4) Describe how the measurement is compared externally to other like settings; differentiate between the actual rate and a percentile ranking.  

For the purposes of this assignment, an analysis of staffing levels is not permitted.  You can find useful information on quality indicators that are of interest to you on these websites and resources.  You may choose only one of the three measures to be some form of patient satisfaction measure. Deconstruct each measure to include descriptions of the each of the following as numbered below: 1) The definition of the measure 2) The numerical description of how the measurement is constructed (the numerator/denominator measure counts, the formula used to construct the rate, etc.) 3) Explain how the data for this measure are collected 4) Describe how the measurement is compared externally to other like settings; differentiate between the actual rate and a percentile ranking. 5) Explain whether the measure is risk adjusted or not.  If so, explain briefly how this is accomplished. 6) Describe how goals might be set for each measure in an aggressive organization, which is seeking to excel in the marketplace. Describe the importance of each measure to a chosen clinical organization and setting. Using these websites and resources you can choose a hospital, a nursing home, a home health agency, a dialysis center, a health plan, an outpatient clinic or private office; a total population of patient types is also acceptable, but please be specific as to the setting. That is, if you are interested in patients with chronic illness across the continuum of care, you might home in a particular health plan, a multispecialty practice setting or a healthcare organization with both inpatient and outpatient/clinic settings. Faculty appointments and academic settings are not permitted for this exercise. For all other settings, consult the instructor for guidance. You do not need actual data from a given organization to complete this assignment. Relate each measure to patient safety, to the cost of poor quality, and to the overall cost of healthcare. Required Readings Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press. Chapter 5: “Data Collection” Chapter 6: “Statistical Tools for QI” Park, J., Konetzka, R. T., & Werner, R. M. (2011). Performing well on nursing home report cards: Does it pay off? Health Services Research, 46(2), 531–554. doi:10.1111/j.1475-6773.2010.01197.x

1. The study in this article evaluates whether or not nursing homes benefit from improvements in quality measures. Four financial outcomes are measured before and after the improvements are enacted. The study shows that the nursing homes that improved quality measures benefited financially.

Suchy, K. (2010). A lack of standardization: The basis for the ethical issues surrounding quality and performance reports. Journal of Healthcare Management, 55(4), 241–251. Because performance reports are easily found online, this article supports creating ethical guidelines for the performance reports of the health care industry. It compares nearly ten different organizations that provide performance reporting, and then it proposes an ethical framework and principles for public quality reporting. Wachter, R. M., & Pronovost, P. J. (2009). Balancing “no blame” with accountability in patient safety. New England Journal of Medicine, 361(14), 1401–1406. This article addresses the issue of individual accountability in health care organizations. It suggests moving from a culture within health care that does not place blame on individuals to a culture where individuals become more accountable. Centers for Medicare & Medicaid Services. (n.d.). Quality initiatives: Overview. Retrieved from http://www.cms.gov/QualityInitiativesGenInfo/ Created by the U.S. Department of Health & Human Services, this website overviews quality initiatives that affect the health care industry. It also provides information and downloadable PDFs on the Post-Acute Care Reform Plan and Development of Quality Indicators for Impatient Rehabilitation Facilities (IRF). Required Media Video: Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: External quality improvement. Baltimore: Author. Note: The approximate length of this media piece is 10 minutes. The presenters in this video discuss various external organizations involved in quality, and examine the enforcement of standards by governmental agencies versus voluntary organizations. This program also addresses the publication of quality information and why organizations should do their own reporting in addition to mandated reporting. Licensing, credentialing, and certification are discussed as they relate to the social compact that health care providers have for quality and safety.]]>