Dashboard Benchmark Evaluation – NHS-FP 6004
Introduction
Dashboards provide important information detailing what benchmarks are being met, or not being met, by a healthcare organization. The benchmarks are set by local, state, and federal laws. Health care organizations use these dashboard metrics to understand the most successful strategies for quality and operation improvement (Vila Health, n.d.). Mercy Medical Center, located in Shakopee, Minnesota, recently reviewed their public health dashboard for their diabetic patients. This review will help determine what processes at Mercy Medical Center are going well, and which areas need improvement. The dashboard metrics, challenges, and evaluations are outlined below. Dashboard Benchmark Evaluation – NHS-FP 6004.
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Dashboard Metrics against Benchmarks
Mercy Medical Center is one of the top rated healthcare organizations located in Shakopee, Minnesota. Mercy Medical Center must adhere to local, state, and federal laws and policies to preserve their high rankings. Senior Human Resources Generalist, Evelyn Unger, provided dashboard metrics for evaluation. These metrics outline the readmission rates locally and nationally, as well as, falls, medication errors, pressure sores, patient injuries, and documentation errors of various healthcare departments within Mercy Medical Center (Vila Health, n.d.). The Local Public Health Act of Minnesota affirms that both the state and local governments are responsible for healthcare in the state of Minnesota. Dashboard Benchmark Evaluation – NHS-FP 6004 This responsibility involves funding statewide initiatives, establishing assessment and planning guidelines, and documenting advancement toward statewide goals (Minnesota Department, 2016).
Mercy Medical Center’s readmission rates are a touch higher than national readmission rates. The dashboard metrics evaluated readmission rates for the year 2016 for Chronic Obstructive Pulmonary Disease (COPD), pneumonia, and heart failure. Local readmission rates for COPD were 31% while the national readmission rates for COPD were 37%. The local and national pneumonia readmission rates were equal at 29%. Yet, local heart failure readmission rates were 40% higher while the national readmission rates were only 37% (Vila Health, n.d.). These dashboard metrics highlight the need for improved heart failure readmission rates.
The fall rates for the year 2016 were increased for Orthopedics and Bariatric Services compared to the 2015 fall rates. However, Medical Surgery and Labor & Delivery both had significant decreases in fall ratings from 2015 to 2016. In 2016, Labor & Delivery managed to have zero falls (Vila Health, n.d.). The prevention of patient falls in hospital settings is a challenge for healthcare organizations. The national average for fall rates ranges from 1.3 to 8.9 falls per 1,000 patient days. These rates are even higher for healthcare departments that work with the elderly, neurological, and physically disabled patients (Gygax, 2017). Bariatric Services exceeded the national average for fall rates with a total of 18 falls for 2016. In addition, Medical Services and Orthopedics were within the national average for fall rates with 10 falls for 2016. The main causes of patient falls have been identified as: (a) inadequate assessment; (b) communication breakdowns; (c) nonadherence to fall safety protocols and practices; (d) insufficient staff training and skills, supervision, and staffing numbers; and (e) inadequate leadership (“Sentinel”, 2015).
Furthermore, medication errors continue to be an issue at Mercy Medical Center. Medical Surgery’s medication errors doubled in 2016 from 4 to 8, while Orthopedics and Bariatric Services remained the same for 2015 to 2016. There are many different factors that contribute to medication errors: (a) illegible prescriptions; (b) distractions, increased workload, and staffing levels; (c) staff knowledge and experience; and (d) mathematical skills and calculations (Kavanagh, 2017). Medication errors can have a major impact on nurses consisting of blame, disciplinary action, job loss, and lawsuits (Kavanagh, 2017). Minnesota developed an Adverse Event Reporting Program in 2003. This program is a non-punitive and mandatory reporting program. The program maintains its non-punitive methods by omitting healthcare professionals’ names from the reporting forms (“Minnesota”, n.d.). In 2015, Minnesota had a reported 316 adverse health events throughout the state. Of the 316 reported events, fourteen were determined to be medication errors. Of the fourteen medication errors, four resulted in death and the other ten resulted in serious injury (Minnesota Department, 2016).
Pressure ulcers were also evaluated through the benchmark dashboard. Pressure ulcers occur “when a patient’s skin breaks down die to pressure or friction” (Minnesota Department, 2016). Each department at Mercy Medical Center had a decrease in pressure ulcer occurrences from 2015 to 2016 totaling nine pressure ulcer events for the entire organization. Minnesota’s Adverse Event Reporting Program recorded a total of 104 pressure ulcers in 2015.
