Discussion: Applying Measurement Tools
One example of a measurement tool is the Healthcare Effectiveness Data and Information Set (HEDIS) comprehensive care measures. Review the components of HEDIS comprehensive diabetes care; then consider the following scenario.
You are a staff nurse working in a private primary care practice. It is a small practice with 2 MDs (internists), 2 nurses, 1 medical assistant, and an office staff for billing. There are approximately 1,000 patients in the practice. You have had no EHR until the last year, but all charts are manual, historically. Your physicians are starting to inquire about quality incentives, particularly regarding patients with diabetes.
Take on the role of the staff nurse in the scenario and post an explanation of how you would go about finding out how many diabetics are in your practice and how many meet all components of HEDIS comprehensive diabetes care.
Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level.
This should be a 3-paragraph (at least 450 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).
*HEDIS tool attached
Expert Solution Preview
Introduction:
Measurement tools are essential to evaluating and improving the quality of healthcare services. In this discussion, we will focus on one such tool, the Healthcare Effectiveness Data and Information Set (HEDIS) comprehensive care measures. We will explore how to utilize HEDIS to evaluate diabetes care in a private primary care practice.
Answer:
As a staff nurse in a private primary care practice, I would start by reviewing all patient charts and identifying those with a diabetes diagnosis. I would then calculate the percentage of diabetic patients in the practice by dividing the number of patients with diabetes by the total number of patients in the practice. Next, I would utilize the HEDIS comprehensive diabetes care measures to assess the care provided to diabetic patients.
HEDIS comprehensive diabetes care includes eight measures that evaluate different aspects of diabetes care, including hemoglobin A1c testing, eye exams, blood pressure management, and cholesterol control. To determine how many patients in the practice meet all components of HEDIS comprehensive diabetes care, I would need to review each patient’s chart and determine whether they received each necessary service, as outlined in the HEDIS measures.
To ensure that all patients are receiving the appropriate diabetes care, I would recommend implementing an electronic health record (EHR) system in the practice, which would enable us to better track patients’ care and provide more efficient care. The adoption of an EHR system would enable us to more easily identify patients needing care and measure performance against HEDIS measures.
Conclusion:
HEDIS comprehensive diabetes care is an essential tool that can be used to evaluate the quality of diabetes care delivered in a private primary care practice. By identifying diabetic patients and measuring their care against HEDIS measures, we can gain insight into areas where the practice is performing well and areas where improvement is needed. Utilizing an EHR system can help identify patients that require more care and help measure performance against HEDIS measures.
