Measuring Quality Guidelines and Grading Rubric

In an 8 to 10-page paper, APA format and 5 references, describe three rate based measurements of quality.

Select three rate based measurements of quality that you will use as the primary basis for this paper.

These measurements must relate to some aspect of clinical or service quality that directly relates to patient care or the patient’s experience of care.  For the purposes of this assignment, an analysis of staffing levels is not permitted.  You can find useful information on quality indicators that are of interest to you on these websites and resources.  You may choose only one of the three measures to be some form of patient satisfaction measure. 

Deconstruct each measure to include descriptions of the each of the following as numbered below: 

1) The definition of the measure 

2) The numerical description of how the measurement is constructed (the numerator/denominator measure counts, the formula used to construct the rate, etc.)  

3) Explain how the data for this measure are collected 

4) Describe how the measurement is compared externally to other like settings; differentiate between the actual rate and a percentile ranking.  

5) Explain whether the measure is risk adjusted or not.  If so, explain briefly how this is accomplished.  

6) Describe how goals might be set for each measure in an aggressive organization, which is seeking to excel in the marketplace. 

Describe the importance of each measure to a chosen clinical organization and setting. 

Using these websites and resources you can choose a hospital, a nursing home, a home health agency, a dialysis center, a health plan, an outpatient clinic or private office; a total population of patient types is also acceptable, but please be specific as to the setting. That is, if you are interested in patients with chronic illness across the continuum of care, you might home in a particular health plan, a multispecialty practice setting or a healthcare organization with both inpatient and outpatient/clinic settings. Faculty appointments and academic settings are not permitted for this exercise. For all other settings, consult the instructor for guidance. You do not need actual data from a given organization to complete this assignment. 

Relate each measure to patient safety, to the cost of poor quality, and to the overall cost of healthcare.

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

Chapter 5: “Data Collection”

Chapter 6: “Statistical Tools for QI”

Park, J., Konetzka, R. T., & Werner, R. M. (2011). Performing well on nursing home report cards: Does it pay off? Health Services Research, 46(2), 531–554. doi:10.1111/j.1475-6773.2010.01197.x

1. The study in this article evaluates whether or not nursing homes benefit from improvements in quality measures. Four financial outcomes are measured before and after the improvements are enacted. The study shows that the nursing homes that improved quality measures benefited financially.

Suchy, K. (2010). A lack of standardization: The basis for the ethical issues surrounding quality and performance reports. Journal of Healthcare Management, 55(4), 241–251.

Because performance reports are easily found online, this article supports creating ethical guidelines for the performance reports of the health care industry. It compares nearly ten different organizations that provide performance reporting, and then it proposes an ethical framework and principles for public quality reporting.

Wachter, R. M., & Pronovost, P. J. (2009). Balancing “no blame” with accountability in patient safety. New England Journal of Medicine, 361(14), 1401–1406.

This article addresses the issue of individual accountability in health care organizations. It suggests moving from a culture within health care that does not place blame on individuals to a culture where individuals become more accountable.

Centers for Medicare & Medicaid Services. (n.d.). Quality initiatives: Overview. Retrieved from http://www.cms.gov/QualityInitiativesGenInfo/

Created by the U.S. Department of Health & Human Services, this website overviews quality initiatives that affect the health care industry. It also provides information and downloadable PDFs on the Post-Acute Care Reform Plan and Development of Quality Indicators for Impatient Rehabilitation Facilities (IRF).

Required Media

Video: Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: External quality improvement. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

The presenters in this video discuss various external organizations involved in quality, and examine the enforcement of standards by governmental agencies versus voluntary organizations. This program also addresses the publication of quality information and why organizations should do their own reporting in addition to mandated reporting. Licensing, credentialing, and certification are discussed as they relate to the social compact that health care providers have for quality and safety.

 In this assignment, you will be exploring actual and potential health problems in the childhood years using a functional health assessment and Erickson’s Stages of Child Development. 

Cite and reference all sources used in your answers, Minimum of 3 references.  Include in your assessment a thorough discussion of Erickson’s Stages of Child Development as it pertains to the development age of the child.

  NO PLAGIARISM

Pretend you are going to meet an expert on methods in teaching freshman composition.  Her name is Sandie Friedman, and she has a lot to say about the use of popular culture (among other subjects) in the freshman composition classroom.  Friedman has invited you to her house because she wants to share her ideas with you and hear your thoughts about this subject.  The first thing you should do before you sit down with an expert on any subject is to be clear where you stand on the matter! 

