Phillip March 12, 2024 No Comments

BUS FPX 4123 Assessment 6 Evaluating Current Quality Assurance Efforts

BUS FPX 4123 Assessment 6 Evaluating Current Quality Assurance Efforts Name Capella university BUS-FPX4123 Quality Assurance and Risk Management Prof. Name Date National Committee on Quality Assurance & HEDIS The National Committee on Quality Assurance (NCQA) is an independent nonprofit organization founded in 1990. It utilizes the Healthcare Effectiveness Data and Information Set (HEDIS) to hold health plans and organizations accountable for their performance (NCQA, 2021). The mission of NCQA is to enhance the quality of healthcare, achieved through quality measures. HEDIS is regarded as one of its significant accomplishments, encompassing standards across six areas of healthcare (NCQA, 2021). Health care organizations employ these measures to identify care gaps and implement improvements, aiming to make a meaningful difference in people’s lives. The HEDIS Roadmap for success gathers information about an organization’s information management practices affecting HEDIS reporting. While it doesn’t evaluate the efficiency of an organization’s information systems, completion of the Roadmap is mandatory annually and is a requisite component of the NCQA HEDIS audit. The Roadmap furnishes auditors with crucial initial information necessary for a successful audit. All information requested in the Roadmap is vital to the audit process, requiring organizations to respond accurately and comprehensively to each question. HEDIS Measures for Cervical Cancer Screenings (CCS) Cervical Cancer Screenings (CCS) are categorized under the effectiveness of care in HEDIS measures. According to the American Cancer Society (2021), in 2021, an estimated 14,480 new cases of invasive cervical cancer were projected, with 4,290 women succumbing to their diagnosis. Cervical cancer has been a leading cause of cancer-related deaths among women in the U.S. since cervical cancer screening measures were initiated in 1999. In 2013, these measurement guidelines were revised to align with the recommendations of the U.S. Preventive Services Task Force (USPSTF) to reduce new diagnoses and deaths (NCQA, 2020). BUS FPX 4123 Assessment 6 Evaluating Current Quality Assurance Efforts Cervical Cancer Screening, primarily conducted via Pap tests, detects precancerous and abnormal cells, aiding in early cancer detection. USPSTF recommends cytology screening every three years for women aged 21 to 29, and for women aged 30 to 65, the same screening along with high-risk human papillomavirus (hrHPV) screening every five years (USPSTF, 2018). These additional measures have demonstrated efficacy in decreasing deaths attributed to invasive cervical cancers. Benefits of Quality Quality programs like HEDIS offer numerous benefits to patients, communities, and organizations. Implementing HEDIS measures is crucial for closing care gaps and has resulted in reduced death rates associated with cervical cancer when adhered to as recommended. For patients, early detection through screening can lead to less invasive and costly treatments. Surgical interventions for precancerous lesions are generally less expensive than treatments for invasive cancers. Additionally, more frequent screenings reduce the risk of recurrence of invasive cervical cancer, further lowering healthcare costs (CDC, 2021). Healthcare organizations benefit from improved health outcomes associated with smaller care gaps, which positively reflect on the organization’s reputation. References American Cancer Society. (2021, January 12). Cervical Cancer Statistics | Key Facts About Cervical Cancer. https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html CDC. (2021, August 18). Cost-Effectiveness of Cervical Cancer Interventions | Power of Prevention. National Center for Chronic Disease Prevention and Health Promotion. https://www.cdc.gov/chronicdisease/programs-impact/pop/cervical-cancer.htm National Committee for Quality Assurance (NCQA). (2021, September 16). About NCQA. NCQA. https://www.ncqa.org/about-ncqa/ National Committee for Quality Assurance (NCQA). (2020, December 28). Cervical Cancer Screening. https://www.ncqa.org/hedis/measures/cervical-cancer-screening/ USPSTF. (2018, August 21). Recommendation: Cervical Cancer: Screening | United States Preventive Services Taskforce. U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening BUS FPX 4123 Assessment 6 Evaluating Current Quality Assurance Efforts

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BUS FPX 4123 Assessment 5 Data-Driven Organizations

