Managing Quality Across Various Health Care Settings

Learning Goal: I’m working on a health & medical question and need an explanation and answer to help me learn.

Complete a 3-5 page assessment template discussing the continuum of patient care, care quality, and communication between physician practices and hospitals.

As a health care administrator, you will likely spend a great deal of your time focused on operations. You may find yourself working in a hospital, clinic, long-term care facility, hospice, urgent care center, home health agency or a number of other types of organizations. Regardless of the type of organization, many of the operational responsibilities are the same.

Health care financing has become quite complex. Because most health care organizations are reimbursed primarily from a third party (insurance company), health care administrators must manage the communication between the patient, the insurance company, and the organization. Consumer-directed health plans (CDHPs) have increased in popularity as a way to reduce insurance premiums; however, the patient has a larger financial responsibility for services compared to managed care plans. This concept is known as cost sharing (Niles, 2021). It is very important to understand the payer mix of your organization, so you understand where and how revenue is coming in.

Information technology is another huge area of focus right now for health care administrators. The health care industry has lagged behind other industries in the area of information technology. The U.S. health care system has seen a large increase in the number of electronic medical records implemented across health care organizations (Niles, 2021). In addition, other technologies such as telehealth, electronic data warehouses (EDWs), and computerized physician order entry (CPOE) are quickly expanding and improving the delivery of health care.

Reference

Niles, N. J. (2021). Basics of the U.S. health care system (4th ed.). Jones & Bartlett Learning.

For this assessment, imagine you have accepted an administrator position at a physicians practice. One of your first tasks is to gather your team to introduce yourself and discuss operational priorities for the practice at a lunch-and-learn.

Instructions

Using course resources along with a minimum of three peer-reviewed articles based on your own research, complete the linked assessment template to address the following:

• Describe where the physician practice and the hospital fall on the continuum of patient care.
• Analyze how providers at each location try to return their patients to their highest level of functioning.
• Explain how a physician practice communicates with the hospital to foster high-quality, efficient, and effective patient care.
• Analyze three peer-reviewed articles that each discuss one of the topics above.
  • Description or summary presents the what of the article, but analysis will pursue the question of so what?
  • Why do these ideas matter and/or how are these ideas connected?
  • What are the potential gaps or questions that remain?

Please use the Assessment 2 Template [DOCX] to organize your paper with the following headings:

• Title Page.
• Agenda.
• Introduction.
  • Professional introduction (1 paragraph).
    • You have license to be creative as you imagine the background you would bring to a position like this one.
  • Agenda (bullet points).
    • Preview the main goals of the lunch-and-learn.
    • Refer to some of the scholarly sources you will summarize.
• Continuum of Care.
  • Describe where the physician practice and the hospital fall on the continuum of patient care.
  • Analyze a peer-reviewed article that discusses where the physician practice and the hospital fall on the continuum of patient care.
• Care Quality.
  • Describe how a physicians practice maximizes patient care quality to return them to the highest level of function, addressing quality standards such as:
    • Maximizing value-based reimbursement.
    • Positive patient experience.
    • Maintaining operational efficiency.
  • Analyze a peer-reviewed article that discusses how a physicians practice maximizes patient care quality to return them to the highest level of function.
• Operational Approach.
  • Describe how the physicians practice and the hospital system communicate to foster high-quality, efficient, and effective care.
  • Analyze a peer-reviewed article that discusses how a physicians practice and the hospital system communicate to foster high-quality, efficient, and effective care.
• Conclusion.
  • Recap the main themes of your lunch-and-learn session.
  • Draw conclusions based on information contained in at least two of the articles you summarized.
  • Offer specific examples to demonstrate application of these ideas in everyday practice.
• References.

Additional Requirements

• Length: Your paper must be a minimum of 3–5 double-spaced pages, not including the title page and References section.
• Font: Times New Roman, 12 point.
• References: Cite at least three peer-reviewed scholarly journal articles or reliable primary sources from government or professional organization publications.
• Style: Format your paper according to APA style. Refer to Evidence and APA for guidance.

Note: Please review the Managing Quality Across Various Health Care Settings Scoring Guide before you begin the assessment.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 2: Explain health care management approaches in diverse health care settings.
  • Provide an introduction that identifies the main topics and relevant professional background, and a conclusion that reiterates the key operational indicators included in the session.
  • Describe the main topics of the lunch-and-learn session, including continuum of care, care quality, and operational approach.
  • Summarize peer-reviewed articles that separately discuss the continuum of patient care, care quality, and operational approach.
• Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others.
  • Write with minimal grammar, usage, spelling, and mechanical errors.
  • Apply proper APA formatting and citation style as required.
  • This is the Assessment 2
  • Managing Quality Across Various Health Care Settings
    Your Name School of Business, Technology, and Health Care Administration, Capella UniversityBHA-FPX4003: Present and Future State Developments within the United States Health Care SystemFacultyDate, YearTemplate Instructions (delete this page after reading)
    • Review the assessment scoring guide before you complete this template so that you understand the difference between “Distinguished,” “Proficient,” “Basic,” and “Non-Performance” grading levels.
    • The headings in the template below are designed to correspond to the scoring criteria. Please maintain these headings.
    • Please delete these instructions and all other instructions [contained in brackets] throughout the template prior to submitting this document for grading.

