Community General Hospital Case Study Paper
Community General Hospital Case Study Paper
It’s your first week on the job—your dream job, actually. You are thrilled to be working as the Assistant Director of Clinical Quality Improvement at Community General Hospital (CGH). For your first project, Dr. Schenk, your boss and mentor, asks you to create a quality and safety dashboard for her monthly report to the Board. You are eager to show off the skills you’ve gained from your master’s program. If this goes well, you might be the one presenting to the Board in a few months.
Dr. Schenk gives you tips on where to start. She shows you some previous dashboards and says that they were not particularly helpful to the Board members, who really want information that allows comparisons to other hospitals. Community General Hospital Case Study Paper
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You wonder aloud whether there are national standards that would be useful, because you have read in the literature that active hospital board reviews of quality and safety using dashboards are associated with better performance (Denham, 2006; Kroch et al., 2006; Jha & Epstein, 2010).
Dr. Schenk agrees, “Yes, you should search the relevant sites for current information. Look at the Joint Commission, CMS Hospital Compare, and the Institute for Healthcare Improvement.” She continues, “Of course, we should have measures that are relevant to our quality and safety issues here at CGH. We need to highlight our current QI projects to show that we are making improvements, but we also want to identify some of the gaps where we could do better. Right now, we are working on reducing surgical site infections, reducing readmissions, and reducing wait times in the Emergency Department.”
Dr. Schenk outlines a few additional instructions:
- Try to kill two birds with one stone—start with measures that the hospital is required to report.
- Present clear metrics that reflect the current status of the hospital.
- Don’t get too bogged down in detail because it will only overwhelm the Board.
Dr. Schenk then leaves you to your research. You look at the websites she has recommended for current reporting requirements and measures. Community General Hospital Case Study Paper
Centers for Medicare and Medicaid Services. (n.d.). Hospital Compare. Retrieved December 5, 2019, from https://www.medicare.gov/hospitalcompare/search.html
Joint Commission. (2019). Performance measurement. Retrieved from https://www.jointcommission.org/performance_measurement.aspx
Institute for Healthcare Improvement. (n.d.). Measures. Retrieved from http://www.ihi.org/resources/Pages/Measures/default.aspx
The websites include so many measures, too many for one dashboard. Clearly you will need to focus the CGH Quality and Safety Dashboard on a subset or aggregation of the many possible measures that you could include.
Next, you remember Dr. Schenk’s advice to keep it relevant. You think about what you know about the hospital. Not everything that you found in your research would be relevant. On the other hand, you didn’t find measures for some things that are relevant for CGH. This hospital is such a vital part of the community. How do you capture that on a dashboard? People love working here. The turnover rate for nurses is low. Physicians move here to practice medicine because this is such a great hospital, in a family-oriented community. And the best part, in your opinion, is that physicians and staff are truly engaged in making things better—probably because everyone from the cleaning staff to the CEO are required to take the CGH Performance Improvement course. It’s hard to put numbers on those indicators. Community General Hospital Case Study Paper
Some other facts are easier to put numbers on. CGH is a nonprofit, 200-bed, non-teaching hospital. In 2019, CGH recorded the following data:
Number of admissions: 11,986
Number of patients over the age of 65: 2,637
Percent of patients over the age of 65: 22%
Percent of patients who identify as a race other than White: 38%
Percent of patients who are female: 59%
Mean length of stay for all patients (days): 3
Percent of patients readmitted within 30 days: 1.4
After completing your research, you now have enough details to select measures and draft the CGH Quality and Safety Dashboard.
