Write a 4-6-page policy proposal and practice guidelines for improving quality and performance associated with the benchmark metric underperformance you advocated for improving in Assessment 1.

Introduction

In advocating for institutional policy changes related to local, state, or federal health care laws or policies, health leaders must be able to develop and present clear and well-written policy and practice guideline proposals that will enable a team, a unit, or an organization as a whole to resolve relevant performance issues and bring about improvements in the quality and safety of health care. This assessment offers you an opportunity to take the lead in proposing such changes.

As a master’s-level health care practitioner, you have a valuable viewpoint and voice to bring to discussions about policy development, both inside and outside your care setting. Developing policy for internal purposes can be a valuable process toward quality and safety improvement, as well as ensuring compliance with various health care regulatory pressures. This assessment offers you an opportunity to take the lead in proposing such changes.

Propose organizational policy and practice guidelines that you believe will lead to an improvement in quality and performance associated with the benchmark underperformance you advocated for improving in Assessment 1. Be precise, professional, and persuasive in demonstrating the merit of your proposed actions.

Note: Remember that you can submit all, or a portion of, your draft policy proposal to Smarthinking for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Requirements

The policy proposal requirements outlined below correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.

• Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
  • What is the current benchmark for the organization and the numeric score for the underperformance?
  • How is the benchmark underperformance potentially affecting the provision of quality care or the operations of the organization?
  • What are the potential repercussions of not making any changes?
    • What evidence supports your conclusions?
• Recommend ethical, evidence-based practice guidelines to improve targeted benchmark performance prescribed by applicable local, state, or federal health care policy or law.
  • What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark?
  • How would these strategies ensure performance improvement or compliance with applicable local, state, or federal health care policy or law?
  • How would you propose to apply these strategies in the context of Eagle Creek Hospital or your own practice setting?
  • How can you ensure these strategies are ethical and culturally inclusive in their application?
• Analyze the potential effects of environmental factors on your recommended practice guidelines.
  • What regulatory considerations could affect your recommended guidelines?
  • What resources could affect your recommended guidelines (staffing, financial, and logistical considerations, or support services)?
• Explain why particular stakeholders and groups must be involved in further development and implementation of your proposed policy and practice guidelines.
  • Why is it important to engage these stakeholders and groups?
  • How can their participation produce a stronger policy and facilitate its implementation?
• Organize content so ideas flow logically with smooth transitions.
  • Proofread your proposal, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.
• Use paraphrasing and summarization to represent ideas from external sources.
  • Be sure to apply correct APA formatting to source citations and references.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• Assessment 2 Example [PDF].

Policy Proposal Format and Length

It may be helpful to use a template or format for your proposal that is used in your current organization. The risk management or quality department could be a good resource for finding an appropriate template or format. If you are not currently in practice, or your organization does not have these resources, many appropriate templates are freely available on the Internet.

Your policy should be succinct (about one paragraph). Overall, your proposal should be 4–6 pages in length.

Supporting Evidence

Cite 3–5 references to relevant research, case studies, or best practices to support your analysis and recommendations.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.

Portfolio Prompt: You may choose to save your policy proposal to your ePortfolio.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Analyze relevant health care laws, policies, and regulations; their application; and their effects on organizations, interprofessional teams, and professional practice.
  • Analyze the potential effects of environmental factors on recommended practice guidelines.
• Competency 2: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.
  • Recommend ethical, evidence-based practice guidelines to improve targeted benchmark performance prescribed by applicable local, state, or federal health care policies or laws.
• Competency 3: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, to inform health care laws and policies for patients, organizations, and populations.
  • Explain the need for creating a policy to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
• Competency 4: Develop strategies to work collaboratively with policy makers, stakeholders, and colleagues to address environmental (governmental and regulatory) forces.
  • Explain why particular stakeholders and groups must be involved in further development and implementation of a proposed policy and practice guidelines.
• Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella’s writing standards.
  • Organize content so ideas flow logically with smooth transitions.
  • Use paraphrasing and summarization to represent ideas from external sources.
• CRITERIANON-PERFORMANCEBASICPROFICIENTDISTINGUISHEDExplain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.

Does not explain the rationale for a policy and practice guidelines addressing benchmark underperformance.

