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Quality Improvement Proposal

Write a quality improvement proposal, 5 pages in length, that provides your recommendations for expanding a hospital’s HIT to include quality metrics that will help the organization qualify as an Accountable Care Organization (ACO).

Understanding health information technology (HIT) is essential to improving individual, community, and population access to health care and health information. HIT enables quick and easy access to information for both patients and providers. Accessible information has been shown to improve the patient care experience and reduce redundancies, thereby reducing health care costs.

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By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:This assessment provides an opportunity for you to make recommendations for expanding a hospital’s HIT in ways that will help the hospital qualify as an Accountable Care Organization (ACO).

Competency 2: Analyze the role of informatics in nursing care coordination.
Recommend ways to expand an organization’s HIT to include quality metrics.
Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice.
Describe three ways in which data reporting specific to client behaviors can shape care coordination, care management, and clinical efficiency.
Competency 3: Analyze ways in which information is collected from client records and is used to influence health outcomes.
Identify potential problems that can arise with data gathering systems and outputs.
Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.
Write clearly and concisely, using correct grammar and mechanics.
Support main points, claims, and conclusions with relevant and credible scholarly or professional evidence, correctly formatting citations and references using APA style.
ASSESSMENT INSTRUCTIONSPortfolio Prompt: You may choose to save your proposal to your ePortfolio.

PREPARATIONIn this assessment, you will again assume the role of case manager at Sacred Heart Hospital. This time, you are asked to develop a strategy for tracking quality metrics to help facilitate the hospital’s qualification for ACO status.Before drafting your proposal, complete the Vila Health: Quality Metrics Tracking simulation exercise linked in the Required Resources.Note: Remember that you can submit all, or a portion of, your draft proposal to Smarthinking for feedback, before you submit the final version for this assessment. However, be mindful of the turnaround time of 24–48 hours for receiving feedback, if you plan on using this free service.REQUIREMENTSDevelop a proposal to expand Sacred Heart Hospital’s HIT to better include quality metrics—with the ultimate goal of qualifying for ACO status.Proposal Format and LengthFormat your proposal using APA style.
Use the APA Style Paper Template, linked in the Required Resources. An APA Style Paper Tutorial is also provided (linked in the Suggested Resources) to help you in writing and formatting your proposal. Be sure to include:
A title page and a references page. An abstract is not required.
A running head on all pages.
Appropriate section headings.
Apply APA formatting to all in-text citations and references.
Your proposal should be 5 pages in length, not including the title page and references page.
Supporting EvidenceCite at least 6 sources of credible scholarly or professional evidence to support your proposal.Writing the ProposalNote: The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that your proposal addresses each point, at a minimum. You may also want to read the Quality Improvement Proposal Scoring Guide to better understand how each criterion will be assessed.

Recommend ways to expand the hospital’s HIT to include quality metrics.
How will you collect information and solve the problem of coordinating care for patients who are not getting diagnostic tests, such as mammograms or colonoscopies?
What can you do to track health information from the community or the population to make necessary improvements?
How can you show the role of informatics in nursing care coordination?
What evidence supports your recommendations?
Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice.
Provide examples.
Identify potential problems that can arise with data gathering systems and output.
What suggestions can you make for avoiding those problems?
Write clearly and concisely, using correct grammar and mechanics.
Express your main points and conclusions coherently.
Proofread your writing to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your needs assessment.
Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
Is your supporting evidence clear and explicit?
How or why does particular evidence support a claim?
Will your audience see the connection?
Additional RequirementsBe sure that you have used the APA Style Paper Template to format your proposal and that your document includes:

A title page and references page.
A running head on all pages.
Appropriate section headings.
In addition, be sure that:

Your proposal is approximately 5 pages in length, not including the title page and references page.
You have cited at least 6 sources of relevant and credible scholarly or professional evidence to support your assessment.
CONTEXT
Health care has undergone a transformation since the release of the Institute of Medicine’s (IOM) report, “To Err Is Human” (IOM, 1999). The report highlighted medical errors as a contributing factor leading to poor patient outcomes. The IOM challenged organizations to implement evidence-based performance improvement strategies in order to improve patient quality and safety. Multiple governmental and regulatory agencies, such as the Center for Medicare and Medicaid Services (CMS), and the Agency for Healthcare Research and Quality (AHRQ) vowed to strengthen and improve incentives for participation, safety, quality, and efficiency in accountable care organizations.

Health information technology (HIT) performs an essential role in improving health outcomes of individuals, the community, and populations. Health organizations, consumer advocacy groups, and regulatory committees have made a commitment to explore current and future opportunities that HIT offers to continue momentum to meet the Institute of Medicine (IOM) goal of improving safety and quality

QUESTIONS TO CONSIDER
As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

What is an ACO?
How are Medicare Cost-Sharing ACOs structured?
How could the Merit-Based Incentive Program System (MIPS) be used to define the quality of health care in the future?
Does the MIPS affect advance practice nurses?
If so, how?
How does health care data affect the care coordination process in nursing practice?
What is the role of nursing informatics and of health care informatics within the broader scope of information technology?
What is the role of informatics in supporting care management profiles in productivity metrics, quality reporting, health education, and predictive analytics?
What potential or actual problems with data gathering systems and output could arise within your practice setting?
RESOURCES
REQUIRED RESOURCES
The following resources are required to complete the assessment.

