This assignment contains both the Discussion & the Individual project. Please make sure that you submit them separately.
The Discussion must be 600 Words
The Project must be 5 pages, excluding the demographic and reference pages
Please see detailed instructions of the assignments attached.
Please use the lecture materials including other resources to complete the assignment, must ensure that you included the lecture materials.
Template for the Project is also ATTACHED
2
DNP-804-ECONOMICS & FIN. ASPECTS OF HEALTHCARE
MODULE 4 DQ
This assignment contains both the Discussion & the Individual project. Please make sure that you submit them separately.
Module 4: Discussion – The Case for Quality Through Innovation
In 600 Words
Address each prompt in your response related to the financial implication of challenging changes in healthcare.
· With all the changes that are occurring in health care today, what are some of the challenges your environment is facing?
· What is your organization doing to plan for the financial consequences associated with these challenges?
· What types of innovation could be utilized to address some of the challenges?
INDIVIDUAL PROJECT
Online Assignment: Quality and Data Analysis
Prompt: In 5 Pages, excluding the demographics and reference pages
Share the aim for your proposal of needed service or change in current service to either increase revenue or decrease expenses .
State your aim clearly.
Your aim should be 1-2 sentences, time-specific and measurable, and include numeric goals.
It should reflect the overarching IHI aims for improvement.
· Safe: Avoid injuries to patients from the care that is intended to help them.
· Effective: Match care to science; avoid overuse of ineffective care and underuse of effective care.
· Patient-Centered: Honor the individual and respect choice.
· Timely: Reduce waiting for both patients and those who give care.
· Efficient: Reduce waste.
· Equitable: Close racial and ethnic gaps in health status.
Instructions:
1. Download the assignment template and create the AIM statement: Module 4_Template_AIM Statement.docx ATTACHED
2. Post your AIM in the assignment area
3. Sharpen your AIM based on feedback received for the Executive Summary in Module 7
This activity is aligned with course outcomes 1, 2, and 3.
Rubric
Module 4: Proposal AIM Rubric
|
Module 4: Proposal AIM Rubric |
||||
|
Criteria |
Ratings |
Pts |
||
|
This criterion is linked to a Learning Outcome AIM Complete AIM statement provided |
|
5 pts |
||
|
This criterion is linked to a Learning Outcome Reflects IHI Aims for Improvement Aligned with the IHI overarching aims to be Safe / Effective / Patient-Centered Timely / Efficient / Equitable |
|
5 pts |
||
|
Total Points: 10 |
RESOURCES
Online Lecture
You have defined your strategic process framework; this week we will dive further into building the case for quality. Your readings this week will inform the development of a specific aim for your proposal, sometimes referred to as a SMART aim, specific, measurable, actionable, relevant, and time-bound. In our role as DNPs, we practice improving value, safety, outcomes, and patient and family experience of care; this may be our global aim.
Your proposal needs a specific aim. Here is an example of a SMART Aim:
· Increase the proportion of adults with sleep apnea who receive appropriate first-line treatment from a baseline level of X to a goal level of Y by June 30, 2022.
Your business proposal and financial plan will need to benefit the organization or patient population from both financial performance and patient outcome perspectives.
Download the PowerPoint presentations below and use them to take notes on the assigned readings in the Waxman and Knighten 3rd Ed text for Chapters 9 and 15:
Chapter 9_ Ensuring Quality Care While Controlling Costs.pptx ATTACHED
Chapter 15_Entrepreneurship and Innovation for Nurse Leaders.pptx ATTACHED
Additional Lecture Materials
Lecture, Book, or Article Title with link
Review the IHI website, link below, regarding setting an Aim. In the IHI Model of Improvement, the Aim answers the question, What are we trying to accomplish?
IHI Resources: https://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementSettingAims.aspx
IHI Setting Aims: https://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementSettingAims.aspx
,
AIM Statement
[Student Name]
Date
Professor Name
DNP 804
AIM STATEMENT 2
AIM STATEMENT 1
I. Module 4: AIM Statement
Aim Statement Worksheet
Instructions for using the template: Remove all yellowed instructional content prior to submitting.
An aim statement is the answer to the first question in the Model for Improvement, “What are we trying to accomplish?” Effective aim statements delineate clear, specific plans for the work ahead.
Use the prompts below to write an effective aim statement. Then use the checklist to double-check your work.
What? What’s the problem or opportunity? Make sure it relates to a fundamental customer need.
E.g. Increase the percent of children who receive a Health Needs Assessment
How much? By how much will you improve? Or “how good” do you want to get?
E.g. 95% of children who should receive a Health Needs Assessment will receive one
By when? What is the date by which you will achieve the level of improvement you’ve set out to accomplish?
