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NURS FPX 6004 Assessment 1 Dashboard Benchmark Evaluation EZ

Dashboard Benchmark Evaluation 

Mercy Medical Center (MMC) is among the top-ranked hospital in Minnesota. In this task, the dashboard metrics of Mercy Medical Center (MCC), will be compared with the national benchmarks to check the performance of the MCC in terms of quality of care being provided to the patients. on analyzing the metrics, further performances of the hospital will be analyzed. The challenges will also be identified to understand the cause of underperformance. And lastly, while outlining the strategies to overcome the underperformances, ethical considerations toward key stakeholders will also be formulated to provide better health services to patients that are not only reliable, and safe but also cost-effective. 

Evaluation of Dashboard Metrics Associated with Benchmark 

On analyzing the metrics of MCC, it can be seen that people from various races have visited the healthcare facility. Most dominantly, 63% of the white population visited the hospital, followed by American Indians around 13%, then 3% of the African American population also visited the hospital, and lastly, then 2% accounts for other races. Similarly in the last quarter of 2020, patients of every age visited the hospital. On examining the eye exam, foot exam, and HgbA1c tests, the decline in tests being conducted can be seen among HgbA1c tests and foot exams. In 2019, Q1 60-foot exams while 60 A1c exams were conducted as compared to 2020 Q1 tests standing at 75-foot exams and 72A1c tests. In 2019 Q2, 50-foot exams were conducted and 28 A1c exams while in 2020 Q2 the dashboard represents the 50-foot exams conducted and 52 A1c tests. In 2019 Q3, the data stands at 42-foot exams and 60 A1c exams while in 2020 Q3, the ratio is seen as 48 eye exams and 78 A1c exams. In the last quarter of 2019, 42-foot exams and 42 A1c exams were performed while in the last quarter of 2020, the data stands at 62-foot exams and 64 A1c exams respectively. On quarterly bases, the number of eye examinations has stayed comparatively constant in 2018 and 2019. But the decline in tests being conducted can significantly be seen in Hgba1c tests and foot exams. Eye exams, foot exams, and A1c exams are strongly linked with diabetes. And on analyzing these metrics with diabetes. These tests are important for diagnosing diabetes in patients. A1c exams are conducted to check the levels of sugar in the body for the past 2 to 3 months. An eye exam is conducted to check for the dilation of pupils. While the foot exam is conducted to check the circulation of blood in the foot along with the sensitivity of nerves (Albright and Fleishcer, 2021). Similarly, the benchmarking criteria outlined by the AHRQ for diabetes is following.

NURS FPX 6004 Assessment 1 Dashboard Benchmark Evaluation EZ

  1. A1c tests for checking the glucose levels, 
  2. Dilated eyes exam, and 
  3. Foot examination for possible sores or nerve damage (AHRQ, 2022)

On comparing these national benchmarks, it can be observed that MMC is unable to achieve the national benchmarks of foot exams and A1c testing. Following these national benchmarks can help in diagnosing diabetes in the early stages helping in managing the disease along with minimizing the prevalence of T2D. As diabetes is one of the most prevalent diseases that has affected people globally. It is considered a growing epidemic as 1 in every 10 people is considered diabetic while 1 in every 5 people are unaware of their diabetic condition. Around 1.4 million new diabetic cases were detected in 2019. All ethnic and racial minority populations, particularly Black teens, had a surge of new instances of diabetes millets in people between the ages of 10 to 19 (CDC, 2022). This causes an alarming situation and conducting these tests will help in diagnosing diabetes at early stages resulting in better health management and better self-care before the conditions lead to complexities and in severe cases to amputations or a condition that can be fatal (Graz et al., 2018). 

Challenges Meeting Prescribed Benchmarks 

Benchmarking is a phrase that relates to a standard or practice that can be followed to evaluate and compare. It serves as a benchmark against which an assessment could be conducted. Benchmarking is used in healthcare to enhance effectiveness, the standard of healthcare, clinical outcomes, and patient satisfaction. Examining guidelines, practices, and evidence-based processes, as well as finding key areas for improvement, is a component of the method. Individual goals may be set for employees to help them achieve a departmental or corporate goal. Whenever new procedures are established, the administration must choose how to monitor performance in order to evaluate whether the benchmark criteria are being met (Rana et al., 2018). 

On comparing these national benchmarks, it can be observed that MMC is unable to achieve the national benchmarks of foot exams and A1c testing. The majority of the nurses at MMC are white nurses. According to CDC, a high ratio of diabetes is found to be among black, Hispanic, and Latinos. And according to the dashboard, American Indians and African Americans are the second and third highest rates of ethnicities who visit MMC. This difference in the socioeconomic factor can be seen as a challenge. It can be seen as a challenge because the highest ratio of the white population is reported in Shakopee. Whereas other races including black, African, and Hispanic make up 43% of the population of the area. If there is no diversity in the nursing staff, there may be cultural, language, and ethnic barriers (AHRQ, 2022). For effective communication and overcoming language barriers, nurses from different races and ethnicities should be on board. Irrespective of the healthcare setting or specialization, communication is found to be the most crucial feature of care delivery and a crucial part of a nurse’s professional conduct (Ali & Watson, 2018). The largest challenges to providing appropriate, ethical, effective, and timely treatment to individuals with inadequate speaking proficiency have been recognized as linguistic impediments. The hiring of trained nurses in this scenario is regarded as useful.

