria which have been identified as essential to high-reliability organizations.
To prepare for this Assignment:
Consider the three steps described by Dr. Chassin and the seven major criteria of the Baldridge Performance Excellence Program, and reflect on how these recommendations can apply to health care organizations, specifically to long-term care facilities.
The Assignment:
In this Assignment you will identify major elements of high-reliability organizations providing long-term care. According to the Baldrige Performance Excellence Program (MBNQA), the criteria are as follows:
Leadership
Strategic planning
Customer and market focus
Measurement, analysis, and knowledge management
Human resource focus
Process management
Business/organizational performance results
Using the Highly Reliable Organization Matrix located in this week’s Learning Resources, complete the matrix by typing in the elements which meet the criteria in rows and columns. Describe each element briefly, give an example as to how this can be met in a long-term care facility, and explain the expected impact on patient care.
Based on the results of the Highly Reliable Organization Matrix, write a 1- to 2-page executive summary to the board of directors of the long-term care organization, describing elements which meet the criteria from the matrix and how any missing elements of the criteria for excellence can be met.
MMHA6700 Healthcare Operations Management
Week 4 Assignment
Project Management Planning
Because many aspects of health care operations are changing, health care administrators oversee a wide variety of projects. These can include logistical projects such as moving a department to a new facility, technology-related projects such as introducing a new system or piece of equipment, or process-related projects such as initiating new procedures for patient discharge. If the project has any degree of complexity, it will benefit from a project management approach. Administrators and managers in health care need to have a working understanding of project management: why it is important, what it accomplishes, and the repercussions on the organization if its basic tenets are ignored or not followed. Within project management, the project plan is the cornerstone of successful execution of a project. The project plan is designed to guide the process and execution of a project.
For this Assignment, you will develop a project plan, using as your focus a work-related project you are doing now or will be doing in the future.
Part 1: Service Level Agreement
It is suggested that the project you select be manageable in scope and not overly complex. You will assume that the objectives and scope of the project you have selected have been vetted and approved. The next step is to develop a project plan. You will develop a project management plan that will walk through key steps of the project management process. The objective of this Assignment is not a deep dive into the full intricacies of project management. Rather, it is to ensure that as a health care administrator, you have a solid theory and practical knowledge of key aspects of the project management process.
For Part 1 of this Assignment, you will create a Service Level Agreement (3–5 pages) which includes the following:
Project Description, Purpose, and Objectives: The project description delineates key aspects of a project. In 1–2 pages, your project plan should:
Describe the project and explain the purpose and justification for the project.
Explain the goals and objectives of the project.
Describe the requirements for the project.
Explain the tangible measures for acceptance criteria used to achieve project success.
Project Scope: The project scope defines the scope of the project and how the scope will be managed. In 2–3 pages, your project plan should:
Summarize, in detail, the expected deliverables for the project.
Explain the acceptance criteria for the project.
Explain the project assumptions, risks, and constraints.
Roles and Responsibilities: By definition, a project is a unique undertaking with a beginning and an end point. One responsibility of management is to determine who will be a part of the project team (including designation of a project manager). Ask yourself, “Who needs to be on this team to ensure that project goals are successfully met?” Consider as well the importance of communication among team members. What communication needs will each individual have? With whom will they communicate and how?
Using the Project Roles and Responsibilities Matrix template in the Learning Resources, list the names* and titles of all individuals or entities involved in the project. Indicate whether each stakeholder is internal or external to the project organization.
Note: For privacy purposes, please use pseudonyms.
Identify the internal and external stakeholders for a project.
Distinguish the roles and responsibilities of the project stakeholders.
Explain how to communicate with project stakeholders.
Part 2: Project Schedule
There are many different methodologies for planning and scheduling a project. For this Assignment, you will develop a Gantt chart that depicts key project activities, time allotted for each activity, and when each activity is scheduled to begin. To do so, you will need to consider dependencies. Some activities will be sequential, others may be simultaneous, and some may overlap.
Note: You may create your own Gantt chart using Excel, or search for and download a Gantt chart template.
Using a Gantt chart, construct a project schedule.
In 2–3 paragraphs of your project plan, explain the estimating techniques used to develop your project schedule. Provide rationale for why these techniques will be effective.
Part 3: Strategies for Maintaining the Project Budget
A project begins with an approved budget. Too often, however, unless the budget is meticulously managed, budget overruns occur. Health care administrators must ensure that the project management process includes careful oversight on spending. In 2–3 pages, describe the project budget key success factors including the following:
Analyze at least three strategies that can be applied for due diligence and maintaining oversight of the project budget.
Explain at least two challenges each of these strategies might present and identify opportunities for improvement.
Compare the positive outcomes that might result from each strategy.
Part 4: Risk Management, Quality Management, and Sustainability
Even the most straightforward and well-planned project can be impacted by unexpected circumstances. Anticipating risks is a key part of project management, and one that a health care administrator or manager must ensure is taken into consideration by the project team. Additionally, If not carefully monitored, budget and time constraints can take a toll on the quality of a project. Create a 2–4 page risk management and quality management plan, which includes the following:
Describe how you plan to manage risks for your project.
Analyze strategies for managing quality within your project.
Analyze strategies for sustainability of your project.
Describe at least two tools and/or techniques you plan to use to manage quality and defend why you chose those tools.
MMHA6700 Healthcare Operations Management
Week 5 Assignment
Productivity Metrics
Note: For the Weeks 5 and 6 Assignments you will use Case 3: Physician Care Services, Inc., from the Middleboro Casebook.