    Introduction[Provide here a personal introduction you’ll share with your team to open the lunch-and-learn session. To engage your audience, be creative as you imagine an appropriate background that makes sense for an administrative position like this one. You have license to combine your own experiences with others that you make up.]
    Agenda[Using bullet points, preview the main goals of today’s lunch-and-learn session.]Continuum of CareOverview[Describe where the physician’s practice and the hospital fall on the continuum of patient care.]
    Further Reading [Summarize a peer-reviewed article that discusses where the physician’s practice and the hospital fall on the continuum of patient care. Following this instruction are a template for the citation and further explanation to guide your summary. Note that the first line of the source citation is left-justified and the lines that follow, including the summary, are indented one tab over.][Author’s last name, First name initial. Middle initial. (Year of publication). Title of the article. Title of the Journal in Italics, volume number(Issue number), pages used. DOI number][Following your citation, summarize the main points of the article. Tab to move the first line over so this summary falls in line with the hanging indent. The entire page is double-spaced with no extra space after the paragraph. Your references will be in APA7 format with the hanging indent and in alphabetical order. Care QualityOverview[Describe how a physicians practice maximizes patient care quality to return them to the highest level of function, addressing quality standards such as maximizing value-based reimbursement, positive patient experience, and maintaining operational efficiency.]
    Further Reading [Summarize a peer-reviewed article that discusses how a physicians practice maximizes patient care quality to return them to the highest level of function. Following this instruction are a template for the citation and further explanation to guide your summary. Note that the first line of the source citation is left-justified and the lines that follow, including the summary, are indented one tab over.][Author’s last name, First name initial. Middle initial. (Year of publication). Title of the article. Title of the Journal in Italics, volume number(Issue number), pages used. DOI number][Following your citation, summarize the main points of the article. Tab to move the first line over so this summary falls in line with the hanging indent. The entire page is double-spaced with no extra space after the paragraph. Your references will be in APA7 format with the hanging indent and in alphabetical order.]Operational ApproachOverview[Describe how the physicians practice and the hospital system communicate to foster high-quality, efficient, and effective care.]
    Further Reading [Summarize a peer-reviewed article that discusses how a physicians practice and the hospital system communicate to foster high-quality, efficient, and effective care. Following this instruction are a template for the citation and further explanation to guide your summary. Note that the first line of the source citation is left-justified and the lines that follow, including the summary, are indented one tab over.][Author’s last name, First name initial. Middle initial. (Year of publication). Title of the article. Title of the Journal in Italics, volume number(Issue number), pages used. DOI number][Following your citation, summarize the main points of the article. Tab to move the first line over so this summary falls in line with the hanging indent. The entire page is double-spaced with no extra space after the paragraph. Your references will be in APA7 format with the hanging indent and in alphabetical order.]Conclusion[Recap the main themes of your lunch-and-learn session, reiterating the goals of the session and offering specific examples to demonstrate application of these ideas in everyday practice.]

    References[Lastname, C. (2018). Title of the source without caps except Proper Nouns or: First word aftercolon. The Journal or Publication Italicized and Capped, Vol#(Issue#), Page numbers.][Lastname, O. (2019). Online journal using DOI or digital object identifier. Main Online Journal Name, Vol#(Issue#), 159–192. doi: 10.1000/182][Lastname, W. (2021). If there is no DOI use the URL of the main website referenced. Article Without DOI Reference, Vol#(Issue#), 166–212. http://www.mainwebsite.org]
    [NOTE: The above references are SAMPLES ONLY. For more information and example related to references, visit Capella’s Writing Center. You are responsible for submitting appropriate in-text and reference page citations.]

  Managing Quality Across Various Health Care Settings Scoring Guide

  CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
  Provide an introduction that identifies the main topics and relevant professional background, and a conclusion that reiterates the key operational indicators included in the session.	Does not provide an introduction and conclusion that discuss the indicators included in the session.	Provides an introduction and conclusion that identify and recap the session topics.	Provides an introduction that identifies the main topics and relevant professional background, and a conclusion that reiterates the key operational indicators included in the session.	Provides an introduction that identifies the main topics and relevant professional background, and a conclusion that reiterates the key operational indicators included in the session, and offers specific examples to demonstrate application of these ideas in everyday practice.
  Describe the main topics of the lunch-and-learn session, including continuum of care, care quality, and operational approach.	Does not identify the main topics of the lunch-and-learn session, including continuum of care, care quality, and operational approach.	Identifies the main topics of the lunch-and-learn session, including continuum of care, care quality, and operational approach.	Describes the main topics of the lunch-and-learn session, including continuum of care, care quality, and operational approach.	Describe the main topics of the lunch-and-learn session, including continuum of care, care quality, and operational approach, and is supported by current scholarly or professional sources.
  Summarize peer-reviewed articles that separately discuss the continuum of patient care, care quality, and operational approach.	Does not identify peer-reviewed articles that separately discuss the continuum of patient care, care quality, and operational approach.	Identifies peer-reviewed articles that separately discuss the continuum of patient care, care quality, and operational approach.	Summarizes peer-reviewed articles that separately discuss the continuum of patient care, care quality, and operational approach.	Analyzes peer-reviewed articles that separately discuss the continuum of patient care, care quality, and operational approach, and draws conclusions based on information contained in at least two of the articles.
  Write with minimal grammar, usage, spelling, and mechanical errors.	Writes with many grammar, usage, spelling, and mechanical errors.	Writes with some grammar, usage, spelling, and mechanical errors.	Writes with minimal grammar, usage, spelling, and mechanical errors.	Writes with superior grammar, usage, spelling, and mechanics.
  Apply proper APA formatting and citation style as required.	Does not apply APA formatting and citation style.	Applies inconsistent APA formatting and citation style.	Applies proper APA formatting and citation style as required.	Applies flawless APA formatting and citation style.