Explains the rationale for a policy and practice guidelines addressing benchmark underperformance, irrespective of a particular need.

Explains the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.

Explains the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws. Clearly articulates the effects of benchmark underperformance and draws sound conclusions about the potential repercussions of inaction, based on credible evidence.

Recommend ethical, evidence-based practice guidelines to improve targeted benchmarked performance prescribed by applicable local, state, or federal health care policies or laws.

Does not recommend practice guidelines to improve targeted benchmarked performance prescribed by applicable local, state, or federal health care policies or laws.

Recommends practice guidelines to improve targeted benchmarked performance prescribed by applicable local, state, or federal health care policies or laws.

Recommends ethical, evidence-based practice guidelines to improve targeted benchmarked performance prescribed by applicable local, state, or federal health care policies or laws.

Recommends ethical, evidence-based practice guidelines to improve targeted benchmarked performance prescribed by applicable local, state, or federal health care policies or laws. Provides clear and compelling justification, substantiated by credible evidence, for applying ethical and culturally inclusive performance improvement strategies.

Analyze the potential effects of environmental factors on recommended practice guidelines.

Does not identify environmental factors that can affect recommended practice guidelines.

Identifies environmental factors that can affect recommended practice guidelines.

Analyzes the potential effects of environmental factors on recommended practice guidelines.

Analyzes the potential effects of environmental factors on recommended practice guidelines. Identifies clear cause-and-effect relationships and the influence of those factors on specific recommendations.

Explain why particular stakeholders and groups must be involved in further development and implementation of a proposed policy and practice guidelines.

Does not explain why particular stakeholders and groups must be involved in further development and implementation of a proposed policy and practice guidelines.

Identifies stakeholders and groups who are not the most logical choices to be involved in further development and implementation of a proposed policy and practice guidelines.

Explains why particular stakeholders and groups must be involved in further development and implementation of a proposed policy and practice guidelines.

Provides a perceptive and succinct explanation of why particular stakeholders and groups must be involved in further development and implementation of a proposed policy and practice guidelines. Offers clear and convincing rationale for stakeholder and group engagement and how it strengthens policy and facilitates changes in practice.

Organize content so ideas flow logically with smooth transitions.

Does not organize content for ideas to flow logically with smooth transitions.

Organizes content with some logical flow and smooth transitions.

Organizes content so ideas flow logically with smooth transitions.

Organizes content so clarity is enhanced and all ideas flow logically with smooth transitions.

Use paraphrasing and summarization to represent ideas from external sources.

Incorporates plagiarized information.

Paraphrasing or summarization is awkward, inaccurate, or borders on plagiarism.

Uses paraphrasing and summarization to represent ideas from external sources.

Uses concise, paraphrasing or summarization to accurately represent ideas from external sources. Exhibits an insightful interpretation and synthesis of credible sources.

 

 

       ***********Previous paper Written

 

Dashboard Benchmark Evaluation

 

Darby Scarantine

Healthcare Law and Policy 

nhs-fpx6004

Professor Melissa Robinson

May 2022

 

 

 

 

 

 

Dashboard Benchmark Evaluation

Collaborative care is significant in interprofessional primary care teams. The benchmarks set forth by the federal, state, and local governments are an essential measure of the performance of an organization. Hence precise and timely data on compliance with those set standards is vital for improving performance. The organization performance dashboards are an important management tool that explains the benchmarks met and underperformance (Ghazisaeidi et al., 2015). Moreover, the performance dashboards are essential for measuring and monitoring performance. There is increased consideration that collaborative teams are a crucial principle and significant means to deliver quality primary healthcare services (Donnelly et al., 2019). Indeed, a collaborative healthcare team supports the delivery of person-centered care and patient and system outcomes (McLaney et al., 2020).

Minnesota and other state practices such as the Medical Practice Act and the Local Public Health Act of Minnesota prepare the health practitioners for leading in a meaningful and ethical way. Moreover, all the healthcare professionals are expected to work in conformance to the standards of good medical practice (Minnesota Medical Association, 2018). One aspect which challenges this action in the professional practice setting is the lack of interprofessional collaborative environments. This paper is a review of the diabetes dashboard in Mercy Medical Center, a villa-affiliated hospital, to determine quality and performance improvement initiatives. While Mercy Medical Center has received accolades for being top-quality healthcare, some areas require improvement. Mainly the hospital provides data on various issues which would affect the organization’s strategic objectives, including examinations, patient safety, demographics, patient experience, and the readmission risks.

