Dashboard Benchmark Evaluation Essay Paper

National organizations such as the Joint Commission expect healthcare organizations to meet the set quality indicators. Healthcare organizations are only accredited upon meeting performance and quality standards. Therefore, healthcare organizations assess their performance areas regularly to determine areas that are meeting performance standards and those that are underperforming. Evidence-based measures are then adopted to improve underperforming metrics resulting in quality patient care and positive health outcomes. This paper presents performance metrics of a hypothetical dashboard, evaluation of dashboard metrics associated with set benchmarks, a challenge that ABC hospital might face while meeting the prescribed benchmarks, evaluation of a benchmark underperformance in the hospital, and advocating for ethical action for targeted stakeholders. Dashboard Benchmark Evaluation Essay Paper

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The Selected Dashboard

The selected dashboard is for ABC Hospital, which is based within the city. The hospital has a bed capacity of 300 and attends to approximately 20 000 patients monthly in the inpatient and outpatient units. The hospital offers a wide range of healthcare services, including preventive, curative, palliative, and rehabilitative. The hospital serves people from the city and its outskirts. Its clients constitute diverse patient populations, including paediatrics, teenagers, youths, young adults, geriatrics, people with acute illnesses, and individuals struggling with chronic diseases, including hypertension, diabetes mellitus, stroke, various cancer forms, and cardiovascular diseases. Additionally, the hospital attends to patients with diverse ethnic backgrounds, including minorities. ABC hospital serves people with diverse socioeconomic backgrounds since their healthcare services are affordable to all individuals, including those with low socioeconomic levels. The dashboard for ABC Hospital presents various quality metrics, including mortality, the safety of care, readmissions, and patient experience Dashboard Benchmark Evaluation Essay Paper.

Evaluation of Dashboard Metrics associated with Benchmarks established by Local, State, or Federal Health Care Policies

Local, state, or federal health care policies have set benchmarks to measure performance and quality healthcare provided to patients. A healthcare organization that meets the set benchmark for a particular metric reflects the provision of quality health care to the patients. On the contrary, failure to meet the benchmark indicates poor-quality patient care. Quality metrics presented in ABC’s dashboard include mortality, care safety, readmissions, and patient experience.

Two of these metrics, including the safety of care and patient experience, are not meeting the benchmark for the organization. Failure to meet patient experience is reflected in the high rate of catheter-associated urinary tract infections (CAUTIs)Dashboard Benchmark Evaluation Essay Paper. The organization’s target for CAUTI is 1.6 per 1,000 urinary catheter days. However, the dashboard indicated that ABC’s actual CAUTI rate was 6.5 per 1,000 urinary catheter days, four times higher than the organization’s target. Additionally, the hospital’s failure to meet the safety of care is reflected in the high rate of patient falls in the medical, surgical, and medical-surgical units. The hospital’s target for patient falls in these departments was 3 falls/1000 patient days. Nonetheless, the dashboard indicated that the hospital’s actual fall rate in these units was 24 falls per 1000 patient days, which is eight times higher than the set organization’s benchmark.

In addition to the organization’s targets, national benchmarks have been established to ensure that these quality metrics are met in healthcare organizations. First, the national benchmark for CAUTI ranges between 1.58 and 1.79 per 1,000 urinary catheter days (Aldecoa et al., 2022). On the other hand, the national benchmark for patient falls in medical, surgical, and medical-surgical units are 3.44 falls per 1000 patient days (Venema et al., 2019)Dashboard Benchmark Evaluation Essay Paper. Based on the evaluation, ABC hospital is underperforming in patient experience and care safety.

A Challenge that the ABC Hospital might face while Meeting the Prescribed Benchmarks

Dashboard indicated that the hospital is underperforming in the safety of care (high fall rate) and patient experience (high CAUTI cases). Thus, the hospital should adopt quality improvement changes to boost performance in these areas. First, ABC hospital will adopt an evidence-based fall prevention intervention such as scheduled hourly rounding to reduce the high rate of falls in affected departments, including the medical, surgical, and medical-surgical units. According to LeLaurin and Shorr (2019), purposeful hourly rounding effectively prevents patients a high risk of falling. During hourly rounding, the healthcare provider identifies the patient’s need that might contribute to the fall and address it, reducing the likelihood of falling. Adopting purposeful hourly rounding as a fall prevention intervention implies that many healthcare workers will be involved in regularly moving around the facility. Thus, implementing this intervention is hindered by staff shortage in the hospital. Additionally, ABC hospital will adopt an evidence-based intervention to reduce the high rate of CAUTIs. For instance, the hospital can replace the indwelling urinary device with external catheters to reduce the high rate of CAUTIs. According to Zavodnick et al. (2020)Dashboard Benchmark Evaluation Essay Paper, replacing the indwelling urinary device with external catheters lowers the CAUTI rate among females receiving intensive care. External catheters are less likely to transmit disease-causing microorganisms to the patient’s urinary tract system. Hence, using external catheters instead of the indwelling urinary device will reduce the high rate of CAUTIs in the hospital. Nonetheless, replacing the indwelling urinary device with external catheters will be hindered by fixed organizational procedures and processes, limiting the execution of alternative healthcare delivery procedures.

