Reolyyy.

RANDAH ZAFAR

Discussion 14

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Introduction

Hospital readmissions are a significant challenge in the healthcare system, leading to increased costs, patient distress, and suboptimal care outcomes. Quality improvement science offers a structured approach to address this issue, guiding the design and implementation of targeted interventions to reduce readmission rates. This research paper will explore the importance of reducing hospital readmissions, the application of quality improvement methodologies, and a case study of a quality improvement project in the emergency room setting (Smeraglio et al., 2019).

Importance of Reducing Hospital Readmissions

Hospital readmissions have significant implications for patients, healthcare systems, and broader societal costs. Unplanned readmissions can reflect poor quality of care, ineffective transition to home, and underlying risk factors that contribute to a patient’s deteriorating health. Estimates suggest that the annual cost of hospital readmissions in the United States exceeds $26 billion, underscoring the financial burden on the healthcare system. (Alkhaldi & Alouani, 2018) . Moreover, reading is associated with diminished quality of life and poorer health outcomes for patients.

Quality Improvement Approach to Reducing Readmissions

Healthcare quality improvement science provides a systematic framework to guide the development, testing, and evaluation of interventions aimed at reducing hospital readmissions. This approach involves the use of data-driven, iterative processes to identify root causes, design targeted solutions, and monitor the impact of changes over time. (Cavanaugh et al., 2014) Quality improvement methodologies, such as Plan-Do-Study-Act cycles, can be leveraged to test and refine interventions in a real-world setting, ensuring that solutions are tailored to the specific needs and context of the healthcare organization.

Emergency Department Quality Improvement Project

One example of a quality improvement project focused on reducing hospital readmissions is a program implemented in the emergency department setting. This project involved the development of a multidisciplinary follow-up program for individuals at high risk of hospital remission. The project team, which included primary care providers, emergency department staff, and care coordinators, worked collaboratively to identify patients at risk, coordinate post-discharge care, and provide ongoing support to ensure a smooth transition to the community.

The purpose of this quality improvement initiative was to improve care coordination, enhance patient engagement, and ultimately reduce the rate of unplanned hospital readmissions. By implementing a structured program that addressed the complex needs of high-risk patients, the healthcare organization aimed to improve outcomes across the organization, including reduced costs, improved quality of care, and enhanced patient satisfaction.(Cavanaugh et al., 2014).

The key to the success of this project was the engagement of a multidisciplinary team, including primary care providers, emergency department staff, care coordinators, and other relevant stakeholders. This collaborative approach ensured that the intervention addressed the diverse needs of patients and leveraged the expertise of various healthcare professionals.

Conclusion

Reducing hospital readmissions is a critical priority in healthcare, as it aligns with the goals of improving patient outcomes, enhancing the quality of care, and managing healthcare costs. Quality improvement science provides a robust framework for designing, implementing, and evaluating interventions to address this challenge. The case study of the emergency department quality improvement project illustrates the potential of this approach, highlighting the importance of a multidisciplinary team, data-driven decision-making, and a focus on continuous improvement (Furterer, 2018).

Overall, the quality improvement project in the emergency department setting demonstrates how healthcare organizations can leverage quality improvement methodologies to address the complex issue of hospital readmissions.

References

Alkhaldi, F., & Alouani, A. (2018). Systemic Design Approach to a Real-Time Healthcare Monitoring System: Reducing Unplanned Hospital Readmissions †. Sensors, 18(8), Article 8. https://doi.org/10.3390/s18082531

Cavanaugh, J. J., Jones, C. D., Embree, G., Tsai, K., Miller, T., Shilliday, B. B., McGuirt, B., Roche, R., Pignone, M., DeWalt, D. A., & Ratner, S. (2014). Implementation Science Workshop: Primary Care-Based Multidisciplinary Readmission Prevention Program. Journal of General Internal Medicine, 29(5), 798–804. https://doi.org/10.1007/s11606-014-2819-8

Furterer, S. L. (2018). Applying Lean Six Sigma methods to reduce length of stay in a hospital’s emergency department. Quality Engineering, 30(3), 389–404. https://doi.org/10.1080/08982112.2018.1464657

Smeraglio, A., Heidenreich, P. A., Krishnan, G., Hopkins, J., Chen, J., & Shieh, L. (2019). Patient vs provider perspectives of 30-day hospital readmissions. BMJ Open Quality, 8(1). https://doi.org/10.1136/bmjoq-2017-000264

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RAHAF ALAHMADI

Role of quality improvement in Hospital readmission Rates

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Hospital readmissions are a significant concern in healthcare, impacting patient outcomes and healthcare costs. Quality improvement initiatives play a crucial role in reducing these readmissions by enhancing care delivery and improving patient outcomes across healthcare settings (Nash, 2019).