Part 2: Written Summary
The strategic use of quality and safety dashboards by a significant portion of healthcare organizations is primarily for offering feedback to clinical managers and teams for the sake of monitoring care quality, enhancing patient safety as well as stimulating research and quality improvement (Rabiei & Almasi, 2022). In this paper, strong emphasis is placed on identifying at least 6 quality measures for inclusion in a dashboard for the Community General Health Board. It will also explain why the selected measures are important to the organization. An analysis of how the Triple Aim/Quadruple Aim is represented in the selected measures. An explanation of how the measures are displayed, communication strategy, and how the dashboards could be used as a leadership tool to enhance patient outcomes is provided. Community General Hospital Case Study Paper
| No. | Indicator | Measures Taken | Expectations |
| 1 | Percentage or number of surgical wound infections among patients admitted at the CGH within 30 days of an operative procedure | Utilization of surgical checklist to assist all staff of the operating team to engage in effective communication with each other and with patients, prior, during and after an operation (Mbagwu, 2020). | I expect the percentage of wound infections to reduce by 50% |
| 2 | Percentage or rate of waiting times in the emergency department | The implementation of the Code Help Program will enable inpatients and families to contact the CGH in the event of an emergency. This program acts a proactive layer of safety implemented to assist in the prevention of negative outcomes prior to occurring (Shen & Lee, 2020). | I expect waiting times to be lower than 1 hour after implementation of the Code Help Program Community General Hospital Case Study Paper |
| 3 | Percentage of patients readmitted at the CGH within 30 days after discharge. | The introduction of follow-up calls with the most susceptible patients for the purpose of reviewing his/her discharge instructions and confirming plans for follow-up care as the fundamental basis for reducing readmissions (Shenoy, 2021). Currently, the CGH has a readmission rate of 1.4. | I expect the rates of readmission to be below 1.4 for the stipulated duration. |
| 4 | Promoting diversity in the racial/ethnic mix of patients accessing services at the CGH | Whilst it may prove difficult to control this particular indicator, the healthcare professionals including managers and leaders must focus on promoting equal and fair treatment of all patients, regardless of their racial/ethnic background. Currently, only 38% of patients visiting the community general hospital are non-white. | I expect the percentage or number of patients that are non-white to be more than 50%. |
| 5 | Promoting patient-centeredness in the delivery of quality care to admitted patients | Assessment of patient satisfaction as well as patient’s willingness to recommend the Community General Hospital. Conducting regular self-monitoring of the work and progress attained on patient safety and care quality will go ahead to enhance the adoption of best practices and improve the facility’s performance (Babalola et al., 2022). | I expect the level of patient satisfaction to increase by threefold, and to report a rise in the number of patients willing to recommend the CGH based on care quality and patient safety. |
| 6 | Percentage of patients aged 65 years and above who are experiencing adverse events within 14 days after admission Community General Hospital Case Study Paper | Assessment of safety is conducted at the aggregated patient level to determine patients who need specialized care (Mbagwu, 2020). | I expect the number of patients aged 65 years and above, and experiencing adverse events to reduce by almost two thirds for this period. |
| Indicators, Measures and Expectations | |||
Community General Hospital Case Study Paper
Importance of These Measures
The centrality of the identified measures is based on how they will be used to inform quality improvement efforts and operational decision-making at the hospital. Similarly, they will be applied to help in the monitoring and evaluation of quality and safety of care offered at the Community General Hospital (Quentin et al., 2019). Therefore, these measures are important since they can be applied to stimulate quality improvement through enabling teams to receive actionable feedback and to implement best practices (Shenoy, 2021).
The Triple Aim framework
Developed by the Institute for Healthcare Improvement (IHI), the Triple Aim is an important framework aimed at supporting the realization of improvements in care quality, patient safety and reduction in healthcare costs (Kokko, 2022). In the selected measures, the triple Aim is fully represented since quality dashboard is primarily centered on fostering the experience of care, expanding access to quality and safe healthcare services and enhancing the health of target populations (Shen & Lee, 2020). Community General Hospital Case Study Paper
Display of Measures
These measures were displaced in a tabular dashboard in order to reveal the key indicators on care quality and patient safety, clinical outcomes as well as patient satisfaction. Ideally, the choice of display was primarily informed by the need to come up with a visual dashboard to monitor the implementation of quality improvement initiatives aimed at responding to the key issues faced by the community general hospital namely: tackling surgical infections, reducing readmissions and reducing wait times in the emergency department (Mbagwu, 2020)
Communication Strategy
The strategy for communicating the dashboard throughout the organization will entail the development and implementation of a clear communication structure aimed at informing all the key stakeholders about the major issues and risks for patients, their caregivers and healthcare practitioners (Rabiei & Almasi, 2022). The promotion of open, two-way communication will form the basis for sharing key information and data regarding the dashboard to the respective parties within and outside the Community General Hospital.
