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AHS450 Quality Management in Health Care
Project #3
Due: 2/
1
3
Project Objective: In Unit 3 you learn about measures of performance. The purpose of a measure is to evaluate whether performance is meeting expectations. The National Quality Measures Clearinghouse contains numerous measures of health care performance. In this project you’ll become familiar with the resources available on the measures website and use the resources to identify measures that can be used to evaluate specific aspects of performance.
Instructions:
Imagine you have been hired as quality director, a newly added position in an large family practice/internal medicine outpatient clinic. The office manager asks you to select performance measures that can be used to judge the clinic’s quality. You know that performance should be evaluated in all three categories: structure, process, and outcome. Thus, you’ll want to identify measures from each category. You go to the Measures Clearinghouse website sponsored by the Agency for Healthcare Research and Quality to find measures that would be relevant for use in a family practice/internal medicine clinic.
Since the clinic is just starting to measure performance, you don’t want to overwhelm them with too many different measures. So you decide to select one structure measure, two process measures and two outcome measures. Descriptions of these types of measures and examples are found in your reading assignments.
1. Go to the National Quality Measures Clearinghouse website (www.qualitymeasures.ahrq.gov) to find measures of performance for an outpatient or ambulatory care clinic. Use the advanced search functions on this site to find structure, process and outcome performance measures.
DO NOT search for measures in the HHS Measure Inventory – use the advanced search function on the Measures Clearinghouse website. Only measures found using this search function should be used to complete the assignment.
2. In the first column of the answer sheet provided below list the measures you found on the clearinghouse website. Be sure you write the measures in descriptive “measurement” terms. The measure should start with words or phrases such as:
· “Percent of ….”
· “Number of ….”
· “Average …..”
3. Identify the numerator and denominator that is used to create each measure. Read though the description of the measure on the clearinghouse website and you’ll find this information. If you’ve forgotten how numerators and denominators are used to create a measure, see pages 31-34 in your text.
Below is an example of how one row on the answer sheet would be completed for an outcome measure that could be used in a dental clinic.
Measure
Numerator
Denominator
Outcome:
Percent of root canal procedures that fail within two years (failure = tooth is extracted)
Number of root canal procedures that fail within two years
Number of root canal procedures performed
Hints:
The advanced search function on the site will help you find measures for a particular care setting. However, don’t “blindly” accept the measures you find. Give some thought as to whether the measure is actually a structure, process or outcome measure as explained your reading material.
Also, be sure the measure is relevant to the clinic where you are working. Some of the measures on the clearinghouse website are used to evaluate larger populations, e.g. all patients in a geographic area or all patients in a health plan. These are not measures that can be used by a single clinic.
Remember the measures you select are to evaluate the performance of what happens in the family practice/internal medicine clinic, not in other settings even though clinic physicians may care for patients in other settings.
Only upload the answer sheet to the assignment drop box. Do not upload the assignment instructions or your grade will be reduced.
This assignment will be graded according to compliance with instructions, accuracy, completeness, and spelling/grammar.
Don’t forget to put your name on the answer sheet.
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AHS 450 Project #3
Student’s Name:
Measure
Numerator
Denominator
Structure:
Process:
Process:
Outcome:
Outcome:
AHS 401
Organizational Studies in Health Care
Assignment II: Development of a Motivation Plan
Case I:
You are the Director of nursing for a 400‐bed nonprofit hospital in the southwest. Susan
Smith joined your hospital as a staff nurse three years ago after relocating from the northeast.
She is 30 years old and has been a staff nurse since graduating from a two‐year college nursing
program 10 years ago. She is married to a lawyer and they have two children ages six and
eight.
Your hospital’s inpatient census has been extremely high because of another hospital’s
closing. The tension on the nursing floors has been running pretty high because of time
pressures to discharge patients early, lack of professional staff, and an upcoming accreditation
visit from the Joint Commission. Because of time restraints, you were unable to complete the
annual performance evaluations. However, all nurses received a 45 percent pay increase. With
this increase, your hospital staff is now the highest paid as compared to other hospitals within
your region. You believe the higher pay compensates your nursing staff for their increased
workload and related stress levels.
Until recently, you have been pleased with Susan’s performance. She had
demonstrated, in the past, her willingness to work hard and has made very few, if any, patient‐
care errors. However, over the last three months, you have noticed that Susan is not
performing at her same level of productivity and appears to argue frequently with the treating
physicians and other staff nurses about the patients’ treatment plans. You frequently hear
Susan complaining that “no one listens to me,” no one wants to hear my opinion,” and “they
don’t pay me enough to do this job.”
Susan was once a highly motivated, productive member of your nursing staff. You
understand that everyone is experiencing more stress than usual because of the increased
workload, but what can be done to motivate Susan to her prior “self”?
Case I Instructions:
1. Putting yourself in the position of Director of nursing prepare a detailed motivation plan
using the principles of the content theories of Maslow, Herzberg, and Alderfer to address the
issues in the case.
2. How do these theories help you as a manager to understand the situation presented?
3. What are the core behaviors you as a leader will use to motivate Susan and other
employees?
Case II:
“My hands are tied,” said laboratory supervisor Melissa Wilson. “Because of the way
this place is organized there’s absolutely nothing I can do to motivate the employees in the
laboratory. I should have listened when I was told 2 years ago that I wouldn’t be free to
supervise normally in this environment.”
“What’s wrong with this environment?” asked Melissa’s manager, assistant
administrator June Allen.
Melissa spread her hands and lifted her shoulders. “You know as well as I do, June.
Goodness knows you’ve worked under it long enough – government. We’re a municipal
hospital, an arm of local government.”
“But we’re still a not‐for‐profit general hospital,” said June. “What makes motivating
employees any different here than it would be almost anywhere else?”
“Almost everything,” said Melissa. “Look what our governmental status and the civil
service system does to us.”
Melissa bent down the little finger of her left hand and said, “First, I can’t give an
employee a pay raise or bonus for good performance because that’s not allowed.” She
gathered the next finger with the small one and continued, “Second, I can’t promote a good
performer because there’s no career ladder structure and I can’t advance anyone unless
something opens up; and third,” she said as she drew the middle finger into a bundle with the
other two, “creating a new position falls somewhere between impossible and taking forever;
and finally if an opening occurs or I manage to get another position approved I’m usually
required to go by the results of some examination in filling the job.”
June Allen shrugged and said, “Civil service has its drawbacks, that’s true, but I think
maybe you’re looking in the wrong places for most of the motivators.”
“I don’t know, June,” Melissa responded. “Oh, I’ve heard all this stuff about how money
supposedly doesn’t really motivate. If that’s so, why do our employees talk about money so
much? As far as I’m concerned, I’ve about decided that ‘thank you’ goes only so far and that’s
not far enough.”
Case II Instructions:
1. Putting yourself in the position of assistant administrator June Allen, prepare a detailed
motivation plan using the principles of the content theories of Maslow, Herzberg, and Alderfer
to address the issues in the case.
2. Prepare a response for your subordinate supervisor Melissa Wilson. Be sure to include some
clear direction for Melissa to follow in seeking more effective ways of motivating her staff and
how to implement the plan.
3. What are the core behaviors you as a leader will use to motivate Melissa?
