This course explores the dynamic between healthcare and quality measures. Healthcare is in flux, moving from quantity of care measures to quality of care measures and improving patient outcomes. These new measures are frequently tied to payor requirements. By the end of the course, students will have a solid understanding of healthcare quality standards, regulations around those standards, and how they are affected by the use of technology and data management. Other topics covered include process improvement and workflow redesign.
Please note that all times in the syllabus and in Blackboard refer to Eastern Time. The discussion board and assignment links for each week will open at the start of the week for submissions.
Discussion Board Posts: Each week there will be a discussion board that addresses a topic within the current module. These assignments will assess your ability to clearly and accurately apply concepts from your readings and from your own experiences. Each week you are expected to submit an initial post and comment on at least 2 other students’ posts. You need to follow APA guidelines for citing any sources you may reference in either your initial post or your response to others. Refer to the Discussion Rubric and weekly discussion question for submission guidelines. Please be sure to follow the individual directions provided with each Discussion Board Prompt, as the requirements may vary from Discussion Board to Discussion Board.
Initial post: You should submit your initial post by 11:59 p.m. Sunday. Your initial post should be approximately 500 words.
Response to others: You should comment on at least 2 other students’ posts by 11:59 p.m. Wednesday. Your comments to others should be thorough, thoughtful, and they should offer some new content. Do not merely respond with “I agree” or “I disagree.” Engage directly with the ideas of your classmates and briefly mention which part of the post you are responding to.
Research Activity: In week 1, write a 3-4 page APA style paper about one quality-focused organization and provide an analysis of how the organization influences and impacts healthcare improvement. Refer to the Research Activity Rubric and assignment instructions for submission guidelines.
Case Study Measuring Performance: In week 2, write a 3-4 page APA style paper providing your response to the case study posed. Refer to the Case Study Rubric and assignment instructions for submission guidelines.
Value Stream Map Activity: In week 3, select a simple healthcare process with which you are familiar, identify the key steps to the process, and draft a process map. Identify which steps in your process map are value-added and which steps are not value-added. Use an online quality improvement tool to generate a Value Added Flow Analysis. Refer to the Value Stream Map Activity Rubric and assignment instructions for submission guidelines.
Article Critique: In week 4, apply critical thinking skills to an article on a quality improvement initiative and write a 4-5 page APA style paper of your critique. Follow a 3 step process for writing critiques to guide your analysis. Refer to the Article Critique Rubric and assignment instructions for submission guidelines.
Statistical Process Control Activity: In week 5, use an online quality improvement tool to create a histogram, control (run) chart and Pareto chart of data provided. Write a 2-3 page summary of the results found. Refer to the Statistical Process Control Activity Rubric and assignment instructions for submission guidelines.
Research Paper: In week 6, write a 5 to 7-page APA style paper on the application of a performance improvement methodology to solve a value-based care performance problem. Your work on this research paper will provide you an opportunity to take a deep dive into a performance improvement methodology and apply it to an authentic value-based care performance problem. Refer to the Research Paper Rubric and assignment instructions for submission guidelines.
Analytics Use Case: In week 7, respond to a scenario by completing an analytics use case from a template. Provide a complete and cohesive response to each item on the template so it is clear how the measure will be used. Refer to the Analytics Use Case Rubric and assignment instructions for submission guidelines.
Reflection: In week 8, a 300-500 word reflection on what you learned in class and how it applies to your current and/or future work. Refer to the Reflection Rubric and assignment instructions for submission guidelines.
All assignments use scoring rubrics to assess student performance. Thoroughly review the rubric and assignment instructions for guidance on what’s required for each assignment.
Your grade in this course will be determined by the following criteria:
Assessment Item | Possible Points | Percent of Total Grade |
---|---|---|
Discussion Boards (8 @ 2.5 points each) | 20 | 20% |
Research Activity | 6 | 6% |
Case Study | 10 | 10% |
Value Stream Map Activity | 6 | 6% |
Article Critique | 17 | 17% |
Statistical Process Control Activity | 6 | 6% |
Research Paper | 25 | 25% |
Analytical Use Case | 6 | 6% |
Reflection | 4 | 4% |
Total | 100 | 100% |
Course learning modules are divided into weeks. Each week starts on Wednesday at 12:00 am Eastern Time (ET) and closes on Wednesday at 11:59 pm ET, with the exception of Week 8, which ends on Sunday. All assignments must be submitted by 11:59 pm ET on the due date.
