Write a 4–6-page report for a senior leader that communicates your evaluation of current organizational or interprofessional team performance

NHS-FP6004 Health Care Law and Policy : Assessment 1

Overview

Write a 4–6-page report for a senior leader that communicates your evaluation of current organizational or interprofessional team performance, with respect to prescribed benchmarks set forth by government laws and policies at the local, state, and federal levels. In addition, advocate for ethical action to address benchmark underperformance and explain the potential for improving the overall quality of care and performance, as reflected on a performance dashboard.

In the era of health care reform, many of the laws and policies set forth by government at the local, state, and federal levels have specific performance benchmarks related to care delivery outcomes that organizations must achieve. It is critical for organizational success that the interprofessional care team is able to understand reports and dashboards that display the metrics related to performance and compliance benchmarks.

Maintaining standards and promoting quality in modern health care are crucial, not only for the care of patients, but also for the continuing success and financial viability of health care organizations. In the era of health care reform, health care leaders must understand what quality care entails and how quality in health care connects to the standards set forth by relevant federal, state, and local laws and policies. An understanding of relevant benchmarks that result from these laws and policies, and how they relate to quality care and regulatory standards, is also vitally important.

Health care is a dynamic, complex, and heavily regulated industry. For this reason, you will be expected to constantly scan the external environment for emerging laws, new regulations, and changing industry standards. You may discover that as new policies are enacted into law, ambiguity in interpretation of various facets of the law may occur. Sometimes, new laws conflict with preexisting laws and regulations, or unexpected implementation issues arise, which may warrant further clarification from lawmakers. Adding partisan politics and social media to the mix can further complicate understanding of the process and buy-in from stakeholders.

Resources

U.S. HEALTH POLICY AND LAW

Oliver, T. R. (Ed.). (2014). Guide to U.S. health and health care policy. Thousand Oaks, CA: SAGE Publications.

Read Chapters 1 and 2, pages 9–35, for background and foundational information regarding health policy in the United States.

HealthCare.gov. (n.d.). Retrieved from http://www.healthcare.gov/

Search this site for information on access to health insurance.

In 2009 and 2010, the health care industry and its related regulations and legislation underwent great upheaval and evolution as the Affordable Care Act (ACA) was enacted. Following resources provide information about the ACA and its implementation:

U.S. Department of Health & Human Services. (n.d.). About the Affordable Care Act. Retrieved from http://www.hhs.gov/healthcare/about-the-law/

Gold, J. (2015). Accountable care organizations, explained. Retrieved from http://khn.org/news/aco-accountable-care-organizat…

This article provides an explanation of accountable care organizations and how they relate to the ACA. You are not required to watch the video.

OLIVER, T. R. (ED.). (2014). GUIDE TO U.S. HEALTH AND HEALTH CARE POLICY. THOUSAND OAKS, CA: SAGE PUBLICATIONS.U. S. GOVERNMENT HEALTH ORGANIZATIONS

Read Chapters 3 and 4, pages 39–63, for background on some of the important governmental health organizations in the United States.

HEALTH CARE COST CONTAINMENT

Birk, S. (2014). Quality, cost and accountable care models for the journey. Healthcare Executive, 29(3), 20–22, 24–28.

In this article, the author identifies the ACO model as a strategy for implementing the ACA and analyzes shared savings and pioneer programs. She also focuses on integrating services into larger health systems and using value-based projects.

HEALTH CARE QUALITY AND SAFETY

Oliver, T. R. (Ed.). (2014). Guide to U.S. health and health care policy. Thousand Oaks, CA: SAGE Publications.

Read Chapter 16, pages 213–223, for information on quality care and safety.

BENCHMARKING

The following resources will further your understanding of the significance of benchmarking in health care as it relates to quality of care, regulatory and government policies, and the law.

Ghazisaeidi, M., Safdari, R., Torabi, M., Mirzaee, M., Farzi, J., & Goodini, A. (2015). Development of performance dashboards in healthcare sector: Key practical issues. Acta Informatica Medica, 23(5), 317–321. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC463935…

Huerta T. R., Hefner J. L., Ford, E. W., McAlearney A. S., & Menachemi N. (2014). Hospital website rankings in the United States: Expanding benchmarks and standards for effective consumer engagement. Journal of Medical Internet Research. 16(2), e64. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC396170…

Martin, E. J. (2015). Healthcare policy legislation and administration: Patient Protection and Affordable Care Act of 2010. Journal of Health and Human Services Administration, 37(4), 407–411.

Nippak, P., Veracion, J. I., Muia, M., Ikeda-Douglas, C. J., & Isaac, W. W. (2016). Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital [PDF]. Health Informatics Journal, 22(2), 102–139.

NCQA. (n.d.). HEDIS measures and technical resources. Retrieved from https://www.ncqa.org/hedis/measures/

This page provides information about the Healthcare Effectiveness Data and Information Set (HEDIS) and other performance measures, which could provide useful information for incorporation into this assessment.

Centers for Disease Control and Prevention. (2018). Performance management and quality improvement: Data and benchmarks. Retrieved from https://www.cdc.gov/stltpublichealth/performance/d…

This web page, which presents the Centers for Disease Control and Prevention\’s (CDC\’s) perspective on why performance and quality measures are important for patient safety and the bottom line in health care.

Dashboard and Health Care Benchmark Evaluation.

This multimedia activity enables you to review a metrics dashboard and hospital fact sheet to evaluate Mercy Medical Center\’s performance relative to local, state, and federal benchmarking requirements. You may choose to use the data presented in this activity as the basis for this assessment.

