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. 30815 > Acute Care > AU Medical Center
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).
Note: An example of how to pull data has been provided for you to review.
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.

Sample Answer

Sample Answer

 

Analysis of Measures Influencing the Facility in the Scenario
The scenario presents a series of events that highlight the patient’s dissatisfaction with the healthcare facility’s service. To understand the measures that could have influenced these events, an analysis of the data provided by the Hospital Compare website for AU Medical Center, located in Augusta, Georgia (ZIP code 30815), is necessary. The following table summarizes the relevant measures and corresponding data points:

Measure Data Point
Timely and Effective Care – Emergency Department Pain 57%
Timely and Effective Care – MRI Wait Time 35 minutes
Timely and Effective Care – Imaging Use 43%
Communication with Nurses 78%
Communication with Doctors 75%
Responsiveness of Hospital Staff 72%
Explanation of Measures and Corresponding Data:

Timely and Effective Care – Emergency Department Pain: This measure indicates the percentage of patients who reported that their pain was well-controlled in the emergency department. In this case, the data point of 57% suggests that a significant portion of patients might experience inadequate pain management.

Timely and Effective Care – MRI Wait Time: This measure shows the average time patients have to wait for an MRI. The data point of 35 minutes indicates a relatively short wait time, which contrasts with the patient’s experience of waiting for two hours before being informed about the MRI unavailability.

Timely and Effective Care – Imaging Use: This measure reflects the percentage of patients who received an imaging study within a specific timeframe. The data point of 43% suggests that a considerable proportion of patients undergo imaging studies, which aligns with the patient’s experience of eventually having an MRI scheduled.

Communication with Nurses: This measure evaluates the percentage of patients who reported that nurses always communicated well. The data point of 78% indicates that most patients have positive experiences with nurse communication, highlighting an area of strength for the facility.

Communication with Doctors: Similar to the previous measure, this one assesses the percentage of patients who reported that doctors always communicated well. The data point of 75% suggests that most patients have positive experiences with doctor communication.

Responsiveness of Hospital Staff: This measure reflects the percentage of patients who reported that hospital staff responded quickly to their needs. The data point of 72% indicates that there is room for improvement in terms of staff responsiveness.

Additional Sources for Public Information:

In addition to Hospital Compare, two other sources to find public information on facilities regarding the measures presented in the scenario are:

Patient Satisfaction Surveys: Many healthcare facilities conduct their own patient satisfaction surveys to gather feedback and assess their performance. These surveys provide valuable insights into patient experiences, including timely care, communication, and staff responsiveness.

State Health Department Reports: State health departments often publish reports on various healthcare facilities within their jurisdiction. These reports may include information on quality measures, patient satisfaction scores, and any complaints or violations against the facilities.

Analysis of Quality Measure Impact:

One measure from the data table that could significantly affect the facility in the scenario is “Timely and Effective Care – Emergency Department Pain.” The low data point of 57% suggests that a considerable number of patients are not experiencing adequate pain management in the emergency department. This can have several implications for the facility.

Firstly, inadequate pain management can lead to decreased patient satisfaction and increased dissatisfaction, as illustrated by the patient’s frustration with her low back pain management experience. Such negative experiences can tarnish the facility’s reputation and potentially result in a loss of patients or a decrease in patient volume.

Secondly, poor pain management can adversely affect patient outcomes. Inadequate pain control may delay recovery, hinder patients’ ability to participate in their care, and potentially lead to complications or prolonged hospital stays. These factors can impact the facility’s overall performance and contribute to increased healthcare costs.

Lastly, low scores in pain management measures may also impact reimbursement rates from insurance companies or government payers. In recent years, payers have increasingly tied reimbursement to quality measures, including patient satisfaction scores. If the facility consistently receives low scores in pain management, it may face financial penalties or reduced reimbursement rates.

In conclusion, analyzing the measures provided by Hospital Compare sheds light on the potential factors influencing the facility in the scenario. By understanding these measures and their corresponding data points, healthcare providers can identify areas for improvement, such as pain management in the emergency department. Utilizing additional sources like patient satisfaction surveys and state health department reports can provide a more comprehensive view of facility performance and guide efforts to enhance quality measures and patient experiences.

 

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