Importance of Reducing Hospital Readmissions

Reducing hospital readmissions is critical to improving patient outcomes, optimizing healthcare resource utilization, and minimizing costs. Frequent readmissions often indicate inadequate post-discharge care leading to increased patient suffering and healthcare system strain. Lowering readmission rates enhances patient satisfaction, reduces the financial burden on both hospitals and patients and aligns with value-based care principles. Additionally, reduced readmissions contribute to public health goals by ensuring continuity of care and better management of chronic conditions (Cram et al., 2022).

Healthcare Quality Improvement Science in Reducing Readmissions

Healthcare quality improvement science employs data-driven strategies to identify the root causes of readmissions and implement evidence-based interventions. QI teams can test small-scale changes, measure outcomes, and refine processes. Lean methodology and Six Sigma techniques can help streamline workflows, reduce errors, and improve care transitions. For example, ensuring comprehensive discharge planning, patient education, and follow-up care are proven QI approaches that reduce preventable readmissions. Engaging multidisciplinary teams ensures a complete view of care processes and fosters collaboration for sustainable improvements (Panju-Merali, 2022).

Example of a Quality Improvement Project

A quality improvement project aimed at reducing emergency room readmissions might focus on improving care transitions for patients with congestive heart failure. The project could involve developing a standardized discharge checklist, including medication reconciliation, scheduling follow-up appointments before discharge, and providing education on management. Additionally, assigning case managers to follow up with patients within 48 hours post-discharge could significantly reduce readmissions. Such a project addresses the critical points of care continuity and empowers patients to manage their conditions effectively (Panju-Merali, 2022).

Teams Needed for the Project

The project would require a multidisciplinary team, including ER physicians, nurses, case managers, social workers, pharmacists, and quality improvement specialists. ER physicians and nurses ensure clinical accuracy and effective discharge practices, while case managers and social workers address social determinants of health and facilitate follow-up care. Pharmacists provide medication counseling and reconciliation, ensuring adherence and minimizing adverse effects. Quality improvement specialists design, monitor, and evaluate the project’s progress using data analytics. Collaboration among these team members ensures a comprehensive and effective approach to reducing readmissions (Levoy et al., 2022).

Purpose and Outcomes of the Quality Initiative

The purpose of the initiative is to reduce preventable readmissions through enhanced care transitions and patient engagement. Additionally, the project aims to enhance interdisciplinary collaboration and foster a culture of continuous quality improvement. Organization-wide benefits include cost savings, compliance with quality standards, and improved performance on key healthcare metrics. These outcomes not only improve individual patient experiences but also strengthen the hospital’s reputation and long-term sustainability (Levoy et al., 2022).

Conclusion

Reducing hospital readmissions through effective quality improvement projects improves patient care, optimizes resources, and fosters a culture of continuous improvement, leading to better health outcomes and financial sustainability for healthcare organizations.

References

Cram, P., Wachter, R. M., & Landon, B. E. (2022). Readmission Reduction as a Hospital Quality Measure. JAMA, 328(16), 1589. https://doi.org/10.1001/jama.2022.18305

Levoy, K., Rivera, E., McHugh, M., Hanlon, A., Hirschman, K. B., & Naylor, M. D. (2022). Caregiver Engagement Enhances Outcomes Among Randomized Control Trials of Transitional Care Interventions. Medical Care, 60(7), 519–529. https://doi.org/10.1097/mlr.0000000000001728

Nash, D. (2019). The Healthcare Quality Book: Vision, Strategy, and Tools, Fourth Edition (Aupha/Hap Book) (4th ed.). Health Administration Press.

Panju-Merali, R. (2022). A Quality Improvement Initiative to Redefine Nurse-Led Discharge Interventions in a Skilled Nursing Facility (SNF) on All-Cause 30-Day Re-admission Rates Using the Re-Engineered Discharge (RED) Program. Doctor of Nursing Practice Projects, 2(2). https://hsrc.himmelfarb.gwu.edu/son_dnp/113/

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MARAM ALBIJALI

Module 14- Discussion Hcm-550

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Selected SDG: Goal 3: Good Health and Well-being

Goal 3 aims to ensure healthy lives and promote well-being for all at all ages. This goal is particularly relevant to vulnerable populations, such as low-income communities, refugees, and people living in conflict zones, who often face significant barriers to accessing healthcare (United Nations, 2015).

Identified Vulnerable Population: Refugees

Refugees are a vulnerable population that often faces numerous health challenges due to displacement, limited access to healthcare services, and exposure to infectious diseases.

