HIM 440 Milestone One complete (1)

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1 Milestone One: Initiation and Preparation Kristina Narragon Southern New Hampshire University HIM-440: Management of Health Information Services Dr. Lisa L Campbell September 17, 2023

2 Initiation and Preparation Integrating multiple healthcare sites into one brand is a challenging task for any merger. The success that St. Catherine’s Medical Center, St. Lukes’s Hospital, and Hickman Community Hospital would like to achieve when merging into Gateway Healthcare Systems is hindered by multiple issues. These problems will need to be rectified to have a successful merger that will benefit the communities being served. Each facility brings value to the merger and by setting goals and implementing a plan, Gateway Healthcare Systems will successfully unite into one brand. Summary There are multiple issues that need to be addressed before the merger and the health information management department can be considered successful. These issues include cultural insensitivity, workplace conflict, non-compliance issues, implementing, updating, and/or training on the technology used in the HIM department. Extensive education will be crucial to solving many of the issues that plague this department. There should be extensive training for management staff to help promote a stronger management team. This will have a big and positive impact on the future of the unified HIM department because management is the foundation of the organization and “You can’t build a great building on a weak foundation” (Hinckley, 2017). Compliance One of the more pressing problems that the Gateway Healthcare System is facing is the number of non-compliance issues and disregard for confidentiality and patient information protection that was observed during a visit to the hospitals while reviewing the policies and procedures and getting to know staff. The Health Insurance Portability and Accountability Act of

3 1996 (HIPAA) Privacy Rule has set standards that protect personal health information and can impose civil and criminal penalties for not following these mandates (CDC, 2022) and there were several incidences of HIPAA violations at all three health care facilities, including improperly managing and disposing of PHI in regular trash, ignoring safeguards such as not logging off of the computer when away from the desk, and disregard for patient confidentiality in public areas. Non-compliance issues need to be addressed immediately as they pose a bigger issue for the organization including possible financial loss from fines and lost revenue, risk of security breaches, poor patient care, damaged reputation. Ensuring that all policies and procedures are up to date and complete will be important, including updated coding quality and productivity standards, as well as consistent employee training pertaining to the policies and procedures and HIPAA and management training to promote a stronger management team who oversees and enforces this. Cultural Diversity Programs for promoting diversity within the staff and patients should be implemented, as well as mandatory attendance for cultural diversity training. Coordinating with the organization’s Human Resource department will be beneficial to help cultivate an inclusive environment. Age diversity is another issue that is impacting quality and productivity. There are several seasoned staff members who bring different skills and experience to the HIM department which can be a strength but also a weakness because they seem to be set in the “way we’ve always done it” mentality and have been resistant to new technology. For instance, the seasoned coders at St. Catherine’s were resistant to using the encoder which would help to increase efficiency and productivity. There is also internal conflict between seasoned, more experienced employees and newer more credentialed staff. This will be addressed by training and promoting education to

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4 help bridge the skills gap in the HIM department. Intensive management training will need to be implemented to promote managerial staff who help to foster an environment of diversity. Mission and Vision Developing a vision and mission statement for the unified HIM department should be completed immediately. This will provide powerful statements that can inspire the staff and help motivate them to stay focused on the organization’s goals during all the changes from the merger. To properly communicate the unified, HIM department’s values and goals, the new mission statement needs to focus on what, why, and how the HIM department does what it does, and the vision statement should communicate the same but be more focused on looking forward and seeing how our organization can impact the world. A suggested mission and vision statement for the unified health information management department is as follows: Mission Statement: We strive to ensure secure, high-quality management of patient health information and timely release of health data for the benefit of patients and providers to allow for the delivery of quality healthcare. (Narragon, 2023). Vision Statement: Committed to providing high quality health information services and patient information access in a secure, timely manner to promote improved healthcare. (Narragon, 2023). SWOT Analysis

5 St. Catherine’s Strengths Level-one trauma facility & Large Hospital (850 beds) Staff & patients come from a variety of ethnic backgrounds Non-bias hiring practices Good reputation in the community Located in a wealthier suburb Strong record of employee retention/Seasoned employees New EHR last year Coding Quality exceeds 95% Weaknesses Difficulty accommodating potential employees with physical needs. New employees and seasoned employee conflict Lower than average salary level compared to competitors New policies and procedures need to be completed Critically low productivity level since EHR implementation Budget issues Lack of credentialed HIM dept employees Weak management (not enforcing break times and use of technology) User resistance and divided HIM dept with some using the encoder system and some still using manual coding book. Violation of HIPAA pertaining to confidentiality and protection of patient information Opportunities Train HIM staff on the EHR and encoder to Increase efficiency/productivity and decrease errors Bridge HIM dept employee skill gaps Assess current employee wages compared to competitors Threats Poor credentialed staff recruits and retention due to competitors paying higher salaries Lack of set policies and procedures for new EHR.

