Posted: August 1st, 2023

Healthcare Industry Quality 250-275 words

Address each questions with 250-275 words using 2 references each.

a. What is the importance of understanding the minimal data set needed to achieve the purpose of the report? How do health care organizations determine if reporting needs to be static or ad hoc? What are the challenges if data does not exist in an extractable format?

b. Describe the requirements for a reporting tool that would facilitate the tracking of a merit-based incentive payment system (MIPS) quality performance in an emergency department environment (e.g., clinical dashboard). Assignment help – Discuss at a high level how MIPS quality measure performance is determined for one or more quality measures that may be used by an emergency department.

c. What are clinical quality measures used for? Identify five clinical quality measures used by CMS. Describe the general structure of the five clinical quality measures you identified and explain how they are reported. Provide an example of how each of the five clinical quality measures you identified are designed to improve the quality of care.

d. What are the role of benchmarks in quality improvement activities? In order to benchmark progress, describe what an organization can compare its benchmarks against. Provide an example of a source for benchmarks.
Healthcare Industry Quality
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Healthcare Industry Quality
a). The minimum data set plays a significant role in the medical facilities reimbursement system through the use of standardized and assessment tools to monitor the quality of nursing facilities care(Singer, Beck, and Buche, 2017). The minimum dataset consists of tools used to measure various factors such as psycho-social functioning, physical, and psychological. Some of the physical factors addressed includes, medical conditions, the vision of the nursing facility as well as mood. The functioning tool measures the daily activities monitoring in the facility as well as the patient’s and staff’s behaviors. The minimum dataset is considered as part of a vital legal process for Medicare with certified nursing homes. The process involves clinical assessment, which assists the nursing home employees to identify various health problems (Singer, Beck, and Buche, 2017). The minimum dataset reveals how residents are taken care of, treatment required as well as examinations by a physician—for instance, ambulatory care visits in the facility.
Additionally, the minimum dataset provides information on the number of emergency visits in the medical facility, which resulted in hospitalization and those not hospitalized in ninety days when assessment took place. Minimum dataset records reveal the facility statistical analysis where resident’s records are accompanied by their age, gender as well as a comparison carried out between the minimum dataset and administrative data systems. Minimum dataset health information is stored and transmitted through the electronic information systems available in the nursing facility and sent to the national minimum dataset.
Ad hoc and static reporting systems are both used in the health care reporting system, although considered based on various factors. First and foremost, Ad hoc is a business intelligence method designing health records according to user needs. The reports accurately answer questions responding to a particular incident. Static is considered a traditional way of reporting which does not apply business intelligence where in some cases, various answers may not be available in static reporting but available in Ad hoc reporting (Gastaldi, et, al., 2018). Ad hoc finds a solution through designing a dataset that provides answers instantly to the occurrence of the event. An ad hoc reporting system is considered to provide the required insight for clinical needs and enhance how to implement changes in the facility. In this case, nursing facilities opt for Ad hoc for quality services, especially in comparing the minimum dataset with the national standards. Static is considered when detained to be compiled through tools such as excel and access, which provides a static report about the health care facility.
Sometimes medical data does not exist in an extractable format, especially data stored in the electronic health records (EHR). When this challenge occurs, health organizations form a safe clinical application or a website to collect data. The process allows the organization to customizes various data features included in data processes. In this case, the personalized elements consist of the creation of a data entry form, which is advantageous, especially for the long-term registry through the use of a manually completed entry form. Most health facilities invest in data entry. The use of customized features offers health facilities valuable data extraction insight.
b). Reporting requirements for merit-based incentive payment systems (MIPS) in emergency departments are several (Baird,and Kaldy, 2018). For instance, providing a list of measures that are important for the casualty as well as other patient’s quality measures that would enhance the physician’s performance. Reports are required to take 45% of the total score, which includes a twelve-month high priority measure. For the emergency department to earn one to three points, the department needs to report at least one single case. For the department to secure three points, sixty percent of evidence needs to be informed (Baird, and Kaldy, 2018). All measures reported must include six quality measures. The department submission of advancing care information, improvement activities to measure whether the department completed at least two high-weighted procedures within ninety days and at least one system for small and less privileged medical facilities. In the department and cost of resources used in emergency processes and procedures. In promoting interoperability, all the electronic health records certified in 2015 must be used for quality performance.
Quality measures healthcare outcomes and patient’s perception in the emergency department aiming at providing efficient, timely, equitable, and patient-centered quality. Quality measures are reported through assessment tools or abstractions submitted by the help of CMS through electronic health records (LaBonte,et, al.,2019). MIPS quality performance measured through a benchmark is divided into actual performance or deciles. A point to note, high performance does not mean high point’s award for the measure.
Quality performance assessment consists of three to ten spots compared to the benchmark. Benchmarking every quality measure twenty cases at a minimum must be reported, attain 60% of data submitted as well as the availability of the reference. A quality performance is represented in deciles, where the first performance represents three points according to 2018 production. The emergency department can decide to calculate overall quality performance, which involves choosing six measures inclusive of a bonus point. In the overall quality performance, at least one of the rules must be a high-priority measure. The CMS, however, calculates a quality score which determines the MIPS final results.
c). A clinical quality measure is assessment tools used to measure healthcare quality of services such as clinical practices, patients engagements, and health outcomes. CMS uses clinical quality measures to enhance public health practices; for instance, patients engagement, health outcomes, clinical processes, effective use of health care resources, and patient safety. Effective use of health care resources is measured based on the already achieved results and compliance. Effective use of resources enables the facility to implement, replace, or improve on the use of funds to enhance quality care (Roberts, Green, and Holt, 2018). Clinical compliance is monitored through the care requirements and monitoring treatment results—for instance, effective use of medical imaging, which improves cost-friendly treatment in chronic diseases.
Patient safety and engagement are measures based on therapeutic failures, which are monitored by the use of analytic applications to check on patient’s vulnerabilities and physician compliance through the use of medical best practices to improve on quality care (Roberts, Green, and Holt, 2018). Health outcomes and patients experience outcome accesses the perception of patients towards a particular treatment, which enhances the implementation of electronic health records and medical policies. Patients’ experience is measured through the use of a satisfaction survey based on received medical care. Health outcome is regulated through the complete satisfaction survey and a balancing metric that shows improvement or decline of work. The results used to identify areas of development and strategies are applied in case of poor performance, for instance, training physicians and other staff members.
d). Benchmarking is part of continuous performance improvement use to measure and improve performance (Gillen, 2017). Benchmarking involves measuring performance, analyzing performance, improving performance as well as control of production in an organization. The primary goal of benchmarking by most organizations is to compare, compete favorably, and identify various opportunities through process mapping and so on. Benchmarking integrates procedures and policies to improve quality. For a successful benchmark, the process prepares carefully, monitors the organization practices, and collaborates with other organizations. There are many healthcare services from public, private hospitals, small healthcare facilities, and so on.
Comparison is vital during benchmarking to determine areas of improvement. Areas of contrast include organizations, health standards, and practices, organization’s performance present and past performance, organization’s competitors and stakeholders, as well as other branches or facilities with similar processes (Paul, and Elder, 2019). Some of the sources of benchmarking include data reports from government and agencies; for instance, the health services administration, backer’s hospital reviews is also a valid source of benchmarking. Becker’s study consists of service-line and system-level data as well as a community clinic association where medical information is collected and stored.