Policy Impacting SDG 3: Universal Health Coverage (UHC)

Universal Health Coverage (UHC) is a policy that aims to ensure that all individuals and communities receive the health services they need without suffering financial hardship. UHC is crucial for refugees, as it can provide them with access to essential health services, including preventive care, treatment, and rehabilitation (World Health Organization, 2018).

Relevance to Vulnerable Population

UHC is particularly relevant to refugees because it addresses the barriers they face in accessing healthcare. By providing comprehensive health coverage, UHC can help improve the health outcomes of refugees and ensure that they receive the care they need to lead healthy lives (Tangcharoensathien et al., 2018).

Embedding Course Material Concepts, Principles, and Theories

To support this analysis, we can refer to the principles of social justice and health equity, which emphasize the importance of providing equal access to healthcare for all individuals, regardless of their socioeconomic status or background (Buse & Hawkes, 2015). Additionally, the concept of health in all policies (HiAP) can be applied, which advocates for integrating health considerations into all sectors of policy-making to address the social determinants of health.

Scholarly, Peer-Reviewed Journal Article

One relevant article is “Health in the sustainable development goals: ready for a paradigm shift?” by Kent Buse and Sarah Hawkes, published in Globalization and Health. This article discusses the importance of addressing the social determinants of health and promoting health equity through the SDGs.

References

Tangcharoensathien, V., Mills, A., Das, M. B., Patcharanarumol, W., & Buntan, M. (2018). Addressing the health of vulnerable populations: social inclusion and universal health coverage. Journal of Global Health, 8(2), 020304. https://doi.org/10.7189/jogh.08.020304

United Nations. (2015). Transforming our world: The 2030 Agenda for Sustainable Development. Retrieved from https://sustainabledevelopment.un.org/post2015/tra…

World Health Organization. (2018). Universal health coverage (UHC). Retrieved from https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)

Buse, K., & Hawkes, S. (2015). Health in the sustainable development goals: ready for a paradigm shift? Globalization and Health, 11(1), 13. https://doi.org/10.1186/s12992-015-0098-8

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MARWA ALSAEEDرد للطالبة الثانية

SDG 3: Good Health and Wellbeing

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SDG 3: Good Health and Wellbeing

Amidst the seventeen Sustainable Development Goals (SDGs), SDG 3, emphasizing Good Health and Wellbeing, stands out as a pivotal player, offering a significant opportunity to enhance global health, as highlighted by the UN (2023). This overarching goal comprises a comprehensive framework with thirteen targets and twenty-eight indicators, primarily aiming to ensure healthy lifestyles and promote well-being for people of all ages. SDG 3 addresses concerns related to maternal and child mortality, combatting infectious and non-communicable diseases, environmental health, road safety hazards, universal healthcare, mental health, and drug misuse treatment (Siegel et al., 2021). Gopalan (2023) notes that the complex network of objectives and indicators within Sustainable Development Goal 3 outlines a comprehensive strategy for addressing various health issues, fostering a society where everyone can enjoy good health.

In pursuit of the SDG 3 objective, the focus narrows down to the most vulnerable members of society, particularly those residing in Low- and Middle-Income Countries (LMICs), especially in South Asia and sub-Saharan Africa. These regions bear the heaviest burden of diseases, and accessing quality healthcare is challenging for numerous reasons. The majority of the world’s maternal fatalities (94%), deaths of children under five (89%), and deaths caused by HIV/AIDS (70%) occurred in LMICs since 2019, emphasizing the critical health challenges faced by these populations (UN, 2023). Moreover, LMICs are disproportionately impacted by emerging issues such as climate change, the spread of COVID-19, and antibiotic resistance.

The Global Financing Facility (GFF), established in 2015 as a collaborative initiative, is a significant policy influencing SDG 3. Gopalan (2023) emphasizes that the GFF focuses on improving nutrition and overall health for women, children, and adolescents in LMICs. Operating on a results-based philosophy, the GFF strategically mobilizes and synchronizes internal and external resources to enhance health outcomes, strengthen health systems, and promote a long-term strategy for health treatments. The 36 countries receiving GFF funding account for 60% of global maternal and infant deaths and 67% of all unmet family planning needs (Siegel et al., 2021). The GFF, through its targeted efforts, becomes a crucial instrument in advancing the global implementation of SDG 3’s objectives.

