*******The underpreforming benchmark needs to focus on focusing the heart failure readmissions for Mercy Medical Center.****
PREPARATION
After reviewing your benchmark evaluation, senior leaders in the organization have asked you to draft a policy change proposal and practice guidelines addressing the benchmark metric for which you advocated action.
In their request, senior leaders have asked for a proposal of not more than 2–4 pages that includes a concise policy description (about one paragraph), practice guidelines, and 3–5 credible references to relevant research, case studies, or best practices that support your analysis and recommendations. You are also expected to be precise, professional, and persuasive in justifying the merit of your proposed actions.
When creating your policy and guidelines it may be helpful to utilize the template that your current care setting or organization uses. Your setting’s risk management or quality department could be a good resource for finding an appropriate template or format. If you are not currently in practice, or your care setting does not have these resources, there are numerous appropriate templates freely available on the Internet.
PROPOSAL REQUIREMENTS
Note: The tasks outlined below correspond to grading criteria in the scoring guide.
In your proposal, senior leaders have asked that you:
- Explain why a change in organizational policy or practice guidelines is needed to address a shortfall in meeting a performance benchmark prescribed by applicable local, state, or federal health care laws or policies.
- What is the current benchmark for the organization? What is the numeric score for the underperformance?
- How might the benchmark underperformance be affecting the quality of care being provided or the operations of the organization?
- What are the potential repercussions of not making any changes?
- Recommend ethical, evidence-based strategies to resolve the performance issue.
- What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark?
- How would these strategies ensure improved performance or compliance with applicable local, state, or federal health care laws or policies?
- How would you propose to apply these strategies in the context of your chosen professional practice setting?
- How would you ensure that the application of these strategies is ethical and culturally inclusive?
- Does your policy encompass the key components of your recommendations?
- Analyze the potential effects of environmental factors on your recommended strategies.
- What regulatory considerations could affect your recommended strategies?
- What organizational resources could affect your recommended strategies (for example, staffing, finances, logistics, and support services)?
- Are your policy and guidelines realistic in light of existing environmental factors?
- Propose a succinct policy and guidelines to enable a team, unit, or the organization as a whole to implement recommended strategies to resolve the performance issue related to the relevant local, state, or federal health care policy or law.
- Identify colleagues, individual stakeholders, or stakeholder groups who should be involved in further development and implementation of your proposed policy, guidelines, and recommended strategies.
- Why is it important to engage these colleagues, individual stakeholders, or stakeholder groups?
- Do your proposed guidelines help colleagues, individual stakeholders, or stakeholder groups understand how to implement your proposed policy?
- How might engaging these colleagues, individual stakeholders, or stakeholder groups result in a better organizational policy and smoother implementation?
- Are your proposal and recommended strategies realistic, given the care team, unit, or organization you are considering?
Expert Solution Preview
Introduction:
In response to the request from senior leaders at Mercy Medical Center, this proposal aims to address the benchmark metric of heart failure readmissions. The underperformance in this benchmark metric poses challenges to the quality of care provided and the overall operations of the organization. This proposal will outline the need for a change in policy and practice guidelines, along with evidence-based strategies to resolve the performance issue. Additionally, the proposal will analyze the potential effects of environmental factors and propose a succinct policy and guidelines for implementation. Engagement of relevant stakeholders will also be emphasized to ensure successful implementation of the proposed strategies.
1. Explanation of the need for a change in policy or practice guidelines:
The current benchmark for heart failure readmissions at Mercy Medical Center and its corresponding numeric score indicate a significant underperformance. This underperformance has a direct impact on the quality of care being provided and the overall operations of the organization. High readmission rates not only lead to poorer patient outcomes but also result in increased healthcare costs and resource utilization. Failure to address this underperformance may lead to reputational damage for the organization and potentially affect reimbursement rates.
2. Recommendation of ethical, evidence-based strategies to resolve the performance issue:
Evidence-based literature suggests several potential strategies to improve performance in reducing heart failure readmissions. These strategies may include enhancing transitional care programs, implementing comprehensive discharge planning, providing patient education and self-management support, improving medication adherence, and fostering effective care coordination and communication. By implementing these strategies, improved performance and compliance with applicable health care laws or policies can be achieved. In the context of Mercy Medical Center, these strategies can be applied by establishing multidisciplinary care teams, utilizing technology for remote monitoring, coordinating care transitions with community providers, and developing patient-centric interventions. To ensure ethical and culturally inclusive care, these strategies should consider the diverse needs of the patient population, promote health equity, and respect patient autonomy and preferences. The proposed policy encompasses these key components and aligns them with the organization’s mission and values.
3. Analysis of potential effects of environmental factors on recommended strategies:
Several regulatory considerations may influence the implementation of the recommended strategies. These may include compliance with state and federal laws related to patient privacy, reimbursement models, and care coordination standards. Organizational resources such as staffing, finances, technology infrastructure, logistical capabilities, and support services must also be considered. The policy and guidelines should be realistic and feasible in light of these environmental factors. Conducting a thorough assessment of existing resources and potential barriers will help ensure successful implementation of the strategies.
4. Proposal of a succinct policy and guidelines for implementation:
The proposed policy and guidelines aim to enable the entire organization at Mercy Medical Center to implement the recommended strategies for reducing heart failure readmissions. The policy should outline clear objectives, roles and responsibilities, and protocols for assessment, intervention, and evaluation. It should emphasize the importance of interdisciplinary collaboration, communication, and continuous quality improvement. The guidelines should provide step-by-step instructions for implementing specific interventions and interventions tailored to individual patient needs. Regular monitoring, data collection, and reporting mechanisms should be established to track progress and identify areas for further improvement.
5. Identification of colleagues, individual stakeholders, or stakeholder groups:
Engaging colleagues, individual stakeholders, and stakeholder groups is crucial for the successful development and implementation of the proposed policy, guidelines, and recommended strategies. Key stakeholders may include physicians, nurses, pharmacists, care coordinators, case managers, patient and family representatives, hospital administrators, and community healthcare providers. Involving these stakeholders is important because their expertise, perspectives, and buy-in are essential for designing effective interventions, ensuring smooth implementation, and promoting sustainable change. The proposed guidelines should provide clear instructions and resources to help these stakeholders understand their roles and responsibilities and effectively contribute to the implementation process. Considering the specific context of Mercy Medical Center and the involved care team, unit, or organization will help ensure the feasibility and practicality of the proposed strategies.
Conclusion:
Addressing the underperformance in heart failure readmissions is crucial for the improvement of patient outcomes and efficient operations at Mercy Medical Center. This proposal highlights the need for a change in policy and practice guidelines, recommends evidence-based strategies, analyzes potential environmental factors, proposes a concise policy and guidelines, and emphasizes the involvement of relevant stakeholders. Implementation of the proposed strategies will not only improve the benchmark metric but also contribute to the overall quality of care provided by the organization.
