NURS FPX 8012 Assessment 2 Proposal for a Change

Name

Capella university

NURS-FPX 8012 Nursing Technology and Health Care Information Systems

Prof. Name

Date

Using Data to Make Evidence-Based Technology Recommendations

(Slide 1) Greetings, everyone. I am Gloria, a DNP-prepared nurse. Today, I present data to leverage Electronic Health Records (EHR) systems for patient safety and organizational performance. This presentation will focus on Cleveland Clinic’s Leapfrog and Medicare Compare scores in three distinct patient safety areas. By analyzing the scores, targeted informatics and technology interventions are recommended.

(Slide 2) Let me explain the two performance evaluation systems better to understand their usage in Cleveland Clinic’s performance. Leapfrog Group is a nonprofit organization that assesses the safety of hospitals. It assigns letter grades (A to F) to hospitals based on their performance preventing medical errors, accidents, and infections. The grades are derived from publicly available data and a hospital survey, including infection rates, safety practices, and error prevention. Medicare Compare is a tool that allows quality care to be compared among healthcare organizations. Centers provide it for Medicare & Medicaid Services (CMS) and provide a star rating (1 to 5) regarding patient safety, experience, outcomes, and timely adequate care provision. 

Leapfrog and Medicare Compare Scores of Cleveland Clinic 

(Slide 3) According to Leapfrog Group, Cleveland Clinic in Ohio has an A grade. This rating system helps people understand the hospital’s performance across different aspects. The three measures to improve and ensure patient safety in an acute care setting includes nurse-to-bedside hours, leadership efforts to prevent errors and medication reconciliation. The recent report shows that the hospital has performed well regarding patient safety. For instance, nursing-to-bedside care takes 8.24 hours every day, efforts to reduce prevent errors are 110.77 out of 120.00, and medication reconciliation is 0.126, which should be less than the 50th percentile (Leapfrog, 2023). 

(Slide 4) Medicare shows that Cleveland has a 5-star rating and has performed quite well regarding patient safety and quality care provisions. The mortality rate is 5 out of 7, readmission is 7 out of 11, and timely and effective care is 10 out of 12. This is usually compared to the national average. Ideally, it should be lower than, for instance, 4 is national mortality, 6 is readmission, and Cleveland is slightly higher in cases like one mortality and readmission measure. The remaining measures for mortality and readmission are either at or below the national average or unavailable for comparison. There is another rating perspective through a patient survey, and it has 4 out of 5 with a 25% response rate (Medicare, 2024a). 

Assessing Cleveland Clinic in Ohio against Two Other Hospitals

(Slide 5) Firstly, I am Comparing Cleveland Clinic with Miami Valley Hospital. As per a recent report on Leapfrog, Miami Valley Hospital received a “B” grade for safety, which is lower than the Cleveland Clinic’s “A” grade (Leapfrog, 2024). Nursing hours per day is 6.82, the error prevention score is 92.31 out of 120, and medication reconciliation is 0.298, indicating a lower performance rate than Cleveland Clinic. Moreover, the Medicare Score shows an overall rating of 3 out of 5 and a patient survey of 2 out of 5, indicating that it lags in multiple performance metrics. Its mortality indicator shows seven out of 7, readmission 11 out of 11, and timely and effective care 11 out of 12, indicating an average performance with variations against national standards (Medicare, 2024b).   

(Slide 6) Atrium Medical Center is the second hospital I compared to Cleveland Clinic. As per the report of Leapfrog, it received a “B” grade for safety, which is lower than Cleveland Clinic, which received an “A” grade. In particular, the Nursing hours per day is 7.25, the error prevention through effective leadership score is 92.31 out of 120, and medication reconciliation is 0.095. This indicates that the medication reconciliation score is slightly better than Cleveland Clinic, while the other two scores are lower (Leapfrog, 2023).

Medicare’s score demonstrates 4 out of 5 in overall rating and 3 out of 5 in patient survey rating. The particular metrics show mortality as seven out of 7, readmission as 10 out of 11, and timely and effective care provision score as 10 out of 12. The data on Medicare shows that most of the data align with the national average, but incidents are either not reported or have no variation inch (Medicare, 2024c). 