The relevance of SDG 3 to the vulnerable population in LMICs is underscored by its comprehensive approach that addresses both the causes and effects of poor health and well-being. Achieving SDG 3 would enable LMICs to reduce avoidable deaths and disabilities, enhance productivity and quality of life, and create more resilient and equitable societies (Siegel et al., 2021). Additionally, SDG 3 is intricately linked to other SDGs, such as poverty eradication, hunger elimination, improved education, gender equality promotion, clean water and sanitation accessibility, economic growth, decent work, and climate change combat. Consequently, achieving SDG 3 aligns with the broader objectives of the 2030 Agenda for Sustainable Development, bringing us closer to the overarching vision outlined by Gopalan (2023).

References

Gopalan, A. (2023). Editorial: Toward 2030: Sustainable Development Goal 3: Good health and wellbeing. An educational perspective. Frontiers in Education, 7. https://doi.org/10.3389/feduc.2022.1106590

Siegel, R., Gordon, K., & Dynan, L. (2021). Behavioral Economics: A Primer and Applications to the UN Sustainable Development Goal of Good Health and Well-Being. Reports, 4(2), 16. https://doi.org/10.3390/reports4020016

United Nations. (UN). (2023). Sustainable Development Goals: 17 Goals to Transform our World. https://www.un.org/en/exhibits/page/sdgs-17-goals-…

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REEM ALSHAMMARI

Financial Condition Analysis

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Financial Condition Analysis

Introduction

Understanding the financial condition of a healthcare organization is vital for effective management and strategic decision-making. Financial analysis serves as a critical tool in assessing an organization’s performance, stability, and overall health. By employing various financial ratios, healthcare managers can gain valuable insights into key aspects such as liquidity, profitability, and leverage. This analysis not only helps in identifying areas for improvement but also supports the organization in navigating the complexities of the healthcare environment. In this discussion, we will explore several important financial ratios, their benefits, and their potential limitations, providing a comprehensive overview of how these metrics can inform management practices in healthcare (Ekmeil& Abumandilm, 2020).

Understanding the financial condition of a healthcare organization is crucial for effective management and strategic planning. Among the various tools available for financial analysis, certain ratios stand out as particularly valuable for assessing a healthcare company’s financial health. These ratios include the current ratio, debt-to-equity ratio, operating margin, and days cash on hand. Each of these ratios provides unique insights into different aspects of financial performance, allowing managers to make informed decisions that can enhance operational efficiency and sustainability (Holmberg & Andersen, 2020).

The current ratio, calculated by dividing current assets by current liabilities, is a key indicator of a healthcare organization’s liquidity. It measures the ability to meet short-term obligations with available short-term assets. A higher current ratio suggests that the organization is in a favorable position to cover its immediate liabilities, which is essential in the fast-paced healthcare environment where cash flow can be unpredictable. However, this ratio has its limitations; it does not account for the quality of the assets involved. For example, if a significant portion of current assets is tied up in inventory or accounts receivable, it may not accurately reflect the organization’s true liquidity position. (World Health Organization 2020).

Another important ratio is the debt-to-equity ratio, which indicates the proportion of debt financing relative to equity financing. This ratio is crucial for understanding the financial leverage of a healthcare organization. A lower debt-to-equity ratio suggests a more conservative approach to financing, which can be beneficial in minimizing risk, especially in an industry characterized by fluctuating revenues. However, this ratio can also be misleading if not considered in context; it does not address the organization’s ability to generate enough cash flow to service its debt. Thus, while it provides insight into the financial structure, it should be interpreted alongside cash flow metrics (Ekmeil, & Abumandilm ,2020).

The operating margin, calculated by dividing operating income by total revenue, offers a direct measure of the organization’s operational efficiency. It reflects the proportion of revenue that remains after covering operating expenses, thereby providing a clear picture of profitability from core activities. A higher operating margin indicates effective cost management and revenue generation, which are vital for sustaining operations in healthcare. However, one limitation of this ratio is that it excludes non-operating income and expenses, which can skew the overall profitability picture. Additionally, operating margins can be volatile in the healthcare sector due to changes in patient volume and reimbursement rates. (World Health Organization.2020).

Lastly, days cash on hand measures the number of days a healthcare organization can continue to operate using only its available cash reserves. This ratio is particularly important for assessing liquidity and financial resilience. A higher number of days suggests that the organization is better positioned to weather financial challenges or unexpected expenses. However, the limitation of this metric is its short-term focus; while it provides insight into immediate liquidity, it does not reflect the overall financial health or long-term sustainability of the organization. Furthermore, organizations with high daily operating expenses may find that even a reasonable amount of cash reserves does not offer adequate liquidity (Holmberg & Andersen, 2020).

