HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes

HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes – Step-by-Step Guide

The first step before starting to write the HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded, in sentence sentence care. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

Instructions for HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes

Explain variance and its common causes in patient care process and outcomes, including costs. Analyze the effects of linking quality improvement measures to payment structures. Discuss the effect that various payment structures have on quality outcomes. Check this HQS 610 Topic 4 Assignment: The Importance Of Public Reporting.

Example 1 Approach to HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes

The patient care process should be uniform, while patient outcomes should be predictable, as Hardiker et al. (2019) support, because nursing interventions may be similar for the same illnesses. The patient care process has essential steps that include collecting patient data, assessing it to pinpoint problems and set objectives, developing a care plan, implementing it, and monitoring it. Patient outcomes vary from mortality, hospital readmissions, and clinical response to total recovery.

Nursing interventions are developed with different medical scenarios and intended outcomes in the mind of a nurse; thus, they are projected to combat the illness effectively. However, correct intervention does not always lead to the desired effect (Fernandez et al. 2019). In addition, patients experience different patient care processes that directly affect patient outcomes. This discussion will explain the variance, its causes in the patient care process and outcomes, and how payment structures affect quality outcomes.

Variance in healthcare denotes a result contrary to the expected result. It is evident in care coordination, care evaluation, and utilization review. This variation could be a common cause occurring throughout the healthcare process or a special cause occurring as an effect of causes outside the established healthcare process, as the Current HAI Progress Report (2021) shows.

Special cause variation is mostly patient variance; for instance, the patient refuses to eat and suffers from pressure ulcers. Such patients will have their care process adjusted to incorporate the developed ulcers. At the same time, the outcome will be different from the expected scenario as it will be delayed, and additional observations are expected due to the ulcer medication. The healthcare professional’s ignorance or facility directive causes common-cause variation, as both are in charge of the patient care process and outcomes.

Husaini and Maddox (2020) list healthcare costs as one of the major causes of variance in the patient care process and outcomes. Higher costs do not necessarily mean quality patient care processes and outcomes. However, higher costs in healthcare can limit access to quality patient care for those patients who cannot afford it. Healthcare costs, staff skills, emergency patients’ time of admission, and patients’ immediate symptoms are causes of natural variation because they are inevitable features of healthcare systems.

Artificial variation is derived from how the healthcare system is set up and run. The causes are how health services are scheduled, staff working hours, how healthcare professionals classify urgent and priority cases, and the order in which patients are treated. Therefore, variance in patient care process and outcome would be noticeable in hospital processes and procedures, patient symptoms, and types of equipment used.

According to Husaini and Maddox (2020), linking quality improvement measures to payment structures leads to the higher quality of care becoming the basis of the payment system. The higher the quality of the care package, the higher the payment for the service will be. This approach to healthcare has resulted in a value-based purchasing program upon which reimbursements can be enacted, as Siemienczuk (2018) explains.

The result is improved patient healthcare and better patient outcomes because healthcare facilities are in business and offering patient care. Healthcare facilities are continuously acquiring professional nurses with distinguished expertise and offering attractive wages to hire talent in the race towards competitive, quality patient care.

As the Centers for Medicare and Medicaid Services (2019) shows, various payment structures affect quality outcomes differently. Pay for performance payment structure emphasizes outcomes of care, but its administrative work is burdensome and hence could ignore patient care in the process. The patient care process is holistic from admission to discharge, not just the care outcome. A retainer-based payment structure increases the revenue per patient, therefore benefiting physicians.

However, patients who cannot afford the fixed care costs forego their preferred services for cheaper options that might not satisfy their health needs. The bundled payment structure ensures better patient outcomes by bringing together multiple caregivers because they are paid as a group. Moreover, the patient care process is streamlined from one point of action and is prompt and planned. Consequently, the patient is denied the opportunity to seek services from physicians they would have preferred.

In almost all patient care processes and outcomes, variance is evident because healthcare systems are not failure-proof, nor are patients fully collaborative. Therefore, common cause variations will always be there in healthcare. Payment structures are forever changing with changing socioeconomic dynamics; thus, they cannot be considered a constant in determining variance in the patient care process and outcome. Healthcare systems and patients’ ability to pay for health care should continuously undergo audits for informed decisions on patient care. Whichever payment structure guarantees better patient outcomes should be considered because different hospital settings will demand different payment structures for quality improvement.

