Healthcare Organizations: Developing an Action Plan - Essay Example

? Developing an Action Plan Table of Contents Table of Contents 2 Introduction 3 Objectives 4 Process to Address the Improvement of HCAHPS Scores 6 Factors to Address in Order to Improve HCAHPS Scores 6 Setting the Stage through a Strong Foundation 8 Financial, Patient, and Staff Implications 9 Cost-Benefits Ratio 11 Implementation Timeline 12 Analyzing the Hospital’s HCAHPS Data (2 weeks) 12 Setting the Improvement Priorities (1 Week) 13 Identification and Implementation of Targeted Interventions (10 Weeks) 13 Engaging the Team for Successful Implementation (12 Weeks) 14 Evaluation of Success and Monitoring 15 Conclusion 15 References 16 Introduction Healthcare organizations exist to provide quality care to patients in order to ensure that the nation achieved its objective of economic growth. In this case, provision of healthcare remains one of the most important aspects of a nation’s agenda. Therefore, the fundamental element in a healthcare organization remains the quality of care that a healthcare organization provided to its patients. In fact, the concern for the quality of care provided by a healthcare facility is as old as the field of medicine. Increasingly, governments, stakeholders in the industry, and regulatory agencies have identified the importance of ensuring that the quality of care was addressed. In effect, stakeholders have designed approaches that healthcare facilities can use in order to improve the quality of care they provided. In addition, stakeholders have identified the incentives to provide to healthcare facilities whose quality of care was in line with the requirements provided by the regulatory agencies and other stakeholders. While the need to improve the quality of care cannot be overemphasized, the healthcare industry has witnessed a number of measures that are pertinent in awarding healthcare institutions rankings after they met various standards. One such measure is the Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) scores, which healthcare providers are supposed to implement in order for them to benefit from incentives accrued from its implementation and high ranking (Zusman, 2012; Jennings, 2010). The proviso of attaching HCAHPS scores to incentives of a healthcare provider has played an instrumental in the need to improve the quality of care. In this case, healthcare facilities have realized that improving the quality of care provided to their patients was an effective approach towards raising their HCAHPS scores. Improving the quality of care is an essential element of enhancing customers’ experience in the healthcare sector, which is crucial in creating a positive customer perception about a healthcare facility. Consequently, customers whose experiences in a healthcare facility were positive provided positive feedback regarding their perception based on their experiences during their time as patients in a healthcare institution, which improves the HCAHPS scores of a healthcare institution. In effect, a high ranking ensures that an organization receives reimbursements and funding of its projects. In line with this, this article develops an action plan for improving HCAHPS scores in a healthcare facility. To carry out a comprehensive plan, the article will highlight the objectives of raising the HCAHPS scores, processes that will address improvement of HCAHPS scores, the implications of the plan on staff, patients, and resources, cost-benefit ratio, and the timeline for implementing the action plan. Objectives The specific objective of raising HCAHPS scores is to improve the quality of care provided by a healthcare facility. On the other hand, the Agency for Healthcare Research and Quality (AHRQ) together with the Centers for Medicare & Medicaid Services (CMS), which were instrumental in developing HCAHPS surveys, identified three goals for HCAHPS. In this case, the two organizations identified the first goal as the production of meaningful data regarding patients’ perceptions on healthcare facilities that was crucial for objective comparison of hospitals based on domains that were important to all consumers. Secondly, the scores report the survey results in a manner that created incentives for hospitals to ensure that they improved the quality of care they provided to their patients. Finally, the organizations identified the importance of HCAHPS in creating an environment that enhanced public accountability and transparency in the manner that hospitals provided care to their patients (Rutledge, 2008; Long, 2012). Overall, HCAHPS scores are essential in ensuring that comparing hospitals was possible in an approach that was standard using one survey. While the above-mentioned are the objectives of HCAHPS scores, it is important to develop the objectives of raising HCAHPS scores in our healthcare facility. First, the overall objective of raising these scores is to ensure that the facility provided quality care to all its patients. In line with this, raising HCAHPS scores is a crucial way of achieving high reliability in the hospital setting (Elliot, Lehrman, Goldstein, Hambarsoomian, Beckett, & Giodano, 2010). In line with this, achieving high reliability ensures that the perceptions of patients towards the care that they received were positive, which was an instrumental approach towards raising HCAHPS scores for the organization. The incentives that the hospital will accrue from raising HCAHPS are another objective towards raising these scores. In this regard, it is evident that