 Another strategy healthcare facilities can implement is the use of technologies that can do the translations of different languages. This way, the nursing staff will be able to communicate to the patient regarding their condition and the patient can effectively communicate in detail regarding their symptoms or the problems they are facing.  

NURS FPX 6004 Assessment 1 Dashboard Benchmark Evaluation EZ

Underperformance of Benchmark 

Assessing the dashboard metrics based on quarterly MCC and comparing it with the national benchmarks for diabetes outlined by AHQR showed some underperforming areas. The decline in the performance of HgbA1c tests is evident in comparing 2018 to 2019. . Non-compliance to this benchmark can cause a higher number of diabetes cases to remain undiagnosed. As in the initial stages, diabetes does not show any symptoms that can signal the development of T2D. But on checking the levels of A1c, a diagnosis of pre-diabetes can be made (Lam & Lee, 2021). The challenge of compliance with A1c testing can be seen regarding the diversity of the nurses on board. In case of non-compliance, a higher number of late diagnoses of diabetes will occur in the hospital increased the number of hospital stays and readmission not only causing work strain on healthcare providers but the strain of financial costs on patients as well. It will also impact the ranking of the MMC in Minnesota. According to AHRQ reports, the occurrence of diabetes is high along with cardiovascular and renal issues. As the most common comorbidities linked to diabetes are heart problems and kidney failures (AHQR, 2020). According to CDC, Adult diabetes patients had hypertension in sixty-nine percent of cases and excessive cholesterol in forty-four percent of cases. Thirty-nine percent had severe kidney illness, and twelve percent had impaired vision or loss of sight. To overcome the health disparities and health inequity, Affordable Care Act (ACA), also provide healthcare coverage to people irrespective of their race, ethnicity, and sex as long as they follow the requirements of receiving Medicaid or Medicare. They provide health insurance for people who do not have one as the medical tests would cause a financial burden on people. using Medicare, people can get their HgbA1c tests to check for signs of pre-diabetes. A diabetes scan remains undiagnosed for a very long because it does not show any early signs. This policy will help in conducting tests for people and diagnosing diabetes among people in its early stages before leading to complications. As it will not only help patients with their healthcare costs but will also lead to better self-management along with less burden on the healthcare sector (Present et al., 2019). 

To increase the frequency of HgbA1c tests in MCC, partnering with the stakeholders can also be fruitful. Effective communication and knowledge regarding the problem will help in overcoming socioeconomic problems. Interprofessional collaboration in the healthcare facility can aid in A1c compliance. It will also help in identifying the reasons for the underperformance of a healthcare facility that can be managed and effectively solved through interprofessional collaboration. Policies imposed by local and federal administrations will also help with following the benchmarks along with overcoming the financial problem or lack of resources. Political measures can be concentrated on all levels with collaborative policy creation in a range of techniques, all of which will include a mechanism for formulating and compliance with applicable laws, or procedures, as well as task allocation for their implementation (Bong, 2019). 

The strategy to follow the compliance will need the cooperation of stakeholders, hiring nurses from the minority groups, implementation of local and national policies, and involving interprofessional collaboration in the healthcare facility. This can help in overcoming the underperformance and detecting pre-diabetes among the patients before the condition leads to complications. Early detection will help in managing diabetes effectively, nurses must also communicate with the patient to increase their knowledge and awareness regarding diabetes. It will help in limiting the healthcare costs for the patient along with minimizing the prevalence of diabetes in Minnesota. 

NURS FPX 6004 Assessment 1 Dashboard Benchmark Evaluation EZ

Ethical Action Directed Towards Stakeholders 

The underperformance of MCC can be overcome with the help of the stakeholders. Therefore, it is important to have effective communication among all the stakeholders involved. This will help in identifying and overcoming the barriers at present in the community. Interdisciplinary or interprofessional collaboration is also essential because as reported in this case, there has been low diversity of nurses on board. It can cause communication barriers with the patient. Having effective communication with the patient is essential in the diagnosis and treatment of the patient. This can primarily be achieved when the administration of the healthcare facility imposes policies to adapt communication as a culture of the facility among the healthcare providers and with the patient. Healthcare providers are more likely to engage in effective communication when leaders or nurse managers set a good example and make it a priority in the healthcare facility (Arruda-Colli et al., 2018). Patient surveys can also be detected to gain insight regarding the progress of strategies implemented for effective communication. Patient surveys aid in identifying the causes of grievances, inquiries, or concerns (Ward, 2018). They can also highlight the positive aspects of the team’s performance. Applying these strategies will help in quality care, patients will be well-aware of their condition, the tests will be conducted in time, A1c compliance will also be followed, and the patient will be able to adhere to their management and treatment plan. It follows the ethical aspects of dignity and respect. The respect and dignity of patients are kept in mind through this approach (McDermott-Levy et al., 2018). It will help the cases of complications and will lead to better self-management. As diabetes is the 5th leading cause of death in the US therefore effective management of this disease should be taken as a top priority (Funnell et al., 2018).