How do you do that?  How does that translate into preparing for a research paper?

You gather your thoughts about a subject by writing about it before you dig too far into the research; thus, before you go to meet Friedman (in other words, before you read what she has written), you need to write down your own opinions so that you’ll have a point of reference.  This will also give you material to draw on as you talk to (interact with) Friedman.  For instance, when she raises a point that you disagree with, you might draw on your notes to explain why you disagree.

Let’s practice this important first step.  Please type the following in a document and save it, along with the other parts of Assignment #2.

Step One:  Your Initial Thoughts

For five minutes, write your responses to the following questions.  What do you think of teachers using popular culture in freshman writing classes?  For instance, do you think it’s all right for students to write papers about television shows like True Blood?  Do you support teachers incorporating current events into the writing classroom?  Should teachers allow students to write about Donald Trump or Lady Gaga?  Why?  Why not?  Do you agree with the view that the only thing students should be studying and writing about in freshman composition is writing itself? In other words, do you agree that the only legitimate topic for writing classes is language and grammar?

Step Two:  Listening To Your Source

Friedman welcomes you to her home, invites you to sit down, and then tells you that she’d like to explain her ideas to you.  She says the following:

In first-year writing programs such as ours at George Washington University, instructors from a variety of disciplinary backgrounds teach seminars with topics of interest to first-year students. The course themes range from: a seminar on the Holocaust, in which students do research at the national Holocaust Memorial Museum; to service learning courses, in which students volunteer for local nonprofits and write for these organizations; to a course on video games; to my own on classic Hollywood films. In their syllabi, instructors must justify their choice of topic as appropriate for a writing course, and they must follow the guidelines in a course template.

Aside from these guidelines, instructors have considerable freedom to choose topics, as one goal of the program administrators is to appeal to a broad spectrum of student tastes. Like many faculty members in our program, I share Harris’s (2006) conception of the work of FYC as introducing students to intellectual writing: the kind of writing about texts and ideas that might appear in The New Yorker, Harper’s, or The Atlantic (p. 10). We don’t have a course specifically on vampires right now, but we have had courses on horror movies. An outstanding student in one of my courses wrote a paper on the history of zombie films—it’s probably only a matter of time before vampires make an appearance.

Should we banish vampires from FYC classes? What should be our response, as writing teachers and program administrators, to “challenging times?” (Friedman 79)

Friedman finishes talking, and you take a moment to digest what she has said.  Before responding with any critique (agreement or disagreement), you should briefly summarize what she has said so that you can be sure you understood her correctly as she spoke; thus, step two is to write a brief summary of Friedman’s statement above (include it as Step Two of Assignment #2).

You gathered your own thoughts.  You listened carefully to Friedman’s.  You summarized her ideas.  Now, you are ready for the next step in effectively interacting with a source:  responding.

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Step Three:  Responding to a Source

The next thing to do is to respond to your source.  In this stage of your notetaking, you should express your opinion of the ideas covered in the source.  What do you think of Friedman’s thoughts on writing classes?  Point out any connections between what she said and what you wrote in your preliminary notes (these might be disagreements or agreements).  Answer the questions she poses at the end:  “Should we banish vampires from FYC classes? What should be our response, as writing teachers and program administrators, to “challenging times?” (Friedman 79)

Challenge yourself to write for five minutes. 

Include this as Step Three of Assignment #2.

Friedman took in every word you said.  She made a few notes as you were talking; now, she replies, and it’s time for the next step in effectively interacting with a source:  listening again!

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Step Four:  Listening Some More!

Do you see a pattern developing?  I like the conversation metaphor as a guide for interacting with a source because it models the give-and-take that should happen when you read.  Figuratively, we are listening and responding, listening some more and responding some more; LITERALLY, we are reading, taking notes, expressing our reactions in writing, reading some more, taking more notes, expressing more reactions in writing.  Rinse, lather, and repeat!

Bruce Ballenger, who wrote a remarkable book called The Curious Researcher, calls this process “writing in the middle” (101).  In other words, if you follow this process, you are already writing your paper as you do the research for it.  So many writers procrastinate and miss the opportunity to dig into their sources.  That missed opportunity leads to shallow interactions with sources, but seizing that opportunity leads to a deeper conversation with sources.  