Learning Modules | Topics | Assignments and Due Dates |
Week 1 1/2 – 1/9 |
Fundamentals of Quality |
Introductory Discussion Research Activity – Wednesday 1/9 |
Week 2 1/9 – 1/16 |
Measuring and Evaluating Performance |
Discussion – Initial post by Sunday 1/13, responses by Wednesday 1/16 Case Study – Measuring Performance – Wednesday 1/16 |
Week 3 1/16 – 1/23 |
Continuous Improvement |
Discussion – Initial post by Sunday 1/20, responses by Wednesday 1/23 Value Stream Map Activity – Wednesday 1/23 |
Week 4 1/23 – 1/30 |
Improving Patient Safety |
Discussion – Initial post by Sunday 1/27, responses by Wednesday 1/30 Article Critique – Wednesday 1/30 |
Week 5 1/30 – 2/6 |
Utilization Management and Applying Statistical Methods |
Discussion – Initial post by Sunday 2/3, responses by Wednesday 2/6 Statistical Process Control Activity – Wednesday 2/6 |
Week 6 2/6 – 2/13 |
Managing Quality in Population Health and Value-Based Care |
Discussion – Initial post by Sunday 2/10, responses by Wednesday 2/13 Research Paper – Wednesday 2/13 |
Week 7 2/13 – 2/20 |
Analytics for Quality/Performance Improvement |
Discussion – Initial post by Sunday 2/17, responses by Wednesday 2/20 Analytics Use Case – Wednesday 2/20 |
Week 8 2/20 – 2/24 |
Putting Healthcare Quality and Safety into Practice |
Discussion – Initial post by Friday 2/22, responses by Sunday 2/24 Reflection – Sunday 2/24 |
Week 1 – Fundamentals of Quality
Learning Outcomes:
Course Materials:
Textbooks
Articles
Reference
Video
Assignments:
Introductory Discussion: Please introduce yourselves to your instructor and classmates. Briefly share your academic and professional backgrounds. What are you most interested in learning about during this course? What questions do you hope to have answered? (ungraded)
Discussion Question: Please choose one of the following discussion questions for your initial post: 1) How would applying the core values and concepts of the Baldridge Performance Excellence Framework (Health Care) improve healthcare quality? What role does analytics play? (See critical concept 2.1 in Spath text). Or 2)Think about your most recent healthcare encounter. Without disclosing the nature of the encounter, what aspects of care or service were you pleased with? What could have been done better, and how could it have been improved? How would you assess the quality of the visit? How much did you pay for the visit? Do you know the total cost?
Research Activity: Many organizations support healthcare quality in the United States. In this activity, investigate one quality-focused organization such as The Joint Commission, Institute for Healthcare Improvement, Leapfrog Group, National Committee for Quality Assurance, National Quality Forum, or Agency for Healthcare Research and Quality, etc. Analyze the following components as they might apply to healthcare improvement and their potential application to a healthcare system:
Consider the three primary quality management activities of measurement, assessment, and improvement as well as who might be responsible for this work in a healthcare organization.
Assignment length: 3-4 pages double-spaced, not including cover page and reference page. Use conventional grammar, punctuation, mechanics and APA formatting. Refer to the Research Activity Rubric for submission standards.
Week 2 – Measuring and Evaluating Performance
Learning Outcomes:
Course Materials:
Textbooks
Articles
Videos
Robert Wood Johnson Foundation. (2013, December 3). How measuring performance data can improve quality [Video file]. Retrieved from https://youtu.be/eWe1YGHC_Y8
Canadian Association of Paediatric Health Centres. (2017, October 4). Using routinely collected health data for research and quality improvement [Video file]. Retrieved from https://youtu.be/xh7ChXW0hGY
Assignments:
Discussion Question: Please choose one of the following discussion questions for your initial post: 1)Explore the CMS Hospital Compare website (www.medicare.gov/hospitalcompare/search.html?). Choose 3 hospitals within 100 miles of your location. Review the data for each of the following broad measurement categories: Process of care measures, Outcome of care measures, and Patients’ hospital experiences. Which hospital rates highest in each of the above categories? As a consumer, would you consider using the data on CMS Hospital Compare website to select a hospital? Why or why not? Do you know of family, friends, or coworkers who have used this website? If so, what was their experience like? If not, what would you tell them to persuade them to use it? Or, 2) In your opinion, what is the greatest barrier to ensuring the quality of data used for performance measurement? Provide at least two examples. How would you address the barriers you identified? How can technology support data quality in these areas?
