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?
• Asssessment InstructionsPreparation
  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.