BUS FPX 4123 Assessment 5 Data-Driven Organizations Name Capella university BUS-FPX4123 Quality Assurance and Risk Management Prof. Name Date Data-Driven Organizations Healthcare organizations rely extensively on data analytics to assess and compare similar organizations across the nation. This study examines the pivotal role of data in enhancing organizational performance and patient outcomes. Data Collection The initial step involves comprehensive data collection, crucial for effective communication of leadership goals within healthcare facilities. By comparing similar organizations nationwide, healthcare entities can identify areas for improvement and foster a culture of quality, value-based healthcare delivery. Quantitative data, particularly measurable metrics, facilitate informed decision-making, patient surveys, and analysis of consumer behavior. Notably, clinical data analysis reveals critical insights into patient trends and preferences, enabling proactive interventions for better outcomes (Titler, 2016). Quality Standardization Quality standardization is imperative for healthcare organizations striving to improve their systems and services. By analyzing data, healthcare entities can identify existing challenges and implement evidence-based solutions. Proactive quality assurance strategies, coupled with continuous review and refinement, ensure ongoing improvements and adherence to best practices. Standardization not only enhances quality but also reduces costs, addressing a significant concern in the healthcare industry (NCVHS, 2002). BUS FPX 4123 Assessment 5 Data-Driven Organizations Implementation Aligning healthcare facilities requires a systematic approach, utilizing methods like the plan-do-check-act cycle. By presenting initiatives to executive, clinical, and administrative personnel, organizations can foster cohesion and efficiency across campuses. Comprehensive data collection, encompassing quality standards, patient surveys, and associate feedback, enables organizations to address patient preferences and treatment variations effectively. Ultimately, the goal is to transform competing facilities into collaborative entities focused on delivering quality patient care (ASQ, 2018). Conclusion In conclusion, the alignment of healthcare systems through data-driven strategies is essential for global healthcare advancements. By prioritizing patient-centric approaches and leveraging data analytics, organizations can achieve significant improvements in service delivery and patient outcomes. References American Society for Quality. (2018). Plan-do-check-act (PDCA) cycle. Retrieved from http://www.asq.org/learn-about-quality/project-planning-tools/overview/pdca-cycle.html NCVHS. (2002). Influence on the population’s health [PDF]. NCVHS. Sipkoff, M. (2013). 9 Ways to Reduce Unwarranted Variation. Retrieved October 26, 2016, from http://managedcaremag.com/archives/2003/11/9-ways-reduce-unwarranted-variation Titler, M. G. (2016). The Evidence for Evidence-Based Practice Implementation – Patient Safety and Quality. Raghupathi, W., & Raghupathi, V. (2014). Big data analytics in healthcare: promise and potential. Health Information Science and Systems, 2, 3. http://doi.org/10.1186/2047-2501-2-3. BUS FPX 4123 Assessment 5 Data-Driven Organizations

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BUS FPX 4123 Assessment 4 Promoting Accountability Through Measures

