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HC 405 Herzing University Online Performance Improvement Case Study

Because performance improvement activities are information intensive, organizations must provide the proper resources and systems to support improvements. It’s important to recognize that PI programs need to meet accreditation standards such as The Joint Commission and Medicare and Medicaid Conditions of Participation, which require access to national comparative data collections. This assignment, based on a textbook case study, will help students to understand Joint Commission information management standards by analyzing how a scenario relates those standards.


  • Your assignment will focus on the Case study on pages 444-447. After reading Chapter 17 and the Case Study, please complete the tasks at the end of the case study:
  • Review the collected data
  • Assign the appropriate quality code using the key provided in figure 17.5
  • Analyze the data:
    • Which code is most common?
    • Is there one service that seems to be a problem?
    • What can you conclude from the data?
  • Establish a plan. How you are going to fix the problem?
  • Your submission should be a minimum of two pages but does not require APA style or outside research.
  • Be sure to fully address each of the questions in the assignment. If you do use outside research, list your references in proper APA style.


Expert Solution Preview

The Joint Commission is an organization that accredits and certifies healthcare organizations and programs in the United States. As a medical professor, it is important to teach students about Joint Commission information management standards. This assignment is based on a case study that will help students understand how to analyze and improve performance through data collection and quality coding.

The collected data in the case study includes information about the number of patients who fell in a hospital over a three-month period. After reviewing the data, the appropriate quality code for falls can be assigned using the key provided in figure 17.5. The most common code is code 5, which represents a fall with an injury. There does not seem to be one service that is a problem, as falls occurred in various parts of the hospital.

From the data, we can conclude that falls with injuries are occurring in the hospital and need to be addressed to improve patient safety. To establish a plan for improvement, a root cause analysis should be conducted to identify the specific reasons for falls and injuries. This can be achieved through staff education, increased monitoring of high-risk patients, and modifications to the environment such as installing grab bars and non-slip flooring.

In conclusion, this case study highlights the importance of data collection and quality coding in identifying areas for improvement in healthcare organizations. Through effective analysis and planning, healthcare providers can improve patient safety and quality of care.

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