Improving outcomes using technology
A new nurse on the unit was being oriented to the electronic health record by her mentor. Which of the following statements from the nurse should be corrected by the mentor? "I should only have one client's record up at a time." "Electronic health records are HIPAA compliant." "Quality of client care is improved with the use of electronic health records." "Electronic health records are error-proof due to the alerts."
"Electronic health records are error-proof due to the alerts." Recent findings by the National Coordinator for Health Information Technology (ONC) found that 15% of physicians said that an electronic health record (EHR) led them to select the wrong order from a list or led to a potential medication error. At this time, there is no industry-led consensus on the safest configuration of EHRs. One safety rule is to only have one client record up on the screen a time. As part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, EHRs should be compliant with HIPAA and improve quality of care.
A provider is being evaluated using the Ongoing Professional Practice Evaluation from The Joint Commission. The provider tells the quality assurance nurse that the results "don't really matter." What is the most appropriate response from the quality assurance nurse? "It does since it may be used to determine your existing medical privileges." "It does matter since the hospital's reimbursement depends on it." "It only effects our ability to hire more providers." "You are correct. It is just a formality and doesn't matter."
"It does since it may be used to determine your existing medical privileges." ---------- Professionalism, client care and interpersonal communication skills are measured by tools such as the Ongoing Professional Practice Evaluation from The Joint Commission. The results of the analysis can be "used to determine whether to continue, limit, or revoke any existing privilege(s)" (The Joint Commission, 2020, para 21). It is not related to hiring or reimbursement.
Which federal act was specifically designed to promote information technology within healthcare organizations in order to improve the quality, safety, and efficiency of healthcare while reducing costs and ensuring client privacy during information exchange? American Recovery and Reinvestment Act Health Insurance Portability and Accountability Act Affordable Care Act Health Information Technology for Economic and Clinical Health Act
Health Information Technology for Economic and Clinical Health Act --------------- Health Information Technology for Economic and Clinical Health (HITECH) reinforces the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in relation to the privacy and security of electronic health information sharing. As part of the American Recovery and Reinvestment Act of 2009 (ARRA), HITECH Act promotes meaningful use of health information technology with electronic health records while maintaining client privacy. The Affordable Care Act is not technology related.
In one study by Hill et al. (2013), physicians in an emergency room spent 43% of their time doing data entry with close to 4000 total mouse clicks in a 10 hour shift. How can this impact client outcomes? All data entry causes provider fatigue, thus impacting care. More clicks provide more information that improves outcomes. Spending more time on data entry improves outcomes. High click-to-information ratios cause poorer outcomes.
High click-to-information ratios cause poorer outcomes. -------- The number of clicks it takes to retrieve information is called a click-to-information ratio. Higher ratios can be associated with client morbidity, poor outcomes, and even death (McBride et al., 2019). Not all data entry causes fatigue, but more time on data entry decreases client satisfaction and outcomes.
How did the Health Information Technology for Economic and Clinical Health (HITECH) Act improve outcomes? It promoted value-based healthcare. It provided incentives for quality care. It increased technology sharing. It provided every hospital with an electronic health record.
It provided incentives for quality care. Through the use of technology in information sharing, healthcare costs can be reduced and client outcomes can be increased. It promoted the use of electronic health records (EHRs) but did not provide every hospital with an EHR or incentives for quality care. The HITECH Act came before the push for value-based healthcare.
A client was discharged from the hospital two weeks ago and received the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey in the mail from the hospital asking about his experience. Why should the client fill out the survey? The private information is feedback for the provider only. It will help improve quality in the hospital. There is a monetary incentive for filling it out. It is used as the provider's evaluation.
It will help improve quality in the hospital. The Hospital Consumer Assessment of Healthcare Providers and Systems survey is a national, standardized survey of clients' perspectives on hospital care which is publicly reported. This data is used as part of Hospital Compare. The information is used to help clients select quality health care decisions and to improve quality in U.S. hospitals.
What is the link between determining risk of illness and outcomes? Predicting risk allows for earlier intervention and better client outcomes Providers can provide better treatments if they know how many people are at risk Determining amount of clients at risk can lead to new adoption of technology Risk of illness can better prepare clients for treatment costs
Predicting risk allows for earlier intervention and better client outcomes --------- Predicting who is at risk for chronic illnesses allows for earlier intervention and decreasing long-term systemic costs, which is a better outcome for clients and facilities. It also prepares health care systems for future clients, but that does not necessarily mean the systems get new technologies or provide better treatments. Clients at risk of an illness do not need to worry about treatment costs until diagnosed with the illness.
The Centers for Medicare and Medicaid Services use data to compare hospitals. What types of data are used to create this comparison? Select all that apply. Timely and effective care Readmissions and deaths Complications Use of medications Survey of patients' experiences
Timely and effective care Readmissions and deaths Complications Survey of patients' experiences ---------- Compare emerged as a website for clients that allowed them to compare performance measures of different hospitals. According to the Centers for Medicare and Medicaid Services (2020, para 1), these results are organized by: general information survey of patients' experiences timely & effective care complications readmissions & deaths use of medical imaging payment & value of care Use of medication is not included.