Case Study-Measuring Performance: For any healthcare activity, four performance factors can be measured: structure, process, outcome, and patient experience. Identify one measure from each of these categories that could be used to evaluate the following ambulatory surgery center admission process:
Upon arrival, the patient reports to the center’s registration or admitting area. The patient completes paperwork, provides an identification card, and supplies insurance information if insured. Money for the patient’s insurance copay or self-pay deposit is collected at this time. Often, patients register on the surgery center’s website before the date of admission to facilitate the registration process. An identification bracelet, including the patient’s name and doctor’s name, is placed around the patient’s wrist. Before any procedure is performed the patient is asked to sign a consent form. If the patient is not feeling well, a family member or caregiver can help the patient complete the admission process.
Describe, in fundamental terms, each measure you selected to evaluate the surgery center’s admission process. What are the numerator and denominator? If the measure does not require a numerator and denominator, explain why. Suppose the manager of the surgery center’s registration area wants to gather data to report performance results for the measures you have chosen. What data sources could be used to gather information for the measures? Why would these data sources be best for gathering reliable data? How does technology support these processes?
Provide your response in a WORD document that is 3-4 pages (not including cover and reference pages), double-spaced. Use APA style format and citations, conventional grammar, punctuation, and writing mechanics. Your case study response should include an introduction that summarizes the case study. Responses to each of the questions posed in the prompt. When responding to these questions, address the scenario presented in the case. Offer your own opinion. Explain what you think about the case study. (Support your responses with references from the class readings.) Refer to the Case Study Rubric for submission standards.
Week 3 – Continuous Improvement
Learning Outcomes:
Course Materials:
Textbooks
Articles
Videos
Assignments:
Discussion Question: Please choose one of the following discussion questions for your initial post: 1) Explain the need for effective data management in healthcare quality. What are the impacts of bad data? How should healthcare organizations ensure data quality? What role does data governance play? Or 2) Of the ground rules listed in critical concept 71, which three are most important for a team to adopt, and why? When choosing the rules, consider your past experiences working with a team or decision-making group.
Value Stream Map Activity: There are three parts to this assignment that you will submit in one Word document. Select a simple healthcare process with which you are familiar, identify the key steps to the process, and draft a process map. Note you can use any tool you would like for this (e.g. Word, PPT, etc). There should be at least 6-8 steps in your process to ensure you have sufficient detail. Then, identify from the customer’s perspective, which steps are value-added and which are non-value-added? Shade the non-value-added steps to be a different color.
Next, you will generate a value-added flow analysis in an Excel spreadsheet using QI Macros. QI Macros is an add-in application that enables you to perform specific quality improvement analyses. In QI Macros, enter data in all five columns for the value-stream analysis. To complete this assignment and another assignment in week 5, you can download a 30-day free trial of QI Macros (https://www.qimacros.com/ ). Before you download the free trial, be sure to check that the two assignments will fall within the 30-days.
See the full assignment instructions in Blackboard. You will submit a screenshot of your process map and Value-Added Flow Analysis as well as a 2-3 page written analysis in a WORD document. Refer to the Value Stream Map Rubric for submission standards.
Week 4 – Improving Patient Safety
Learning Outcomes:
Course Materials:
Textbooks
Articles
Reference
Videos
Assignments:
Discussion Question: Please choose one of the following discussion questions for your initial post: 1) Read the description of the wrong-site surgery event in critical concept 8.2 and the root causes identified by the team who conducted the root cause analysis. Find at least two peer-reviewed sources that identify corrective actions aimed at preventing wrong-site surgeries. Which of these actions would help prevent a similar event from occurring at the hospital described in critical concept 8.2? How can technology be used to support these efforts? Or 2) What does reliability mean to you? In your experience, what healthcare process have you found to be reliable? What process have you found to be unreliable? Explain what is different about the reliable process versus the unreliable process. How can technology be used to support process reliability?