reimbursements in the healthcare sector are increasingly based on the HCAHPS scores of a healthcare facility (Cliff, 2012; Zusman, 2012). In effect, a healthcare facility that wants to ensure that their reimbursement was procedural and increased overtime should ensure that their HCAHPS scores were always high. On the other hand, funding various projects in hospitals is increasingly based on the quality of care that healthcare providers gave their patients. In effect, the hospital aims at raising HCAHPS scores in order to benefit from these incentives. Low HCAHPS scores have an implication on the number of clients that a healthcare facility received. In line with this, word of mouth and HCAHPS scores that were in the public domain affected the choice of hospital for clients (Huppert & Carlson, 2010). In line with this, the incentive to have a positive outlook from potential customers is an aim towards raising HCAHPS scores in the healthcare facility. Finally, the healthcare facility’s final objective is to provide the best practices in aspects of care giving. One such area that the action plan will identify is the area of pain management in the organization. In line with this, research indicates that one effective approach that contributed to improved HCAHPS scores is effective approaches to management of pain among patients (Hanna, Fernandez, Barrett, Williams, & Pronovost, 2012; Martin, Kelly,& Roosa, 2012). In fact, hospital staff recognized the importance of improving pain management in order to ensure that patients’ perceptions due to the experiences that they underwent during the process of providing care improved and was positive. Process to Address the Improvement of HCAHPS Scores The process to address the improvement of HCAHPS scores will encompass two processes that are pertinent in achieving the objectives of raising these scores. First, it is essential to identify the aspects that are going to influence the improvement of HCAHPS scores. Thereafter, the process will involve building a firm foundation, which sets the stage for the implementation of the approaches that aim at improving HCAHPS scores. Factors to Address in Order to Improve HCAHPS Scores The hospital will not treat HCAHPS as the only measure of quality and aim its improvements efforts based on its HCAHPS survey reports. However, the hospital is going to incorporate a broad focus within the overall context of improving the quality of care and the hospital’s safety standards. One such area that the hospital will include is the area of case management, which has a relationship with the HCAHPS scores in a hospital. By case management, the hospital will focus on the aspects of “improving coordination of care, utilization management, and discharge/transition management” in order to improve the clinical outcomes during providing care and consequently raise HCAHPS scores in the hospital (Bower, 2012). It is crucial to consider the experience of hospital staff before implementing the action plan. In this case, it is evident that the experience of nurses was an effective way of providing quality care to patients. In this case, the nurses and hospital staff have to meet the standards of healthcare staffing service (HCSS) firms whose certification is by The Joint Commission (TJC) (Shaffer & Tuttas, 2010). In effect, this will ensure that the hospital will have the requisite expertise to implement a successful program that will improve HCAHPS scores. In addition, it is important to ensure that the nurse-patient ratio was high in order to allow the hospital to meet its objective of raising HCAHPS scores (Rutledge, 2008). Communication is crucial in raising HCAHPS scores within the hospital setting. In this case, researchers have identified communication with nurses and physicians as instrumental in improving the quality of care, which consequently raises HCAHPS scores. In addition, communication contributes to responsiveness of hospital staff to patient’s needs, which raises the quality of care that a hospital will provide its patients. On the other hand, it is crucial for hospital staff to communicate with patients about their medication and discharge information in order for the hospital to improve its quality of care, which will help it achieve the overall objective of raising HCAHPS scores in the facility (Rutledge, 2008). In line with this, communication strategies within the hospital will undergo a review in order to identify the approaches that nurses and physicians used to communicate amongst themselves and to their patients. In effect, the review will provide the way forward and highlight the areas that require addressing in order to provide holistic care. The hospital setting and environment require a review that will ensure that the hospital raised the quality of care it provided. In line with this, patients’ perception regarding the hospital contributed to the ranking of the hospital’s HCAHPS scores (Rutledge, 2008). In line with this, the hospital will create an environment that was clean and quiet since such an environment was not only effective in giving care, but it was also instrumental in raising HCAHPS scores in an organization. To achieve this, it will be essential to carry out a review of the staff responsible for maintaining a clean environment within the hospital setting in order to ensure that they understood their role in maintaining a clean environment. Furthermore, the disposal of waste materials is crucial towards maintaining cleanliness not only in the patients’ rooms, but also in the hospital