E.g. January 31, 2020
For whom? Who is the customer or population who will benefit from the improvement?
E.g. Children under the age of 12 who have an initial referral to Child Protective Services
Where? What are the boundaries of the process or system you’re trying to improve? Where does it begin and end?
E.g. In Middlesex County
Aim Statement
E.g. By January 31, 2020, of children under the age of 12 for whom a Health Needs Assessment is recommended, 95% will receive the assessment in Middlesex County.
DNP 804: AIM Statement Template
2
Reference
Institute for Healthcare Improvement (IHI). (2022). AIM statement worksheet. http://www.ihi.org/resources/Pages/Tools/Aim-Statement-Worksheet.aspx
,
Financial and Business Management for the Doctor of Nursing Practice Third Edition
© Springer Publishing Company, LLC.
1
Juli Maxworthy
Chapter 9: Ensuring Quality Care While Controlling Costs
Introduction
Quality Definition
For the purposes of this chapter, quality is defined by the National Academy of Medicine (NAM—formally known as the Institute of Medicine [IOM]) as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (IOM, 1999, p. 211).
© Springer Publishing Company, LLC.
2
Crossing the Quality Chasm (2001)
The report suggests that care should be:
Safe (avoiding injury to patients)
Effective (providing care based on scientific knowledge while minimizing the overuse, underuse, or misuse of care)
Patient centered (being respectful, responsive, and considerate of patient preferences, needs, and values)
Timely (minimizing delays and wait times)
Efficient (avoiding waste)
Equitable (providing care that does not vary based on race, gender, geography, or socioeconomic status)
© Springer Publishing Company, LLC.
3
AACN Core Competencies for Professional Nursing Education That Pertain to Quality (2021)
Domain 5: Quality and Safety Descriptor: Employment of established and emerging principles of safety and improvement science. Quality and safety, as core values of nursing practice, enhance quality and minimize risk of harm to patients and providers through both system effectiveness and individual performance.
Domain 6: Interprofessional Partnerships Descriptor: Intentional collaboration across professions and with care team members, patients, families, communities, and other stakeholders to optimize care, enhance the health care experience, and strengthen outcomes.
Domain 7: Systems-Based Practice Descriptor: Responding to and leading within complex systems of health care. Nurses effectively and proactively coordinate resources to provide safe, quality, equitable care to diverse populations.
© Springer Publishing Company, LLC.
4
AACN Core Competencies for Professional Nursing Education That Pertain to Quality (2021) (cont’d)
Domain 8: Information and Health Care Technologies Descriptor: Information and communication technologies and informatics processes are used to provide care, gather data, form information to drive decision making, and support professionals as they expand knowledge and wisdom for practice. Informatics processes and technologies are used to manage and improve the delivery of safe, high quality, and efficient health care services in accordance with best practice and professional and regulatory standards.
Domain 9: Professionalism Descriptor: Formation and cultivation of a sustainable professional nursing identity, accountability, perspective, collaborative disposition, and comportment that reflects nursing’s characteristics and values.
Domain 10: Personal, Professional, and Leadership Development Descriptor: Participation in activities and self-reflection that foster personal health, resilience, and well-being, lifelong learning, and support the acquisition of nursing expertise and assertion of leadership (AACN, 2021).
© Springer Publishing Company, LLC.
5
Quality Improvement Strategies/Techniques
STRUCTURE/PROCESS/OUTCOME
Avedia Donabedian defined quality as a function of structures, processes, and outcomes of care (Donabedian, 1966). He identified seven pillars he considered to be attributes of quality:
Efficacy: the ability of care to improve health
Effectiveness: the degree to which attainable health improvements are realized
© Springer Publishing Company, LLC.
6
Quality Improvement Strategies/Techniques (cont’d)
Efficiency: the ability to obtain the greatest health improvement at the lowest cost
Optimality: the most advantageous balancing of costs and benefits
Acceptability: conformity to patient preferences regarding accessibility, the patient–practitioner relationship, the amenities, the effects of care, and the cost of care
Legitimacy: conformity to social preferences concerning all of the above
Equity: fairness in the distribution of care and its effects on health
© Springer Publishing Company, LLC.
7
Quality Improvement Strategies/Techniques (cont’d)
PLAN–DO–CHECK–ACT (PDCA) OR PLAN–DO–STUDY–ACT (PDSA)
Is a successive cycle that starts off small to test potential effects on processes, but then as the proof of concept is determined, it gradually leads to larger and more targeted change. PDSA/PDCA was made popular by Dr. W. Edwards Deming, who was considered by many to be the father of modern quality control; however, he always referred to it as the “Shewhart cycle.” Later in Deming’s career, he modified PDCA to PDSA because he felt that “check” emphasized inspection over analysis “study.”