Lastly, the hospital facility must implement ethical guidelines and principles that will help the patient former nursing staff, healthcare practitioners, and stakeholders to abide by the ethical principles.

Conclusion

 Mercy Medical Centre is a well-renowned hospital in Minnesota. On analyzing the dashboard metrics, a decline in foot examinations and HgbA1c tests was seen. These tests are important for the diabetes diagnosis as is outlined in national benchmarks for diabetes by AHQR. In order to overcome these performances involvement of stakeholders can help in overcoming the social-economic issues that hospitals may be facing leading to the underperformance. It will help in the diagnosis of diabetes in the early stage and effective management before leading to diabetic complications.

References 

AHRQ. (2022). National Diabetes Benchmarks Detail. https://nhqrnet.ahrq.gov/inhqrdr/National/benchmark/table/Diseases_and_Conditions/Diabetes#:~:text=NationalDiabetes%20Quality%20Measures%20Compared,depending%20on%20the%20desired%20outcome

AHRQ. (2020). Improving Diabetes Care Quality. Ahrq.gov. https://www.ahrq.gov/data/monahrq/myqi/diabetes.html 

NURS FPX 6004 Assessment 1 Dashboard Benchmark Evaluation EZ

Agency for Healthcare Research and Quality.(2020). NHQDR Data Tools | AHRQ Data Tools. Ahrq.gov. https://datatools.ahrq.gov/nhqdr 

Albright, R. H., & Fleischer, A. E. (2021). Association of select preventative services and hospitalization in people with diabetes. Journal of Diabetes and its Complications35(5), 107903. https://doi.org/10.1016/j.jdiacomp.2021.107903  

Ali, P. A., & Watson, R. (2018). Language barriers and their impact on provision of care to patients with limited English proficiency: Nurses’ perspectives. Journal of clinical nursing27(5-6), e1152-e1160. https://doi.org/10.1111/jocn.14204

Arruda-Colli, M. N. F. D., Sansom-Daly, U., Santos, M. A. D., & Wiener, L. (2018). Considerations for the cross-cultural adaptation of an advance care planning guide for youth with cancer. Clinical practice in pediatric psychology6(4), 341.  https://doi.org/10.1037/cpp0000254 

Bong, H. E. (2019). Understanding moral distress: How to decrease turnover rates of new graduate pediatric nurses. Pediatric Nursing45(3), 109-114. https://www.mghpcs.org/MunnCenter/Documents/weekly/nov-21/Understanding-Moral-Distress-Decrease-turnover-rates.pdf 

Centres for Disease Control and Prevention. (2022, 4 January 24). The facts, the stats, and impacts of diabetes. Centers for Disease Control and Prevention.  https://www.cdc.gov/diabetes/library/spotlights/diabetes-facts-stats.html#:~:text=37.3%20million%20Americans%E2%80%94about%201,t%20know%20they%20have%20it

Funnell, G., Naicker, K., Chang, J., Hill, N., & Kayyali, R. (2018). A cross-sectional survey investigating women’s information sources, behaviour, expectations, knowledge and level of satisfaction on advice received about diet and supplements before and during pregnancy. BMC pregnancy and childbirth18(1), 1-10. https://doi.org/10.1186/s12884-018-1834-x 

NURS FPX 6004 Assessment 1 Dashboard Benchmark Evaluation EZ

Graz, H., D’Souza, V. K., Alderson, D. E., & Graz, M. (2018). Diabetes-related amputations create considerable public health burden in the UK. Diabetes research and clinical practice135, 158-165. https://doi.org/10.1016/j.diabres.2017.10.030

Lam, K., & Lee, S. J. (2021). Prediabetes—A risk factor twice removed. JAMA Internal Medicine181(4), 520-521. https://doi.org/0.1001/jamainternmed.2020.8773/

McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of global health nursing practice. Nursing Outlook66(5), 473-481. https://doi.org/10.1016/j.outlook.2018.06.013 

Present, M. A., Nathan, A. G., Ham, S. A., Sargis, R. M., Quinn, M. T., Huang, E. S., & Laiteerapong, N. (2019). The impact of the affordable care act Medicaid expansion on type 2 diabetes diagnosis and treatment: a national survey of physicians. Journal of community health44(3), 463-472. https://doi.org/10.1007/s10900-019-00637-6 

Rana, J. S., Karter, A. J., Liu, J. Y., Moffet, H. H., & Jaffe, M. G. (2018). Improved cardiovascular risk factors control associated with a large-scale population management program among diabetes patients. The American Journal of Medicine131(6), 661-668. https://doi.org/10.1016/j.amjmed.2018.01.024 

Ward, P. (2018). Trust and communication in a doctor-patient relationship: a literature review. Arch Med3(3), 36. https://doi.org/10.4172/2472-1654.100146 

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