Health system assessment

Healthcare assessment systems provide a reliable tool that can be used to measure healthcare systems’ performance in various aspects. A good healthcare assessment system is based on selecting appropriate methods of conducting an assessment, an appropriate framework, collection, and analysis of data (Brouwers et al., 2019). This paper will consider the previous use of particular methodologies in the particular concept, the ability of a methodology to engage all the stakeholders in the healthcare system relevant in the assessment, the relevance or responsiveness of methodology to the triggers of carrying out the assessment, and finally the acceptability of the methodology to the stakeholders involved in the assessment including but not limited to the trustworthiness and reliability of a model to maintain confidentiality (Scanlon et al., 2020). In this paper, data collection will include health facilities and standard household surveys, in-depth interviews, participant observations, and health information systems reports. Specifically, the paper will address the American Heart Association located in Houston. The organization serves patients with heart-related problems such as heart failure and stroke. Particularly, the specific population to be addressed in the paper will include the patients with heart failure and how they interact with the organization. From research and practice, interviews and health system reports have been identified as reliable sources of information required as indicators in health system assessment. According to Tashobya et al., a health system assessment entails considering multiple factors that operate in different dimensions for improving care, analyzing such findings, and incorporating these findings into practice. This greatly provides a basis for this assessment.

Assessment Goal(s)

The goals for completing the assessment are founded on helping me demonstrate my knowledge, skills, and attitude regarding leadership. By completing the assessment plan, I shall be able to showcase my competency in leadership through practical involvement in innovative healthcare system development (Scanlon et al., 2020). I hope to learn the skills and knowledge required to assess healthcare systems throughout the whole project. Through this, I able to learn the various frameworks that have been adopted to carry out healthcare system assessment, the effectiveness of these frameworks, and most importantly, the preferred methodologies that can be involved in data collection. Developing the assessment plan will inform my quest to acquire problem-solving skills through being innovative and creative (Brouwers et al., 2019). The exercise entails incorporating innovation to develop an assessment plan that provides a platform for understanding a healthcare system’s problems, challenges, or failures, providing a basis for problem-solving. Problem solving and innovation are essential for healthcare professionals and, most importantly, when one is tasked with overseeing various problems where able to come up with better patient quality care by implementing the new policy.

During the implementation of the assessment, I oversee some challenges that would come my way. I anticipate some challenges emanating from the stakeholders I plan to involve in the research, including reluctance to participate in the research, concealing crucial information for fear of seniors, and giving wrong information. Therefore, I plan to research more on ways to assure the stakeholders of the confidentiality of the information they give, relieving them of fears they would have (Kumah et al., 2020). Researchers always struggle with the challenge of aligning the methodologies they should use in data collection with the data collection objectives. The main problem we have in our hospital is the readmission of CHF patients. With the help of this health assessment, I able to decrease the unnecessary readmissions. Therefore, I plan to carry out extensive data collection regarding the CHF readmission The main challenges is to coordinate the discharge planning with medical team especially with the cardiologist for the follow up appointments. Leaders in healthcare face multiple challenges, including balancing patient needs and business needs of the organizations, devising reimbursement models to reduce operational costs, assembling resources and skills for technological advancements, addressing workforce challenges, and scheduling the follow up appointments. To overcome these challenges, I plan to involve the staff including the Physicians, Cardiologists, Case manager, Patients and their families in the discharge planning to increase their willingness and motivation to lead the changes. Also planning to give the proper education regarding the importance of follow up appointments.  As a case manager we always having the issues with readmission of Congestive Heart Failure patients. It affects the financial part of the Hospital System and also the patients are getting frustrated about the care which affects the patient satisfaction survey.

Introduction:

Support groups are a way to feel connected, to meet other people who share similar experiences, and to help prevent isolation and loneliness.  you and your loved one can connect with people online or in real life. The AHA’s support networkTrusted Source is the main organization.