BUS FPX 4123 Assessment 4 Promoting Accountability Through Measures Name Capella university BUS-FPX4123 Quality Assurance and Risk Management Prof. Name Date Introduction As the owner and CEO of Egebrecht Group Homes, ensuring the safety and health of our residents is paramount. With an average of six to ten adult residents, many of whom have mental impairments, it’s imperative to address any issues promptly to maintain quality care. Recently, concerns have arisen regarding medication administration, including missed doses and discrepancies in documentation. This necessitates the development of an action plan to uphold the standards of care for our residents. Affordable Care Act The Affordable Care Act (ACA), signed into law in March 2010, aimed to enhance healthcare accessibility and quality for Americans. Beyond expanding insurance coverage, the ACA mandates improvements in various healthcare facets, such as providing conducive environments for breastfeeding mothers and increasing transparency regarding calorie information in restaurants. Moreover, it has facilitated better access to prescription medications, including brand name and generic drugs, thereby benefiting millions of Americans and fortifying the healthcare system (Rapogel et al., 2010). Assessment of Educational Needs Conducting an assessment of educational needs at Egebrecht Group Homes involved employing a discrepancy analysis methodology. This entailed self and peer assessments, alongside reflective practices to evaluate performances and processes. Identifying weaknesses and strengths through performance reviews is vital for continuous organizational growth and ensuring patient safety remains a focal point. Plan of Action Addressing the identified issues necessitates a comprehensive plan of action. By meticulously examining the situation, which involves missing medications and incomplete documentation, we gathered data from written statements and video footage. Subsequently, a new medication reconciliation process was implemented, requiring dual verification of medications by two staff members to mitigate errors. Any instances of medication errors are promptly reported to the relevant authorities for appropriate disciplinary action, emphasizing the importance of adherence to established protocols and standards. BUS FPX 4123 Assessment 4 Promoting Accountability Through Measures Plan-Do-Check-Act (PDCA) Model Employing the Plan-Do-Check-Act (PDCA) model, a systematic approach to process improvement, is crucial in ensuring sustained enhancements. Initially developed by Walter A. Shewhart in the 1920s, PDCA involves planning, implementing, reviewing, and acting based on observed outcomes. Regular evaluation and adjustment of processes are fundamental to fostering a culture of continuous improvement within the organization, necessitating active involvement and commitment from all levels of management. Conclusion The implementation of an updated medication reconciliation process is poised to enhance accuracy and prevent medication errors at Egebrecht Group Homes. By prioritizing patient safety and adhering to established protocols, we strive to deliver high-quality care consistently. Embracing standards of service and continuous improvement ensures that our organization remains responsive to evolving healthcare needs. References Barnsteiner, J. (n.d.). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. NCBI.NLM.NIH.Gov. Retrieved July 20, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK2648/ Rapogel, N., Gee, E., & Calsyn, M. (2010, March 23). 10 Ways the ACA Has Improved Health Care in the Past Decade. Americanprogress.Org. https://www.americanprogress.org/issues/healthcare/news/2020/03/23/482012/10-waysaca-improved-health-care-past-decade/ BUS FPX 4123 Assessment 4 Promoting Accountability Through Measures

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BUS FPX 4123 Assessment 3 The Affordable Care Act Quality Initiatives

BUS FPX 4123 Assessment 3 The Affordable Care Act Quality Initiatives Name Capella university BUS-FPX4123 Quality Assurance and Risk Management Prof. Name Date Quality Measures and Initiatives Under the Affordable Care Act (ACA) Quality measures were firmly established before the enactment of the Affordable Care Act (ACA) in 2013. However, the ACA has significantly influenced the presentation and evaluation of healthcare initiatives. One notable effect of the ACA is the implementation of Performance Improvement Plans (PIPs) as part of quality initiatives. These initiatives include measuring hospital readmission rates and implementing Medicare’s pay-for-performance model for hospital systems. Hospitals are incentivized to meet and improve upon designated quality measures for selected patients, often those with acute and chronic conditions such as Congestive Heart Failure, Diabetes, Pneumonia, and COPD (Reineck & Kahn, 2013). Additionally, hospitals are assessed based on Hospital Acquired Conditions (HACs), with reimbursements reduced for those in the top quartile of HACs compared to the national average (Reineck & Kahn, 2013). These initiatives serve to hold hospitals accountable for the care they provide from admission to discharge. Goals of the Affordable Care Act (ACA) The ACA, enacted in 2010, aimed to reform the US healthcare system by expanding Medicare and Medicaid, with a primary focus on providing coverage for the uninsured. It introduced mandates for individuals to enroll in healthcare coverage and for employers to offer health insurance to their employees. While the individual mandate penalty was removed in 2018, the ACA persists with three core goals: making affordable health insurance accessible to more Americans, expanding Medicaid coverage, and supporting innovative medical care delivery (HealthCare.gov, 2021). These goals were intended to improve population health and increase access to healthcare services, particularly for those without insurance coverage. BUS FPX 4123 Assessment 3 The Affordable Care Act Quality Initiatives Measuring ACA Goals The ACA’s goals are evaluated by tracking various indicators of care. Insurance companies provide enrollment data through attribution lists, offering insights into enrollment trends nationwide. Healthcare organizations report outcome measures, such as Length of Stay (LOS), which can indicate the quality of care provided. Additionally, re-admission rates are considered alongside LOS to assess effectiveness. The ACA emphasizes preventive care as a means of maintaining financial stability for healthcare organizations (Dlugacz, 2006). Conclusion While the overarching goals of the ACA are evident, achieving them involves addressing numerous sub-goals. No single measure can fully capture an organization’s performance; instead, a range of indicators must be considered. The ACA has prompted a focus on preventive care, chronic conditions, and collaborative healthcare delivery, highlighting the importance of addressing health disparities and expanding insurance coverage (CMS, 2010). References CMS. (2010). Read the Affordable Care Act, Health Care Law. HealthCare.Gov. https://www.healthcare.gov/where-can-i-read-the-affordable-care-act/ Dlugacz, Y. (2006). Measuring health care: Using quality data for operational, financial, and clinical improvement. Wiley. HealthCare.gov. (2021). Type of plan and provider network. https://www.healthcare.gov/choosea-plan/plan-types/ Reineck, L. A., & Kahn, J. M. (2013). Quality Measurement in the Affordable Care Act. A Reaffirmed Commitment to Value in Health Care. American Journal of Respiratory and Critical Care Medicine, 187(10), 1038–1039. https://doi.org/10.1164/rccm.201302- 0404ed BUS FPX 4123 Assessment 3 The Affordable Care Act Quality Initiatives

