Health Assignment 3

Assignment 3: Health Information Technology (HIT) System Project Report (25 points)
For this assignment, students will examine a set of national healthcare performance measures, focus on querying a national dataset to obtain and analyze data originating from health databases, and generate a HIT report of findings. Students will access data reported to the National Committee for Quality Assurance (NCQA) and found in the Centers for Medicare and Medicaid Services (CMS) research databases, the Chronic Conditions Data Warehouse (CCW). The CCW supports chronic conditions, health policy analysis, and other CMS initiatives.

Students will access the CMS Mapping Medicare Disparities (MMD) dataset and search for data to answer a query or question that is utilized to request information from a database or dataset. Students will use spreadsheet skills and design visual graphs/charts to compare, interpret, and integrate findings into a scholarly analytical HIT report recommending improved outcomes and further queries. See the course module for resources on the CMS MMD tool as well as tutorials for creating Excel spreadsheets and charts.

Assignment Criteria:
For the HIT Report, address the following dataset query from your workplace:
1. Query: Using the latest year’s available data, is there a difference in the prevalence of heart failure for selected populations (White, Black, Hispanic, Asian/Pacific Islander, American Indian/Alaskan Native, and Other) for Florida’s Medicare recipients compared with the national prevalence of heart failure for these six populations of Medicare recipients?

2. Search the CMS MMD dataset by following these steps. You will conduct six searches for data by only changing the race/ethnic parameters (White, Black, Hispanic, Asian/Pacific Islander, American Indian/Alaskan Native, and Other).
Data from each search will be presented in a downloadable spreadsheet showing data for all states and the comparison to the nation. You will locate in the dataset the record (a row in the spreadsheet table) for Florida and then move across the row to find the comparison prevalence data for the nation.
Getting started:
a. Visit the CMS Medicare Mapping Disparities page (see Modules/Week 7)
b. Choose the Population tab at top. From the Get Started box, select “GO” to begin your first search of the dataset.
c. From the drop-down boxes which are dataset fields, choose the following parameters. Note that the comparison group is the nation and the national parameters in the search must match those set for the state.

Dataset Fields: Search Parameters

Year: most recent single year of data available at the time you complete this assignment
Geography: State Territory
Measure: Prevalence
Adjustment: Unsmoothed Actual
Analysis: Difference from National Average
Domain: Primary Chronic Conditions
Condition: Heart Failure

Sex: All
Age: All
Race and Ethnicity: White (and then change this population to
Black, Hispanic, Asian/Pacific Islander, American
Indian/Alaskan Native, and Other)
Dual Eligible: Medicare Only
Medicare Eligible: All

Comparison Sex: All
Comparison Age: All
Comparison Race and Ethnicity: White (and then change this population to
Black, Hispanic, Asian/Pacific Islander, American
Indian/Alaskan Native, and Other)
Comparison Dual Eligible: Medicare Only
Comparison Medicare Eligibility: All

3. Extract the relevant data from each of the spreadsheets and construct one spreadsheet using MS Excel. Present the raw prevalence data (White, Black, Hispanic, Asian/Pacific Islander, American Indian/Alaskan Native, and Other ) in a table format with headers and formulas to determine and show the differences in state and national prevalence and averages. See the course module for an example of a final spreadsheet.
4. Transform the data from the spreadsheet and create two charts: an Excel line chart and a bar chart using the spreadsheet’s raw data table. Utilize color to showcase the findings. Review the literature to determine whether a line or bar chart is appropriate for presenting prevalence data. Cite a source to support your choice of chart.
5. Generate the HIT Report document that will include your analyses, a copy of your Excel spreadsheet and one preferred selected chart. For your analyses include the following:
a. Intro to the paper and brief overview of heart failure prevalence in the United States as a population health problem. Cite sources.
b. Answer the dataset query by reporting a summary of findings from the Excel table and selected chart. Your selection of a chart should present the data most clearly and be best practice for showing prevalence data. Cite sources. Include the table and selected chart within the text or as appendices per APA 7th edition format.
c. Analyze the table and your chart for trends and presence of health disparities among the races/ethnicities. Cite sources.
d. As the DNP leading this report, propose one additional source of data to be collected and tracked in the EHR. Generate a new dataset query question that includes this additional source of data. Cite sources.
e. Propose one specific evidence-based recommendation/strategy to the workplace that could improve health outcomes for Florida’s Medicare heart failure patients (choose one specific race/ethnicity, gender, or age). The recommendation should be supported by evidence from the current literature. Cite one or more sources.
e. End the paper with a brief conclusion explaining the relevance of using HIT databases/datasets such as the CMS MMD to generate information and knowledge for clinical practice. Cite a source.
6. The scholarly paper should be in narrative format, 5 to 6 pages excluding the title and reference pages.
7. Include an introductory paragraph with a purpose statement and a conclusion.
8. Utilize level 1 and 2 headings to organize the paper.
9. Write the paper in third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To clarify: “I, we, you, me, and our” may not be used. In addition, describing yourself as the researcher or the author should not be used.
10. Include a minimum of five professional peer-reviewed scholarly journal references to support the paper (review in Ulrich Periodical Directory) and be less than five (5) years old. Cite the CMS MMD dataset as a reference and to support tables/charts.
11. APA7th edition format required (attention to spelling/grammar, a title page, direct quotes, a reference page, table/chart formatting, and in-text citations).
12. Submit the assignment to Turnitin prior to the final submission, review the originality report, and make any needed changes.
13. Submit by the posted due date.

