Organizational & System Leadership. Health, Medicine, Nursing.

Organizational & System Leadership
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Organizational & System Leadership
Introduction
The Veterans Health Administration (VHA) focuses on the refinement of systems of quality measurement. The organizational structure of VHA for quality measurement occurs in three levels: the national level, the Associate Chief Medical Director for Quality Management, which focuses on leadership provision, setting of policies, furnishing measurement tools, development, and distribution of quality measures as well as delivery of educational programs. Then there is the intermediate level, where VHA operates four regional offices with the staff responsible for the review of risk management data, investigates the quality problems, alongside making sure the aspect of compliance with accreditation requirements. Then there’s the hospital level where the staff works directly to the chief of staff or the hospital director responsible for implementing the VHA quality management policy. The philosophy of the Veterans Health Administration concerning quality measurement identifies the level of morality required for the provision of America’s veterans in compliance with the accepted standards. The VHA integrates various techniques that focus on quality into a multifaceted improvement program that also entails the accreditation program alongside traditional quality assurance activities. Health Plan Employer Data and Information Set (HEDIS) represents one of the most widely applicable as well as thoroughly developed performance measurement framework (Weeks & West, 2019).
Βeta-Blocker Treatment after a Heart Attack
The Beta-Blocker measure focuses on reflecting the quality of services provided to patients suffering from heart failure and decreased left ventricular systolic function. This measure’s goal is to determine the nature and quality of follow-up care provided to patients suffering from acute myocardial infarction. The use of oral β-adrenergic blocking agents significantly reduces the mortality rate after acute myocardial infarction. The measure also decreases the risk of reinfection alongside stroke (Binswanger et al., 2019).
Data collection
The level of performance for the measure of the Beta-blocker treatment details the percentage of patients taken to hospital and afterward discharged alive during a specific period. This is done with the primary diagnosis of acute myocardial infarction and those qualified for an outpatient prescription for β-Blockers. To maintain high performance, the VHA ensures monitoring through adverse incident databases and undertaking patient satisfaction survey programs, alongside contraction of external peer review of 50,000 records annually (Binswanger et al., 2019).
Numerical Description of Measurement/Formula
This is measured by the use of denominator criteria applicable in the identification of the intended patient population.
The reliability of the measure towards schizophrenia patients was tested in a study conducted on 12 outpatient individuals presented with this condition. Although Schizophrenia patients exhibit low activity levels, there was a positive correlation between behavioral intentions and task self-efficacy through outcome expectancies. The research showed that the measure is effective in the prediction of positive behavior among schizophrenia patients.
Measurement Compared to like Settings
The principle suggests two kinds of mental simulation that can be distinguished as action planning and coping planning. The decisions that inform how, where, and when the desired action is taken comprise action planning. On the other hand, coping planning is steps taken in response to anticipated challenges to the adoption of desired behavior. Whereas the two kinds of planning are critical at the initiation stage for health behavior, coping is crucial at both the initiation stage and ensures that the desired behavior is maintained (Binswanger et al., 2019).
Finally, the phase-specific self-efficacy stage envisions self-efficacy as a required quality at every step of the change process. However, the nature of self-efficacy changes with the different stages. Therefore, the change agent must exercise discretion in creating a distinction between action, coping, and recovery self-efficacy.
Risk Adjusted Measurement
The measure easily predicts treatment change; however, the extent of its efficiency is dependent upon the individual behavior traits desired. Participants for this study were selected in line with the Canadian Physical Activity Guidelines; they ranged between the ages of 18 and 64. A discriminatory approach was used, whereby only outpatients with full privileges were selected for the study. In addition, patients hospitalized with other conditions like angina pectoris and myocardial infection were excluded from the study. Based on the findings of the study, there is a high level of reliability of predicting treatment intentions among Schizophrenia patients (Binswanger et al., 2019).
Measurement in an Aggressive Organization
The goal measurement within an aggressive organization is a system established to monitor clinical quality. The measurement provides VA with a strategy for obtaining measurement alongside benchmarking of healthcare quality alongside their efficiencies. The system enhances the process of identifying various quality improvement chances (Binswanger et al., 2019). The method entails a range of measures key to addressing the level of access to care, quality of healthcare provided, and the level of efficiency.
Ambulatory Follow-up after Hospitalization for Mental Illness
The ability to access ambulatory care services provides a key driver for the results amongst Medicare beneficiaries that leaves the emergency department. Such Ambulatory follow-up care is a necessity, especially after discharge from the emergency department (ED). The rate of follow-up care, especially after the release from the emergency department, helps in improving results. This is since the acute problem that prompts emergency department visits is easily placed into check, therefore optimizing chronic disease management. For instance, the aspect of using health insurance help improve accessibility to follow-up care. However, there is a high probability that it does not eliminate various barriers to care.
The Federal agencies and the national societies approve the application of timely follow-up care, especially following the Emergency Department discharge, as one of the indicators of quality of care (Hunter, et al., 2018).
Collection of Data
The data is collected from prior research on different clinically meaningful categories related to outcomes after ED visits. The information is easily retrieved from the Medicare inpatient alongside outpatient files (Hunter, et al., 2018).
Measurement Compared to like Settings
The healthcare institutions are identified as safety-net hospitals, depending on their positioning at the disproportionate share percentage. The rest of the classification are considered as the non-safety net. The hospital comparisons of overall star rating alongside the patient proportion provide a high percentage on the Hospital Consumer Assessment of Healthcare Providers and systems patient experience survey (Hunter, et al., 2018).
Risk Adjusted Measurement
The main point of interest is in the number of days taken for the ambulatory follow-up to be provided, especially after the emergency department discharge. The daily event rates calculation focuses on 30 days focusing on ambulatory follow-up visits from the claims file categorized in accordance with service codes (Hunter et al., 2018).
The aspect of inconsistent rates of ambulatory follow-up after discharge from the emergency department provides a good opportunity for improving the level of care. In this case, the older age, alongside the burden that comes with chronic diseases Medicare beneficiaries related to other emergency department patients, poses a high risk immediately after discharge. The various vulnerable subgroup is subjected to longer periods of follow-ups. The indication of low mortality rates amongst those subject to ambulatory follow-ups is a clear indication of how follow-up care is essential to reducing danger a...