A senior leader that communicates your evaluation of current organizational or interprofessional team performance
Write a 3-5 page report for a senior leader that communicates your evaluation of current organizational or interprofessional team performance, with respect to prescribed benchmarks set forth by government laws and policies at the local, state, and federal levels.
In the era of health care reform, many of the laws and policies set forth by government at the local, state, and federal levels have specific performance benchmarks related to care delivery outcomes that organizations must achieve. It is critical for organizational success that the interprofessional care team is able to understand reports and dashboards that display the metrics related to performance and compliance benchmarks.
Maintaining standards and promoting quality in modern health care are crucial, not only for the care of patients, but also for the continuing success and financial viability of health care organizations. In the era of health care reform, health care leaders must understand what quality care entails and how quality in health care connects to the standards set forth by relevant federal, state, and local laws and policies. Understanding relevant benchmarks that result from these laws and policies and how they relate to quality care and regulatory standards is also vitally important.
Health care is a dynamic, complex, and heavily regulated industry. For this reason, you will be expected to constantly scan the external environment for emerging laws, new regulations, and changing industry standards. You may discover that as new policies are enacted into law, ambiguity in interpretation of various facets of the law may occur. Sometimes, new laws conflict with preexisting laws and regulations, or unexpected implementation issues arise, which may warrant further clarification from lawmakers. Adding partisan politics and social media to the mix can further complicate understanding of the process and buy-in from stakeholders.
Choose one of the following two options for a performance dashboard to use as the basis for your evaluation:
Option 1: Dashboard Metrics Evaluation Simulation
Use the data presented in your Assessment 1 Dashboard and Health Care Benchmark Evaluation activity as the basis for your evaluation.
Note: The writing you do as part of the simulation could serve as a starting point to build upon for this assessment.
Option 2: Actual Dashboard
Use an actual dashboard from a professional practice setting for your evaluation. If you decide to use actual dashboard metrics, be sure to add a brief description of the organization and setting that includes:
The size of the facility that the dashboard is reporting on.
The specific type of care delivery.
The population diversity and ethnicity demographics.
The socioeconomic level of the population served by the organization.
Note: Ensure your data are Health Insurance Portability and Accountability Act (HIPAA) compliant. Do not use any easily identifiable organization or patient information.
To complete this assessment:
Review the performance dashboard metrics in your Assessment 1 Dashboard and Health Care Benchmark Evaluation activity, as well as relevant local, state, and federal laws and policies. Consider the metrics that are falling short of the prescribed benchmarks. Note: The writing you do as part of the simulation could serve as a starting point to build upon for this assessment.
Write a report for a senior leader that communicates your evaluation of current organizational or interprofessional team performance, with respect to prescribed benchmarks set forth by government laws and policies at the local, state, and federal levels. In addition, advocate for ethical and sustainable action to address benchmark underperformance and explain the potential for improving the overall quality of care and performance, as reflected on the performance dashboard.
Make sure your report meets the Report Requirements listed below. Structure it so that it will be easy for a colleague or supervisor to locate the information they need, and be sure to cite the relevant health care policies or laws when evaluating metric performance against established benchmarks.
Sample Solution
Evaluation of Organizational Performance Against Regulatory Benchmarks
Introduction
This report evaluates the performance of a hypothetical healthcare organization against regulatory benchmarks established at the local, state, and federal levels. By examining key performance indicators (KPIs) related to patient outcomes, quality of care, and efficiency, this analysis aims to identify areas of strength and opportunities for improvement. This assessment will be grounded in relevant healthcare laws and policies, such as the Affordable Care Act (ACA) and Centers for Medicare & Medicaid Services (CMS) regulations.
Full Answer Section
Organizational Overview
For the purpose of this evaluation, we will consider a medium-sized community hospital serving a diverse population with a mix of urban and rural demographics. The hospital offers a range of services, including inpatient care, outpatient services, and emergency care.
Performance Dashboard Metrics
The following performance dashboard metrics will be evaluated against relevant benchmarks:
Patient Safety: Hospital-acquired infections (HAIs), patient falls, and adverse drug events (ADEs).
Quality of Care: Readmission rates, mortality rates, and patient satisfaction scores.
Efficiency: Average length of stay (ALOS), emergency department (ED) wait times, and operating room (OR) utilization.
Financial Performance: Revenue cycle management, payer mix, and cost per case.
Benchmarking and Performance Evaluation
To assess performance, we will compare the organization's metrics to established benchmarks from regulatory agencies, industry standards, and peer institutions.
Patient Safety: The hospital's HAI rates should be compared to national benchmarks established by the Centers for Disease Control and Prevention (CDC). Exceeding these benchmarks indicates a need for improvement in infection prevention and control practices.
Quality of Care: Readmission rates should align with CMS's readmission reduction programs, and mortality rates should be compared to similar hospitals using risk-adjusted data. Patient satisfaction scores should be benchmarked against industry standards.
Efficiency: ALOS should be evaluated in relation to national averages and compared to similar hospitals. ED wait times and OR utilization should be optimized to improve patient flow and resource allocation.
Financial Performance: Revenue cycle management should adhere to CMS guidelines, and payer mix should reflect the local population's insurance coverage. Cost per case should be monitored to identify opportunities for cost reduction.
Addressing Benchmark Underperformance
To improve performance in areas falling short of benchmarks, the organization should implement targeted interventions. For example, if HAI rates are elevated, a comprehensive infection prevention and control program should be implemented, including education, surveillance, and antimicrobial stewardship. Additionally, fostering a culture of safety and empowering frontline staff to report and address safety concerns is essential.
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