Implementing Advanced EHR System to Improve Medicare Compare Scores

(Slide 7) According to Medicare’s timely and effective care, it is notable that the emergency department volume (60k+) annually and the average time patients spend in the emergency room would be 179 minutes, both of which are very high for Cleveland Clinic. Further, hospital return days are also higher than as per the data for heart attack (12.9 days per 100 discharges) and heart failure patients (20 days per 100 discharges) (Medicare, 2024a).

Implementing an advanced EHR system within Cleveland Clinic, with gradation through multi-factor authentication, encryption, optimized alert system, speech recognition features, and a user-friendly interface, can help maintain a 5-star Medicare rating. For the high emergency department and long patient wait times, speech recognition can streamline documentation, allowing healthcare providers to record patient information quickly and accurately (Dinari et al., 2023).

Thereby reducing time spent on administrative tasks and improving patient care for patients in need of acute care in Cleveland Clinic. Multifactor authentication and encryption ensure that patient data is secretly accessed and transmitted, maintaining patient privacy and trust, which is crucial for compliance and safety standards (Singh & Natarajan, 2023). A user-friendly interface can facilitate quicker and more intuitive use by staff and patients, leading to more efficient care delivery and reduced error, directly assessing the high hospital return days for acute care reasons such as heart attack and heart failure patients (Pierce et al., 2020). 

Implementing Advanced EHRs System to Improve Leapfrog Compare Scores

(Slide 8) As per Leapfrog’s report, the organizational performance has room for improvement to become Ohio’s best healthcare organization. For instance, as mentioned, for Cleveland Clinic’s leadership to prevent error is 110.77, and the best needs to have 120. Nursing and bedside care, which is crucial for the acute patient care unit, scores 70, and the best hospital scores 100. Communication with doctors scores 90, the best one should score 98, while communication with nurses scores 91, and the best score 96. Most importantly, the patient response score is 85, while the best score scores are 95 (Leapfrog, 2023). So, these EHR system enhancements can help Cleveland Clinic maintain its Leapfrog A grade.

The hospital can ensure that patient safety measures remain high by optimizing nursing-to-bedside care times and enhancing error prevention with a robust, secure EHR system. This will build trust and streamline the process between patients and healthcare providers, improving communication (Pierce et al., 2020). Improved medication reconciliation through advanced EHR features can lower the rate of errors, further boosting patient outcomes and satisfaction in Cleveland Clinic. These technological upgrades will support timely and effective care delivery, reducing mortality and readmission rates to align more closely with national averages and enhancing the hospital’s reputation and performance metrics (Li et al., 2021).

Performance Data for Executive Appeal

(Slide 9) The presentation is structured to establish the current performance metrics of Cleveland Clinic based on Leapfrog and Medicare compare scores, highlighting areas of strengths and opportunities for improvement. This approach is designed to appeal to an executive-level audience by providing a clear, data-driven overview of the hospital’s status, which is crucial for strategic decision-making. Specific examples, such as high emergency department volume and extended patient wait times, underscore the urgency for improvement and illustrate how EHR  systems can address these challenges effectively (Tsai et al., 2020). The advanced EHR system at Cleveland Clinic includes a patient care workflow, enhancing data security and accuracy, and ultimately improving patient outcomes.

Additionally, leveraging advanced EHR systems streamline administrative processes, for instance the data showing communication gaps with doctors (90, should be 98) and nurses (91 should be 96). It will position the clinic as a leader in innovative healthcare systems. Including comparative data with other hospitals contextualizes the hospital’s performance, fostering a competitive mind among executives. The desired impact is to convince the executive-level audience at the Cleveland Clinic of the tangible benefits of implementing patient outcomes, improved organizational performance, and a stronger reputation in the healthcare industry (Johnston et al., 2022).

Conclusion 

(Slide 10) In conclusion, implementing advanced EHR systems with speech recognition, multifactor authentication, encryption, and a user-friendly interface offers substantial benefits for Cleveland Clinic. These technological enhancements will streamline documentation, enhance data security, and improve the overall efficiency of care delivery, directly addressing high emergency department volumes, extended patient wait times, and high hospital return rates.

