Value-Based Purchasing

The Center for Medicare and Medicaid Services (C.M.S.) began phasing in its value-based purchasing program in 2007.  Value based purchasing links payment directly to the quality of care provided. It is one strategy being used by C.M.S. to transform the current payment system by rewarding providers for delivering high quality, efficient clinical care.

There are three aspects to the program: patient experience, hospital-acquired conditions and achievement of expected treatment for specific clinical diagnoses.

Select one of the following hospital-acquired conditions:

1.   Surgical site infection

2.   Pressure Ulcers
                                                                                                  
3.   Catheter-associated urinary tract infections

4.   Harm related to falls

For your Final Paper:

1.   Include a brief discussion of the chosen hospital-acquired condition and why it is considered preventable.

2.   Explain the legal implications related to a patient developing the condition and the role that disclosure plays.

3.   Describe accreditation expectations related to this condition.

4.   Analyze the outcomes of continuous quality monitoring consider cost as it relates to quality.

The following questions and/or topics should be utilized in the development of your Final Paper

The following questions and/or topics should be utilized in the development of your Final Paper:

Hospital acquired conditions:

1.   What is meant by the term “hospital acquired condition”?

2.   Is the condition you selected always preventable? Why or why not?

3.   How does reducing or preventing this condition indicate quality healthcare practices?

Legal implications:

1.   What role does communication between the healthcare team and the patient/family play in preventing this condition?

2.   Why might a healthcare provider be reluctant to discuss the development of this condition with the patient and family?

3.   What are the potential ramifications of not discussing the development of this condition with the patient and family?

4.   How might members of the healthcare team present this information to the patient and family?

5.   What, if any, is the link between disclosure and litigation?

Accreditation expectations:

1.   The Joint Commission accredits 82% of the hospitals in the United States. (Sollecito & Johnson, 2013, p. 516).

2.   What expectations does the Joint Commission have with regards to the condition you selected?

3.   How is it assessed by surveyors during an accreditation survey?

Outcomes related to cost and quality:

1.   What continuous quality improvement strategies might you use to involve members of the healthcare team in planning and implementing improvements related to this issue?  

2.   Provide examples for each of the following performance improvement levels: localized improvement, organizational learning, process reengineering, and evidence-based medicine. (Refer to page 5 in your text if needed.)

3.   What role does education, research, collaboration, information technology, leadership, and teamwork play in addressing this issue?

4.   Of the strategies listed which one do you believe would generate the best outcomes and cost the least to implement? Explain your opinion.

The Final Paper must be eight-to ten-pages (excluding title and references pages) and should demonstrate understanding of the reading assignments, class discussions, your own research and the application of new knowledge. Your paper must use a minimum of six scholarly, peer-reviewed sources from the Ashford University Library that were published within the past five years and that are referenced according to APA guidelines as outlined in the Ashford Writing Center.

Writing the Final Paper

The Final Paper:

1.   Must be eight to ten double-spaced pages in length (excluding title and reference pages), and formatted according to APA style as outlined in the Ashford Writing Center.
2.   Must include a title page with the following:

a.   Title of paper
b.   Student’s name
c.   Course name and number
d.   Instructor’s name
e.   Date submitted

3.   Must begin with an introductory paragraph that has a succinct thesis statement.
4.   Must address the topic of the paper with critical thought.
5.   Must end with a conclusion that reaffirms your thesis.

6.   Must use at least six scholarly, peer-reviewed sources that were published within the past five years from the Ashford University Library.
7.   Must document all sources in APA style, as outlined in the Ashford Writing Center.
8.   Must include a separate reference page, formatted according to APA style as outlined in the Ashford Writing Center.

This is HCA 375  McLaughlin and Kaluzny’s Continuous Quality Improvement in Health Care 4^th edition.