Redford Hannah D223 Task 1 Healthcare Organization Analysis
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D223 – UKM1 – Healthcare Organization Analysis
Hannah Redford
D223: Healthcare Policy and Economics February 5, 2024
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A1. Selected Healthcare Organization from the AHD Site
The chosen healthcare organization is Providence Regional Medical Center located in Everett, WA 98201
. A2. Significance of Chosen Healthcare Organization
This healthcare organization is one of personal significance to me. It is an acute care facility within the county where I reside. It is an established hospital known to the community for short-term acute care visits and provides multiple clinical services. This hospital treated a family member after having a random seizure, in a few words this hospital evaluated my mother for neuro deficits after her seizure and ran multiple tests to try and figure out what caused her seizure. A3. Type of Facility The AHD website reports that Providence Everett is a short-term acute care facility. The types of clinical services offered include cardiovascular, neurosciences, oncology, orthopedic, intensive care (for adults and neonates), surgery, wound care, radiology, rehabilitation, and emergency services. According to the AHD website, this facility is listed as being Joint Commission accredited. A3a. Type of Control – The type of control for this facility is a voluntary nonprofit, Church organization. This indicates that the hospital is tax-exempt if care is provided as charity or uncompensated care. The
National Library of Medicine reports the standards for a nonprofit organization as “operating an emergency department that cares for anyone regardless of ability to pay; participating in Medicare and Medicaid; creating a governing board that represents the community; and reinvesting surplus funds rather than disseminating them as dividends” (Rozier, 2020). There are
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signs throughout the hospital expressing that the hospital is committed to caring for patients no matter their ability to pay. This is a demonstration of how the facility informs the services provided because of the facility's type of control.
A4. Discussion of the Healthcare Organizations Overall Star Rating
Providence Regional Medical Center has a total performance score (TPS) of 0.00. This score indicates that no refinement is needed for Medicare payments. According to the definitions
from AHD, TPS illustrates the score that is assigned to a facility that is used as the foundation for adjustments on Medicare payments. The elements that are a part of this calculation are total patient revenue, gross discharges, and total patient days. Providence Regional Medical Center had a total revenue of $3,035,898,032 in the last fiscal year. The discharge gross was 26,316 and the total patient days was 180,817.
The Care Compare website lists that the overall star rating for Providence Regional Medical Center (PRMC) is three out of five stars. The components used to measure this are mortality rates, safety of care, readmission, the experience of patients, timely and effective care. This facility scored thoroughly in all categories except in timely and effective care with only eleven out of twelve measures and readmission with only nine out of eleven measures. This score
means that PRMC could improve its score by making sure every patient receives care in a timely
matter while remaining effective. For readmission, this score relays that to decrease the likelihood of readmission soon after discharge they need to ensure that proper patient education is provided at the appropriate level as well as an explanation of any follow-up appointments needed while answering any questions the patient may have. A4a. Additional Source of Quality Data Clinical Outcomes
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is
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a survey that is sent out annually to patients and the outcomes are disclosed to the Centers for Medicare & Medicaid Services. The outcomes of the survey are used as reliable data on healthcare facilities.
A5. Organizational Ethics Reflected in Facility and Control Type Being a short-term acute care facility as well as a nonprofit organization, there is a code of ethics that is required to be sustained. One example is that a facility must practice the ethic of patient autonomy. Autonomy is respecting the patient’s individual choice for their medical care. A patient may disagree with a medical provider's opinion or decision, so it is a medical facility's responsibility to respect the individual's wishes. An example of this is a patient refusing a medication recommended by the provider due to undesirable side effects. Due to the facility being nonprofit, the ethical principle of justice is critical. As mentioned in the last sentence, a nonprofit organization is committed to treating patients despite their capability to pay. Justice is the proposition that every individual patient will be given care that is equal in conformity with need, effort, contribution, and merit (Western Governors University, 2020). An example of justice would be a patient presenting to the emergency department with stroke symptoms but said
patient does not have active insurance. This patient should still be treated to the full capability of the hospital's resources despite the patient’s ability to pay for treatment costs.