compound since it had an impact on patients’ experiences. Setting the Stage through a Strong Foundation HCAHPS scores focus on the patient and raising them requires patient-centered objectives in order to achieve this overall objective. In line with this, it is essential to ensure that the domains that the hospital will focus on directed their activities towards improving patients’ experiences and perceptions about the hospital. Under the domain of hospital’s leadership, the plan will ensure that hospital leaders were visible and participated by making rounds in the hospital and talking to the patients and their families about the care that they were receiving. In addition, senior physicians and clinicians will engage in activities that promoted efforts towards achieving patient-centered care in the hospital. In addition, the action plan will ensure that there will be an integration of patient experience and its alignment with organizational priorities that include the safety and quality of care provided, which will be under effective case management (Zusman, 2012). The hospital will involve patients and their families in developing approaches that will improve their perception about the hospital. In line with this, the hospital will create a partnership between it, patients, and their families at each level and engage patients in dialogue that will be beneficial to the hospital’s objective in raising HCAHPS scores. In order to establish effective contact, the hospital will engage patients in dialogues through focus groups, making phone calls after discharge, regular rounding with patients in order to implore their perceptions, identifying, and responding to their needs within the hospital setting. The hospital will carry out the recruitment of members of staff who engaged patient-centered values. Existing workforce will undergo training in order to ensure that their values and their job descriptions included responsibilities that focused on the patient. In this case, orientation and training will be crucial in reinforcing behavior centered on the patient in the implementation of the plan. In addition, the hospital will ensure that it implemented a reward system that rewarded and celebrated members of staff who engaged in patient-centered activities. Importantly, staff members will participate in the process of designing a process centered towards the patients in order to promote accountability within the hospital. Focusing on patient-centered care is an effective approach towards raising HCAHPS scores (Giordano, Elliot, Goldstein, Lehrman, & Spencer, 2010). Financial, Patient, and Staff Implications There are implications that will result on the implementation of this plan. First, financial resources will be crucial in implementing this plan in a manner that was successful. On the other hand, the hospital will benefit financially due to the reimbursements it will accrue once it implements a program that raised its HCAHPS scores. The plan requires training of the hospital staff in order for each hospital staff to learn and participate in the process of implementing the best approaches towards raising HCAHPS scores. In addition, the value-based purchasing (VBP) program is one of the implications of implementing approaches that raised HCAHPS scores in a hospital. In this regard, the program focuses on the performance of a hospital in the payments that the hospital will receive (Cliff, 2012). Therefore, raising HCAHPS scores will ensure that the hospital’s payments based on VBP increased, which will make the hospital attain its objectives that required funding. On the other hand, the consequences of a successful implementation of approaches that ensured raising HCAHPS scores contributes to more clients using the hospital as their choice. In effect, there will be additional revenue in the hospital due to more clients using the hospital as their choice due to the improved HCAHPS scores and the discharged patients who used word-of-mouth to recommend the hospital to other people (Huppertz & Carlson, 2010). The implementation of this program will be crucial for patients since they ultimately stand to benefit. First, participating in the process of care giving is an essential way of ensuring that patients were aware of the medication and procedures that they were undergoing, which improved the process of healing. In addition, effective communication that the plan proposes will ensure that patients interacted with caregivers and provided feedback that was crucial in promoting care giving and new approaches to healing. On the other hand, the plan seeks to improve the quality of care that the hospital provided to its patients. In line with this, patients will benefit from the new approaches that the hospital will implement towards achieving high HCAHPS scores and patients’ experiences within the hospital setting will improve. Moreover, implementing approaches that aimed at providing all patients’ care that was equal despite their ethnic and racial background will help bridge the ethnic and race gap that existed among various patients (Goldstein, Elliott, Lehrman, Hambarsoomian, & Giordano, 2010). The hospital staff will be crucial in implementing these approaches. In this regard, the training provided to the hospital staff will inculcate the best approaches that focused on patients during the process of care giving. In line with this, there will be a reinforcement of the roles and responsibilities of nurses and other staff during their training in order to implement this program. On the other hand, researchers