The Dashboard as a Leadership Tool
Research has shown that quality dashboards are extensively used in boards of high-performing healthcare facilities. At the CGH, the dashboard can be used as a vital leadership tool for evaluating, measuring and monitoring the quality of care as well as patient safety at this particular healthcare organization. Equally, the hospital-wide quality and safety dashboard may also be used by hospital leaders to take into consideration the key quality indicators and measures that can be pursued to ensure the successful realization of improvement initiatives at a tactical level (Weggelaar-Jansen et al., 2018). Community General Hospital Case Study Paper
References
Babalola, O., Goudge, J., Levin, J., Brown, C., & Griffiths, F. (2022). Assessing the utility of a quality-of-Care assessment tool used in assessing comprehensive care services provided by community health workers in South Africa. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.868252
Kokko, P. (2022). Improving the value of healthcare systems using the Triple Aim framework: A systematic literature review. Health Policy, 126(4), 302-309. https://doi.org/10.1016/j.healthpol.2022.02.005
Mbagwu, C. (2020). Quality improvement initiative: Reducing surgical site infections in medical facility serving the underserved population. https://doi.org/10.26226/morressier.5ebc4ac6ffea6f735881a411
Quentin, W, Partanen, V.M, Brownwood I, et al. (2019). Measuring healthcare quality. In: Busse R, Klazinga N, Panteli D, et al., editors. Improving healthcare quality in Europe: Characteristics, effectiveness and implementation of different strategies [Internet]. Copenhagen (Denmark): European Observatory on Health Systems and Policies. https://www.ncbi.nlm.nih.gov/books/NBK549260/
Rabiei, R., & Almasi, S. (2022). Requirements and challenges of hospital dashboards: A systematic literature review. https://doi.org/10.21203/rs.3.rs-1450850/v1
Shen, Y., & Lee, L. H. (2020). Improving the wait time to triage at the emergency department. BMJ Open Quality, 9(1), e000708. https://doi.org/10.1136/bmjoq-2019-000708
Shenoy, A. (2021). Patient safety from the perspective of quality management frameworks: A review. Patient Safety in Surgery, 15(1). https://doi.org/10.1186/s13037-021-00286-6
Weggelaar-Jansen, A. M., Broekharst, D. S., & De Bruijne, M. (2018). Developing a hospital-wide quality and safety dashboard: A qualitative research study. BMJ Quality & Safety, 27(12), 1000-1007. https://doi.org/10.1136/bmjqs-2018-007784 Community General Hospital Case Study Paper
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To Prepare:
Review the Community General Hospital Case Study presented in the Learning Resources.
Complete the Week 7 Discussion in which you research quality and safety measures and select 6–8 measures for inclusion in a dashboard for the Community General Hospital Board.
Review any feedback received in Discussion about your chosen measures.
Determine how you will display the measures in your dashboard.
Assignment
Part 1: Dashboard
Using Microsoft Excel or PowerPoint, create a quality dashboard based on the Community General Hospital Case Study. Your dashboard must include 6–8 measures. Use mock data to represent the measures you have chosen. Community General Hospital Case Study Paper
Part 2: Written Summary
To accompany your dashboard, write a 2- to 3-page paper in which you do the following:
Identify the 6–8 quality measures you have chosen for your dashboard.
Explain why these measures are important to the organization.
Analyze how the Triple Aim/Quadruple Aim is represented in your chosen measures.
Explain how you displayed the measures. Justify your choice of display.
Provide a strategy for communicating the dashboard throughout the organization.
Explain how the dashboard could be used as a leadership tool to improve patient outcomes. Community General Hospital Case Study Paper