Benchmark Challenges
Challenges are a common occurrence when involving interprofessional teams. The challenges for Mercy Medical Center’s benchmarks include cultural diversity of the organization and within the community and inadequate staffing. Mercy Medical Center is located in Shakopee, Minnesota. Nearly 75% of Shakopee is white (U.S. Census, 2017) and about 85% of Mercy Medical Center employees identify as white. For patients and employees of Mercy Medical Center who do not identify as white there may be issues with cultural beliefs, language barriers, and communication related to meeting benchmark goals Dashboard Benchmark Evaluation – NHS-FP 6004. In addition, Shakopee is a small community. In 2017, the U.S. Census Bureau (2017) recorded 40,893 residents in Shakopee, Minnesota with the majority of those residents being under 18 years of age. This makes it difficult for Mercy Medical Center to have adequate staffing numbers for their various departments. Inadequate staffing has been shown to increase challenges in healthcare. Studies have shown that inadequate staffing can lead to increased fall rates, improper medication administration, inadequate staff training, and failure to deliver acceptable patient care (AHC Media, 2018).
Evaluation of Benchmark Underperformance
The Medical Surgery and Labor & Delivery departments at Mercy Medical Center have improved their fall rates from 2015 to 2016. Conversely, the Orthopedics and Bariatric Services departments’ fall rates were higher in 2016. Since the Orthopedics and Bariatric Departments treat a greater number of patients, improvement of the fall rates at Mercy Medical Center are especially crucial. Implementation of fall prevention programs throughout Mercy Medical Center could aid in reducing the fall rates for the Orthopedics and Bariatric Departments. In addition, improvement of staffing numbers and staff workload will also help decrease fall rates and improve patient outcomes.
Ethical Action to Address Benchmark Underperformance
Fall prevention needs to be a priority at Mercy Medical Center. Addressing issues with cultural differences and staffing numbers will help improve fall rates for all of Mercy Medical Center, but especially the Orthopedics and Bariatric Services. The introduction of fall prevention programs should be established hospital-wide. However, it is essential that fall prevention trainings are provided in multiple languages and feature various cultural scenarios. This will provide the diverse groups within Shakopee the opportunity to relate more and better understand fall prevention strategies (Wan, Neni, Siew & Ying, 2018). In addition, improvements to Mercy Medical Center’s staffing numbers should be made. Improving staffing numbers will help decrease workload on nurses, thus improving falls risk factors. With adequate staffing there is typically enhanced communication, thorough patient assessments, improved safety practices and support, and a variety of knowledge levels among staff (“Sentinel”, 2015). Expansion of advertisements and recruitment of staff may improve staffing numbers and cultural diversity for Mercy Medical Center, thus improving patient outcomes and decreasing costs for Mercy Medical Center Dashboard Benchmark Evaluation – NHS-FP 6004.
Conclusion
Benchmark evaluations have benefitted Mercy Medical Center in identifying which dashboard metrics are being met for local, state, and federal levels. These dashboard metrics also detected areas for improvement. Mercy Medical Center should investigate their staffing needs to improve their falls, medication errors, and pressure ulcers rates. Fall prevention programs should be offered hospital-wide and provided in various languages to ensure inclusivity of minority groups. Improving upon Mercy Medical Center’s dashboard metrics will ensure improved patient outcomes and potentially reduce healthcare costs related to falls, medication errors, and pressure ulcers.
References
AHC Media. (2018). Citing Inadequate Staffing, Nurses Sue Detroit Hospital: No breaks over long work shifts alleged. Hospital Employee Health, 37(2), 14-N.PAG.
Gygax Spicer, J. (2017). The Got-A-Minute Campaign to Reduce Patient Falls with Injury in an Acute Care Setting. MEDSURG Nursing, 26(5), 313-326.
Kavanagh, C. (2017). Medication governance: preventing errors and promoting patient safety. British Journal of Nursing, 26(3), 159-165.
Minnesota Department of Health. (2016, February). Adverse Health Events in Minnesota. Retrieved from http://www.health.state.mn.us/patientsafety/ae/2016ahereport.pdf
Minnesota Public and Private Policy Medical Errors and Patient Safety. (n.d.). Retrieved from http://qups.org/med_errors.php?c=individual_state&s=24&t=all
Sentinel Event Alert brings falls back into the spotlight. (2015). Patient Safety Monitor Journal, 16(12), 4-6.
U.S. Census Bureau QuickFacts: Shakopee city, Minnesota. (2017). Retrieved from https://www.census.gov/quickfacts/fact/table/shakopeecityminnesota/PST045217
Vila Health. (2018). Dashboard and Health Care Benchmark Evaluation. Retrieved from http://media.capella.edu/CourseMedia/NHS6004/DashboardandHealthCareBenchmarkEvaluation/media.asp#intro
Wan Yi, A., Neni, H., Siew Tiang Lydia, L., & Ying, L. (2018). Evaluation of a fall prevention educational video on fall risk awareness, knowledge and help seeking behaviour among surgical patients. Singapore Nursing Journal, 45(1), 27-33. Dashboard Benchmark Evaluation – NHS-FP 6004