Assignment: Adjustments to Transitions in Health Care Delivery

Consider what you’ve learned so far about the transition from volume- to value-based reimbursement. Different organizations will respond to the impact of this change in various ways. Based on its actions, an organization may flourish, or it may fail as its reimbursement decreases. As reimbursement methodology changes, institutions must adapt.

To prepare for this Assignment:

Read Case 5: Middleboro Community Hospital in this week’s Learning Resources, and consider the actions taken by this organization. Review data tables regarding their case mix (top DRGs), Patient Days, and CMS Core Measures. These metrics address both qualitative and quantitative measures in this organization.

The Assignment:

Write a brief, 2-page executive summary of the impact of the transition from volume-based to value-based health care. Specifically, address how this change in reimbursement methodology impacts operational requirements and how it can be implemented. Recommend at least two adjustments to operations which may position the organization for success under value-based health care.

Assignment: High Reliability in Health Care – Long-Term Care

There are three imperative steps that need to be taken. The first is a strong commitment by leadership to this very high level of safety and quality. The leadership must set the goal and example for everyone in order to achieve high reliability. The second is to embed all of the principles and practice of a culture of safety throughout the organization which emphasizes trust, reporting of unsafe conditions, and highly effective improvement over time. The third step is to utilize powerful Robust Process Improvement tools like Six Sigma, Lean, and change management to create near perfect processes, similar to the tools that we see in industries like commercial aviation today, and sustain very high levels of safety over long periods of time.
—Dr. Mark R. Chassin

These three steps: commitment by leadership, development of a culture of safety, and the use of process improvement tools, are the core recommendations made by Dr. Chassin, the president of The Joint Commission and the president of the Joint Commission Center for Transforming Healthcare. A first step in identifying whether these recommendations are being met is to compare elements of an organization to criteria which have been identified as essential to high-reliability organizations.

To prepare for this Assignment:

Consider the three steps described by Dr. Chassin and the seven major criteria of the Baldridge Performance Excellence Program, and reflect on how these recommendations can apply to health care organizations, specifically to long-term care facilities.

The Assignment:

In this Assignment you will identify major elements of high-reliability organizations providing long-term care. According to the Baldrige Performance Excellence Program (MBNQA), the criteria are as follows:

• Leadership
• Strategic planning
• Customer and market focus
• Measurement, analysis, and knowledge management
• Human resource focus
• Process management
• Business/organizational performance results

Using the Highly Reliable Organization Matrix located in this week’s Learning Resources, complete the matrix by typing in the elements which meet the criteria in rows and columns. Describe each element briefly, give an example as to how this can be met in a long-term care facility, and explain the expected impact on patient care.

Based on the results of the Highly Reliable Organization Matrix, write a 1- to 2-page executive summary to the board of directors of the long-term care organization, describing elements which meet the criteria from the matrix and how any missing elements of the criteria for excellence can be met.