Article Critique: In this assignment, you will apply critical thinking skills to appraise strategies for increasing the reliability and safety of healthcare processes by critiquing an article on a quality improvement initiative. You will choose one of the articles provided and prepare your critique following the guide in the assignment instructions in Blackboard. Write your critique in standard essay form using APA style and format, conventional grammar, punctuation, and mechanics. Your critique should be 4-5 pages, double-spaced, not including cover page and reference page. It is generally best not to follow the author’s organization when organizing your analysis since this approach lends itself to summary rather than analysis. See the full assignment instructions in Blackboard and refer to the Article Critique Rubric for submission standards.
Week 5 – Utilization Management and Applying Statistical Methods
Learning Outcomes:
Course Materials:
Textbooks
Articles
Videos
Assignment:
Discussion Question: Please choose one of the following discussion questions for your initial post: 1) Which utilization management practices does your health insurance company follow to control costs and ensure the provision of medically necessary services? This information may be available in your insurance benefits booklet or on your health plan’s website. If you do not have health insurance, go to the website of any major health insurance company and list the practices the company follows to control costs and to ensure the provision of medically necessary services. Or 2) How is the Choosing Wisely initiative (Vogel, 2015) being used to impact utilization? Is it successful? Why or why not?
Statistical Process Control Activity: Read the articles linked to the assignment instructions in Blackboard on control charts. Use the sample data provided and QI Macros to complete a histogram, run chart, and Pareto chart. Draft a 2-3 page summary of your results including a discussion on the upper control limit and lower control limit. In addition to your summary, include a screenshot of each of the charts you completed and submit in one Word document. See Blackboard for the full assignment instructions and refer to the Statistical Process Control Rubric.
Week 6 – Managing Quality in Population Health and Value-Based Care
Learning Outcomes:
Course Materials:
Textbooks
Articles
Videos
Assignments:
Discussion Question: Please choose one of the following discussion questions for your initial post: 1) Go to the County Health Rankings website (www.countyhealthrankings.org) and explore the health outcomes and health factors data for the county where you reside. Is this information presented in an easy to understand format? Describe one or more population healthcare initiatives that could improve health outcomes or reduce factors that affect health outcomes in your county. Consider this week’s readings in your response. Or 2) How is quality managed in population health and value-based care? Provide examples from the readings to illustrate your key points. How can informatics support this work?
Research Paper-Applying a Performance Improvement Methodology: For this research paper, you will choose one value-based care performance problem from a list provided in the assignment instructions in Blackboard. Next, you will select one performance improvement methodology such as PDSA/PDCA, LEAN or Six Sigma/DMAIC, to apply to your chosen value-based performance problem. Your deliverable is a 5-7 page APA style paper. See the full assignment instructions in Blackboard and refer to the Research Paper Rubric for submission standards.
Week 7 – Analytics for Quality/Performance Improvement
Learning Outcomes:
Course Materials:
Textbook
Articles
Videos
Assignments:
Discussion Question: Please choose one of the following discussion questions for your initial post: 1) Explain how advanced analytics is being used for quality/performance improvement. Provide two specific examples. Consider this week’s readings and videos in your response. Or, 2) Describe how the analytics strategy framework could be used for quality/performance improvement. Which step do you think might be the most challenging to implement? Explain why?
Analytics Use Case: For this assignment, you will download the Analytics Use Case (form plus examples) from the Strome (2013) textbook and complete the template for the following scenario. Norfolk Health has one hospital and four clinics in the community. Norfolk has an integrated EHR system in places and uses lean methods for quality improvement. The organization now wants to develop a population health QI program related to childhood immunization status.
Select one of the immunization measures provided in the assignment instructions in Blackboard and complete the use case template that describes how analytics might be used to support this work. You will submit your completed use case template. See the full assignment instructions in Blackboard and refer to the Analytics Use Case Rubric for submission standards.
Week 8 – Putting Healthcare Quality and Safety into Practice
Learning Outcomes:
Course Materials:
Textbooks
Articles
Video
Assignments:
Discussion Question: Please choose one of the following discussion questions for your initial post: 1)Describe what is required to become an analytical organization. Which step do you think would be most challenging and why? How can healthcare organizations build effective analytic teams? Or, 2) How can healthcare organizations put a patient safety or QI culture into practice? Provide two examples other than the reading assignment.
Reflection Paper: Provide a response of about 350-500 words that reflect on what we have covered in this class and your experience. What are the top three things you learned in this class and why? Make sure to address both healthcare quality and informatics in your response. How can you apply these learnings? How is what you learned in this class to your current and/or future work?
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