Houston Methodist Hospital providing the local support to the CHF patients Virtual Heart Failure Support Group that meets on the second Wednesday of every month. During the sessions various disciplines, present interesting and engaging heart failure topics. Interaction is encouraged so everyone can ask questions and participate in discussions with other attendees.  Contact Wayne Brewer by phone or text at 832.215.0456 or by

Email wbrewer@twu.ed .

WomenHeart Houston is the first support group in the Texas Medical Center for women living with heart and vascular disease and meetings are free of charge and open to all, regardless of where treatment is received. Meetings are held the second Wednesday of every month from 6:00 -7:00 pm.

Email: women@texasheart.org

Heart Sisters another online support system for Women which is peer-led by WomenHeart Champions, women heart disease survivors who have made the selfless commitment to become leaders in their communities and providers of the much needed support for other women living with heart disease. All support meetings are done over Zoom. People can talk in real-time to other women living with heart disease from the comfort and privacy of your own home.

Email heartsistersonline@womenheart.org

Macrosystem:

At this level, I shall assess the organization at an institutional level concerning specific factors such as leadership, staff performance, finances, and quality healthcare environment. Therefore, I plan to assess healthcare from this dimension through the review of reports, interviews with the organization’s top management, and assessment of the general quality of the organization’s output through surveys and interviews of patients. I shall review the efficiency, equity, and quality of care offered by evaluating medical-legal suits associated with the health care systems and the recovery rate of patients (Kumah et al., 2020).

Microsystem:

At the microsystem levels, assessments will be based on a unit level. This will assess the care units involved directly in the delivery of care, including various hospital departments, concerning their leadership, staff performance, opportunities, and the healthcare environment (Kumah et al., 2020). To assess the microsystem level, I plan to carry out interviews with patients. These people have had encounters with the healthcare systems and families to assess their experience with the healthcare systems. I also shall carry out surveys and observations of the participants, including but not limited to the staff and patients.

The organization’s mission is to contribute to health well-being and contribute to health by provision of the best care to patients through education, research, and clinical practice. The organization’s vision is based on being the leader in improving healthcare quality and reducing the healthcare costs of the communities we are esteemed to serve (Bernal-Delgado et al., 2015). The organization’s core values are quality care,excellence, decency, community well-being, access to care, and equity in healthcare availability. The strategic plan for the organization is to invest in all aspects of healthcare to provide care in surrounding communities by emerging opportunities to help patients with the various delivery models devised by the organization.

Macrosystem:

Effective leadership can mean the difference between failure and success. I plan to assess the leadership in the organization by looking into factors such as leadership styles used in the organization, the skills of those assuming leadership roles in communication and supervising, the approaches of the leaders in addressing issues in the organization, and the general result of all this. In assessing the leadership structure, I shall seek to identify the skills of those assuming leadership roles by assessing their ability to solve problems, panning ability, and persuasion (Bernal-Delgado et al., 2015). I shall assess this by reviewing the leadership qualifications through in-depth interviews, interviews with subordinate staff on what they thought about their leaders and assessing their success in leadership through teamwork adoption and quality of healthcare provision. Formal communication is based on the policies and administration of the organization. Therefore, to assess it, I plan to observe and interview various departmental heads on how they relay information and receive it from other departments within the institution. To assess staff involvement in decision-making, I shall interview them on whether they are allowed to set their performance targets, are engaged in coming up with work schedules, and whether employee surveys are held on various decision making. Leadership styles can include transformational or democratic leadership (Bernal-Delgado et al., 2015). To assess the leadership styles in the organizations, I shall assess the management principles of leadership through interviews and surveys and the results of their leadership.

Microsystem:

At the micro-level, I shall assess leadership at the basic units in the institution. These include the departmental levels such as nursing, rehabilitation, and emergency. To assess the leadership at these levels, I plan to interview patients in wards and people from the community who might have encountered the healthcare systems on their experiences and interactions with the healthcare providers (Naeini et al., 2019). Also, I can make visits to such departments to observe teamwork amongst the staff, including nurses and physicians. Informal decision-making is the most prominent method of communication about patient care. Since this communication mainly thrived among coworkers, and therefore I would assess this through observations of single-strand communication, gossip chains, probability chains, and cluster chains among staff.