identify communication as the most important aspect in raising HCAHPS scores. In effect, this action plan will consequently enhance communication between nurses and their patients and provide nurses with important insights that they will use in improving care. In addition, the plan will improve communication between physicians and their patients with physicians discussing issue related to discharge and medication with their patients (Rutledge, 2008). On the other hand, the plan will help enhance communication between members of staff. Hence, staff members will be able to gain knowledge and experiences from each other with the skills and knowledge gained effective in enhancing quality care that the hospital seeks to provide to its patients. Cost-Benefits Ratio Quantifying the costs of implementing these interventions is challenging. In line with this, the costs that the hospital will incur in relation to implementing these intervention measures is in training the staff about the implementation of these strategies. In this case, the hospital will only rely on its workforce to analyze the approaches to implement, and to carry out the training of the staff. In this case, the hospital will only incur costs in the material that it uses during training. In addition, the implementation of these intervention measures will not require any restructuring and there are no additional costs incurred by the hospital in implementing these intervention measures. The benefits of implementing these interventions are numerous. On one hand, the consumers will benefit from the improved quality of care that the hospital will offer after the full implementation of these intervention measures. On the other hand, the hospital will benefit in terms of improved care provided to patients and the incentives related to the number of customers the hospital will receive and the increased reimbursements, which is based on the improved HCAHPS scores. In effect, the benefits far outweigh the costs of implementing these interventions. Hence, the cost-benefits ratio is low, which implies that the implementation of the interventions will be successful. Implementation Timeline The implementation process will consist of five series of steps that will ensure that the program became a success following its full implementation. First, the implementation plan will analyze the HCAHPS data, set the priorities that require improvement, identify and carry out the identified interventions, engage the team required to raise HCAHPS scores, and measure while monitoring the scores after implementation in order to evaluate the success of the approaches used. Analyzing the Hospital’s HCAHPS Data (2 weeks) This stage will take a period of two weeks. In this stage, hospital leaders will scrutinize eight publicly reported HCAHPS indicators that are essential in providing requisite knowledge and information that will guide the process of implementing intervention procedures that will raise HCAHPS scores in the hospital. In this case, hospital leaders will analyze the current performance of the hospital in terms of HCAHPS scores it scored in the recent public rankings. Other than the current performance of the hospital, leaders will pay attention to trending, which will highlight the historical trends of the hospital’s HCAHPS scores and analyze the conditions that contributed to these changes. In addition, hospital leaders will engage in benchmarking the hospital’s performance with that of other hospitals that were similar in various aspects, which will identify the approaches that similar hospitals used to post better HCAHPS scores than their hospital. Finally, it is important for the leaders to carry out a unit analysis on each unit in the hospital and identify the aspects that make some units focus on patient-centered care while others failed to focus on patients. These activities will take a period of two weeks in order to develop the approaches that will enhance successful implementation of the plan. Setting the Improvement Priorities (1 Week) After a successful analysis of the HCAHPS data, the next step involves setting improvement priorities in the hospital setting. Using HCAHPS values that account for 30% of the value-based purchase program, the hospital will identify the areas that require improvement (Cliff, 2010). Since hospital leaders have analyzed the HCAHPS data and identified the areas that require improvement, this step should take a week in order to enable the hospital leaders time to move to the next stage. Among the priority areas include nurse communication, physician communication, responsiveness of staff, pain management, medication communication, cleanliness, quiet at night, and discharge information (Cliff, 2010). Nonetheless, it is common knowledge that the hospital may not need to implement strategies in all these areas. In effect, the hospital leaders will take a week to analyze the areas that require prioritizing. Identification and Implementation of Targeted Interventions (10 Weeks) Under this step, the hospital will carry out an external review and internal review in order to identify interventions that will address the areas prioritized. During an external review, hospital leaders will identify practices and approaches that other hospitals have used and proved to be successful in raising the hospitals’ HCAHPS scores. In the analysis, the leaders should also identify the approaches that other hospitals have used although these approaches were not successful. This analysis should be comprehensive in order to