In order to apply health care quality concepts to a health care issue or a facility using the measurement-related concept of structure, process, or outcome, it is necessary to understand that the three complement each other.
Application of Health Care Quality Concepts
In order to apply health care quality concepts to a health care issue or a facility using the measurement-related concept of structure, process, or outcome, it is necessary to understand that the three complement each other. In other words, one is not more important than the other. Criteria and standards are essential to evaluating the three. A criterion is typically evidence driven and based on efficacy. Standards should be set at a minimal, ideal, or achievable level to meet the goals behind specific quality of care evaluations.
For this Discussion, you will select a health care quality concept; apply that concept to a real health care issue; identify the issue as structure, process, or outcome; and apply it to the Six Quality Dimensions you read about in Crossing the Quality Chasm.
To prepare:
Review the Learning Resources on health care quality concepts.
Select a health care quality concept from the Learning Resources.
Note: For this Discussion you are required to complete your initial post before you will be able to view and respond to your colleague’s postings. Begin by clicking on the “Post to Discussion” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post a cohesive response to the following:
Describe the health care quality concept you selected. Apply it to a health care issue in your health care facility or one you are familiar with. Identify the issue as a structure, process, or outcome and explain why you made this differentiation. Then apply it to the Six Quality Dimensions found in Crossing the Quality Chasm.
Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.
Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.
By Day 5
Respond to two of your colleagues’ postings and continue the Discussion through Day 7 by describing how you might use the quality initiative or program you found in reading your colleagues’ responses in your own facility.
MMHA6900 Healthcare Quality Management
Week 3 Discussion
Variations in Quality of Medical Practice
Variations, too much or too little in health care, are an indication of poor quality in medical practice and often raise questions about the quality and efficiency of the use and allocations of resources, and they have important implications for health care and health policy.
In this Discussion, you will conduct an evaluation of the variation of issues affecting Medicare reimbursements to determine warranted or unwarranted variations. You will provide an analysis of those variation issues that may affect reimbursements and recommend ways to overcome the issue(s).
To prepare:
Read/review the Dartmouth Atlas Data document, containing key statistics per state, and the Learning Resources related to variations in quality in medical practices.
Dartmouth Atlas Data document (Excel spreadsheet)
Note: For this Discussion you are required to complete your initial post before you will be able to view and respond to your colleague’s postings. Begin by clicking on the “Post to Discussion” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
The Discussion:
In an attempt to figure out why there is a tremendous difference between Medicare reimbursements between states, data were pulled from the top and the bottom of the list that include the following information adjusted for price, age, sex, and race. The 90th percentile group is at or above $10,578, and the 10th percentile group is at or below $7,497.
By Day 3
Post a cohesive response to the following:
Using the Excel spreadsheet (Dartmouth Atlas) and other Resources for the week, post your analysis of the variation issues that may affect diverse Medicare reimbursements and why. Recommend strategies for overcoming the issues.
Note: Local governmental differences are not a valid reason.
Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.
Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.
By Day 5
Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7 by identifying any common patterns or trends that may have emerged.
MMHA6900 Healthcare Quality Management
Week 5 Discussion
Data Collection and Statistical Tools
Shewhart’s Theory for Statistical Process Control (SPC) requires a change in thinking from error detection to error prevention and has a number of benefits in health care. Several of the benefits include patient focus, increased quality awareness, decisions based on data, implementing predictable health care processes, reduced costs, fewer errors resulting in increased patient safety, and improved processes that result in improved health care outcomes and better quality care. However, every process varies. In SPC terminology as it relates to a control chart, a common cause variation does not suggest that a process functions at a desirable or undesirable level, but whether the nature of the variation is stable or predictable within certain limits. A special cause variation is a negative finding, and any changes made in a health care organization should not be made until it identifies and eliminates special causes. A control chart will tell a health care organization if a variation is a common or special cause and how to approach an improvement process. If it is a special cause the health care organization should investigate it and eliminate the variation, not change the process. If there is a common cause variation, the implementation of a process change is what will address the variation. Control charts will reveal whether the change was effective (Joshi et.al, 2014).
In this Discussion, you will look at these statistical tools for quality improvement and describe the differences between common cause variation and special cause variation. You will also explain any ethical, legal, or moral obligations that would support your rationale.
To prepare:
Review the Learning Resources for the week as they relate to Statistical Process Control, common cause, and special cause variation.
Read the following situations and determine whether each situation is a common cause variation or a special cause variation:
Dispensing the wrong medication to a patient
Dispensing the correct medication several hours after it was supposed to be dispensed
For both of these examples, apply data-collection and statistical tools to measure and explain your rationale for your determination.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleague’s postings. Begin by clicking on the “Post to Discussion” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post a cohesive response to the following:
Post your analysis for each example of common cause error or special cause error. Explain any ethical, legal, or moral obligations that would support your rationale.
Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.
Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.
By Day 5
Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7 by providing additional recommendations they hadn’t considered. Support their ideas and/or defend yours.
