Capella University Quality Assurance and Risk Management Discussion Questions

This unit explores the issue of accountability, or who is responsible for defining, measuring, and reporting on quality measures. There is a formal process that expects accountability across the health care continuum. You will explore the current best practices and trends from an internal and external focus.

Use the Measuring Health Care text to read the following: 

Chapter 5, “Promoting Accountability through Measurements,” pages 94–114. This chapter looks at who is accountable and how in measuring and reporting health care quality. While measuring of outcomes and processes is wonderful, someone or a department needs to be tasked with the responsibility for this ongoing effort.

  • Chapter 6, “The Rationale for External Drivers,” pages 115–134. There are many external drivers that also drive health care quality. Quality is not an internal method sitting in isolation. This chapter looks at who the external stakeholders are and the important role that these organizations provide to health care.

1. Determining Accountability-Read the information below and provide in a 250-300 word post, outline your plan of what needs to happen. Be sure to highlight who is accountable for each step of your plan. Your plan should have a minimum of five steps. What is your role in the PDCA plan designed by the CEO? Is the role appropriate? Who is most accountable – the CEO or the DON? How do you follow the PDCA model while moving swiftly on this issue? 

You are the owner and CEO of group homes that serve those with mental impairments. Each group home services six to ten adult residents. Your group homes are located in neighborhoods throughout the community. The group homes are staffed with caregivers who have been trained as Certified Nurse Assistants (CNAs) or Home Health Aides (HHAs). You have a Director of Nursing (DON), an RN, who is responsible for writing the medical care plans and ensuring the needed medications and treatments are provided for each resident. The medications are given by the caregiver staff of each building.

  • The DON has come to meet with you. The DON reports that the medications at one facility are not being given on time, and some appear to be missing. The DON is particularly concerned about pain medications for one resident with rheumatoid arthritis. This client has been experiencing more pain symptoms and seems to be in tears often in the later day due to pain. The DON is concerned that this resident’s pills have actually been stolen.
  • 2. Media Messages

The media carries messages rapidly across all areas of the nation. The media has been successful at uncovering fraud, discovering specific health issues, and disseminating helpful information. The media also may create challenges for health care managers faced with different crises and situations. Health care managers must be aware of the impact the media may have on their own organization.

You are the administrator of a local nursing home. During the evening shift, one of the cognitively impaired residents eloped (escaped from the facility). This resident was found several miles from the facility six hours later huddled in a ditch, cold, and dirty. You have spent most of the night dealing with the staff involved, the resident’s family, and local law enforcement. As you turn toward your office door at 8 a.m., a reporter is waiting for your statement.

In a 250- to 300-word response, develop your “media release” statement. Carefully word this piece recognizing that you want to continue to present your facility in a favorable light in the community and do not wish to pinpoint (in the media) who the accountable staff may be.  Respond to the media release as a patient advocate. Does the media release provide a balanced response to the incident? Is the public’s right to know balanced by the rights of privacy for the patient? Is there a feeling that the facility responded correctly?

Expert Solution Preview

In this unit, we are discussing accountability in the healthcare industry and how it relates to measuring and reporting on quality measures. We will explore the role of internal and external stakeholders in promoting accountability and improving healthcare quality. Two key readings from the “Measuring Health Care” text have provided us with insights into these topics.

1. Determining Accountability:
As the owner and CEO of group homes that serve individuals with mental impairments, my role is to ensure accountability in the administration of medications and the overall care of residents. To address the issue of missing and improperly administered medications, the following plan outlines the necessary steps and the accountability for each:

Step 1: Investigation and Documentation
– The Director of Nursing (DON) will conduct a thorough investigation to determine the extent of the issue and gather documented evidence.
– The DON is accountable for conducting the investigation and compiling all relevant information.

Step 2: Review and Analysis
– The DON and I will review the collected information to identify patterns and potential causes of the medication errors.
– Both the DON and I are accountable for reviewing and analyzing the data.

Step 3: Implement Corrective Measures
– Based on the review and analysis, the DON will develop a plan to address the medication administration issues, including additional training, revised protocols, or staff reassignment.
– The DON is primarily accountable for implementing corrective measures, but I will oversee and support the implementation.

Step 4: Monitoring and Evaluation
– Regular monitoring and evaluation will be conducted to ensure the effectiveness of the implemented measures.
– The DON, caregivers, and I all share accountability for monitoring and evaluating the medication administration practices.

Step 5: Feedback and Continuous Improvement
– Feedback will be provided to caregivers regarding their performance and adherence to the revised protocols.
– The DON and I are accountable for providing feedback and initiating continuous improvement processes.

Regarding my role in the PDCA (Plan-Do-Check-Act) model designed by the CEO, it is appropriate as the CEO to oversee the entire process and ensure that accountability is upheld at every stage. However, in this specific scenario, the role of the DON is more accountable for the day-to-day operations, investigation, analysis, and implementation of corrective measures.

2. Media Messages:
As the administrator of a local nursing home, drafting a media release statement after a resident eloped requires careful consideration of presenting the facility in a favorable light while respecting the privacy of staff involved. The statement should also balance the public’s right to know with the patient’s right to privacy. Here is an example of a media release statement:

“We deeply regret the incident involving one of our residents who eloped from our facility during the evening shift. The safety and welfare of our residents are our utmost priorities, and we take this matter very seriously. Upon becoming aware of the situation, we promptly initiated a comprehensive search, involving local law enforcement, to ensure the resident’s safe return.

Our dedicated staff followed established protocols and prioritized the well-being of the resident throughout the process. We are grateful for the swift action and collaboration of the staff, the resident’s family, and the local authorities, which led to the resident being found and brought back to the facility.

At this time, we are conducting an internal review to identify any areas for improvement and implement additional safeguards. We remain committed to delivering compassionate and quality care to all our residents. Patient privacy is of the utmost importance to us, and we will continue to protect their confidentiality while addressing this incident.

We appreciate the community’s support during this challenging time and will provide further updates as appropriate.”

This media release statement seeks to strike a balance between acknowledging the incident, demonstrating accountability, and safeguarding patient privacy. It conveys a commitment to addressing the issue, improving practices, and ensuring the community’s confidence in the facility’s ongoing care.

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