Macrosystem:

The provision of effective, patient-centered, and high-quality care in the organization is dependent on appropriately skilled personnel and appropriate staffing patterns of individuals tasked with the health care delivery. At this level, I shall aim my assessment to identify the grouping of workers with different skills, experience, and expertise. At the macro level, I plan to evaluate the established delivery system in the organization for any provisions of the staff’s interactions in the execution of various activities. To assess the skill set needed, a review of the roles to be performed by individuals in various positions would be effective in identifying the skills that the staff is needed to have (Naeini et al., 2019). To establish the staffing patterns, I shall review the organization’s structure to identify the various groups of departments that work within the organization.

Microsystem:

To determine staff mixing at the micro-level, I plan to observe staff in the execution of their duties and establish whether they interact or are grouped in a particular way during the performance of their duties (Naeini et al., 2019). I shall also interview various staff to establish their roles in organizations and observe them during their work to identify their roles depends on the education, experience, skills and ability to perform different task.

Macrosystem:

Staff support and satisfaction are vital in determining the motivation of an employee to work. To determine staff satisfaction, I shall conduct employee satisfaction surveys and use the employee satisfaction index, which provides one of the best methods for determining their satisfaction (DeLone et al., 2019). To determine the performance of the staff, I shall assess the quality of their work and level of execution through self-evaluation and public feedback.

Microsystem:

To assess the satisfaction of the staff at the micro-level, I shall install staff suggestion boxes in the organization where the staff can drop their suggestions about their satisfaction. Also, I shall have one-on-one meetings with them where they air their views or complaints about satisfaction. To assess their performance, I plan to rely on feedback from the patients and their peers (DeLone et al., 2019). For example, I shall rely on feedback given by patients in the wards to determine the performance of nurses while also using feedback from department heads to determine the performance of staff. I shall interview the staff to determine their perspectives on their growth and development in the organization. Also, I shall carry out a survey amongst the employees to establish a survey report on their satisfaction and support in the organization (Naeini et al., 2019).

Macrosystem:

In determining the list of stakeholders in the organizations, I plan to consider the list of parties considered to be stakeholders in the healthcare system and then narrow it down to determining the specific groups of stakeholders that take part in the healthcare system. Such stakeholders include families, patients, government, insurance companies, and physicians (Baltussen et al., 2017). To obtain information about interprofessional collaboration and coordination, I shall interview the various groups of stakeholders and ask them questions such as whether they work together or interact with others in their duties, how they interact, what impact would lack collaboration bring about, and what goes wrong with regards to coordination and collaboration.

Microsystem:

At the microsystem level, I would seek the opinions of stakeholders, particularly those of the patients, their families, and healthcare providers involved in direct healthcare delivery to the patients. Other groups of stakeholders include financial departments, billing audit functions, and pharmaceutical firms. The stakeholders are obligated to collaborate and coordinate their roles in facilitating the delivery of quality care for patients. Particularly, pharmaceutical firms are working towards availing various medical facilities that help in the recovery of patients while nurses and physicians prescribe and administer these medications (Baltussen et al., 2017). The government is tasked with multiple functions, including financing these healthcare organizations to run their errands, employment of staff, and provision of necessary healthcare equipment.

Macrosystem:

Organizational culture shapes the thinking, feeling, and behavior in healthcare organizations. To assess inclusivity and equity in the organization, I can work on capturing the perceptions of the staff. This would involve interviewing the staff on incidents they might have encountered to test the incidence of inclusion and equity in the organization. I can also assess the diversity across organizational levels. To assess the teams’ culture at the macro levels, I would assess the values expected from the staff as stipulated by the organization and their program (Baltussen et al., 2017). To determine the focus of care of the organization, I would assess where more efforts were being put into the organization, including more allocation of resources, more staffing, and more representation in the management. To determine whether the system is open or closed, I would assess how the organization’s core values are stipulated or where they are sourced from, or references where open sources would lead to the conclusion of an open organizational culture.

