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Assignment: Dashboard and Health Care Benchmark Evaluation

Assignment: Dashboard and Health Care Benchmark Evaluation

The Health Point is a level 1 Trauma Center based in Minnesota whose aim is to enhance the quality, safety, and effectiveness of patient care by adopting technologies and developing tools that transform practice and research. The served area has a population of 223, 170 thus the hospital sees more than 30, 000 people yearly. The hospital offers general and surgical medical services to its patients. The area has diverse ethnic backgrounds comprising of seven different racial backgrounds.  The main population targeted by the hospital are people with limited economic power and the hospital has unrivaled fame on its ability to enhance the health of the served population. The hospital has to meet specific standards set by the local and federal governments. To help in achieving these standards the hospital has implemented a clinical patient Safety Dashboard. The aim of this paper is to evaluate the clinical dashboard metrics against the local, state and federal policies, analyze the challenges that meeting the benchmarks pose to the hospital, evaluate benchmark underperformance and offer ethical action to use on handling the benchmark underperformance.

Clinical Safety Dashboard

The hospital has implemented the clinician safety dashboard to handle preventable medical errors. The dashboard was instituted to ensure that the organization has zero events of preventable harm. The clinical dashboard offers instant access to patient safety indicators on its inpatient units. It is used by care partners to get relevant patient information in one view and thus facilitates compliance with patient diet orders and helps in monitoring patients who require more frequent turning and repositioning (Badgeley et al., 2016). Nurses can customize the dashboard based on shift assignment, view medication changes, and vaccines reminders and monitor high-risk patients. clinical coordinators also benefit from the dashboard because it supports the shift report and the coordinator can monitor changes in patient condition, staff workload, patient census, and the dashboard has color change tool that indicates patient discharge or transfer. The nurse managers use the dashboard to get audit information on vaccines, falls and central lines among others and get an update on patient needs and unit census (Badgeley et al., 2016). Providers use the system during rounds to ascertain that the patients have all orders while senior leadership can access patients’ real-time information on any unit and at any time.

Benchmarks

The dashboard metrics that are linked to the clinical safety dashboard are readmission rates, fall rates, wrongful prescriptions, and hospital-acquired infections.  Every hospital has to ensure that the readmission rates do not exceed the 30-day national average readmission rates (Mehtsun et al., 2018). Health Point COPD readmissions exceeded the 40% limit but pneumonia readmissions reduced since it was below the 30% national average rate. The hospital also exceeded the 17 % rate set for medical care readmission which can be linked to the discharge protocol that occurs between 8.00 am and 12.59 pm and patients discharged between 8.pm and midnight have a high probability of returning within 72 hours. The hospital score is below the required benchmark since it has excess readmission rates. The law on readmission is stipulated in section 3025 of the Affordable Care Act and it mandates that CMS should cut down the payments to hospital with excess readmissions (Mehtsun et al., 2018).

Equally, the hospital performance on fall rates was higher than the set standard of 11.5 per 1000 patient days (Cotton et al., 2016). The standards are also on the Affordable Care Act as part of the non-reimbursement policy. The rate falls indicate the quality of healthcare since increased falls complicate lives of patients and results in deaths at times. The falls were recorded on the surgical and orthopedic units. When installing the dashboard, the target was to reduce the falls by 70% but Health Point only achieved a 50% decrease an indication that the hospital failed to meet the internal benchmark as well as the national benchmark. The hospital implemented the Fall Injury Reduction Protocol Policy but did not follow through because the policy offers an algorithm that aids in identifying and preventing falls by at least 80% (Lachance et al., 2016).

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The clinical dashboard had a positive impact because it reduced the number of wrongful prescriptions. Care transition is linked to

Assignment Dashboard and Health Care Benchmark Evaluation

Assignment Dashboard and Health Care Benchmark Evaluation

medical and prescription errors especially when the patient file cannot be accessed. The number of prescription errors reduced from 13% to 5% which is great. In Minnesota, there is a report dubbed Adverse Health Report that outlines the number of medical events seen with the state annually. Previously, the hospital always contributed the highest percentages but currently, it has enhanced its systems. The hospital managed to act on the figures after following the Adverse Health Care Events Reporting Law. The Law stipulates that a hospital should report any adverse event, come up with a multidisciplinary team to assess the situation and generate recommendations to prevent future occurrences (MDPH, 2019).

In terms of hospital-acquired infections (HAI), the Health Point performed below the local benchmark. In Minnesota, all hospitals are supposed to adopt HAI intervention plan as outlined in the Maryland Healthcare-Associated Infections Prevention Plan. The plan helps in eliminating hospital-acquired infections (Evans et al., 2018). However, in Health Point, the number of collapsed lungs amounted to 0.41% cases, split wounds accounted for 1.91% cases and blood clots increased by 4.6%.  Due to these incidences, the hospital HAI levels were at 20%. Although it was a reduction from previous 50% it was still below the state benchmark which was 10% calculated from the HAI infection average from hospitals across the state.