Summary

In summary, the analysis of financial condition through key ratios like the current ratio, debt-to-equity ratio, operating margin, and days cash on hand is essential for effectively managing healthcare organizations. Each ratio offers distinct advantages, such as insights into liquidity, financial leverage, operational efficiency, and cash reserves, which are critical for informed decision-making. However, it is equally important to recognize their limitations, as factors like the quality of assets, cash flow capabilities, and industry context can influence their interpretation. By utilizing a combination of these financial ratios and understanding their implications, healthcare managers can develop strategies to enhance organizational performance, improve financial stability, and ultimately deliver better patient care. A thorough financial analysis not only aids in the current assessment but also prepares healthcare organizations for future challenges in a rapidly evolving industry.

References:

Ekmeil, F. A. R., & Abumandil, M. S. (2020). The Effect Of Market Structure And Financial Ratios On Financial Performance In Palestinian Private Hospitals During Coronavirus Disease, Covid-(19). European Journal of Molecular & Clinical Medicine, 7(06), 2020.

https://www.researchgate.net/profile/Mohanad-Abuma…

Holmberg, M. J., & Andersen, L. W. (2020). Estimating risk ratios and risk differences: alternatives to odds ratios. Jama, 324(11), 1098-1099.

https://jamanetwork.com/journals/jama/article-abst…

World Health Organization. (2020). Programme Budget Performance Assessment: 2018–2019 (No. SEA/RC73/5). World Health Organization. Regional Office for South-East Asia.

https://iris.who.int/bitstream/handle/10665/334057…

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RAWAN BAJUNAID

MODULE 14 DISCUSSION

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Financial Analysis Conditions

Finances are the foundation of any organization’s existing decision-making and future investments from external stakeholders. Therefore, to identify the organization’s financial strength, financial analysis is developed using several valuable ratios. Each ratio uniquely identifies the organization’s strengths and weaknesses. To analyze the economic stability and performance of the healthcare facility, the following ratios help manage the analysis (Gapenski, 2015).

Current Ratios

The current ratio in any financial analysis is responsible for effectively identifying the organization’s ability to pay its short-term liabilities. This includes analyzing the liquidity of the organization’s finances, which indicates how effectively an organization can have the capital to pay its short-term liabilities. The benefit of choosing this ratio is the identification of financial liquidity. On the other hand, the limitation might include the insignificant analysis of the quality of the assets within any organization (Tricco et al., 2020).

Debt to Equity Ratio

This ratio includes the division of the company’s total liabilities but the total stakeholder’s equity expected from the organization. On the other hand, it is the analysis of the regularity of the debt-to-equity mechanism of any organization. The lower value of this ratio indicates stability in the organization’s financial structure. Using this ratio can be effective for the healthcare facility to attract new investors and manage higher debt-to-equity ratios for further stability (Tricco et al., 2020)

Return on Equity

Using this ratio within any healthcare organization or any other financial analysis can help the organization find the equity paid to the stakeholders on the net income generated. It is the ratio identified by dividing the company’s net income by the stakeholder’s equity paid. A higher value of this ratio indicates better equity returns and identifies a significant growth in any company’s net income of any company. Using this ratio for the health facility can present the organization’s overall profitability after paying all the debts. This manages an attractive asset provided for the company. However, this ratio can be specific to a single organization or industry and can be used for comparison purposes (Panigrahi, 2021).

Return on Assets

This is another applicable financial ratio that can be used to identify the investment approach within any organization. Overall, this ratio determines the overall profitability generated by the organization by developing different long and short-term assets. It is the measure of a company’s effective investment strategy and asset management that helps it create profits. A healthcare facility uses this ratio significantly to identify the individual earnings from each invested asset. It can create a compelling asset profile for the organization that the investors can use to manage future asset development. The only limitation to using this ratio is its high chances of manipulation as only a single organization uses it, and it cannot be used across the sector or industry to provide a comparative analysis (Panigrahi, 2021),

References

Gapenski, L. (2015, March 1). Understanding Healthcare Financial Management, Seventh Edition (Aupha/Hap Book) (7th ed.). Health Administration Press.

Panigrahi, Cma. ) A. (2021, October 11). Financial Analysis by Return on Equity (ROE) and Return on Asset (ROA) – A Comparative Study of HUL and ITC. Papers.ssrn.com. https://papers.ssrn.com/sol3/papers.cfm?abstract_i…

Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K., Colquhoun, H., Kastner, M., Levac, D., Ng, C., Sharpe, J. P., Wilson, K., Kenny, M., Warren, R., Wilson, C., Stelfox, H. T., & Straus, S. E. (2020). A scoping review on the conduct and reporting of scoping reviews. BMC Medical Research Methodology, 16(1), 1–10.