In the Middleboro Physician Care Services, Inc. case, you are asked to examine the operations of an ambulatory, non-emergent care clinic which treats private and occupational health patients and provides services which do not include continuing or specialized medical care. Physician Care Services, Inc. is currently facing a number of challenges and opportunities which will impact their profitability.
To prepare for this Assignment:
Read Case 3: Physician Care Services, Inc., including Tables 3.2 and 3.3. Review the issues that surround provider productivity, to evaluate whether the organization can be successful in the new era of health care reform.
The Assignment:
In 2–3 pages, describe the metric(s) you will use to evaluate the organization’s productivity. Explain how you will use the metric in evaluating productivity, and how the data will help measure the potential of the organization’s success in the new era of health care reform.
Note: You will use the metric in the Week 6 Assignment.
MMHA6700 Healthcare Operations Management
Week 6 Assignment
Productivity Recommendations
Last week, you familiarized yourself with the Physician Care Services, Inc. case and selected metrics that would help you to evaluate the organization’s productivity, with an eye to determining whether they could be successful in the current environment of health care reform. Based on your conclusions, you will have at least identified one or two areas of need which could benefit from change.
To prepare for this Assignment:
Review Case 3: Physician Care Services, Inc. from Week 5, and the Assignment you submitted at the end of that week.
Now, you will develop recommendations to improve productivity and patient satisfaction. Consider what you know of Lean Management and Six Sigma principles and practices. Based on this understanding, ask yourself: What would the president and medical director want to know before making any financial and organizational decisions?
The Assignment:
Based on the metrics you selected in Week 5, analyze opportunities for improvement using Lean Management and Six Sigma principles (2 pages).
Develop five measurable stretch goals (2 pages).
Create a presentation with speaker notes, 5–7 slides in length (200–400 words per slide), that defines a culture of accountability and quality excellence and recommends how to foster this in the emergency department.
MMHA6700 Healthcare Operations Management
Week 8 Assignment
How Is Information Technology Transforming Health Care?
How is information technology (IT) transforming health care? The impact of new initiatives which provide patient access to providers is enormous and potentially astronomical. Consider the ways in which initiatives such as patient portals, innovative care such as medical apps or tele-visits, and directives such as Meaningful Use improve patient health clinical outcomes. How do these initiatives impact the financial health of the company? Will these costly IT initiatives create a positive return on investment?
To prepare for this Assignment:
Read this week’s resources, then identify a new initiative utilizing new technology in your organization or a health care organization with which you are familiar. (Examples: online training for annual competency training, tele-visits, a move from traditional servers to cloud data management, operations systems in place in supply chain management, bar coding, inventory management, etc.) Once you have identified the initiative, conduct an online search to find information about IT implementation for similar initiatives in other industries.
The Assignment:
In 3–4 pages, describe the operational impacts of the new initiative you identified. Explain how the initiative transformed your organization. Apply your observations about other industries to your analysis of the initiatives in your organization. Assess how the common traits of a successful IT transformation apply to your organization.
MMHA6700 Healthcare Operations Management
Week 9 Assignment
Operational Process Flow
Process improvement requires the analysis of processes and of data. In this Assignment, you will develop a process flow for an operational activity that takes place in your organization, whether or not you work in the field of health care.
To prepare for this Assignment:
Read the articles and watch the videos on process mapping and critical path. Identify an operational activity within your organization, or an organization with which you are familiar. These activities could include business planning, staff training initiatives, changes in case management, etc.
The Assignment:
Using what you have learned about process mapping in this week’s resources, create a process mapping flowchart to measure operational data of the activity using Microsoft PowerPoint or Microsoft Visio. Identify the important measurements within your process which provide operational data. Then, based on the process map you have created, list and describe these measurements and the critical path within your process, utilizing any additional process improvement tools necessary. Your completed Assignment should include the flowchart, a description of process measurements, the critical path analysis, and a 1- to 2-page summary.
MMHA6700 Healthcare Operations Management
Week 11 Project
Operational Implications of Process Improvement
During this class, we examined a range of methods used in operations management to monitor, assess, and improve performance in health care organizations. In this final Assignment, you will review the Learning Resources made available throughout the class, and any additional external resources you may find. Then, you will synthesize your understanding of these resources, applying your knowledge to the Pediatric Hospital case study.
According to the case study, a kaizen event revealed that variability in operations performance and outcomes was the root cause of a bottleneck in scheduling MRIs. Three solutions were provided, including:
Modify the master schedule.
Streamline the insurance authorization process.
Implement standardized work instructions.
To prepare for this Assignment:
Read the Pediatric Hospital in Tough Market Pegs Growth to Lean Process Improvement case study by Tonya Vinas, located in the Learning Resources. Review the key metrics and current state of the organization before the interventions were conducted.
The Assignment:
In a 6- to 7-page report to the board of directors (not including title page or references):
Assess operations requirements and resources for Pediatric Hospital. Describe what is working and what is not working.
Conduct a quantitative and qualitative benchmark literature review and scan of operations best practices (from the health care industry or outside the health care industry) and provide and evaluate an example of an initiative that a high-reliability health care organization has implemented, and indicate how Pediatric Hospital can implement that initiative.
Evaluate Pediatric Hospital’s readiness for the transition of health care systems from a volume- to value-based delivery system. Using data provided in this case, provide relevant and practical recommendations to improve its readiness and how it might affect the implementation of the initiative.
Analyze the operational implications of 2–3 current health care reforms and mandates that might affect the implementation of the initiative.
Consider current and future trends and forces in operations management excellence and assess how these can help this Pediatric Hospital and other similar health care organizations to become a sustainable model for high-reliability organization.
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