Vila Health: Quality Metrics Tracking | Transcript.
This multimedia simulation will enable you to develop a strategy for tracking quality metrics to help facilitate a hospital’s qualification for ACO status.
APA Style Paper Template [DOCX].
Use this template to develop a quality improvement proposal for expanding the hospital’s HIT.
SHOW LESS

SUGGESTED RESOURCES
The resources provided here are optional. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The MSN-FP6612 Emerging Health Care Models and Care Coordination Library Guide can help direct your research, and the Supplemental Resources and Research Resources, both linked from the left navigation menu in your courseroom, provide additional resources to help support you.

Improving Care Coordination
Drake, B. F., Tannan, S., Anwuri, V. V., Jackson, S., Sanford, M., Tappenden, J., . . . Colditz, G. A. (2015). A community-based partnership to successfully implement and maintain a breast health navigation program. Journal of Community Health, 40(6), 1216–1223.
Describes a project to implement patient navigation in a partner clinic.
Madore, S., Kilbourn, K., Valverde, P., Borrayo, E., & Raich, P. (2014). Feasibility of a psychosocial and patient navigation intervention to improve access to treatment among underserved breast cancer patients. Supportive Care in Cancer, 22(8), 2085–2093.
Discusses ways to increase the quality of care by combining patient navigation with telephone counseling to guide newly diagnosed breast cancer patients in overcoming treatment barriers.
Praetorius, T. (2016). Improving care coordination using organisational routines. Journal of Health Organization and Management, 30(1), 85–108.
Discusses ways of improving the quality of care coordination through the systematic application of the theory of organisational routines to standardised care pathways.
Accountable Care Organizations
Center for Medicare and Medicaid Services. (2015). Accountable care organizations (ACO). Retrieved from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html
Provides general information about ACOs and links to additional information and resources.
Spencer, G. (2014). Making the move to an ACO. Healthcare Financial Management, 68(2), 92–96.
Describes how a multispecialty group practice became one of the first physician group practices to be designated a Medicare Shared Savings Program ACO.
Suggested Writing Resources
You are encouraged to explore the following writing resources. You can use them to improve your writing skills, and as source materials for seeking answers to specific questions.

APA Module.
Academic Honesty & APA Style and Formatting.
APA Style Paper Tutorial [DOCX].
Additional Resources for Further Exploration
The following resources provide information about the Merit-based Incentive Payment System (MIPS) program addressed in the Questions to Consider. This system, instituted by the Centers for Medicare and Medicaid Services in 2017, replaced the Physician Quality Reporting System (PQRS). The MIPS is a payment system that emphasizes and rewards exceptional health care delivery and performance.

Cardona, D., Black-Schaffer, S., Shamanski, F., & Myles, J. (2017). Medicare’s new quality payment program has started—Are you ready? Archives of Pathology & Laboratory Medicine, 141(6), 741–745.
Centers for Medicare & Medicaid. (n.d.). Quality payment program: Improvement activities. Retrieved from https://qpp.cms.gov/mips/improvement-activities
Centers for Medicare & Medicaid. (n.d.). Quality payment program: MIPS overview. Retrieved from: https://qpp.cms.gov/mips/overview
Hayden, R. & Coffin, J. (2016). The components of the merit-based incentive payment system. The Journal of Medical Practice Management: MPM, 32(3), 173–176.
Capella Resources

ePortfolio.
This resource provides information about ePortfolio, including how to use the different features of the product.
Quality Improvement Proposal Scoring Guide

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Recommend ways to expand an organization’s HIT to include quality metrics. Does not recommend ways to expand an organization’s HIT to include quality metrics. Provides recommendations that only indirectly address the problem or overlook important contextual factors (constraints, resources, attitudes, additional information) affecting the best solution to the problem. Recommends ways to expand an organization’s HIT to include quality metrics. Recommends ways to expand an organization’s HIT to include quality metrics. Provides a precise formulation of the issues and clear rationale for proposed solutions.
Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice. Does not provide a limited or superficial description of the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice. Provides a limited or superficial description that overlooks key aspects of information gathering and its application to organizational practice. Describes the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice. Describes the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice. Draws well-justified conclusions from an insightful synthesis of credible evidence and insight into the information gathering process. Provides clear, relevant examples.
Identify potential problems that can arise with data gathering systems and outputs. Does not identify potential problems that can arise with data gathering systems and outputs. Identifies potential problems that are not clearly connected to data gathering systems and outputs. Identifies potential problems that can arise with data gathering systems and outputs. Identifies potential problems that can arise with data gathering systems and outputs. Provides concise, accurate problem definitions, notes key uncertainties, and offers specific, insightful suggestions for avoiding the problems.
Write clearly and concisely, using correct grammar and mechanics. Does not write clearly and concisely, using correct grammar and mechanics. Writing is not consistently clear or concise, or errors in grammar and mechanics inhibit effective communication. Writes clearly and concisely, using correct grammar and mechanics. Writes clearly and concisely. Grammar and mechanics are error-free.
Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style. Does not support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style. Evidence is not persuasive or explicitly supportive of main points, claims, or conclusions. Sources lack relevance or credibility, or are incorrectly formatted. Supports main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style. Supports main points, claims, and conclusions with relevant, credible, and convincing evidence. Combines the skillful application of error-free source citations with a perceptive and accurate synthesis of the evidence.

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