Benchmark Evaluation

Coordination between the hospital management and inter-professional team is the key toward meeting benchmarks for metrics like wrongful prescriptions, HAIs, readmissions rates, and patient falls. Health point current focus is expanding its business across the state, which hinders its ability to concentrate on adopting interventions that can enhance its ability to meet the benchmarks. Apart from hospital expansion, the hospital rooms are small which makes it hard to implement measures to curb patient falls like patient call and light programs. Nevertheless, the hospital has managed to streamline its records in the pharmacy department and it has adopted efficient systems. The approach can be linked to the positive results seen in reduction in the numbers of wrongful prescriptions in the hospital. The systems have also enabled the hospital achieve the set targets on medical prescription mistakes. To handle the negative results seen in the hospital, an adjustment of organizational processes and procedures to meet the set standards can help in meeting the areas that are not within the expected benchmarks.

Ethical Action for Addressing the Benchmark Underperformance

A prevalent problem in the hospital is the increase in fall rates. Ethical approaches need to be considered when addressing the fall rates problem. The issue is mostly handled by nurses especially strategies like call lights or hourly rounds. The nurses thus have to be motivated and be involved in any decision made towards curbing the fall rates within the hospital. With motivation, the nurses will adopt the set interventions and will ensure that the number of falls per year reduces improving the patient falls metric (Spetz, Brown & Aydin, 2015). It is the nurses’ duty to take charge of the risks to enhance care delivery. When it comes to patient falls, autonomy dictates that patients can refuse the help from the nurse when getting out of bed and it’s their right to choose to fall. The same autonomy principle also mandates the nurses to inform the patients about their rights when using instruments like call lights and bells. Ethically, nurses should inform the patient about their rights as well as the consequences of any decision they make (Wilson et al., 2016). The patient then decides on whether they require assistance or not. Nevertheless, the nurses should ensure that the patient sees the need for help as a way of mitigating falls. Any advice offered to the patient should be based on evidence-based practices to help in making the right and ideal decisions.

Another ethical angle in falls is the fact that hospital falls generate income for hospitals due to compensation offered by the insurance companies (Spetz, Brown & Aydin, 2015). Nurse impartiality when reducing fall risks is therefore affected when looking at this notion. Nonetheless, the nursing creed postulates that patient interest should be placed above everything. Nurses should, therefore, take all measures to ensure that patient falls are mitigated like adopting the call lights and responding to them appropriately. In Health Point, there is a need to create a policy that calls for adoption of call lights. To ensure that the effectiveness of the strategy is enhanced, the policy will create a training option for nurses on how to respond to call light signals and education strategies to use when training patients on how to use the call lights. The policy will not only ensure that quality of care is preserved but also will enhance the benchmark performance. The burden of improving the patient falls benchmark lies on the nurses for two main reasons. First, reducing the rate falls is part of their responsibility and most research on falls outline that it is hard to mitigate them if nurses have not accepted the provided strategies (Wilson et al., 2016). Secondly, the approach needs a multidisciplinary team and nurses are part of the team. They, therefore, have to take necessary actions to help the hospital meet its set objectives.

Conclusion

Evaluating any implemented dashboard is essential to find out the areas that require improvement. Health Point has implemented a clinical safety dashboard to enhance its performance.  An evaluation of the dashboard reveals that the hospital performance in various benchmarks is below the national, local and state standards. For instance, the readmissions rates are high, fall rates are also high as well as hospital-acquired infections. Nevertheless, the hospital has managed to reduce the number of wrongful prescriptions. The hospital has the ability to enhance the underperforming benchmarks like the falls and it’s the nurses’ duty to ensure that the metrics are improved.

Option 1: Dashboard and Health Care Benchmark Evaluation Simulation
If you decide to use one of the simulation dashboards for your evaluation, review both dashboards, as well as the relevant local, state, and federal laws and policies linked in each dashboard. Choose one of the dashboards and consider the metrics within it that are falling short of the prescribed benchmarks.
Option 2: Actual Dashboard From a Professional Practice Setting
If you choose an actual dashboard from a professional practice setting for your evaluation, be sure to add a brief description of the organization and setting that includes:
The size of the facility that the dashboard is reporting on.
The specific type of care delivery.
The population diversity and ethnicity demographics.
The socioeconomic level of the population served by the organization.
Note: Ensure that your data is Health Insurance Portability and Accountability Act (HIPAA) compliant. Do not use any easily identifiable organization or patient information.

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Benchmark – Effective Approaches in Leadership and Management – Rubric

Rubric Criteria

Total 150 points

Criterion

1. Unsatisfactory

2. Less Than Satisfactory

3. Satisfactory

4. Good

5. Excellent

Professional Standards of Practice to Rectify Issue or Maintain Professional Conduct (B)

Professional Standards of Practice to Rectify Issue or Maintain Professional Conduct (D3.4)

0 points

How professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is not discussed.

16.88 points

A summary of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. The summary is incomplete. More information is needed. There are significant inaccuracies.

17.78 points

A general discussion of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. There are some gaps in the discussion; some information is needed. There are minor inaccuracies. Rationale is needed for support.

20.03 points

A discussion of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. Minor detail is needed for clarity or accuracy. Rationale provides adequate support.