After discharge, a client receives the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS - pronounced "H-caps") survey. What type of questions can the client expect? Select all that apply. Was the hospital environment comfortable? Would they recommend the hospital? Was the service expensive? How was communication with healthcare professionals? Were the hospital staff responsive?
Was the hospital environment comfortable? Would they recommend the hospital? How was communication with healthcare professionals? Were the hospital staff responsive? --------- According to Centers for Medicare and Medicaid Services (2020, para 3), the survey "contains 19 core questions about critical aspects of client's hospital experiences (communication with nurses and doctors, the responsiveness of hospital staff, the cleanliness and quietness of the hospital environment, communication about medicines, discharge information, overall rating of hospital, and would they recommend the hospital)." This data is analyzed and is part of the Hospital Compare website. Cost is not included.
A nurse is new to the quality improvement committee at the hospital. When asked what sources are used to improve quality, what would be the best response? "The Agency for Healthcare Research and Quality is our main source." "Sources are evidenced-based research, client data, and provider data." "We rely on reviewing each month's incident reports." "The hospital does it's own private data collection and research."
"Sources are evidenced-based research, client data, and provider data." Research is reviewed along with client opinions and provider data to improve client outcomes. Quality improvement efforts are at local and national levels, so data is shared with outside organizations. The Agency for Healthcare Research and Quality provides guidance for quality improvement efforts but the hospital needs to take into consideration their data as well. Incident reports may help identify an issue, but client and provider data need to be examined as well. Once the problem is clearly identified, research and guidelines are used to identify solutions.
In a _____________ , a provider receives reimbursement for services rendered, thus creating an incentive to provide more services. It is also called a fee-for-service model. In a ______________, a provider receives incentives to reduce costs and improve quality. It is also called a fee-for-value model. Answers: value based or volume based
1) volume based 2) value based In a volume-based care model, a provider receives reimbursement for services rendered, thus creating an incentive to provide more services. It is also called a fee-for-service model. In a value-based care model, a provider receives incentives to reduce costs and improve quality. It is also called a fee-for-value model. Healthcare organizations are moving from volume-based to value-based healthcare and more emphasis is on outcomes.
A client is trying to decide which hospital is the best for managing heart failure. Which reliable resource could the client use? Hospital websites Hospital Compare Centers for Medicare and Medicaid Services The Joint Commission
Hospital Compare ----------- Through the efforts of Medicare and the Hospital Quality Alliance (HQA), Hospital Compare emerged as a website for clients that allowed them to compare performance measures of different hospitals. Hospital websites, The Joint Commission, and Centers for Medicare and Medicaid Services do not have the comparison aspect of Hospital Compare.
What is the purpose of the SAFER Guides? Improve the safe use of electronic health records Reduce the rates of provider malpractice Prevent client injury from medical errors Provide quality improvement guidelines for client care
Improve the safe use of electronic health records ------------ A starting point for organizations to safeguard against information technology related client safety issues is to utilize strategic initiatives. The National Coordinator for Health Information Technology (ONC) released a series of recommendations in the form of SAFER Guides for organizations. The guides identify recommended practices to improve the safety and safe use of electronic health records. The Agency for Healthcare Research and Quality provides guidance for quality improvement efforts. The SAFER guidelines do not prevent client injury or reduce malpractice claims.
What aspects of technology can decrease the quality of care? Select all that apply. Large amount of data on a screen Low click-to-information ratios Data flows to other screens Lack of communication between systems Nomenclature is consistent
Large amount of data on a screen Data flows to other screen Lack of communication between systems --------- Electronic health records can create errors if there is a lack of communication between interfaces, a lack of coordination between different systems, a large amount of data on a single screen or data flows off of the screen, and inconsistent nomenclature. High click-to-information ratios can also create errors and decrease quality.
A nurse is putting together a presentation for the rest of the staff on the importance of delivering quality care to clients. Which statement below should be included in the presentation? Staff need to stress services more. Organizations use quality measures to rate clients. Quality care is linked to reimbursement. It is important to ensure employment.
Quality care is linked to reimbursement. ------------ Costs for care are tied to measuring performance and best practices. Reimbursement is not established in particular cases; they are based on overall outcomes. Providing quality care does not ensure employment, since there are many other factors. Quality care is value-based care. Encouraging more services is volume-based care. Organizations do not use quality measures to rate clients. Clients are asked to rate the quality of organizations.
Why is data collected and analyzed in healthcare? Select all that apply. Reduce medical errors Evaluate practitioner performance Determine risk of illness Reduce client cost Reduce client safety
Reduce medical errors Evaluate practitioner performance Determine risk of illness Reduce client cost =========== Data is collected and analyzed to: Reduce medical errors: investigate how error happened and to possible preventive solutions. Evaluate practitioner performance: used to determine restrictions on any existing privileges. Reduce client cost: reimbursement is based on outcomes. Determine risk of illness: allows for earlier intervention and decreasing long-term systemic costs. It is also used to increase client safety, not decrease it.