provide the hospital leaders with the requisite information on the approaches to use in the hospital’s setting. In effect, four weeks will be crucial to ensure that the external review was successful. An internal review should take a period of six weeks since it should incorporate carrying out a study within the hospital setting. In this case, hospital leaders will use the expertise of their staff by asking the staff members to provide approaches that they considered effective as interventions in the identified prioritized areas. In line with this, leaders should investigate low-performing units, highlight the differences between these units and the high-performing units, and even exchange team leaders in these units in order to investigate whether replication of the high-performance unit’s approaches was possible. Engaging the Team for Successful Implementation (12 Weeks) This is the most fundamental stage. However, it is important to implement the plan in one unit that was lowly performing before implementing the plan to the entire hospital setting. In this case, a pilot implementation will identify one unit that will carry out the implementation of the project for 12 weeks, which is enough time to allow for a successful implementation and evaluation. Nonetheless, hospital leaders will involve patients, staff, and the patients’ families at this stage in providing feedback regarding the implemented approaches in the hospital setting. Importantly, this is the stage that the leaders will provide the hospital staff with the appropriate training, which will take two weeks for successful implementation. In this case, the two weeks are included in the 12-week period for the pilot test. In addition, motivation will be essential in helping the hospital staff embrace these interventions. Following the evaluation and monitoring, the hospital leaders will train all the staff for two weeks in order to get into the final stage of full implementation. Evaluation of Success and Monitoring Evaluation of successful implementation should occur after six months following a full implementation. On the other hand, monitoring should be on a monthly-basis in order to ensure that the interventions implemented achieved the set objectives. Conclusion A hospital can use various approaches improve its HCAHPS scores. However, it is important for healthcare facilities to identify the aspects that require prioritizing in order to develop effective interventions for these areas. In line with this, the hospital leaders should analyze a hospital’s HCAHPS data and identify areas they will address in order to implement effective interventions and solutions. Implementing these approaches in a manner that was consistent will help the hospital achieve its objectives and improve the quality of care it provided their patients. Improving the quality of care was instrumental in improving patients’ satisfaction (Windish & Olson, 2011). In effect, the hospital will achieve the overall objective of raising its HCAHPS scores, which will enable it improve its financial position due to the attachment of these scores to reimbursements in hospitals. References Bower, K. A. (2009). Managing Care: The Crucial Nursing–Case Management Partnership. Nurse Leader 26-29. Cliff, B. (2012). Excellence in Patient Satisfaction Within a Patient-Centered Culture. Journal of Healthcare Management 57(3): 157-159. Elliot, M. N., Lehrman, W. G., Goldstein, E., Hambarsoomian, K., Beckett, M. K., & Giodano, L. A. (2009). Do Hospitals Rank Differently on HCAHPS for Different Patient Subgroups? Medical Care Research and Review 67(1): 56-73. Giordano, L. A., Elliot, M. N., Goldstein, E., Lehrman, W. G., & Spencer, P. A. (2010). Development, Implementation, and Public Reporting of the HCAHPS Survey. Medical Care Research and Review 67(1): 27-37. Goldstein, E., Elliot, M. N., Lehrman, W. G., Hambarsoomian, K., & Giordano, L. A. (2010). Racial/Ethnic Differences in Patients' Perceptions of Inpatient Care Using the HCAHPS Survey. Medical Care Research and Review 67(1): 74-92. Hanna, M. N., Fernandez, M. G., Barrett, A. D., Williams, K. A., & Pronovost, P. (2012). Does Patient Perception of Pain Control Affect Patient Satisfaction Across Surgical Units in a Tertiary Teaching Hospital? American Journal of Medicine Quality 27(5): 411-416. Huppertz, J. W., & Carlson, J. P. (2010) Consumers’ Use of HCAHPS Ratings and Word-of- Mouth in Hospital Choice. Health Research and Educational Trust 1602-1613. DOI: 10.1111/j.1475-6773.2010.01153.x Jennings, N. (2010). Defining a Caring Hospital by Using Currently Implemented Survey Tools. Journal of Holistic Nursing 28(3): 187-192. Long, L. (2012). Impressing Patients While Improving HCAHPS Scores. Nursing Management Journal, 32-37. Martin, L., Kelly, M. J., & Roosa, K. (2012). Multidisciplinary Approach to Improving Pain Management. Critical Care Nursing Quarterly 35(3): 268-271. Rutledge, N. (2008). The 411 on HCAHPS. Nursing Management Journal 29-32. Shaffer, F. A., & Tuttas, C. (2008). HCAHPS: Nursing Moment’s in the Sun. Nurse Leader 48- 51. Shaffer, F. A., & Tuttas, C. (2010). Completing the Circle: The Embodiment of Quality Across the Care Delivery Continuum. Nurse Leader 35-39. doi:10.1016/j.mnl/2010.07.005 Windish, D. M., & Olson, D. P. (2011). Association of Patient Recognition of Inpatient Physicians with Knowledge and Satisfaction. Journal for Healthcare Quality 33(3): 44-49. Zusman, E. E. (2012). HCAHPS Replaces Press Ganey Survey as Quality Measure for Patient Hospital Experience. Neurosurgery 71(2): 21-24. Read More