Back to our metaphorical conversation.  Friedman listened to you, and now she responds:

As a choice of course theme, pop culture is double-edged. On one hand, students are drawn to courses that feature vampires, Harry Potter, Mad Men, and video games. On the other hand, such courses may seem less than serious, to both colleagues and students. Our program directors have occasionally wondered whether pop culture themes lead students to give courses low ratings for “intellectual challenge” on course evaluations. But I believe that teaching writing through pop culture can have the same intellectual rigor as courses that “sound serious,” courses with themes grounded in philosophy, science, or for that matter, writing studies. It depends on the pedagogical goals and how we approach those goals. I would argue that vampires can offer just as much material for intellectual inquiry as, for instance, Beaufort’s (2012) proposed course, “Locating Self in Landscape” (p. 5). (Friedman 81)

Briefly summarize Friedman’s ideas expressed above.  Include the summary as Step Four in Assignment #2.

Step Five:  Informed Response

You are deep into the process now, and that means your responses should become more pointed.  Take five minutes to respond to Friedman’s remarks from Step Four (I’ll include them here for easier access):

As a choice of course theme, pop culture is double-edged. On one hand, students are drawn to courses that feature vampires, Harry Potter, Mad Men, and video games. On the other hand, such courses may seem less than serious, to both colleagues and students. Our program directors have occasionally wondered whether pop culture themes lead students to give courses low ratings for “intellectual challenge” on course evaluations. But I believe that teaching writing through pop culture can have the same intellectual rigor as courses that “sound serious,” courses with themes grounded in philosophy, science, or for that matter, writing studies. It depends on the pedagogical goals and how we approach those goals. I would argue that vampires can offer just as much material for intellectual inquiry as, for instance, Beaufort’s (2012) proposed course, “Locating Self in Landscape” (p. 5). (Friedman 81)

As you respond, try to incorporate the summaries and responses you’ve already written in previous steps.

Ladies and gentleman, this is how you deal with sources for a research paper!  We will stop after five steps, but obviously you would repeat this with an actual source as many times as it might take to fully understand the source and its relation to your paper.

Again, compile all five steps into one document and label it Assignment #2. 

You’ve talked to Sandi Friedman; you’ve listened and summarized; you’ve responded to and questioned her.  It’s important that you now clearly differentiate your opinion of her article from the article itself.  In other words, you should–after reading and interacting with any source–take the time to objectively summarize it.  This will help you when you write about the source in your paper.  Your readers might not have read Friedman, for instance, so they deserve an objective account of Friedman’s ideas BEFORE you analyze her ideas.  It also clarifies you own thinking.  You want to be certain you correctly understand Friedman’s ideas (or any source) before you begin analyzing them.  What if you misunderstood and ended up agreeing with a view you actually disagree with?  What if you criticized someone for an idea that is nowhere in his or her writing?

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Thus, the next step in Assignment #2, which is all about effective interaction with a source, is to summarize Sandi Friedman’s “This Way for Vampires:  Teaching First-Year Composition in ‘Challenging Times.'” Please include this summary in the same document as Steps One – Five.  The following information and video will help you write your summary.

The best (and ONLY, in my opinion) way to summarize an article is to outline it.  You must identify the author’s thesis, and then you must trace the author’s steps in defending that thesis.  Once you have carefully outlined the article, you must turn the outline into a narrative, which means you must write a paragraph (or two or three or …).  The summary must be accurate and objective.  You save your reaction to it for another time.  I am going to include the outline and summary I wrote for Friedman’s article later, but please watch this video first.  In it, Nicole Wesley, a teacher from Asheboro, North Carolina, provides practical advice for writing a summary.

To Prepare:

• Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
• Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
• Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (4-5 pages):

Developing Organizational Policies and Practices

Add a section to the paper you submitted in Module 1. The new section should address the following:

• Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
• Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
• Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
• Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
• Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations.

 

Epidemiologic surveillance is used in public and global health. For this Assignment, begin by locating a recent article about an outbreak of an infectious or communicable disease. The article can come from a newspaper or other source but your paper must be supported with at least three scholarly sources of evidence in the literature which may include your text or course readings.

For this Assignment, review the following:

• AWE Checklist (Level 4000)
• Walden paper template (no abstract or running head required)
• The Week 3 Assignment Rubric

By Day 7 of Week 3

Write a 3- to 4-page paper that includes the following:

• A summary of the article, including the title and author
  • Identify the title of the article with in-text citation and corresponding reference in reference list
• The relationship among causal agents, susceptible persons, and environmental factors (epidemiological triangle)
• The role of the nurse in addressing the outbreak
• Possible health promotion/health protection strategies that could have been implemented by nurses to mitigate the outbreak