22.5 points

A through discussion of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. An understanding of the importance of professional standards of practice in resolving issues and maintaining professional conduct is demonstrated. Strong rationale supports discussion.

Ensuring Professionalism Through Diverse Health Care Settings (B)

Ensuring Professionalism Through Diverse Health Care Settings (C1.1)

0 points

Discussion on what additional aspects managers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is omitted. The discussion fails to meet the assignment criteria.

22.5 points

A partial summary on what additional aspects managers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. The summary contains significant omissions. There are inaccuracies.

23.7 points

A general discussion on what additional aspects managers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. It is unclear how some of the aspects continue to address the selected issue, or the aspects do not appear to relate to a diverse health care setting.

26.7 points

A discussion on what additional aspects managers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. Overall, the aspects presented address the selected issue and relate to a diverse health care setting. The items proposed in the discussion generally support professionalism in diverse health care settings.

30 points

A detailed discussion on what additional aspects managers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. The aspects presented clearly continue to address the selected issue and relate to a diverse health care setting. The items proposed in the discussion support the exemplification of professionalism in diverse health care settings.

Paper Format (use of appropriate style for the major and assignment)

Paper Format (use of appropriate style for the major and assignment)

0 points

Template is not used appropriately, or documentation format is rarely followed correctly.

2.25 points

Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.

2.37 points

Appropriate template is used. Formatting is correct, although some minor errors may be present.

2.67 points

Appropriate template is fully used. There are virtually no errors in formatting style.

3 points

All format elements are correct.

Argument Logic and Construction

Argument Logic and Construction

0 points

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

5.63 points

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

5.93 points

Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

6.68 points

Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

7.5 points

Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

5.63 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

5.93 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

6.68 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

7.5 points

Writer is clearly in command of standard, written, academic English.

Leadership Style to Address Issue

Leadership Style to Address Issue

0 points

A leadership style to address the chosen issue is omitted. The proposed item is not a leadership style.

16.88 points

A leadership style to address the chosen issue is partially summarized. The characteristics of the leadership style are vaguely presented. It is unclear why this style could be successful in this setting.

17.78 points

The characteristics of the identified leadership style are described. A general explanation of why this style could be successful in this setting is presented. There are some gaps in the explanation. More information or rationale is needed.

20.03 points

The characteristics of the identified leadership style are described. An explanation of why this style could be successful in this setting is presented. Some rationale is needed for support.

22.5 points

The characteristics of the identified leadership style are clearly described. A detailed explanation of why this style could be successful in this setting is presented. Strong rationale is provided for support.

Selected Issue, Setting, and Impact on Patient Safety

Selected Issue, Setting, and Impact on Patient Safety

0 points

The issue described does not meet the assignment criteria. The description of the issue and its impact to quality of care and patient safety is omitted.

16.88 points

A partial summary of the issue is presented. How it impacts quality of care and patient safety is unclear. There are omissions of key information.

17.78 points

A general description of the issue is presented. A summary of how it impacts quality of care and patient safety is presented; more information is needed. There are some inaccuracies.

20.03 points

A description of the issue is presented. How the issue impacts quality of care and patient safety is presented. Some detail is needed for clarity or accuracy.

22.5 points

A clear description of the issue is presented. How the issue impacts quality of care and patient safety is detailed and accurate.

Differing Roles and Approaches of Nursing Leaders and Nursing Managers (B)

Differing Roles and Approaches of Nursing Leaders and Nursing Managers (C1.3)

0 points

Explanation of the differing roles and approaches for nursing leaders and nursing managers is omitted.

16.88 points

A partial explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. It is unclear how the roles and approaches relate to the selected issue, or how they would promote patient safety and quality care. Rationale using theories, principles, skills, and nursing manager or nursing leader roles is not used.

17.78 points

A general explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. A general summary of how the roles and approaches relate to the selected issue, and how they would promote patient safety and quality care, is provided. Some rationale using theories, principles, skills, and nursing manager or nursing leader roles is used.

20.03 points

An explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. An explanation of how the roles and approaches relate to the selected issue, and how they would promote patient safety and quality care, is provided. Rationale using theories, principles, skills, and nursing manager or nursing leader roles is used. Some detail is needed for accuracy or clarity. More rationale is needed in some areas. The explanation demonstrates a general understanding of the of nursing leadership and management roles in the promotion of patient safety and quality care.

22.5 points

A detailed explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. A well-developed explanation of how the roles and approaches relate to the selected issue, and how they would promote patient safety and quality care, is provided. Rationale using theories, principles, skills, and nursing manager or nursing leader roles is used. The explanation demonstrates insight into exercising the roles of professional nursing leadership and management in the promotion of patient safety and quality care.

Thesis Development and Purpose

Thesis Development and Purpose

0 points

Paper lacks any discernible overall purpose or organizing claim.

5.63 points

Thesis is insufficiently developed or vague. Purpose is not clear.

5.93 points

Thesis is apparent and appropriate to purpose.

6.68 points

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

7.5 points

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Documentation of Sources

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

0 points

Sources are not documented.

3.38 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

3.56 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

4.01 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

4.5 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

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