Dashboard Metrics Associated with Benchmarks

The most significant benchmark in the healthcare system set by the federal and the local government is the health safety and patient experience. The Local Public Health Act of Minnesota is deliberate in recording the achievement of statewide goals such as strengthening governmental public health. Mercy Center Dashboards include metrics of new patients by demographic characteristics, the trends in an eye exam, foot exam, and HgbA1c for diabetes patients. The dashboard’s main areas of concern are a decline in the HgbA1c test, low foot exam rate, and increased eye exams. Diabetes patients have a high risk of disability, and hence a comprehensive and coordinated care process is crucial. Early identification of diabetes complications is necessary for effective treatment.

Moreover, the dashboards include demographic elements of the patients by race and age. Federal policy such as the Affordable Care Act (ACA) emphasizes structural access to care and utilization. While most of the residents within the community are whites, the dashboard would include how the number of minorities accessing healthcare relates to the affordability of the healthcare services. This benchmark has financial implications for the organization since it emphasizes a focus on the social dimensions of healthcare delivery.

Minnesota and federal policy priority areas include patient safety, person-centered care, and care coordination. Performance measures which explain the protection of the patients from harm are significant (NHQDR, 2022). Patient safety has become an important consideration from the increased complexity in the delivery of care which increases the risks of harm to the patients. Hence it is also important for the organization to have dashboards for risk management trends (Simsekler et al., 2019). Generally, the most significant safety issues include medication errors, falls, and hospital-acquired infections. Mercy Center Dashboard shows fluctuations in HgbA1c exams and maintained low foot exam. For instance, in Q2 2020, the foot exam declined from 58 in Q2 2019 to 50. Only in Q4 2019 (70%) and Q1 2021 (75%) that the results similar to the benchmark value of 84% (NHDQR, 2022, June 30). Similarly, the eye exam in the facility also falls below the benchmark value of 75.2 since the highest incidence is reported at 60% in Q4 (NHDQR, 2022, June 30). The benchmark for HgbA1c exams is 79.5 %, and in most of the periods, the facility performance is below 60%. However, for 2020 there is an improvement in the outcome to 72 in Q1 and 78 in Q3. 

Diabetes is among the most significant disease and condition which concerns federal and local policymakers. The unidentified metrics are substantial in defining diabetes complications. While with enhanced use of technology, self-management is a priority to maintain a high quality of life, determining the complexity is essential to ensure low risks of harm. Minnesota Insulin Safety Net Program identifies the risks of diabetes and its complications, such as loss of vision or nerve damage and chronic kidney disease, among others, as a critical public health issue. Establishing appropriate measures is significant in helping the patients manage their conditions.

Patient safety can be enhanced through interpersonal collaboration when handling sensitive care procedures like surgery which requires the interventions of multidisciplinary teams. Concerns on staffing, including the number and the experiences of the health practitioners performing the operations, are significant. It is a major concern that the Mercy Medical Center performance dashboard does not include explicit information regarding staffing performance. The facility only includes data on the number of physicians in 2021(433) and the volunteers (200) but does not show the trends of the population of other healthcare facilities. In contrast, consumer advocacy medicine has recognized that outstanding performance in areas of safety risks is inevitable. Such metrics as staffing are significant in defining the organization’s strategic direction. Indeed, such a level of performance is necessary for compliance with both federal and local regulations.

A Challenge Posed by Meeting the Prescribed Benchmark

The strategic challenge is one of the most significant factors in adherence to patient safety and patient experience in caring for chronic conditions such as diabetes. However, this has to be considered within limits and the impacts of other challenges such as operational concerns and the quality of collaboration among the healthcare teams. Indeed, with an aging population, effective patient outcome is a source of competitive advantage. In this case, eye exam, foot exam, and HgbA1c below the benchmark lead to patient dissatisfaction since it heightens the occurrence of diabetes-related complications. In particular, overpayment without positive healthcare outcomes is a major concern in the United States and remains an important performance measure (Shrank, Rogstad, & Parekh, 2019). One of the major domains of waste results from the failure of care delivery, mainly concerning patient safety. Any healthcare system has an opportunity for growth and profitability when there is an execution of known best care practices (Shrank et al., 2019). The main factors which impact the organization’s competitiveness are the worse clinical outcomes and high risks of patient injuries.

