NHS-FPX6004 – Health Care Law and Policy – Assessment 1

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.In the era of health care reform, many of the laws and policies set by government at the local, state, and federal levels have specific performance benchmarks related to care delivery outcomes that organizations must achieve. It is critical for organizational success that the interprofessional care team is able to understand reports and dashboards that display the metrics related to performance and compliance benchmarks.Maintaining standards and promoting quality in modern health care are crucial, not only for the care of patients, but also for the continuing success and financial viability of health care organizations. In the era of health care reform, health care leaders must understand what quality care entails and how quality in health care connects to the standards set by relevant federal, state, and local laws and policies. An understanding of relevant benchmarks that result from these laws and policies, and how they relate to quality care and regulatory standards, is also vitally important.Health care is a dynamic, complex, and heavily regulated industry. For this reason, you will be expected to constantly scan the external environment for emerging laws, new regulations, and changing industry standards. You may discover that as new policies are enacted into law, ambiguity in interpretation of various facets of the law may occur. Sometimes, new laws conflict with preexisting laws and regulations, or unexpected implementation issues arise, which may warrant further clarification from lawmakers. Adding partisan politics and social media to the mix can further complicate understanding of the process and buy in from stakeholders.How many health care laws can you name that affect your practice in your current or future workplace? How do they impact your daily work? How many regulatory agencies oversee the types of services your health care organization provides? Which regulatory agencies apply to your workplace setting? Are you familiar with the process of complying with those agencies in order to maintain certification? You might be overwhelmed as you consider these broad questions.

Demonstration of Proficiency

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

• Competency 1: Analyze the effects of health care policies, laws, and regulations on organizations, interprofessional teams, and personal practice.
  • Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization or an interprofessional team.
• Competency 3: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.
  • Advocate for ethical action in addressing a benchmark underperformance, directed toward an appropriate group of stakeholders.
• Competency 4: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, for health care policies and law for patients, organizations, and populations.
  • Evaluate dashboard metrics with regard to benchmarks set by local, state, or federal health care policies or laws.
  • Evaluate a benchmark underperformance in a heath care organization or an interprofessional team that has the potential for greatly improving overall quality or performance.
• Competency 6: Apply various methods of communicating with policy makers, stakeholders, colleagues, and patients to ensure that communication in a given situation is professional, clear, efficient, and effective.
  • Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically, with correct use of grammar, punctuation, and spelling.
  • Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.

Preparation

For this assessment, you may choose one of the following three options for a performance dashboard to use as the basis for your benchmark evaluation.

Option 1: Dashboard and Health Care Benchmark Evaluation Simulation

You may use the data presented in the Dashboard and Health Care Benchmark Evaluation media piece as the basis for your assessment submission.If you decide to use the simulation dashboard for your evaluation, review the dashboard, as well as relevant local, state, and federal laws and policies. Consider the metrics within the dashboard that are falling short of the prescribed benchmarks.

Option 2: Actual Dashboard From a Professional Practice Setting

If you choose an actual dashboard from a professional practice setting for your evaluation, be sure to add a brief description of the organization and setting that includes:

• The size of the facility that the dashboard is reporting on.
• The specific type of care delivery.
• The population diversity and ethnicity demographics.
• The socioeconomic level of the population served by the organization.

Note: Ensure that your data is Health Insurance Portability and Accountability Act (HIPAA) compliant. Do not use any easily identifiable organization or patient information.

Option 3: Hypothetical Dashboard Based on a Professional Practice Setting

If you have a sophisticated understanding of dashboards that are relevant to your own practice, you may also construct a hypothetical dashboard for your evaluation, based on that setting. Your hypothetical dashboard must present at least four different metrics, at least two of which must be underperforming the relevant benchmark set forth by a federal, state, or local laws or policies. In addition, be sure to add a brief description of the organization and setting that includes:

• The size of the facility that the dashboard is reporting on.
• The specific type of care delivery.
• The population diversity and ethnicity demographics.
• The socioeconomic level of the population served by the organization.

Note: Ensure that your data is HIPAA compliant. Do not use any easily identifiable organization or patient information.

Instructions

Structure your report in such a way that it would be easy for a colleague or supervisor to locate the information they need. Be sure to cite relevant local, state, or federal health care laws or policies when evaluating metric performance against prescribed benchmarks. Cite an additional 2–4 credible sources to support your analysis and evaluation of the challenges in meeting the benchmarks, the potential for performance improvement, and your advocacy for ethical action.You may wish to review the Dashboard Benchmark Evaluation Example [DOC] for additional support in planning and developing your submission for this assessment.Note: The tasks outlined below correspond to grading criteria in the scoring guide.In your report, be sure to:

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• Evaluate dashboard metrics against the benchmarks set by local, state, or federal health care laws or policies.
  • Which metrics are below the mandated benchmarks in the organization? Evaluate weaknesses within the entire set of benchmarks.
  • What are the local, state, or federal health care laws or policies that set these benchmarks?
• Analyze challenges that meeting prescribed benchmarks can pose for the organization or for an interprofessional team.
  • What are the specific challenges or opportunities that the organization or interprofessional team might have in meeting the benchmarks? For example, consider:
    • The strategic direction of the organization.
    • The organization’s mission.
    • Available resources:
      • Staffing.
      • Operational and capital funding.
      • Physical space.
      • Support services (any ancillary department that supports a specific care unit in the organization, such as a pharmacy, cleaning services, and dietary services).
    • Cultural diversity in the organization.
    • Cultural diversity in the community.
    • Organizational processes and procedures.
  • How might these challenges be contributing to benchmark underperformance?
• Evaluate a benchmark underperformance in the organization or interprofessional team that has the potential for greatly improving overall quality or performance.
  • Which metric is underperforming its benchmark by the greatest degree?
  • Which benchmark underperformance is the most widespread throughout the organization or interprofessional team?
  • Which benchmark affects the greatest number of patients?
  • Which benchmark affects the greatest number of staff?
  • How does this underperformance affect the community the organization serves?
  • Where is the greatest opportunity for improvement in the overall quality or performance of the organization or interpersonal team—and ultimately in patient outcomes?
• Advocate for ethical action in addressing the benchmark underperformance that has the potential for greatly improving overall quality or performance.
  • At which group of stakeholders should your advocacy be directed? Which group could be expected to take the appropriate action to improve the benchmark metric?
  • What are some ethical actions that the stakeholder group could take that support improved benchmark performance?
  • Why should the stakeholder group take action?
• Communicate your findings and recommendations in a professional and effective manner.
  • Ensure that your report is well organized and easy to read.
  • Write clearly and logically, using correct grammar, punctuation, and mechanics.
• Integrate relevant sources to support your arguments, correctly formatting source citations and references using current APA style.
  • Did you cite relevant local, state, or federal health care laws or policies when discussing the mandated benchmarks?
  • Did you cite an additional 2–4 credible sources to support your analysis, evaluation, and advocacy?

Additional Requirements

• Structure: Include a reference page.
• Length: 2–5 pages should be sufficient for presenting a thorough and concise evaluation, not including any pages for presenting your data and your reference page.
• References: Cite 2-4 current scholarly or professional resources.
• Format: Use APA style for references and citations.
  • You may wish to refer to the following APA resources to help with your structure, formatting, and style:
    • APA Style and Format.
    • APA Paper Tutorial.
    • APA Paper Template.
• Font: Times New Roman font, 12 point, double-spaced for narrative portions only.