References

Centers for Medicare and Medicaid Services (CMS) (2019). HCAHPS: Patients’ Perspectives of Care Survey. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS

Current, H. A. I. progress report| HAI| CDC, 2021. Healthcare-Associated Infections (HAIs): Current HAI Progress Report. https://www.cdc.gov/hai/data/portal/progress-report.html

Fernandez, M. E., Ten Hoor, G. A., Van Lieshout, S., Rodriguez, S. A., Beidas, R. S., Parcel, G., Robert, A. C., Markham, M. C., & Kok, G. (2019). Implementation mapping: Using intervention mapping to develop implementation strategies. Frontiers in public health, 7, 158. https://doi.org/10.3389/fpubh.2019.00158

Hardiker, N. R., Dowding, D., Dykes, P. C., & Sermeus, W. (2019). Reinterpreting the nursing record for an electronic context. International journal of medical informatics, 127, 120-126. https://doi.org/10.1016/j.ijmedinf.2019.04.021

Husaini, M., & Maddox, K. E. J. (2020). Paying for Performance Improvement in Quality and Outcomes of Cardiovascular Care: Challenges and Prospects. Methodist DeBakey cardiovascular journal, 16(3), 225. https://doi.org/10.14797/mdcj-16-3-225

Siemienczuk (2018). Ready or Not, Quality-Based Reimbursement Is Here. https://lopes.idm.oclc.org

Example 2 Approach to HQS 610 Topic 4 DQ 2 Explain variance and its common causes in patient care process and outcomes

Managing variance is crucial to quality improvement. Quality improvement is largely affected by two types of variance – common-cause variance and special-cause variance. Common-cause variation is random variation present in stable healthcare processes (Bowen & Neuhauser, 2013). Special-cause variation is an unpredictable deviation resulting from a cause that is not an intrinsic part of a process (Bowen & Neuhauser, 2013). Variation in a process is normal and expected. Over a given period, it is essentially unavoidable. The tactic to manage variation depends on the main concern and perspectives of the QI leadership and the intended generalizability of the results of the improvement effort.

Unnecessary clinical variation leads to increased costs, as seen in many surgical procedures and the encompassing episodes of care (Ardoin & Malone, 2019). Factors that influence and raise costs include the use of unnecessary preoperative testing, physician preference decisions that increase implant costs or extend operating-room time, and a lack of standardized postoperative care that leads to prolonged lengths of stay and inappropriate use of post-acute resources (Ardoin & Malone, 2019). Failure to standardize the coordination of care can also lead to unnecessary ER visits and hospital readmissions. Due to cost related issues like the ones mentioned above a there have been a few payments linked to quality programs like:

·      The Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions (CMS, 2023).

·      The Hospital Value-Based Purchasing (VBP) Program adjusts hospitals’ payments based on their performance on 4 domains that reflect hospital quality: (1) the clinical outcomes domain, (2) the person and community engagement domain, (3) the safety domain, and (4) the efficiency and cost reduction domain (CMS, 2023).

·      The Hospital-Acquired Condition (HAC) Reduction Program is a Medicare value-based purchasing program that reduces payments to hospitals based on how they perform on measures of hospital-acquired conditions (CMS, 2023).

·      The Comprehensive Care for Joint Replacement (CJR) model encourages physicians, hospitals, and post-acute care providers to work together to improve quality of care for patients undergoing hip and knee replacement inpatient surgeries (CMS, 2023).

I personally think that linking payment methods for quality outcomes is a good concept. These methods ensure that hospitals and clinics start to focus on delivering quality care rather than just care. The effect of these are mostly positive because it ensures better care and safety for patients. Of course, these can sometimes limit what providers can do without approval from insurance, delaying care and increasing length of stay. But overall if we compare these there are more good effects than bad.

References

Ardoin, D., & Malone, J. (2019). Reducing Clinical Variation to Drive Success in Value-Based Care (Part 1). Healthcare Financial Management Association, https://www.hfma.org/operations-management/care-process-redesign/reducing-clinical-variation-to-drive-success-in-value-based-care0/.

Bowen, M., & Neuhauser, D. (2013). Understanding and managing variation: three different perspectives. Implementation Science, 8 (Suppl 1), S1. https://doi.org/10.1186/1748-5908-8-S1-S1.

CMS. (2023). Linking quality to payment. Retrieved from Data.CMS.gov: https://data.cms.gov/provider-data/topics/hospitals/linking-quality-to-payment#comprehensive-cjr-model