A6. The Nurse’s Role in Value-Based Care (VBC)
Nurses play a significant role in revenue responsibility for the healthcare facility. One representation of this would be nurses abiding by strict infection control. Healthcare-acquired infection treatment costs are not usually reimbursed by insurance. The extended stay of the patient, and extra resources (medication, equipment, etc.) will end up costing the facility
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numerous amounts of money, as well as unnecessary illness to the patient. This does not deliver the standards of value-based care. Staving off secondary infections within the facility can save the patient and hospital time, money, and supplies. One instance of this could be a nurse not properly performing hand hygiene and breaching the sterile technique when inserting an indwelling catheter and the outcome was the patient developing a urinary tract infection. This infection will incur more medication to battle the infection, supplies, and thus a longer hospital stay for the patient. The cost of these results will add up to a vast sum that becomes the hospital's
responsibility. A7. Organizational Change Improving VBC Delivery Example(s) The objective of value-based care is to lower costs while improving patient outcomes. One way to do this is to supply patients with sufficient education. Often, patients are discharged from the hospital without comprehending their instructions regarding a new medication, change in lifestyle, or follow-up appointments. Lack of comprehension contributes to readmissions and affects value-based care negatively. It is the responsibility of medical providers and nurses to efficiently educate their patients through meaningful conversation and printed materials to guarantee comprehension. A patient's barriers to learning and preparedness to learn must be evaluated and the staff should take the appropriate steps to achieve the needs of the patient. These actions can improve education and essentially amplify value-based care. B. Financial Comparison of Selected Healthcare Organization to Nearby Healthcare Organization
The second healthcare facility that will be compared to Providence Regional Medical Center is Harbor View Medical Center located in Seattle, WA. This facility provides short-term acute care. The financial structure of this establishment is Governmental, County this indicates
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that the hospital is owned by the county that the hospital resides in and governed by a board of trustees appointed by the county. The total patient revenue for Harbor View was 3,089,709,313 and their net income was $-3,881,762 compared to Providence Regional whose net income was $-140,056,001 and the total patient revenue was 3,035,707,456. Comparing the data Harbor View had a greater total patient revenue and a net income percent of -0.1% compared to Providence Regional which had a net income of -4.6%. B1. Alignment with VBC When examining the data Providence Regional Medical Center of Everett Washington is more aligned with value-based care. The Medicare Care website demonstrates that Providence Regional has Clostridium difficile infection occurrences. Providence data showed that they were better or no different than the national benchmark for Healthcare-associated infections (HAIs) while Harbor View was worse or no different than the national benchmark for HAIs. Hospital-
Acquired Condition Reduction Program was created by the Centers for Medicare & Medicaid Services because of the impact that HAIs have on value-based care (
Hospital Acquired Conditions
, 2022). The program aims to lower complications and infections and to improve value-based care. These facts help decide that Providence Regional is more conformed to value-
based care. B2. Alignment with Equitable Patient-Centered Care
Data also shows that Providence provides more equitable patient-centered care. Healthcare equity is defined as no individual facing a disadvantage in reaching their full potential
based on race, age, disability, sexual orientation, socioeconomic status, or geographical background (
CMS Framework for Health Equity 2022-2032
, 2022). Since Providence Regional is a nonprofit organization, CMS prohibits them from denying care to patients in need. The CMS
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states that the crucial factor in equitable care is the eradication of discrepancies and inequalities in health and healthcare. That proves that Providence provides equitable care to all who require medical services. B3. Sources to Inform Organizational Transformation
A resource of trustworthy financial data source is the American Hospital Directory (AHD). Their website gives access to the user to look at any healthcare facility and outlines information gathered concerning revenue, income, and other financial data. One resource for quality data is the HCAHPS survey mentioned earlier. The survey is given to those who recently had a hospital visit and report their answers for review. The two resources both contain information that is valuable regarding healthcare facility data.
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References
American Hospital Directory (2021). Free Profile. Retrieved from https://www.ahd.com/
CMS Framework for Health Equity 2022-2032. Centers of Medicare & Medicaid Services. (2022). https://www.cms.gov/files/document/cms-framework-health-equity-ad.pdf
Hospital acquired conditions. CMS.gov. (2022, August 10). https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/
Value-Based-Programs/HAC/Hospital-Acquired-Conditions
Medicare.gov. (n.d.). Www.medicare.gov. https://www.medicare.gov/care-compare/details/hospital/500014?
city=Everett&state=WA&zipcode=
Medicare.gov. (n.d.). Www.medicare.gov. https://www.medicare.gov/care-compare/details/hospital/500064?
city=Seattle&state=WA&zipcode=
Rozier, M. D. (2020). Nonprofit Hospital Community Benefit in the U.S.: A Scoping Review From 2010 to 2019. Frontiers in Public Health
, 8
. https://doi.org/10.3389/fpubh.2020.00072
Western Governors University - WGU (2020). Organizational Systems and Healthcare Transformation D221.
Retrieved on February 1, 2024