SCHOLARLY WRITING

Resources about APA style and formatting can be found in the Supplemental Resources in the left navigation menu of your courseroom. A variety of writing resources are also available in the NHS Learner Success Lab, linked in the navigation menu.

LIBRARY RESEARCH GUIDE

You may choose other resources to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The NHS-FP6004 – Health Care Law and Policy library guide can help direct your research.

Assessment Instructions

Note: Your evaluation of dashboard metrics for this assessment is the foundation on which all subsequent assessments are based. Therefore, you must complete this assessment first.

Write a report for a senior leader that communicates your evaluation of current organizational or interprofessional team performance with respect to prescribed benchmarks set forth by government laws and policies at the local, state, and federal levels. In addition, advocate for ethical action to address benchmark underperformance and explain the potential for improving the overall quality of care and performance, as reflected on a performance dashboard.

Review the performance dashboard metrics, as well as relevant local, state, and federal laws and policies. Consider the metrics that are falling short of the prescribed benchmarks. Structure your report so that it will be easy for a colleague or supervisor to locate the information they need, and be sure to cite the relevant health care policies or laws when evaluating metric performance against established benchmarks.

Note: Remember that you can submit all, or a portion of, your draft report to Smarthinking for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

PREPARATION

Choose one of the following three options for a performance dashboard to use as the basis for your evaluation:

Option 1: Dashboard Metrics Evaluation Simulation

Use the data presented in the Dashboard and Health Care Benchmark Evaluation multimedia activity as the basis for your evaluation.

Note: The writing that you do as part of the simulation could serve as a starting point to build upon for this assessment.

Option 2: Actual Dashboard

Use an actual dashboard from a professional practice setting for your evaluation. If you decide to use actual dashboard metrics, 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 your data are Health Insurance Portability and Accountability Act (HIPAA) compliant. Do not use any easily identifiable organization or patient information.

Option 3: Hypothetical Dashboard

If you have a sophisticated understanding of dashboards relevant to your own practice, you may also construct a hypothetical dashboard for your evaluation. Your hypothetical dashboard must present at least four different metrics, at least two of which must be underperforming the prescribed benchmark set forth by a federal, state, or local laws or policies. In addition, 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 your data are HIPAA compliant. Do not use any easily identifiable organization or patient information.

REQUIREMENTS

The report requirements outlined below correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.

Evaluate dashboard metrics associated with benchmarks set forth by local, state, or federal health care laws or policies.

Which metrics are not meeting the benchmark for the organization?

What are the local, state, or federal health care policies or laws that establish these benchmarks?

What conclusions can you draw from your evaluation?

Are there any unknowns, missing information, unanswered questions, or areas of uncertainty where additional information could improve your evaluation?

Analyze one challenge that meeting prescribed benchmarks can pose for a heath care organization or interprofessional team.

Consider the following examples:

Strategic direction.

Organizational mission.

Resources.

Staffing.

Financial: Operational and capital funding.

Logistical considerations: Physical space.

Support services (any ancillary department that gives support to a specific care unit in the organization, such as pharmacy, cleaning services, dietary, et cetera).

Cultural diversity in the organization and community.

Procedures and processes.

Address the following:

Why do the challenges you identified contribute, potentially, to benchmark underperformance?

What assumptions underlie your conclusions?

Evaluate a benchmark underperformance in a heath care organization or interprofessional team that has the potential for greatly improving overall quality or performance. Focus on the benchmark you chose to target for improvement.

Which metric is underperforming its benchmark by the greatest degree?

Which benchmark underperformance is the most widespread throughout the organization or interprofessional team?

Which benchmark affects the greatest number of patients? Which benchmark affects the greatest number of staff?

How does this underperformance affect the community that the organization serves?

Where is the greatest opportunity to improve the overall quality of care or performance of the organization or interpersonal team and, ultimately, to improve patient outcomes, as you think about the issue and the current poor benchmark outcomes?

Advocate for ethical action, directed toward an appropriate group of stakeholders, to address a benchmark underperformance.

Who would be an appropriate group of stakeholders to act on improving your identified benchmark metric?

Why should the stakeholder group take action?

What are some ethical actions the stakeholder group could take that support improved benchmark performance?

Organize content so ideas flow logically with smooth transitions.

Proofread your report, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your evaluation and analysis.

Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.

- Be sure to apply correct APA formatting to source citations and references.

Example Assessment: You may use the Assessment 1 Example [PDF] to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

Report Format and Length

Format your report using APA style.

Use the APA Style Paper Template [DOCX]. The APA Style Paper Tutorial [DOCX] will help you in writing and formatting your report. Be sure to include:

A title page and references page. An abstract is not required.

A running head on all pages.

Appropriate section headings.

Be sure your report should be 4–6 pages in length, not including the title page and references page.

Supporting Evidence

Cite 4–6 credible sources from peer-reviewed journals or professional industry publications to support your analysis of challenges, evaluation of potential for improvement, and your advocacy for ethical action.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.

Portfolio Prompt: You may choose to save your report to your ePortfolio.

COMPETENCIES MEASURED

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Analyze relevant health care laws, policies, and regulations; their application; and their effects on organizations, interprofessional teams, and professional practice.

Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization or interprofessional team.

Competency 2: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.

Advocate for ethical action, directed toward an appropriate group of stakeholders, to address a benchmark underperformance.

Competency 3: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, to inform health care laws and policies for patients, organizations, and populations.