Quality Improvement Proposal

To provide quality healthcare and enhance patient safety, a healthcare organization should aim to qualify as an Accountable Care Organization (ACO). It gives patients higher confidence levels for managing their health needs and better healthcare solutions at reduced hospital costs. Evidence-based solutions such as care plans have improved patient outcomes at a reduced expense. An ACO is well aligned for using care plans to manage the patient’s complex health needs (Fraze et al., 2020). 

NURS FPX 6612 Assessment 2 Quality Improvement Proposal

ACOs are recognized as successful in providing quality healthcare to patients with depression and can reduce preventable hospitalizations. A comparison is made between ACO and non-ACO hospitals, and findings indicate that preventable hospitalizations are much lower in ACO-affiliated healthcare settings (Barath et al., 2020). 

Establishing coordinated medical care for the broader community and population results in improved quality and safety outcomes for patients in ACOs. Accountable Care Organization is designed to address the cost and quality of healthcare services to patients. All stakeholders in the ACO healthcare setting are held responsible for the care provided to patients at affordable and reduced rates, and waste is avoided (Moy et al., 2020). 

This assessment recommends expanding an organization’s Health Information Technology (HIT) to include quality metrics. It describes the main focus of information gathering and how it contributes to guiding the development of organizational practice. It identifies potential problems that can occur in data-gathering systems. 

Recommendations to Expand HIT

Health Information Technology (HIT) is utilized to provide quality healthcare to patients at an affordable cost. It gives better access to data, filters out the most relevant information, and data analytics are available to medical practitioners and caregivers with detailed insight into patients’ complex health needs. Patients’ health records are well managed through a unique medical registration number (MRN) assigned to each patient. 

A directory of each individual is maintained with the health records, detailed examination, and medication prescribed. All healthcare staff, including doctors, paramedics, and nurses, can access the electronic folders and plan better healthcare for quality health outcomes at lower hospitalization costs.

HIT shall be expanded at full scale across the board in any healthcare setting for an organization to stay at par to cater to the healthcare needs of its patients. A suitable and easy access system shall be designed for timely patient care on time. Patients can view their health charts and detailed examinations on their mobile applications. In contrast, healthcare staff can access patient portfolios on hospital site computers, and remote access is also provided through hospital databases.

For example, a 61-year-old woman, Caroline McGlade’s Electronic Health Record (EHR), is available and contains information on her previous history, lab examinations, and diagnosis of a case of potential breast cancer. For effective management and provision of nursing care, health information technologies play a vital role in accomplishing desired quality improvement in patient outcomes (Alaei et al., 2019). 

Focus on Information Gathering and Guiding the Organizational Development

The main focus of information gathering is the provision of good quality healthcare to patients at reduced rates and catering to complex healthcare needs. The data gathered and the use of informatics and analytics help caregivers to plan better care and remove any redundancies of information that may be present in the hospital database. 

Organizations have evolved through the progressive implementation of change in using databases. A robust and dedicated health system is available for every individual. Organizational productivity has increased manifolds regarding patient outcomes and employee efficiency. All healthcare staff has shown better patient management by using digital health records.

Doctors and other healthcare staff have been given extended control over their achievements and accomplishments in performing duties for healthcare services. Performance charts and projected growth is available to all healthcare professionals at their staff portals. Employees can give feedback on their satisfaction levels of working and suggest any modifications or enquire about any query if it arises during their work hours. 

NURS FPX 6612 Assessment 2 Quality Improvement Proposal

Monitoring and managing healthcare databases are challenging, though their effectiveness for organizational development is critical for an ACO hospital to accomplish the desired outcomes for patients. Artificial Intelligence and other advanced information and communication technologies can provide better solutions for the healthcare profession, particularly in nursing informatics (Robert, 2019).

Problems with Data Gathering Systems

Data gathering is challenging, and its management and handling are equally demanding. Data gathering, preprocessing relevant data, and data analysis are the three main steps to resolve the problems that arise with data gathering systems. 

Firstly, if staff is not well trained in using digital health databases. This will confuse patients’ data collection and management. Information required shall be explicit, and healthcare staff must acquaint themselves with essential healthcare tools. Proper training and guidance shall be provided to healthcare staff.

Data security and access to data are critical to protecting patients’ sensitive data. Adequate protocols in information security shall be implemented to avoid any unfavorable situation of patient data breaches.  

This will ensure the protection of patients’ sensitive data and that systems with the state of the art technologies are in place to monitor and safeguard sensitive information. The organization shall establish a safe and secure data protection system with the help of strong management support. Data security would be ensured through dedicated resources, so patients’ sensitive information is only shared with the concerned healthcare staff.       

Handling and storing data are critical, as the data size continuously expands with rapid developments. Therefore, online data storage using cloud strategies shall be implemented to meet the data storage requirement.

The stress related to using health information technologies (HIT) daily among physicians and other healthcare staff is measurable. Healthcare organizations must be aware of this stress burnout in medical staff and take appropriate actions to overcome it (Gardner et al., 2018).