The identified challenges, including staff shortage and fixed organizational procedures and processes, potentially contribute to benchmark underperformance. The hospital cannot adopt purposeful hourly rounding to prevent falls among patients at a high risk of falling due to the inadequacy of staff needed to move around the wards at regular intervals to identify patients at high risk of falling and prevent them from falling. Furthermore, ABC hospital cannot replace the indwelling urinary device with external catheters since fixed organizational procedures and processes hinder the implementation of new procedures. The first assumption underlying the conclusion is that the hospital does not have the financial resources required to hire more staff. Additionally, it is assumed that the hospital cannot change its organizational procedures and processes Dashboard Benchmark Evaluation Essay Paper.

Evaluation of a Benchmark Underperformance in ABC Hospital

Benchmark underperformance with the potential to improve a hospital’s overall quality or performance are high CAUTIs, and high rate of patient falls. The metric that is underperforming its benchmark by the greatest degree is patient falls. The hospital’s target for patient falls is 3 falls/1000 patient days. On the contrary, the actual rate of patient falls based on data obtained from the dashboard was 24 falls per 1000 patient days. This proportion was eight times higher than the set organization’s benchmark. Additionally, the benchmark underperformance most widespread throughout the hospital is patient falls. High patient fall rates are the most significant clinical issue facing medical, surgical, and medical-surgical units. Furthermore, the high rate of patient falls is the benchmark, affecting the greatest number of patients in the hospital. According to Galet et al. (2018)Dashboard Benchmark Evaluation Essay Paper, patient falls are a significant clinical problem, resulting in fall-related injuries, longer stay, high readmission rate, and increased cost of care. Thus, a high rate of falls in the hospital results in adverse outcomes among patients receiving medical care in medical, surgical, and medical-surgical units. Lastly, high fall rates are the underperforming benchmark affecting the highest number of staff, especially those working in the medical, surgical, and medical-surgical units.

The high rate of patient falls, and CAUTIs results in adverse health outcomes such as fall-related injuries, longer stay, and high readmission rates. Consequently, individual patients take longer than expected before resuming their daily duties, which affects the entire community that the hospital serves. The greatest opportunity to improve an organization’s performance or overall quality of care involves adopting evidence-based interventions to improve underperforming areas, which will result in positive patient outcomes.

Advocating for Ethical Action Directed toward Stakeholders

Hospital stakeholders who can address benchmark underperformance are the top managers. The hospital’s management should hire more staff to participate in hourly rounding, reducing the high rate of falls. Additionally, the managers should accept external catheters as a new performance procedure to reduce the high rate of CAUTIs. These changes will improve the underperforming area, resulting in quality care and positive health outcomes. Ethical actions that the management could take to support improved benchmark performance involve prioritizing patient care and preventing patients from potential harm. The management will prevent patients from adverse outcomes associated with the underperforming areas.

Overall, underperforming areas in the hospital, based on data obtained from the dashboard, are high patient falls and CAUTIs. The organization’s challenges associated with these benchmarks include staff shortage and fixed organizational procedures and processes. The management should address the underperforming areas to improve the quality of care and patient outcomes Dashboard Benchmark Evaluation Essay Paper.

References

Aldecoa, Y. S., Alanazi, A., Saleh, G. B., Alshanbari, N., Humayun, T., Alsheddi, F., … & Alanazi, K. H. (2022). Rates of urinary catheter-associated urinary tract infection in Saudi MOH hospitals: a 2-year multi-centre study. International Journal of Infection Control, 18. DOI: 10.3396/ijic.v18.21703.

Galet, C., Zhou, Y., Ten Eyck, P., & Romanowski, K. S. (2018). Fall injuries, associated deaths, and 30-day readmission for subsequent falls are increasing in the elderly US population: a query of the WHO mortality database and National Readmission Database from 2010 to 2014. Clinical epidemiology, 10, 1627. Doi: 10.2147/CLEP.S181138

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in geriatric medicine, 35(2), 273-283. Doi: 10.1016/j.cger.2019.01.007

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Venema, D. M., Skinner, A. M., Nailon, R., Conley, D., High, R., & Jones, K. J. (2019). An observational study of patient and system factors associated with unassisted and injurious falls in hospitals. BMC geriatrics, 19(1), 1-10. https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-019-1368-8.

Zavodnick, J., Harley, C., Zabriskie, K., & Brahmbhatt, Y. (2020). Effect of a female external urinary catheter on the incidence of catheter-associated urinary tract infection. Cureus, 12(10). Doi: 10.7759/cureus.11113 Dashboard Benchmark Evaluation Essay Paper