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BUS FPX 4123 Assessment 2 Data Assessment in Organizations

BUS FPX 4123 Assessment 2 Data Assessment in Organizations Name Capella university BUS-FPX4123 Quality Assurance and Risk Management Prof. Name Date Introduction Patients are the top priority in healthcare, and delivering quality healthcare on a daily basis is paramount. Researching specific areas of healthcare and implementing changes based on research outcomes is essential for improvement. The Healthcare Effectiveness Data and Information Set (HEDIS) Measures of Care provides a comprehensive tool to explore various aspects of healthcare. Understanding the areas that require improvement is crucial. In this paper, the focus is on Adult BMI Assessment as a measure within HEDIS, highlighting the importance of BMI assessment and management and addressing the significance of reducing obesity rates in healthcare. HEDIS Measures of Care The Healthcare Effectiveness Data and Information Set (HEDIS) is a comprehensive tool widely used by most HMO and PPO health plans to measure performance in critical dimensions of care and service delivery. It offers objective, clinical performance measures based on detailed criteria, facilitating comparisons of health plans’ performance. HEDIS encompasses a wide array of health issues, including but not limited to appropriate antibiotic use, high blood pressure, asthma, behavioral health, medication management, cancer screenings, cardiovascular disease, and weight assessment and counseling (NCQA, 2013). Adult BMI Assessment Obesity stands as a significant cause of preventable mortality, contributing to a considerable portion of deaths in the United States annually. Body Mass Index (BMI) serves as a fundamental weight-for-height screening tool to identify potential weight issues in adults and assess their risk for developing associated health complications. The Adult BMI Assessment measure evaluates whether adults have had their BMI measured at least once in the past two years, aiming to gauge their risk for overweight or obesity and associated health complications (NCQA, 2013). The prevalence of obesity in the United States is alarming, with more than two-thirds of adults considered overweight and over one-third considered obese. Obesity is linked to a myriad of serious health issues, including but not limited to diabetes, cardiovascular diseases, certain cancers, and premature death. Interventions such as behavioral counseling and physical activity are recommended to mitigate obesity-related risks. However, a significant portion of adults fail to meet the recommended physical activity levels, exacerbating the obesity epidemic (NCQA, 2013). Expectations Implementing the Adult BMI Assessment measure is crucial in combating the rising obesity epidemic. Projections indicate a substantial increase in obesity rates by 2030, with significant economic implications. However, modest weight loss can yield considerable health benefits, including improvements in blood pressure, cholesterol levels, and blood sugars. Monitoring BMI allows healthcare providers to identify at-risk individuals and provide targeted interventions to promote healthy weight management (NCQA, 2013). BUS FPX 4123 Assessment 2 Data Assessment in Organizations Summary and Conclusion Reducing obesity rates through interventions such as the Adult BMI Assessment measure not only promotes healthier individuals but also reduces mortality rates and yields substantial cost savings. Given that obesity is the most preventable cause of death, it is imperative for healthcare organizations to prioritize efforts in this area. Implementing measures to assess and address obesity risk factors is an essential step toward improving population health and reducing healthcare costs. References Arterburn, D. E., Alexander, G. L., Calvi, J., Coleman, L. A., Gillman, M. W., Novotny, R., … Sherwood, N. E. (2010). Body Mass Index Measurement and Obesity Prevalence in Ten U.S. Health Plans. Clinical Medicine & Research, 8(3-4), 126–130. http://doi.org/10.3121/cmr.2010.880. Dietz, W. H., Benken, D. E., & Hunter, A. S. (2009). Public Health Law and the Prevention and Control of Obesity. The Milbank Quarterly, 87(1), 215–227. http://doi.org/10.1111/j.1468-0009.2009.00553.x. National Committee for Quality Assurance (NCQA). (2013). Improving quality and patient experience: The state of health care quality 2013. Retrieved from http://www.ncqa.org/Portals/0/Newsroom/SOHC/2013/SOHC-web_version_report.pdf. BUS FPX 4123 Assessment 2 Data Assessment in Organizations