Conclusion

In a nutshell, It is concluded that the role of health information technology (HIT) is central to the development of an Accountable Care Organization. The organization must implement HIT to benefit from new and innovative information and communication technologies. Data gathered must be coordinated, and every individual patient shall have a unique MRN for better analysis of patient history and complex health needs. The major problems in data gathering systems are the collection of relevant data, its preprocessing, and data analytics. Providing healthcare professionals with formal training and guidance can address these problems. Data security, sanctity, and storage are among the significant challenges concerned authorities must consider providing good quality healthcare at reduced costs.  

References

Alaei, S., Valinejadi, A., Deimazar, G., Zarein, S., Abbasy, Z., & Alirezaei, F. (2019). Use of health information technology in patients care management: A mixed methods study in Iran. Acta Informatica Medica, 27(5), 311. 

https://doi.org/10.5455/aim.2019.27.311-317 

Barath, D., Amaize, A., & Chen, J. (2020). Accountable care organizations and preventable hospitalizations among patients with depression. American Journal of Preventive Medicine, 59(1), e1–e10. 

https://doi.org/10.1016/j.amepre.2020.01.028 

Fraze, T. K., Beidler, L. B., Briggs, A. D. M., & Colla, C. H. (2020). Translating evidence into practice: ACOs’ use of care plans for patients with complex health needs. Journal of General Internal Medicine, 36(1), 147–153. 

NURS FPX 6612 Assessment 2 Quality Improvement Proposal

https://doi.org/10.1007/s11606-020-06122-4 

Gardner, R. L., Cooper, E., Haskell, J., Harris, D. A., Poplau, S., Kroth, P. J., & Linzer, M. (2018). Physician stress and burnout: The impact of health information technology. Journal of the American Medical Informatics Association, 26(2), 106–114. https://doi.org/10.1093/jamia/ocy145 

Moy, H., Giardino, A., & Varacallo, M. (2020). Accountable Care Organization. PubMed; StatPearls Publishing. 

https://www.ncbi.nlm.nih.gov/books/NBK448136/ 

Robert, N. (2019). How Artificial Intelligence is changing nursing. Nursing Management (Springhouse), 50(9), 30–39. 

https://doi.org/10.1097/01.numa.0000578988.56622.21

Assessment 2 Quality Improvement Proposal

• • Overview: 

Write a quality improvement proposal, 5–7 pages in length, that provides your recommendations for expanding a hospital’s HIT to include quality metrics that will help the organization qualify as an accountable care organization.
Health care has undergone a transformation since the release of the Institute of Medicine’s 2000 report To Err Is Human: Building a Safer Health System. The report highlighted medical errors as a contributing factor leading to poor patient outcomes. The Institute of Medicine challenged organizations to implement evidence-based performance improvement strategies in order to improve patient quality and safety. Multiple governmental and regulatory agencies, such as the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Quality and Research (AHRQ), vowed to strengthen and improve incentives for participation, safety, quality, and efficiency in accountable care organizations (ACOs).
Health  information technology (HIT) performs an essential role in improving health outcomes of individuals, the community, and populations. Health organizations, consumer advocacy groups, and regulatory committees have made a commitment to explore current and future opportunities that HIT offers to continue momentum to meet the Institute of Medicine’s goal of improving safety and quality.
Understanding HIT is important to improving individual, community, and population access to health care and health information. HIT enables quick and easy access to information for both patients and providers. Accessible information has been shown to improve the patient care experience and reduce redundancies, thereby reducing health care costs.
This assessment provides an opportunity for you to make recommendations for expanding a hospital’s HIT in ways that will help the hospital qualify as an ACO.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• • Competency 2: Explain the relationship between care coordination and evidence-based data. 
    • Recommend ways to expand an organization’s HIT to include quality metrics.
    • Identify potential problems that can arise with data gathering systems and outputs.
  • Competency 3: Use health information technology to guide care coordination and organizational practice. 
    • Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice.
  • Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards. 
    • Write clearly and concisely, using correct grammar and mechanics.
    • Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
  • Reference
    Institute of Medicine. (2000). To err is human: Building a safer health system. Washington, DC: National Academies Press.
    Competency Map
    CHECK YOUR PROGRESSUse this online tool to track your performance and progress through your course.
• Toggle DrawerResourcesHealth Informatics
  