MMHA6900 Healthcare Quality Management
Week 6 Discussion
Physician Profiling and Health Care Quality Outcomes
Physician profiling is a collection of provider-specific and practice-level data used to analyze physician practice patterns, utilization of services, and outcomes of care. Physician report cards (which may be a component of a physician profile) compare physicians on outcomes related to measures such as quality, patient satisfaction, and cost-utilization patterns.
In this Discussion, you will identify three strategies for improving physician quality practice ranking on physician profiling and quality report cards. Be sure to justify your recommendations.
To prepare:
Review the Learning Resources as they relate to quality-improvement assessment and health care quality outcomes.
Note: For this Discussion you are required to complete your initial post before you will be able to view and respond to your colleague’s postings. Begin by clicking on the “Post to Discussion” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post a cohesive response to the following:
Post an analysis of physician quality practice data. Then, recommendthree strategies for improving physician quality practice rankings on physician profiling and quality report cards. Justify your recommendations with references to your Learning Resources or other academic resources.
Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.
Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.
By Day 5
Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7 by either agreeing or disagreeing with their recommendations and stating why.
MMHA6900 Healthcare Quality Management
Week 7 Discussion
Culture Connections and Patient Safety
Culture drives quality—if an organization does not have a culture in which they hold themselves and others accountable, it is probable that it will not achieve and sustain high-level quality outcomes. Patient safety is defined as freedom from accidental injury; you have seen how medical errors are harmful, and that there are second victims that suffer as well. Remember quality can be defined as “the cumulative impact of all that happens to a patient while in an organization’s care” (Porter, 2012, p. 193).
A Just Culture gives organizations a template to uniformly address the shortcomings or errors of those who fail. It addresses failures in four different areas, which include 1) human errors and mistakes, meaning unintentional harm; 2) carelessness or at-risk behavior—or not paying attention that results in an error; 3) recklessness or a flagrant disregard for norms where an error occurs unintentionally, but because of recklessness; and 4) those who just do not pay attention and have no regard for authority.
In this Discussion, you will identify a model that a health care organization might use to improve their culture of quality and describe whether the ethical theory of Just Culture would improve the quality and why.
To prepare:
Review Learning Resources on culture and patient safety.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleague’s postings. Begin by clicking on the “Post to Discussion” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post a cohesive response to the following:
Post a model you have selected that health care organizations might use to improve the culture of quality. Describe whether the ethical theory of Just Culture would improve the quality of a health care organization and how.
Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.
Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.
By Day 5
Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7 by agreeing or disagreeing with their rationale and explaining why.
MMHA6900 Healthcare Quality Management
Week 10 Discussion
Impact of IHI Triple Aim
Organizations and communities that attain the Triple Aim will have healthier populations, in part because of new designs that better identify problems and solutions further upstream and outside of acute health care. Patients can expect less complex and much more coordinated care and the burden of illness will decrease. Importantly, stabilizing or reducing the per capita cost of care for populations will give businesses the opportunity to be more competitive, lessen the pressure on publicly funded health care budgets, and provide communities with more flexibility to invest in activities, such as schools and the lived environment, that increase the vitality and economic wellbeing of their inhabitants.
—Institute for Healthcare Improvement (2016b)
This week, you will explain why you think the Triple Aim program is successful and, based on the initiatives, recommend two strategies you would take to improve implementation of health care quality initiatives within your organization or a health care organization in which you are familiar.
To prepare:
Review the IHI White Paper in this week’s Learning Resources titled A Guide to Measuring the Triple Aim: Population Health Experience of Care, and Per Capita Cost.
Note: For this Discussion you are required to complete your initial post before you will be able to view and respond to your colleague’s postings. Begin by clicking on the “Post to Discussion” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post a cohesive response to the following:
Explain why you think the Triple Aim programs have been successful.Based on the success of the Triple Aim initiatives, recommend two strategies you would take to improve implementation of health care quality initiatives within your organization (or an organization you are familiar with). Describe challenges/opportunities you may encounter in doing so.
Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.
Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.
By Day 5
Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7with your ideas/recommendations that may be missing and/or appropriate in their analysis.
MMHA6900 Healthcare Quality Management
Week 11 Discussion
Transitioning the Health Care System to Population Health
Congratulations! This is your final Discussion for this course! As you reflect upon all that you have learned here, take a look at the directed reflection provided below. Please respond with what you identify as future trends in health care quality management, how the shift to population health may support or hinder quality, and what you think future expectations about excellence will be from a stakeholder’s point of view. Thank you for this opportunity to share 11 weeks with you, and we wish you the best in your future endeavors.
To prepare:
Review Learning Resources as they relate to transitioning to population health.
Note: For this Discussion you are required to complete your initial post before you will be able to view and respond to your colleague’s postings. Begin by clicking on the “Post to Discussion” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post a cohesive response to the following:
What have you identified as future trends in health care quality management?
How does the shift to population health initiatives support or hinder health care quality management?
What are future expectations about excellence in health care quality from a stakeholder’s point of view?
Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.
Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.
By Day 5
Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7.
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