References
Baird, R., & Kaldy, J. (2018). Quality Counts, but How Do We Really Measure It?. Caring for the Ages, 19(2), 15.
Gastaldi, L., Pietrosi, A., Lessanibahri, S., Paparella, M., Scaccianoce, A., Provenzale, G., … & Gridelli, B. (2018). Measuring the maturity of business intelligence in healthcare: Supporting the development of a roadmap toward precision medicine within ISMETT hospital. Technological Forecasting and Social Change, 128, 84-103.
Gillen, D. (2017). Benchmarking and performance measurement: the role in quality management. AM Brewer, KJ Button, & DA Henshe, Handbook of Logistics and Supply-Chain Management (Handbooks in Transport, Volume 2), 325-338.
LaBonte, C. T., Payne, P., Rollow, W., Smith, M. W., Nissar, A., Holtz, P., & Sessums, L. L. (2019). Performance on Electronic Clinical Quality Measures in the Comprehensive Primary Care Initiative. American Journal of Medical Quality, 34(2), 119-126.
Medford-Davis, L., Marcozzi, D., Agrawal, S., Carr, B. G., & Carrier, E. (2017). Value-based approaches for emergency care in a new era. Annals of emergency medicine, 69(6), 675-683.
Paul, R., & Elder, L. (2019). A guide for educators to critical thinking competency standards: Standards, principles, performance indicators, and outcomes with a critical thinking master rubric. Rowman & Littlefield.
Roberts, M., Green, F., & Holt, W. (2018). A Health Plan’s Journey to Identifying Meaningful Quality Measures. American Journal of Medical Quality, 33(6), 657-661.
Singer, P. M., Beck, A. J., & Buche, J. (2017). Standardizing Organizational-level Behavioral Health Workforce Data Collection through a Minimum Data Set.

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