When the patient receives her Explanation of Benefits from her insurance company, she realizes the MRI was not pre-certified correctly. Now she owes a large portion of the bill because the physician did not try other means, such as physical therapy, prior to receiving a costly MRI.
Access Medicare’s Hospital Compare website and complete the following steps:
Locate the Find a Hospital box.
Enter the ZIP Code and hospital name provided by your faculty member.
Select search.
Review the category tabs (e.g., General Information) at the top of the hospital’s profile to complete this assignment.
Complete the chart on the Using Data to Address Quality Measures worksheet using the data from Hospital Compare.
You are provided with 3 categories relevant to the scenario. If you would like to identify an additional measure(s) and data from Hospital Compare that relate to the scenario, please use the blank line item in the table or add another row(s).
Note: An example of how to pull data has been provided for you to review.
350- to 700-word that analyzes the measures that have an influence on the facility in the scenario.
Include the following in
Explain the measures and corresponding data listed in the table.
Provide the data table listing the measures and corresponding data points within the presentation.
Analyze 2 sources, in addition to Hospital Compare, that you would use to find public information on facilities regarding the measures presented in the scenario.
Select 1 measure from the data table and analyze how the quality of this measure could affect the facility in the scenario.
Cite 3 peer-reviewed or similar references to support your presentation on the references slide.
Format your assignment according to APA guidelines.
HCS/493 v1
HCS/493 v1
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Using Data to Address Quality Measures worksheet
Read the following scenario:
The patient is a 40-year-old female who presents to the emergency department for low back pain. The pain has been happening for 2 weeks and no injury has been noted. The patient has no history of previous low back pain. The emergency department immediately orders an MRI of the lumbar spine for low back pain. The patient waits in her room in the emergency department for 2 hours without anyone checking on her. She is finally told that the in-house MRI is down for maintenance, so they schedule her appointment for another day. The patient is at the emergency department for more than 280 minutes from arrival to discharge.
Later, the patient goes to her appointment for her MRI at the radiology department. She has to register and provide all the same information that she has already given at the clinic regarding her history and other pertinent information. The patient’s appointment was scheduled for 1 p.m., and at 1:45 p.m., and she still has not been called back. No one has updated her regarding the delay. Finally, the patient is taken back for her test at 2 p.m. and is not given any explanation for the delay except that they are short staffed. The patient is not happy about her experience at the radiology department.
The patient receives her Explanation of Benefits from her insurance and realizes that the test was not pre-certified correctly. Now she owes a large portion of the bill because the physician did not try other means, such as physical therapy, prior to receiving a costly MRI.
Access the Hospital Compare website and complete the following steps:
Locate the Find a hospital box.
Enter the zip code and hospital name provided by your faculty member.
Select search.
Review the category tabs (e.g., General Information) at the top of the hospital’s profile to complete this assignment.
Complete the chart below using the data from Hospital Compare.
You are provided with three categories relevant to the scenario. If you would like to identify additional measure(s) and data from Hospital Compare that relate to the scenario, please use the blank line item in the table or add another row(s).
Note: An example of how to pull data has been provided for you to review.
Data Table
|
Category From Scenario |
List the Measure Used to Represent the Category |
Statistic for Hospital Measure |
Statistic for State Measure |
Statistic for National Measure |
|
Use of Medical Imaging |
||||
|
Timely and Effective Care |
||||
|
Patient Satisfaction: Communication from Nurses |
Write a 350- to 700-word paper that analyzes the measures that have an effect on the facility in the scenario. Include the following in your paper:
Explain the measures and corresponding data listed in the table.
Provide the data table listing the measures and corresponding data points within the presentation.
Analyze two sources, in addition to Hospital Compare, that you would use to find public information on facilities regarding the measures presented in the scenario.
Select one measure from the data table and analyze how the quality of this measure could affect the facility in the scenario.
Cite 3 peer-reviewed, scholarly, or similar references to support your presentation on the references slide.
Format your assignment according to APA guidelines.
Submit your assignment.