Cleveland Clinic can maintain its high Leapfrog and Medicare ratings by optimizing communication between healthcare providers and patients and enhancing patient safety measures. These improvements align with national standards and strengthen the hospital’s reputation, ensuring it remains a leading healthcare organization in Ohio.

References

Dinari, F., Bahaadinbeigy, K., Bassiri, S., Mashouf, E., Bastaminejad, S., & Moulaei, K. (2023). Benefits, barriers, and facilitators of using speech recognition technology in nursing documentation and reporting: A cross‐sectional study. Health Science Reports, 6(6), e1330. https://doi.org/10.1002/hsr2.1330 

Johnston, C. F., Butcher, D., & Aveyard, H. (2022). An integrative review exploring the impact of Electronic Health Records (EHR) on the quality of nurse–patient interactions and communication. Journal of Advanced Nursing, 79(1), 48-67. https://doi.org/10.1111/jan.15484 

Leapfrog. (2023, December 26). Atrium Medical Center | ratings | leapfrog group. Ratings.leapfroggroup.org. https://ratings.leapfroggroup.org/facility/details/36-0076/atrium-medical-center-middletown-oh 

NURS FPX 8012 Assessment 2 Proposal for a Change

Leapfrog. (2023, June 23). Cleveland Clinic Health System – Fairview hospital | ratings | Leapfrog Group. Ratings.leapfroggroup.org. https://ratings.leapfroggroup.org/facility/details/36-0077/cleveland-clinic-health-system—fairview-hospital-cleveland-oh 

Leapfrog. (2024, January 24). Miami Valley Hospital | ratings | leapfrog group. Ratings.leapfroggroup.org. https://ratings.leapfroggroup.org/facility/details/36-0051/miami-valley-hospital-dayton-oh 

Li, E., Clarke, J., Neves, A. L., Ashrafian, H., & Darzi, A. (2021). Electronic health records, interoperability and patient safety in health systems of high-income countries: A systematic review protocol. BMJ Open, 11(7), 1–5. https://doi.org/10.1136/bmjopen-2020-044941 

Medicare. (2024a, April 24). Fairview Hospital. Www.medicare.gov. https://www.medicare.gov/care-compare/details/hospital/360077?id=7ce5e752-da69-45b9-881a-9539ecd85a0b&state=OH 

Medicare. (2024b, April 24). Miami Valley Hospital. Www.medicare.gov. https://www.medicare.gov/care-compare/details/hospital/360051?id=0e23bf3b-d061-4aba-87e9-79a3376c045c&state=OH 

Medicare. (2024c, April 24). Atrium Medical Center. Www.medicare.gov. https://www.medicare.gov/care-compare/details/hospital/360076?id=f653fc74-6544-41db-8b47-8d8c79a7e6f5&state=OH&measure=hospital-overall-rating 

NURS FPX 8012 Assessment 2 Proposal for a Change

Pierce, R. P., Eskridge, B. R., Rehard, L., Ross, B., Day, M. A., & Belden, J. L. (2020). The effect of electronic health record usability redesign on annual screening rates in an ambulatory setting. Applied Clinical Informatics, 11(04), 580–588. https://doi.org/10.1055/s-0040-1715828 

Singh, B. M., & Natarajan, J. (2023). A novel secure authentication protocol for eHealth records in cloud with a new key generation method and minimized key exchange. Journal of King Saud University. Computer and Information Sciences/Maǧalaẗ Ǧamʼaẗ Al-Malīk Saud : Ùlm Al-Ḥasib Wa Al-Maʼlumat, 35(7), 101629–101629. https://doi.org/10.1016/j.jksuci.2023.101629 

Tsai, C. H., Eghdam, A., Davoody, N., Wright, G., Flowerday, S., & Koch, S. (2020). Effects of electronic health record implementation and barriers to adoption and use: A scoping review and qualitative analysis of the content. Life, 10(12), 1–27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7761950/