© Springer Publishing Company, LLC.
8
Quality Improvement Strategies/Techniques (cont’d)
PRACTICE MANAGEMENT
Is the continuum of processes, often unique for each practice, that impact the provision of patient care. These processes include staffing, scheduling, billing, and quality improvement practices. The goal of quality management in this area is to not only improve the outcomes of individuals in the department but also improve the systems or processes in the practice.
© Springer Publishing Company, LLC.
9
Principles of Economics and Finance to Redesign Effective and Realistic Care Delivery Strategies
PAY FOR PERFORMANCE
Pay-for-performance systems link compensation to measures of work quality or goals.
The 2006 IOM report, Preventing Medication Errors, recommended “incentives … so that profitability of hospitals, clinics, pharmacies, insurance companies, and manufacturers (are) aligned with patient safety goals … (to) strengthen the business case for quality and safety” (IOM, 2006a, p. 349).
© Springer Publishing Company, LLC.
10
Principles of Economics and Finance to Redesign Effective and Realistic Care Delivery Strategies (cont’d)
A second report, Rewarding Provider Performance: Aligning Incentives in Medicare (2006b), stated, “The existing systems do not reflect the relative value of health care services in important aspects of quality, such as clinical quality, patient-centeredness, and efficiency … nor recognize or reward care coordination … (in) prevention and the treatment of chronic conditions” (p. 1).
© Springer Publishing Company, LLC.
11
Principles of Economics and Finance to Redesign Effective and Realistic Care Delivery Strategies (cont’d)
VALUE-BASED PROGRAMS
A statement a decade ago from the CMS Report to Congress: Plan to Implement a Medicare Hospital Value-Based Purchasing Program (CMS, 2007) stated, value-based purchasing “(VBP), which links payment to performance, is a key policy mechanism that CMS is proposing to transform Medicare from a passive payer of claims to an active purchaser of care” (p. 2).
© Springer Publishing Company, LLC.
12
Principles of Economics and Finance to Redesign Effective and Realistic Care Delivery Strategies (cont’d)
Since the implementation of the ACA, CMS has developed multiple programs as a mechanism to pay for quality care. These value-based programs reward (via incentive payments) providers were instituted as part of their overarching quality strategy to reform the processes by which health care is delivered and paid. The value-based programs have three aims (CMS, 2017):
Better care for individuals
Better health for populations
Lower cost
© Springer Publishing Company, LLC.
13
Principles of Economics and Finance to Redesign Effective and Realistic Care Delivery Strategies (cont’d)
CMS values these programs because they see it as way to pay providers who provide high-quality care and not base their payments on volume, which they had been doing in the past. CMS started with four original value-based programs with the goal to link provider performance of quality measures to provider payment. Those initial programs included:
Hospital Value-Based Purchasing (HVBP) Program
Hospital Readmission Reduction (HRR) Program
© Springer Publishing Company, LLC.
14
Principles of Economics and Finance to Redesign Effective and Realistic Care Delivery Strategies (cont’d)
Value Modifier (VM) Program (also called the Physician Value-Based Modifier or PVBM)
Hospital-Acquired Conditions (HAC) Program
Medicare Access and CHIP Reauthorization Act (MACRA)
MACRA shifts the focus from volume to value. In this new model, providers will be paid on how well they meet certain quality measures and create value for their patients. MACRA repealed the sustainable growth rate (SGR) formula and replaced it with a new value-based reimbursement system called the Quality Payment Program (QPP).
© Springer Publishing Company, LLC.
15
Principles of Economics and Finance to Redesign Effective and Realistic Care Delivery Strategies (cont’d)
Medicare Access and CHIP Reauthorization Act (MACRA)
MACRA shifts the focus from volume to value. In this new model, providers will be paid on how well they meet certain quality measures and create value for their patients. MACRA repealed the sustainable growth rate (SGR) formula and replaced it with a new value-based reimbursement system called the Quality Payment Program (QPP).
© Springer Publishing Company, LLC.
16
Principles of Economics and Finance to Redesign Effective and Realistic Care Delivery Strategies (cont’d)
Additionally, it streamlines providers’ reporting and gives them two paths to choose from for determining how the value and quality of their care will be measured.
The first path is The Merit-Based Incentive Payment System (MIPS) and the other is the Advanced Alternative Payment Models (APMs).
© Springer Publishing Company, LLC.
17
Principles of Economics and Finance to Redesign Effective and Realistic Care Delivery Strategies (cont’d)
Meaningful Measures
Launched in 2017 and updated in 2021 (MM2.0) by CMS to increase efficiencies by:
Utilizing only quality measures of highest value and impact focused on key quality domains.
Aligning measures across value-based programs and across partners, including CMS, federal, and private entities.