6 St. Luke’s Strengths Busy hospital Serves the most diverse patient population Does have credentialed HIM staff Weaknesses Staff diversity is low High Staff turnover No HIM manager or director on staff Older EHR with poor interoperability No staff left who is trained on encoder Poor productivity goals Internal conflict between seasoned, experienced staff and new, inexperienced supervisor Coding quality at 85% Violation of HIPAA for confidentiality and protection of patient information Opportunities Upgrade EHR to improve interoperability, patient care, and increased employee efficiency. Contact encoder customer service to promote increased productivity/efficiency through encoder use training Investigate reason for poor staff retention Threats Possible threat to security due to outdated EHR Inability to keep credentialed staff Hickman Strengths Older, well-established facility in the community Close, family-like staff Staff longevity/retention The patient population is changing and becoming more culturally diverse. Weaknesses Accessibility issues and Noncompliance with ADA guidelines due to lack of cultural diversity Poor leadership and diversity awareness Lack of diverse employees Lowest paying hospital in area Lack of credentialed staff in HIM department Lack of quality and productivity expectations for coding charts Violation of HIPAA mandate for confidentiality and protection of patient information Opportunities Implement an EHR and encoder to improve efficiency with coding and billing, as well as interoperability Contact groups who provide cultural diversity workshops to provide staff education. Bring in outside source for Leadership training Threats Continued noncompliance could result in costly fines Possible discrimination suit from disabled African American applicant who was deemed “not a good fit” despite being qualified.

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7 Unified HIM Department SWOT Analysis Strengths Staff retention at some facilities Well-established facilities with a good reputation in the community they serve. Busy hospitals Culturally diverse staff and patient population Weaknesses Lack of interoperability Lack of strong leadership Employee resistance to new technology Poor staff retention at several facilities Budget concerns HIPAA violations and lack of professionalism by staff Opportunities Implement or update technology Compensation analysis to assess competitor salaries and possibly offer more better wages. Leadership training to strengthen management Bridge skill gaps through HIM department employee Implement appropriate safeguards to protect PHI Implement strict policies and procedures for proper management of PHI Threats Decreased productivity/efficiency Possible threat to security from HIPAA violation Lack of credentialed management and employees Inconsistency with policy and procedures Lack of consistent staff education/training Conclusion The findings from the SWOT analysis help to highlight the issues that plague the three hospitals and the areas where more attention should be focused. This will help Gateway Healthcare Systems not only be successful with merging into one unified brand but also successfully serve the health care community and provide quality patient care according to the new mission and vision statement. The focus will be on a more diverse, qualified, and better compensated staff that will uphold the ethical standards of the HIM professional and reflect positively on the HIM department. There will also be a push for stronger management to help foster a more diverse, positive work environment and a culture of compliance because “following company guidelines ensures that everyone is working together towards a common goal, while also ensuring that time and resources are used efficiently” (Ronzio, 2022)

8 References CDC. (2021). Health Insurance Portability and Accountability Act of 1996 (HIPAA) | CDC . https://www.cdc.gov/phlp/publications/topic/hipaa.html#:~:text=The%20Health %20Insurance%20Portability%20and,the%20patient's%20consent%20or%20knowledge. Hinckley, G. B. (2017). TOP 25 STRONG FOUNDATION QUOTES | A-Z Quotes . A-Z Quotes. https://www.azquotes.com/quotes/topics/strong-foundation.html Ronzio, C. (2022). How to ensure employees follow procedures and policies . https://trainual.com/manual/how-to-ensure-employees-follow-procedures Narragon, K. (2023a). Module One: Mission and Vision Development. In SNHU . https://learn.snhu.edu/d2l/lms/dropbox/user/folder_submit_files.d2l? db=2450181&grpid=0&isprv=0&bp=0&ou=1379599

HIM 440 Milestone One complete (1)

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