DHA-802 Case Study:
Managing Quality Performance with Innovative Technology Solutions
The Case
Imagine you are the chief information officer (CIO) for a large health system that includes five hospitals and 12 remote outpatient clinics. You met with the chief operating officer (COO) yesterday to discuss concerns regarding the organization’s cardiothoracic surgery specialty, which incurred a recent quality score decrease on several healthcare rating websites. Results from the preliminary investigation and root cause assessment of the decreased ratings indicated that enhanced decision support software could be used by healthcare personnel to improve root cause identification, solution identification, and performance improvement monitoring. Your charge is to develop a project plan, publish a request for proposal, create an implementation plan for a software solution, and establish a performance monitoring process to track cardiothoracic surgery quality metrics.
Assumptions
Research posits that complications after cardiothoracic surgery occur in 66.6% of the operative survivors. Research provides these examples: postoperative blood product use, atrial fibrillation, prolonged ventilation, renal failure, reoperation for bleeding, pacemaker/ICD insertion, renal failure, and pneumonia had the strongest impact on long-term survival.
Post-surgical complications are coded on the billing claim using ICD-10-CM codes.
If the post-operative condition was present on admission, the post-surgical complication code should not be reported on the claim. Present-on-admission codes are required to indicate a condition present prior to admission of the patient.
The case study identified an increase in post-operative complications in the cardiovascular surgical practice in the past year.
The data reflects that post-operative complication codes increased, and present-on-admission codes decreased in the past year.
Clinical documentation of the present on admission status by the provider can ensure accurate ICD-10-CM coding and a decrease in complication rates.
A data visualization dashboard is needed to track the volume and trends of post-surgical complications and their present on admission status.
Improving trends validate the effectiveness of CDS systems, data analytics, and stakeholder training.
Resources
The following resources are suggested helps for successful completion of course assignments. Given the transitory nature of online resources, some items may not be available. Some items are not available in the GCU Library. Resources are ordered by potential utility.
Topic 2: Project Plan
Simon Sez It. (2016, May 24). Microsoft Project 2016 tutorial for beginners part 1: The MS Project 2016 workspace [Video]. YouTube.
Simon Sez It. (2019, April 2). Microsoft Project tutorial: The ultimate MS Project 2016 tutorial for beginners [Video]. YouTube.
Microsoft. (2022). Plan projects and track deadlines. Author.
https://support.microsoft.com/en-us/topic/plan-projects-and-track-deadlines-bc510256-04b0-4cf1-bbc0-058bab51c513
Grevendonk, J., Taliesin, B., & Brigden, D. (2013). Planning an information systems project: A toolkit for public health managers. World Health Organization (WHO), Program for Appropriate Technology in Health (PATH).
https://path.azureedge.net/media/documents/TS_opt_ict_toolkit.pdf
Sutton,R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: Benefits, risks, and strategies for success. NPJ Digital Medicine, 3(17). https://doi/org/10.1038/s41746-020-0221-y
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005290/
Agency for Healthcare Research and Quality. (2019). Clinical decision support. Author.
https://www.ahrq.gov/cpi/about/otherwebsites/clinical-decision-support/index.html
Byrne, C., Sherry, D., Mercincavage, L., Johnston, D., Pan, E., & Schiff, G. (n.d.). Advancing clinical decision support: Key lessons in clinical decision support implementation. Westat.
https://www.healthit.gov/sites/default/files/acds-lessons-in-cds-implementation-deliverablev2.pdf
Centers for Medicare and Medicaid Services. (2021). Clinical decision support mechanisms. Author.
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Appropriate-Use-Criteria-Program/CDSM
Leading Edge. (2022). Strategic planning and strategic IT planning for long-term and post-acute care (LTPAC) providers: A “how to” workbook. Author.
https://leadingage.org/case-studies/strategic-planning-and-strategic-it-planning-long-term-and-post-acute-care-ltpac
Zielinska-Tomczak, L., Cerbin-Koczorowska, M., Przymuszala, P., & Marciniak, R. (2021). How to effectively promote interprofessional collaboration? – A qualitative study on physicians’ and pharmacists’ perspectives driven by the theory of planned behavior. BMC Health Servicers Research, 21(903), 1-13. https://doi.org/10.1186/s12913-021-06903-5
https://link.springer.com/article/10.1186/s12913-021-06903-5
Centers for Medicare and Medicaid Services. (2021). Quality programs. Author.
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/Quality-Programs
National Healthcare Safety Network (NHSN). (2022). National Healthcare Safety Network (NHSN): Patient safety component manual. Author.
https://www.cdc.gov/nhsn/pdfs/pscmanual/pcsmanual_current.pdf
Pahwa, S., Bernabei, A., Schaff, H., Stulak, J., Greason, K., Pochettino, A., Daly, R., Dearani, J., Bagameri, G., King, K., Viehman, J., & Crestanello, J. (2021). Impact of postoperative complications after cardiac surgery on long-term survival. Journal of Cardiac Surgery, 36(6), 2045-2052. https://doi.org/10.1111/jocs.15471.
https://pubmed.ncbi.nlm.nih.gov/33686738/
Topic 4: Request for Proposal (RFP)
Office of the National Coordinator for Health Information Technology (ONC). (2018). Request for proposal (RFP) template for health information technology.
https://www.healthit.gov/resource/request-proposal-rfp-template-health-information-technology
RFP 360. (n.d.). The healthcare RFP: Everything you need to know.
CNY Care Collective. (n.d.). Electronic medical record (EMR): Request for proposal (RFP) Sample.
https://cnycares.org/media/1761/emr-rfp-sample.pdf
State of Connecticut Office of Health Strategy. (n.d.). Request for proposals: Data analytic services for health care benchmarks and primary care target initiatives and OHS analytics needs.
https://portal.ct.gov/-/media/OHS/Solicitations/Contracts/Cost-Growth-Benchmark-RFP/Request-for-Proposal-Data-Analytics.pdf
Tarrant County Hospital District d/b/a JPS Health Network. (2021). Request for proposal #2021923871: Clinical decision support mechanism.
https://www.jpshealthnet.org/sites/default/files/2021-05/RFP%232021923871%20Clinical%20Decision%20Support%20Mechanism%20Final.docx
In this assignment, you will apply research to select and request a decision support software platform that will address the needs identified in the case. Instructor feedback about your request will inform your remaining assignments in the course.
General Requirements:
Use the following information to ensure successful completion of the assignment:
Refer to “DHA-802 Case Study,” located in the Class Resources for this course.
Refer to the project plan you began in the Topic 2 assignment.
Refer to the HealthIT.gov request for proposal (RFP) template found at https://www.healthit.gov/resource/request-proposal-rfp-template-health-information-technology
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
Directions:
Review the information in “DHA-802 Case Study.” This includes narrative information as well as additional resources.
Use the HealthIT.gov request for proposal (RFP) template t prepare a request for a recommended software solution that can be presented to the vendor to garner information about their available products.
Make an executive summary of the RFP process. Include the following in your summary:
An overview of the needs presented in the case.
A research-supported overview of RFP best practices.
A research-supported overview of RFP process steps.
A research-supported overview of RFP process challenges.
A research-supported rationale for the software solution selected through the RFP process
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