A second domain that affects competitiveness is the lack of care coordination. For diabetes patients, care coordination is central to health and function; otherwise increases dependency (Darwish et al., 2017). Indeed, avoidable complications and increased unnecessary emergency visits are key cost areas that would impact the market share. Indeed, one major concern is the lack of clear details on the population of various healthcare professionals involved in the care process and how their roles are coordinated. Diabetes care requires the role of a multidisciplinary team. 

In other instances, subjecting patients to low-value care reduces satisfaction when patient outcomes remain low. From a strategic viewpoint over, testing and overtreatment are key cost concerns. The primary assumption underlying my beliefs is the need to target minority groups for expansion. Healthcare affordability is instrumental since there is a constant increase in the immigrant population with higher risks of diabetes and related complications. Indeed, while Mercy Medical Center’s new patients are significantly white, expansions to the minority-dominated areas depend on addressing those costs concerns for all the domains. Tan et al. (2019) explain the disparities in the outcomes of patients admitted for diabetic foot infections. Particularly the risks of amputations are highest for African Americans and Hispanics than for Caucasian white (Tan et al., 2019). Moreover, it would also be necessary to consider the impact of possible pricing failure that would result from the expansion. Patient safety and improved healthcare outcomes at relatively low costs are a significant source of competitive advantage and a key strategic factor in the United States.

A Benchmark Underperformance

Clear documentation of the resources is necessary to determine all the quality and safety metrics. This is directly linked to the staffing challenges likely to influence eye exam, foot exam and HgbA1c that are below benchmarks. Physicians, nurses, dieticians, and physiotherapists, among others, are important members of the multidisciplinary team. Providers from a range of disciplinary help determine the value of collaborative care (Donnelly et al., 2019). Nurses play a significant role in managing chronic diseases, and hence nurse-patient ratio, nurse satisfaction, and experiences are fundamental performance metrics. Moreover, physicians or nurse practitioners must work collaboratively with other providers to deliver various services or programs. Hence there is a need for the hospital to improve performance management for better patient safety and experience. The local Public Health Act recommends a comprehensive recording of compliance with state guidelines as a key performance measure (Minnesota Department of Health, 2017). Hence instead of recording only the number of physicians in the current year, it would be better to show staffing trends and include records for all healthcare professionals. If the hospital can improve recording procedures, processes, and outcomes from a safety standpoint, it is easy to identify the specific areas of improvement. For instance, the whole patient population, the number, and the experiences of all the healthcare practitioners relate directly to safety. Indeed, while the facility recorded the number of physicians in 2021, there is no comparison with previous data amidst a change in the patient population. It is also a significant concern since diabetic patients require an interprofessional group to deliver various healthcare interventions.

A Recommendation for Ethical Action to Address a Benchmark Underperformance

The main ethical action for Mercy Medical Center is to leverage patient safety in through physician-nurse collaboration. Particularly the low level of an eye exam, foot exam, and HgbA1c can be improved through clear communication between different healthcare professionals. Collaboration between physicians and nurses is significant in improving patient care (Sabone et al., 2019). When healthcare professionals work together to maximize the value, it will improve patient outcomes and reduce complications. This is especially important in caring for patients with chronic conditions patients. The collaboration will help the organization identify significant setbacks in its procedures and processes using evidence-based approaches. Positive patient outcomes include treatment and care interventions, and both must be recognized as central to positive effects. Finally, appropriate documentation, especially on staffing, is necessary to track the available human resources necessary to improve healthcare outcomes.

Conclusion

This dashboard benchmark evaluation of the facility shows the need to improve documentation to improve patient safety and experiences. Minnesota has emphasized the need for the active recording of compliance with the benchmark. One of the significant challenges to the organization is strategic direction, especially as it concerns an expansion of the market size. Enhancing physician-nurse collaboration is important for maximizing value to the patients. The objective is to maximize the delivery of high-quality services at a low cost to improve patients’ experience and outcomes.