Health Week 6
Discussion Board Posting (3 points):
From the course readings, think about the use of social media and mobile devices in the healthcare workplace.
• Analyze and explain the use and purpose(s) of mobile health tools and social media by healthcare professionals in your current or past workplace.
• Assess a current social media and/or email policy in current or past practice. Review the ANAs Code of Ethics and the ANA Guidelines for Social Media (see Modules/Week 6)
• Identify how the workforce policy supports ethical and professional nursing practice.
• Explain one successful interprofessional strategy the DNP could propose to ensure patient privacy and ethical professional practice by healthcare team using social media and mobile devices by healthcare team members. Support with one or more best practices and the current literature.

Health Assignment 2: Workflow Diagram and Report (27 points)
As the Doctor of Nursing practice (DNP) prepared nurse in a leadership role in a work setting, you are asked to conduct an evaluation of system usability post implementation of a new system and generate a summary report for use by the Nursing Informatics Specialist and the interprofessional team.

In the workflow redesign process (see readings in the textbook), the DNP-prepared nurse will visually map the sequence of tasks, events, and interactions that make up a work process so that a process can be analyzed, improved, or changed. For example, with implementation of an electronic medical record (EMR), the nurses’ documentation for patient education will change from paper to electronic. An informatics nurse, with input from the DNP-prepared nurse, will develop and analyze clinical workflows to help (for example) in designing screens or inputs that match how nurses most efficiently/effectively provide care or document nursing care and patient education in the EMR.

As another example, an administrator might request the DNP to diagram the current steps in admitting patients to the emergency department as a way of determining if the process can be improved/changed. In addition, a DNP nurse educator might develop a workflow diagram as a written handout to outline the steps in teaching diabetic patients how to correctly draw up and inject daily insulin.

A workflow diagram is sometimes called a process map or simple flowchart and these graphic diagrams are created to initially document an existing process (how it is currently performed) and then to diagram the change in the process (the future state). The steps in the process will flow between resources such as machines, people, or departments. The conditions and decisions that move the process through a sequence of steps are visually seen through these diagrams. Abstract boxes and diamonds are used as well as real-life objects representing patients/staff, forms, products, departments, and more. A swimlane diagram is different from a simple flowchart. It can be described as a process map but with the roles and responsibilities of staff, the patient, and departments clearly set as separate lanes through the process map.

Review the readings, course presentations, and possible free, online flowcharting diagraming tools found in Modules/Week 4.

