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HEALTH CARE STANDARDS , QUALITY, and BENCHMARKING 1 Latisha Fowler Capella University NHS6004 - Health Care Law and Policy Health Care Standards, Quality, and Benchmarking October 27, 2019

HEALTH CARE STANDARDS , QUALITY, and BENCHMARKING 2 A healthcare dashboard is an easily readable display usually with graphs which displays the key performances and indicates in which management wish to monitor regularly. A dashboard provides pertinent information such as data, KPI’s and other essential metrics used to analyze data of a specific healthcare department and to measure overall performance. Benchmarking is the process of comparing a practice’s performance using an external standard. The purpose of benchmarking is to be used by facilitators as a motivational practice to engage in areas that need improvement, also help members, staff/employees understand where their performances fall with in comparison to others. Benchmarking has often been used to stimulate healthy productive competition which in the end encourage staff/employees reflect on their own work performance. The performance measurement collects and reports data on practices clinical processes and outcomes. The benefit of measuring clinical performance, it can increase work improvement and enables the practice to track their improvements over a period. The information reported is usually used to identify and prioritize improvement goals and to track the progress towards the goals set and to monitor any changes that are already made. The Agency for Healthcare Research and Quality (AHRQ) is a government agency that functions as a part of the U.S. Department of Health & Human Services (HHS) which protects the health of all Americans and provides essential human services, especially for those least able

HEALTH CARE STANDARDS , QUALITY, and BENCHMARKING 3 to help themselves. Both the AHRQ and HHS work collaboratively and were established to support the research which helps improve the overall quality of healthcare. Mercy Medical Center (MMC) located in Shakopee, Minnesota has received phenomenal accolades ranging from highest safe surgery ratings by a consumer advocacy magazine, to women’s choice best hospital patient experience in emergency care. Despite the amazing accolades MMC has received there are many departmental issues that need improvement, while reviewing their dashboard to see which area is having the most problems and evaluate their overall performance, there were some areas of concerns to me. While being highly regarded in women’s choice magazine for emergency care experience their stats do show that majority of their patients are women being 18,235 out of 36,192 and they may be regarding for highest safe surgeries but there seems to be something going terribly wrong with the after care due to the high post discharge readmissions. Evaluating Mercy Medical Center’s dashboard, the stats show that there are issues with understaffing of nurses in all the departments. FTE stands for full time equivalency and MMC has below the average daily census and scheduled RN FTE’s this is should be a major issue of concern because this can lead to the RN’s that are on hand to work longer hours to compensate for being understaffed. Being overworked can be the indication as to why there are so many documentation and medication errors, not properly informing patients with post discharged instructions and after care. The mis-documentation can also make patients unable to get the assistance that is needed such as home health care and other social services needed to assist in decreasing readmission and improving the overall quality of life. The federal law under the Affordable Care Act (ACA) is

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HEALTH CARE STANDARDS , QUALITY, and BENCHMARKING 4 also not being beneficial especially for surgical or severely ill patients which rush to get Medicare patients discharged within 30 days giving nurses inadequate time assisting patients with managing long term care. Many issues were also documented in several articles that most nurses are restricted as to the amount of care they are legally able to provide to patients at the RN level especially if they are not advanced practice nurses such as a Nurse Practitioner or Certified Midwives and even in some states they have limited decision making when it comes to treating an patient. This restriction can cause that in emergency they have to provide minimum basic care until a doctor is available, poor working conditions and stress can cause a lot of nurses to get overwhelmed feeling overworked, undervalued and under appreciated making it more than likely that they wish not to come to work. Overall department evaluations should be done as it seems that most issues are due at the management level, so that there can be a solution as to why they are understaff regularly, the management of the nurses and department heads should have an open forum to see what is the current issues in particular with the nurses department and how can it be resolved. When giving nurses the open floor to voice their opinions it gives them a sense of having a voice and that their concerns matter and who is better to assist in rectifying an issue that those suffering from the results of the issues. Providing incentives is also a positive way to help motivate staff, studies has shown that many works more effective when there is a reward. As the director, being the leader you are expected to know what the average daily census is for the department and staff as well as expected to know how many the right balance between quality and safety of your patients as well as your staff by having an effective staffing plan. Several evidence-based studies have shown that has proven that the higher nurse to patient ratio has resulted in lower patient adversities.

HEALTH CARE STANDARDS , QUALITY, and BENCHMARKING 5 The understaffing of nurses seems to be a national issue and many nurses are outraged and are protesting against unhealthy work condition and being over worked and underpaid causing them to be a liability to themselves as well as the patients. Finances and budgeting seems to be the source of majority of the issue however most benchmark results are high in the post discharge readmission, documentation errors and medicine errors there are many factors that contribute to this occurrence but the cost should never outweigh the priority which is the safety and care of not only the patients but the staff as well.

HEALTH CARE STANDARDS , QUALITY, and BENCHMARKING 6 Citation http://strategiesfornursemanagers.com/ https://www.ahrq.gov/ https://doi.org/10.1016/j.ijnurstu.2014.08.006 https://www.healthline.com/health-news/nurses-overworked-understaffed-070714#1 https://www.scientificamerican.com/article/widespread-understaffing-of-nurses-increases-risk- to-patients/ Reed, G., & Reed, D. H. (1999). Experience measuring performance improvement in multiphase picture archiving and communications systems implementations. Journal of digital imaging , 12 (2 Suppl 1), 141–143. doi:10.1007/bf03168783 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 : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH , 23 (5), 317–321. doi:10.5455/aim.2015.23.317-321

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