 

 

 

 

 

 

 

 

References

Darwish, A., Hassanien, A. E., Elhoseny, M., Sangaiah, A. K., & Muhammad, K. (2017). The impact of the hybrid platform of Internet of things and cloud computing on healthcare systems: Opportunities, challenges, and open problems. Journal of Ambient Intelligence and Humanized Computing, 10(10), 4151-4166. https://doi.org/10.1007/s12652-017-0659-1

Donnelly, C., Ashcroft, R., Mofina, A., Bobbette, N., & Mulder, C. (2019). Measuring the performance of interprofessional primary health care teams: Understanding the teams perspective. Primary Health Care Research & Development, 20. https://doi.org/10.1017/s1463423619000409

Ghazisaeidi, M., Safdari, R., Torabi, M., Mirzaee, M., Farzi, J., & Goodini, A. (2015). Development of performance dashboards in the healthcare sector: Key practical issues. Acta Informatica Medica, 23(5), 317. https://doi.org/10.5455/aim.2015.23.317-321

McLaney, E., Morassaei, S., Hughes, L., Davies, R., Campbell, M., & Di Prospero, L. (2022). A framework for interprofessional team collaboration in a hospital setting: Advancing team competencies and behaviors. Healthcare Management Forum, 35(2), 112-117. https://doi.org/10.1177/08404704211063584

Minnesota Department of Health. (2017).Local Public Health Act Performance Measures Data Book,2016. https://www.health.state.mn.us/communities/practice/lphact/annualreporting/docs/2016_databook.pdf

Minnesota Medical Association. (2018). MMA Policies 2018. MMA. https://www.mnmed.org/MMA/media/Hidden-Documents/MMA-Policies-2018.pdf

Moss, E., Seifert, P., & O’Sullivan, A. (2016). Registered nurses as interprofessional collaborative partners: Creating value-based outcomes. OJIN: The Online Journal of Issues in Nursing, 21(3). https://doi.org/10.3912/ojin.vol21no03man04

NHDQR. (2022, June 30). NHQDR web site – Minnesota diabetes benchmark details. AHRQ. https://nhqrnet.ahrq.gov/inhqrdr/Minnesota/benchmark/table/Diseases_and_Conditions/Diabetes

NHQDR. (2022). NHQDR web site National Diabetes benchmark summary. https://nhqrnet.ahrq.gov/inhqrdr/National/benchmark/summary/Diseases_and_            Conditions/Diabetes

Sabone, M., Mazonde, P., Cainelli, F., Maitshoko, M., Joseph, R., Shayo, J., Morris, B., Muecke, M., Wall, B. M., Hoke, L., Peng, L., Mooney-Doyle, K., & Ulrich, C. M. (2019). Everyday ethical challenges of nurse-physician collaboration. Nursing Ethics, 27(1), 206-220. https://doi.org/10.1177/0969733019840753

Shrank, W. H., Rogstad, T. L., & Parekh, N. (2019). Waste in the US health care system. JAMA, 322(15), 1501. https://doi.org/10.1001/jama.2019.13978

Simsekler, M. C., Kaya, G. K., Ward, J. R., & Clarkson, P. J. (2019). Evaluating inputs of failure modes and effects analysis in identifying patient safety risks. International Journal of Health Care Quality Assurance, 32(1), 191-207. https://doi.org/10.1108/ijhcqa-12-2017-0233

Tan, T., Calhoun, E. A., Knapp, S. M., Lane, A. I., Marrero, D. G., Kwoh, C. K., Zhou, W., & Armstrong, D. G. (2022). Rates of diabetes-related major amputations among racial and ethnic minority adults following Medicaid expansion under the Patient Protection and Affordable Care Act. JAMA Network Open, 5(3), e223991. https://doi.org/10.1001/jamanetworkopen.2022.3991

Tan, T., Shih, C., Concha-Moore, K. C., Diri, M. M., Hu, B., Marrero, D., Zhou, W., & Armstrong, D. G. (2019). Disparities in outcomes of patients admitted with diabetic foot infections. PLOS ONE, 14(2), e0211481. https://doi.org/10.1371/journal.pone.0211481