Assignment Criteria:
1. Identify a nursing-related or clinical/administrative/educational procedure/process or protocol of interest that needs redesign or optimization because of bottlenecks and/or inefficiencies in the current process. (Review the Week 4 article by Vankipuram et al.)
2. Generate a swimlane diagram (label as Figure 1) to visually show the current process and roles and responsibilities of individuals or departments in separate lanes involved in the process. For the swimlane diagram use standard flowchart symbols (e.g., diamond, oval, rectangle, directional arrows, etc.) to show the steps in the process. Go further and show separate lanes as an overlay showing roles, responsibilities, or functions for individuals/departments in those steps. Show the “as-is” state with the identified bottleneck or inefficiency in the process. Clearly show decision points in the process as well as the start and end of the process. Find an example of a swimlane diagram in the textbook and in the course module.
3. As Figure 2, create a second swimlane diagram of the “future” redesigned state of this process that shows an improved process. Use the same free swimlane software to create this diagram. Show or include the steps in the “future” process and roles and responsibilities (via separate lanes for individuals or departments in the process).
4. Write an analysis/summary report for use by the NIS and the interprofessional team that includes:
a. Identification of the process/problem to be solved in the current or “as-is” state. Include an explanation of why things are done in this way and what data are currently collected in this process. Insert Figure 1.
b. Discussion of the bottlenecks and inefficiencies in the current process including how this current process affects patient safety and quality of care. Cite sources.
c. Explanation and justification of the process re-design. Analyze how the redesign promotes efficiency, effectiveness, and quality of care. Insert Figure 2. Cite sources.
d. Justification for why the work redesign is important and is also critical to the organization’s business success. Support justification with one or more references.
e. Explanation of who will be affected by the redesign and one or more specific quality metrics the DNP will suggest for evaluating this redesign.
f. Identification of one or more specific strategies you expect the DNP needs to implement to promote system-wide acceptance and adoption of this redesign. Cite sources.
5. Complete one formal, narrative written analysis/summary report that includes a title page, two swimlane diagrams, and a reference page(s). You may insert the diagrams within the text or as appendices. See the APA 7th edition manual for format.
6. The narrative written analysis/summary should be 6–7-page excluding the title and reference page.
7. Include an introductory paragraph with a purpose statement and a conclusion.
8. Include Level 1 and 2 headings to organize the paper.
9. Write the paper in third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To clarify: I, we, you, me, our may not be used. In addition, describing yourself as the researcher or the author should not be used.
10. Include a minimum of five professional peer-reviewed scholarly journal references to support the paper (review in Ulrich Periodical Directory) and be less than five (5) years old.
11. APA 7th edition format required (attention to spelling/grammar, a title page, a reference page, paraphrasing/quotes, and in-text citations).
12. Submit the assignment to Turnitin prior to the final submission, review the originality report, and make any needed changes.
13. Submit by the posted due date.

Assignment 2: Workflow Diagram and Report Grading Rubric (27 points)
Assignment Criteria 9 points 7 points 4 points 1 point
All topics/criteria addressed, and all questions fully answered. All topics/criteria addressed, and most questions fully answered. All topics/criteria addressed, and most questions partially answered. One or more topics/criteria not addressed or completely answered.
Quality/Accuracy of Information 12 points 10 points 8 points 0 point
Information clearly relates to the main topic/criteria. It includes several supporting details and/or examples. Both swimlane documents are logically clear and use standard flowchart symbols and separate swimlanes to show process, decisions, and roles of personnel. Information clearly relates to the main topic/criteria. It provides supporting details and/or examples.
wimlane diagrams use standard flowchart symbols for process and decisions. Separate swimlanes for the roles of personnel need some clarity. Information clearly relates to the main topic/criteria. A few details and/or examples are given. Swimlane diagrams lack use of standard flowchart symbols and/or separate lanes for roles of personnel. Information has little or nothing to do with the main topic/criteria. Swimlane diagrams are not submitted.
Organization 4 points 2 points 1 point 0 point
Information is very organized with well-constructed paragraphs and levels of heading. Information organized with well-constructed paragraphs and levels of heading. There is an attempt at organization, but errors exist. No levels of heading. The information or overall structure appears disorganized.
Sources 2 points 1 point 0.5 point 0 point
All references are from a relevant professional peer-reviewed scholarly journal, within a 5-year timeframe, or a classic/ historical source. The majority of references are from a relevant professional peer-reviewed scholarly journal, within a 5-year timeframe or a classic/historical source. Some references are from non-peer-reviewed scholarly sources or older than 5-years. Majority of references are from non-peer-reviewed scholarly sources or older than 5-years.
Earned Points
Up to 10% of the assigned points (total points of assignment) can be deducted from the earned points for errors in APA style [title page, introduction, purpose statement, level heading, conclusion, references, citations, and format], spelling, and/or grammar.
Final Total

Translating week8

• Discuss two different ways the DNP prepared nurse can disseminate findings and the potential impact.
• Explain the peer review process and why it is so important.
• Explain strategies the DNP can utilize to avoid unintentional plagiarism.

Translating week 5
• Start with your PIO/PICO/PICOT question.(What is the effectiveness of ABC PLEASE,DBT skills education on females aged 18 to 99 years old with Major Depressive Disorder after six-weeks?)

• Post an explanation of your intervention as you will write up in the IRB application. ABC PLEASE DBT skills