  • Padden, J. (2019).Documentation burden and cognitive burden: How much is too much information? CIN: Computers, Informatics, Nursing, 37(2), 60–61.
  • Son, H., & Nahm, E.-S. (2019). Older adults’ experience using patient portals in communities: Challenges and opportunities. CIN: Computers, Informatics, Nursing, 37(1), 4–10.
  • Venzon, A., Le, T. B., & Kim, K. (2019). Capturing social health data in electronic systems: A systematic review. CIN: Computers, Informatics, Nursing, 37(2), 90–98.
  • SHOW LESSAccountable Care Organizations
  • Centers for Medicare and Medicaid Services. (n.d.).Accountable care organizations (ACOs).Retrieved from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html 
    • Provides general information about ACOs and links to additional information and resources.
  • Spencer, G. (2014).Making the move to an ACO. Healthcare Financial Management, 68(2), 92–96x. 
    • Describes how a multispecialty group practice became one of the first physician group practices to be designated a Medicare Shared Savings Program ACO.
  • Merit-Based Incentive Payment System
    The following resources provide information about the Merit-Based Incentive Payment System (MIPS). This system, instituted by the Centers for Medicare and Medicaid Services in 2017, replaced the Physician Quality Reporting System (PQRS). MIPS is a payment system that emphasizes and rewards exceptional health care delivery and performance.
  • Cardona, D. M., Black-Schaffer, S., Shamanski, F., & Myles, J. L. (2017).Medicare’s new quality payment program has started—Are you ready?Archives of Pathology & Laboratory Medicine, 141(6), 741–745.
  • Centers for Medicare and Medicaid Services. (n.d.).Quality Payment Program: Improvement activities.Retrieved from https://qpp.cms.gov/mips/improvement-activities
  • Centers for Medicare and Medicaid Services. (n.d.).Quality Payment Program: MIPS overview. Retrieved from https://qpp.cms.gov/mips/overview
  • Hayden, R., & Coffin, J. (2016). The components of the Merit-Based Incentive Payment System. Journal of Medical Practice Management: MPM, 32(3), 173–176.
  • Writing Resources
    You are encouraged to explore the following writing resources. You can use them to improve your writing skills and as source materials for seeking answers to specific questions.
  • APA Module.
  • Academic Honesty & APA Style and Formatting.
  • APA Style Paper Tutorial [DOCX].
  • Capella Resources
  • ePortfolio.

Research Resources
You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The MSN-FP6612: Emerging Health Care Models and Care Coordination Library Guide can help direct your research. The Supplemental Resources and Research Resources, both linked from the navigation menu in your courseroom, provide additional resources to help support you.
As you review these resources, you may want to consider the following questions:

• • What is an ACO? 
    • How are Medicare cost-sharing ACOs structured?
  • How could MIPS be used to define the quality of health care in the future? 
    • Does MIPS affect advance practice nurses?
    • If so, how? If not, why not?
  • How does health care data affect the care coordination process in nursing practice?
  • What is the role of nursing informatics and of health care informatics within the broader scope of information technology?
  • What is the role of informatics in supporting care management profiles in productivity metrics, quality reporting, health education, and predictive analytics?
  • What potential or actual problems with data gathering systems and output could arise within your practice setting?

Assessment Instructions

Preparation
In this assessment, you will again assume the role of case manager at Sacred Heart Hospital. This time, you are asked to develop a strategy for tracking quality metrics to help facilitate the hospital’s qualification for ACO status.
Before drafting your proposal, complete the following simulation exercise:

• • Vila Health: Quality Metrics Tracking.
  • Note:Remember that you can submit all or a portion of your draft to Smarthinking for feedback before you submit the final version of this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
    Requirements
    Develop a proposal to expand Sacred Heart Hospital’s HIT to better include quality metrics—with the ultimate goal of qualifying for ACO status. Use the following template for your proposal:
  • APA Style Paper Template [DOCX].
  • Writing the Proposal
    The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that your proposal addresses each point, at a minimum. You may also want to read the Quality Improvement Proposal Scoring Guide to better understand how each criterion will be assessed.
  • Recommend ways to expand the hospital’s HIT to include quality metrics.
    • How will you collect information and solve the problem of coordinating care for patients who are not getting diagnostic tests, such as mammograms or colonoscopies?
    • What can you do to track health information from the community or the target population to make necessary improvements?
    • How can you most effectively and efficiently show the role of informatics in nursing care coordination?
    • What evidence supports your recommendations?
  • Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice.
    • Provide examples to support your description.
  • Identify potential problems that can arise with data gathering systems and output. 
    • What suggestions can you make for avoiding those problems?
  • Write clearly and concisely, using correct grammar and mechanics.
    • Express your main points and conclusions coherently.
    • Proofread your writing to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.
  • Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
    • Is your supporting evidence clear and explicit?
    • How or why does particular evidence support a claim?
    • Will your audience see the connection?
  • Additional Requirements
    Proposal Format and Length
    Format your proposal using APA style:
  • Use theAPA Style Paper Template [DOCX]provided. Be sure to include:
    • A title page and references page. An abstract is not required.
    • A running head on all pages.
    • Appropriate section headings.
  • See also theAPA Style Paper Tutorial [DOCX]to help you in writing and formatting your proposal.
  • Your proposal should be 5–7 pages in length,not includingthe title page and references page.
  • Supporting Evidence
  • Cite at least six sources of credible scholarly or professional evidence to support your proposal.
  • Apply APA formatting to all in-text citations and references.
  • Portfolio Prompt: You may choose to save your proposal to your ePortfolio.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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