Using Data to Address Quality Measures

 

 

Read the following scenario.

The patient is a 40-year-old female who presents to the emergency department for low back pain. The pain has been present for 2 weeks, and no injury has been noted. The patient has no history of previous low back pain. The emergency department immediately orders an MRI of the lumbar spine for low back pain. The patient waits in her room in the emergency department for 2 hours without anyone checking on her. She is finally told that the in-house MRI is down for maintenance, so she schedules an appointment for another day. The patient is at the emergency department for more than 280 minutes from arrival to discharge.

Two days later, the patient goes to her appointment for her MRI at the radiology department. She must register and provide all the same information that she has already given at the emergency department regarding her history and other pertinent information. The patient’s appointment was scheduled for 1 p.m., and at 1:45 p.m. she still has not been called back for her test. No one has updated her regarding the delay. Finally, the patient is taken back for her test at 2 p.m. and is not given any explanation for the delay except that the department is short-staffed. The patient is not happy about her experience at the radiology department.

When the patient receives her Explanation of Benefits from her insurance company, she realizes the MRI was not pre-certified correctly. Now she owes a large portion of the bill because the physician did not try other means, such as physical therapy, prior to receiving a costly MRI.

Access Medicare’s Hospital Compare website and complete the following steps:

Locate the Find a Hospital box.
Enter the ZIP Code and hospital name provided by your faculty member. (Use Texas Health Huguley Hospital Fort Worth South Zip Code is 76028.)
Select search.
Review the category tabs (e.g., General Information) at the top of the hospital’s profile to complete this assignment.
Complete the chart on the Using Data to Address Quality Measures worksheet using the data from Hospital Compare.

You are provided with 3 categories relevant to the scenario. If you would like to identify an additional measure(s) and data from Hospital Compare that relate to the scenario, please use the blank line item in the table or add another row(s).
Write a 350- to 700-word paper that analyzes the measures that have an influence on the facility in the scenario.

Include the following in your paper:

Explain the measures and corresponding data listed in the table.
Provide the data table listing the measures and corresponding data points within the presentation.
Analyze 2 sources, in addition to Hospital Compare, that you would use to find public information on facilities regarding the measures presented in the scenario.
Select 1 measure from the data table and analyze how the quality of this measure could affect the facility in the scenario.
Cite 3 peer-reviewed or similar references to support your presentation on the references slide

 

Sample Solution

This analysis examines the quality of care provided by Texas Health Huguley Hospital Fort Worth South based on data from Medicare’s Hospital Compare website. The focus is on measures related to patient experience, efficiency of care, and complications.

Data Analysis

The following table summarizes the key measures and corresponding data for Texas Health Huguley Hospital Fort Worth South:

Measure Data
Overall Hospital Star Rating 4 stars
Patient Experience Star Rating 4 stars
Timely Emergency Department Care 96%
Patients Receiving Effective Treatment for Heart Attack 93%
Hospital Readmission Rate for Heart Failure 33%

Additional Sources

Analysis of Selected Measure: Timely Emergency Department Care

A high percentage of patients receiving timely emergency department care is a positive indicator of the hospital’s efficiency and responsiveness. However, a 4% of patients waiting longer than 30 minutes for a doctor could still represent significant delays for some individuals.

Improving Timely Emergency Department Care

To improve timely emergency department care, the hospital could:

  • Increase staffing levels: Ensure adequate staffing to reduce wait times.
  • Streamline triage processes: Implement more efficient triage protocols to quickly identify and prioritize patients.
  • Improve communication: Enhance communication with patients to keep them informed about wait times and treatment progress.

Conclusion

Texas Health Huguley Hospital Fort Worth South demonstrates strong performance in several quality measures, including patient experience and effective treatment for heart attack. However, there is room for improvement in timely emergency department care. By addressing this area, the hospital can further enhance the quality of care it provides to patients.

References

  1. Centers for Medicare & Medicaid Services. (n.d.). Hospital Compare. Retrieved from https://www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/hospital-compare
  2. The Leapfrog Group. (n.d.). Hospital Safety Grades. Retrieved from https://www.leapfroggroup.org/

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