Describe how goals might be set for each measure in an aggressive organization, which is seeking to excel in the marketplace. 

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In an 8 to 10-page paper, APA format and 5 references, describe three rate based measurements of quality.

Select three rate based measurements of quality that you will use as the primary basis for this paper.

These measurements must relate to some aspect of clinical or service quality that directly relates to patient care or the patient’s experience of care.  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.

. Describe two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario.

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What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient. As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives on a daily basis. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. In this Discussion, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

Scenario 1:

As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.

Scenario 2:

A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway.

Scenario 3:

You see another nurse practitioner writing a prescription for her husband who is not a patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide whether or not to report the incident.

Scenario 4:

During your lunch break at the hospital, you read a journal article on pharmacoeconomics. You think of a couple of patients who have recently mentioned their financial difficulties. You wonder if some of the expensive drugs you have prescribed are sufficiently managing the patients’ health conditions and improving their quality of life.

To prepare:

· Review Chapter 1 of the Arcangelo and Peterson text, as well as articles from the American Nurses Association, Anderson and Townsend, the Drug Enforcement Administration, and Philipsend and Soeken.

· Select one of the four scenarios listed above.

· Consider the ethical and legal implications of the scenario for all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family.

· Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario.

With these thoughts in mind:

Post an explanation of the ethical and legal implications of the scenario you selected on all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family. Describe two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario.

LINKS:

https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/

https://www.ismp.org/recommendations/error-prone-abbreviations-list

Describe collaborative skills you would use to create a more positive atmosphere.

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As you learn more about the health care industry, you will find that it is a highly collaborative environment. All systems within health care must collaborate and communicate effectively to serve their consumers.

Note: It is important to complete this assignment prior to working on the Importance of Communication: Part 2.

Read the scenario provided.

Write a 350- to 525-word paper that discusses the principles of communication presented in the scenario.

  • Describe verbal and nonverbal cues from the scenario.
  • Based on the description of each group member, speculate as to how well this group will collaborate.
  • How can verbal and nonverbal communication be perceived as defensive?
    • How can this affect relationships in the work place?

Submit your assignment to the University of Phoenix Center for Writing Excellence plagiarism checker Turnitin® and WritePoint® powered by Grammarly®.

Include the report from Turnitin® and from WritePoint® with your assignment.

Note: Follow the Turnitin® and WritePoint® tutorials to learn how to open, save, and submit the reports with your assignment.

Cite at least 1 peer-reviewed, scholarly, or similar reference.

Format your assignment according to APA guidelines.

Directions for part 2

 

As the meeting drew to a close, it was clear that the members still did not agree on the marketing plan addressed. Robert is frustrated by the end of the meeting and tells the group that they can just work it out on their own. The group leader asks the other members to create their own marketing plan to bring back to the group at a later date.

Write a 350- to 525-word paper that discusses important collaborative skills and the significance of effective communication when working in groups. Include the following:

  • Describe collaborative skills you would use to create a more positive atmosphere.
  • Explain the importance of effective communication and the drawbacks of the ineffective communication used in this scenario.
    • Consider the email and the face-to-face meeting.
  • Explain the role active listening could have played in this scenario.

Submit your assignment to the University of Phoenix Center for Writing Excellence plagiarism checker Turnitin® and WritePoint® powered by Grammarly®.

Include the report from Turnitin® and from WritePoint® with your assignment.

Cite at least 1 peer-reviewed, scholarly, or similar reference or your textbook.

Format your assignment according to APA guidelines.

Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis

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You see a 1-week-old Asian infant for a weight check. The infant is back to his birth weight and is breastfeeding for 10 minutes every 2 hours with one 3-hour stretch a day. He is alert, has bowel movements with each feeding, and wets 8–10 diapers a day. His blood type is A+ and his mother’s blood type is A+. Coombs’ testing at birth was negative. You note slight scleral and skin jaundice.

Case Study 2

Jimmy is a 3-year-old “picky” eater according to his mother. He refuses to eat anything but waffles for breakfast and macaroni and cheese or chicken nuggets for lunch and dinner. He will eat apples and bananas but refuses all vegetables except corn. After a normal physical examination, you obtained blood testing that revealed the hemoglobin is 11.4 mg/dl and his hematocrit is 30% (both obtained by venipuncture). The CBC revealed microcytic hypochromic RBCs.

Case Study 3

Melissa is a 13-year-old who presents to your office for a well-child check. Physical examination reveals a thin child who is short of stature. Breast Tanner stage is II and pubic hair development is Tanner I. Neurologic, skin, heart, lung, abdominal, and HEENT examinations are normal.

To prepare:

  • Review “Endocrine and Metabolic Disorders” and “Hematologic Disorders” in the Burns et al. text.
  • Review and select one of the three provided case studies. Analyze the patient information.
  • Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
  • Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
  • Consider strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

Read a selection of your colleagues’ responses.