Prioritizing outcome and patient-reported measures.
Transforming measures to fully digital by 2025 and incorporating all-payer data.
Developing and implementing measures that reflect social and economic determinants. (CMS, 2021)
© Springer Publishing Company, LLC.
18
Healthcare Quality/Finance Concepts
Benchmarking
Is a method that assists in comparing outcomes of two or more entities.
The entity can consist of another provider, facility, country, and others.
Is an excellent tool to share improvements not only in a particular place or time but how it compares to others.
© Springer Publishing Company, LLC.
19
Healthcare Quality/Finance Concepts (cont’d)
Cost–Benefit Analysis
Is the process of analyzing health care resource expenditures relative to their possible benefit.
This analysis may be helpful and necessary as a mechanism to setting priorities when choices must be made in the face of limited resources.
This analysis is used in determining the degree of access to, or benefits of, healthcare to be provided.
© Springer Publishing Company, LLC.
20
Healthcare Quality/Finance Concepts (cont’d)
Cost–Effectiveness Analysis
The central purpose of cost-effectiveness analysis (CEA) is to compare the costs and the values of different healthcare interventions in creating better health and longer life.
As with any system financing health care, there are often limited budgets and a vast number of potential spending options.
© Springer Publishing Company, LLC.
21
Healthcare Quality/Finance Concepts (cont’d)
Cost per Encounter
This can be expressed simply as the product of three key cost drivers:
Intensity of services
Productivity/efficiency
Resource prices/salaries and wages
The mix and quantity of services that are combined to produce the encounter of care define the intensity of services.
© Springer Publishing Company, LLC.
22
Healthcare Quality/Finance Concepts (cont’d)
Data
Is the basic element by which many critical decisions are based. It cannot be stressed enough the importance of providing data to support an initiative.
Another important element to this is ensuring data integrity. It is essential to ensure that whatever data is provided to back up an identified need has been thoroughly examined to ensure its accuracy and integrity.
© Springer Publishing Company, LLC.
23
Healthcare Quality/Finance Concepts (cont’d)
INCREMENTAL COST-EFFECTIVENESS RATIO
Is a term used in CEA in health eco
Graduatewriterhelp.com Plagiarism Free Papers
Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we\’ll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.
Why Hire Graduatewriterhelp.com writers to do your paper?
Quality- We are experienced and have access to ample research materials.
We write plagiarism Free Content
Confidential- We never share or sell your personal information to third parties.
Support-Chat with us today! We are always waiting to answer all your questions.
All Rights Reserved Terms and Conditions
College pals.com Privacy Policy 2010-2018
Graduatewriterhelp.com is an online academic writing site catering to students from all educational levels, from high school and college to graduate level and beyond. The website has a team of experienced writers who are equipped with the knowledge and skills required to provide top-notch custom writing services for any task assigned by our customers.
At Graduatewriterhelp.com, we specialize in offering assistance with the following tasks: essays, research papers, projects, case studies, book reviews, lab reports, presentations, term papers and even editing or proofreading services as well. All these tasks can be done according to the instructions provided by our clients without compromising on the quality or accuracy of work delivered within shorter periods of time as per customer requirements. Clients also have access to knowledgeable customer support staff, which assists them with their queries at any time during the day or night when placing orders through our website interface.
In addition to the regular services offered by Graduatewriterhelp.com such as essay writing help for high school and college assignments; dissertation/thesis preparation for postgraduate programs; coursework composition for undergraduates; editing/proofreading services for students who require revisions on pre-written works; we also offer specialized services like grant proposal writing assistance for those seeking funds from external bodies; data analysis report creation based on statistical information collected from relevant sources; CV/resume formatting according to employer expectations; literature reviews postulating various interpretations on certain topics etcetera based on customer needs..
We also facilitate the completion of important applications such as those needed while applying abroad or enrolling into some universities where thoroughness is critical in order secure admissions favorably that meet admission criteria demandingly set forth by these institutions due to intense competition witnessed globally today among prospective applicants vying places available therein limited vacancies so created thereupon every academic year…
Moreover, our experts are qualified in diverse fields being well versed in different areas of knowledge too, thus enabling us to cover almost any topic that may come your way thereby providing comprehensive solutions pertaining same conclusively efficient manner possible, meeting customer deadlines within the desired timeframe successfully sans excuses whatsoever implicated concerning inconsistency matters grade expectation meeting provided via us hereunder…
By availing our services at Graduatewriterhelp.com, clients can rest assured that their work will be completed accurately within their specified deadlines without compromising quality standards expected out of professional service providers like ourselves.
Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.
You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.
Read moreEach paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.
Read moreThanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.
Read moreYour email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.
Read moreBy sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.
Read more