Microsystem:

The microsystem provides an appropriate level for assessing the organization’s culture and the level of social justice. I am planning for meetings and interviews with workers of different ethnicities, genders, and various demographic features to determine whether they have any reported experiences of discrimination at work. To determine whether the business perspective of the organization has in any way overcome the caring culture, I plan to hold interviews with patients, families, and various members of the community to determine their experiences with the healthcare systems. This will also help me get their perspective on the level of care offered in the hospital and any incidences of medical negligence. At the micro-level, I can assess the team culture by conducting interviews with the staff about their ways of performing various functions and observing their execution of various functions such as patient care of dispute handling.

Macrosystem:

Health environments help in the identification of environmental signals that would impact the operations of the organization affecting its performance, including the delivery of care. The SWOT analysis can be vital in highlighting various factors that affect an organization from its environment. Therefore, I would seek to analyze the organization’s strengths, weaknesses, opportunities, and threats through interviews and observations (Baernholdt et al., 2018). To assess whether the environment invites the comfort for the patients, I would identify the challenges faced by the families and the patients and analyze them to identify whether they are related in any way to the patient.

Microsystem:

Observations of patients in wards would provide a great opportunity to assess the physical environment and interviews at a particular unit level (Baernholdt et al., 2018). I would also assess the roles of religion in the healthcare delivery of the organization and the role of social work in providing psychological well-being to the patients.

Macrosystem:

My finance consultant in the organization would be senior managers and financial staff. These groups of people have the relevant knowledge and awareness of the organization’s finances and, therefore, would be a perfect target (Bradley et al., 2016). From the information availed from these officials, I would seek to identify the labor costs in the organization relative to the patient volume and operation ratios of the organizations. I would also assess the major ways in which the organizations acquire their revenue and how the major ways in which they spend it. As part of this assessment spoke to one of the financial counsellors [ Ms. Claudia], according to her if patients get readmitted for the core measures [ CHF, Pneumonia or Stroke] hospital will not able to get any reimbursement from the insurance and most of the time that consider as loss to the organizations.

Microsystem:

At the microsystem, I would seek to identify the hospitals’ spending from departmental levels. This, for example, would include the assessment of how nurses contribute to the organization’s finances and what would be some of the ways they spend (Bradley et al., 2016). I would assess the organization by determining their major financing priorities and thoroughly evaluating where they spend much and where they opt to allocate fewer resources. One of most common areas that the hospital losing money is the improper material management. Second is the staff call in to the point where need to utilize the contract or Supplemental staff.

Macrosystem:

Health technologies can be described as any technological advancement a given organization makes. Such technological advancements would include introducing electronic health records storage and investing in various equipment (Kärnä & Julin, 2015). To assess the integrated health technologies, I would assess the inclusion of such technological advancements in the organization, such as incorporating updated machines or equipment in patient servicing. Also, through interviews, I would seek to identify the investment of the organization’s management in technology by allocating more finances and any effort made to influence the technological aspect.

Microsystem:

At the micro-level, I would assess the inclusion and role of technology in the performance of the various organization. For example, I would assess the use of up-to-date technologies like electronic record storage for the records unit (Kärnä & Julin, 2015). For the nursing unit, I would assess the use of technologies in aspects like patient diagnosis and evaluation. Also provide continuing education to the staff with UpToDate technology.

Macrosystem:

Quality and safety measures help minimize various risks in organizations. to assess the measures, I would first research the major risks in the given organization to come up with a rationale for the necessary safety measures in the organization (Hughes, 2008). To assess these measures, I would employ the use of the quality assessment tool to assess the quality and safety measures. I would also assess the number or proportion of physicians certified by the boards, the ratio of healthcare providers to patients, and the record-keeping methods used in the organization.