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BUS FPX 4123 Assessment 1 Quality Management Organizations

BUS FPX 4123 Assessment 1 Quality Management Organizations Name Capella university BUS-FPX4123 Quality Assurance and Risk Management Prof. Name Date Quality Management in Healthcare Organizations Quality management is essential for the smooth operation of healthcare organizations, with patient safety being paramount in quality improvement efforts. The role of management organizations profoundly impacts patient-centered care and the leadership within healthcare institutions. Role of Quality Management Organization Quality improvement enables healthcare organizations to establish strategies for achieving optimal patient outcomes and processes. A quality management organization sets standards for healthcare institutions to enhance operations and processes, thus providing better outcomes and services to patients (NCBI, n.d.). Implementing a Plan-Do-Check-Act (PDCA) Cycle is crucial for ensuring quality improvement. This four-step process involves planning, executing, assessing, and standardizing procedures (ASQ, n.d.). Constant evaluation in a cyclical manner aids in discarding unsupported ideas and progressing towards organizational success (ASQ, n.d.). Quality Effort Impact Quality efforts in healthcare ensure that organizations prioritize patients’ well-being while optimizing organizational performance. Patient safety practices, particularly in medication administration, play a pivotal role in preventing harm (NCBI, n.d.). Collaborative patient-centered care, supported by quality initiatives, aims to deliver the best possible outcomes. From an administrative perspective, tracking and enforcing quality initiatives minimize errors and establish clear directions for care (AHRQ, n.d.). BUS FPX 4123 Assessment 1 Quality Management Organizations Educational Needs of a Quality Management Organization Institutions such as the Institute for Healthcare Improvement (IHI) offer continuing education to meet healthcare organizations’ quality improvement needs. Health leaders are tasked with delivering high-value care today and innovating for future models (IHI, 2021). Quality standards are upheld through surveys, site visits, and policy enhancements. National Organization Comparison The Joint Commission (TJC) sets global standards for quality improvement and patient safety in healthcare. As a nonprofit organization, TJC is dedicated to evaluating healthcare institutions and fostering a culture of safe and effective care (The Joint Commission, 2021). The Agency for Healthcare Research and Quality (AHRQ) spearheads efforts to improve America’s healthcare system by generating evidence and providing resources for informed decision-making (AHRQ, n.d.). Working collaboratively, AHRQ ensures that healthcare data is utilized effectively (AHRQ, n.d.). References Agency for Healthcare Research and Quality. (n.d.). Learn from Defects Tool. Retrieved from https://www.ahrq.gov/hai/cusp/toolkit/learn-defects.html American Society for Quality. (n.d.). Plan-do-check-act (PDCA) cycle. Retrieved from http://www.asq.org/learn-about-quality/project-planning-tools/overview/pdca-cycle.html Institute for Healthcare Improvement. (2021). Learn, Connect, and Grow with IHI | IHI – Institute for Healthcare Improvement. Retrieved from http://www.ihi.org/education/Pages/default.aspx The Joint Commission. (2021). About Us. Retrieved from https://www.jointcommission.org/about-us/ National Center for Biotechnology Information. (n.d.). Executive summary of to err is human. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK225179/ BUS FPX 4123 Assessment 1 Quality Management Organizations

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