analyze the challenges that meeting the benchmarks pose to the hospital
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.
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.
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.
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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