Microsystem:

At this level, I shall assess the number of patients receiving preventative services such as vaccination for example with COVID-19 vaccines for heart failure patients and the number of individuals who have successfully controlled particular conditions such as blood sugar levels (Hughes, 2008).  I would also assess protocols for emergency handling of heart failure patients who present with high blood sugars, renal insufficiencies, and hypertension, which are lethal conditions. I shall assess the number of heart failure patients admitted for surgery who survive and those who die from surgical complications and surgery-related infections. Quality and safety measures raising questions include adherence to aseptic techniques, monitoring such as ECGs, and verification of all procedures and compliance to these can be vital for a patient’s health.

Macrosystem:

Policies are necessary to assess; a code of conduct, recruitment policy, drug and safety policy, and anti-discrimination policy. To assess the policies and procedures relevant to the organization’s concerns, I would engage the stakeholders through interviews, asking them questions relating to the various policies that guide the performance of various procedures in the organization (Sarto, & Veronesi, 2016). This would include questions relating to the specific policies and how they affect the operations of the organizations. I would also develop an evaluation framework with guidelines for the specific questions I would ask specific stakeholders and then develop an evaluation plan from which I can process the data and analyze the results.

Microsystem:

The primary way of assessing the policies and procedures of the organization at the micro level would involve the engagement of the staff (Sarto, & Veronesi, 2016). I would also compare the differences in the level of healthcare provided with the inclusion of the policies and when they were not included. An interview with the staff would help provide insights into their experiences working under the policies and carrying out various procedures in the line of duty.

To assess the system’s strengths, I would include an assessment of the alignment of the assessment findings with the goals, mission, and vision of the organization. The system’s strength will be ascertained if they are appropriately aligned. Also, I would evaluate the effectiveness of healthcare in promoting healthcare to the community to evaluate the strength of the system (Sarto & Veronesi, 2016). Finally, I would incorporate the findings of the quality and safety section to determine the system’s effectiveness in delivering its mandate.

In data analysis, I would first analyze the strengths and the weaknesses associated with the health care system. This I will achieve by characterizing the outcome of the assessment regarding their strengths and weaknesses (Sarto & Veronesi, 2016). To determine the issues that might emanate from my project, I would consider analyzing the project’s findings and relating them with the objectives and goals of the assessment to see if any of the objectives were met. If a substantive number of the objectives were met, then the assessment would be considered to have been effective. After implementing all my interventions and that way I can decrease the unnecessary readmission of CHF patients. Otherwise, I have to reinforce the interventions to the team members and also analyze the problems through the thorough assessment from the beginning.

Various other issues can be assessed in the organization. Such issues include the heart failure readmissions, staff and patient ratio and the roles of the government in the delivery of care in the organization (Sarto & Veronesi, 2016). Readmissions of patients with heart failure after hospital discharge signifies the need to better manage a patient or change the mode of management. Specifically, I would seek to assess the number of readmitted patients, the severity of their statuses during readmission, the number of deaths associated with readmissions and the various ways these have been handled in the past. Staff and the patient ratio are a critical determinant of the quality of care to be offered in the organization and also in other organizations. where the healthcare system is overwhelmed by the number of patients, the delivery of care may become impaired with low-quality care characterizing such systems. To carry out such a project, the use of observation surveys and interviews would be vital as they are key in obtaining first-hand information that helps in making various conclusions.

As a part of the Health Assessment Plan, I got an opportunity to discuss about the increased number of readmissions among the CHF patients to my manager Mr. Tony Jawe MSN RN CCM. Most of the time patients get admitted because they are not able to get the follow up appointments with their cardiologist in the timely manner. Sometimes the patients are non-complaint to their medications. We have special program called transition of care to those CHF patients to make sure they get the appointments in timely manner which is coordinate by the case manager. Also arranging the Skilled nurse visits for non-compliant patients to reinforce about the medications and need to do follow up appointments.