Application: Quality Measures “The gold standard for defining quality measurement remains…

Application: Quality Measures

“The gold standard for defining quality measurement remains Donabedian’s three-element model of structure, process, and outcome” (Varkey, p. 30).

Although this model of quality measurement may apply to all kinds of clinical care facilities, you will focus on hospitals for this assignment so that you can make use of data on the CMS’s “Hospital Compare” Web site. Using this Web site, you will examine quality information for a particular hospital, and conduct some basic benchmarking analysis.

To prepare for this Application:

Visit the Hospital Compare Web site:


    Click on the links at the top titled "learn about the new organization of our Hospital Compare Measures" and review them briefly.
On the top left there is another tap titled "About Hospital Compare Data" that Shows information on Process of Care Measures, Outcome of Care Measures, and Outpatient Imaging Efficiency Measures.
As you consider this information, bring to mind the six dimensions of quality: Safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Search...through step 3.
For the purposes of this assignment, go back to the 1st page and select a hospital by either entering the zip code for the hospital or the name of the hospital. When you've done that and clicked on Show Hospitals, you should have hospitals that you can compare. Follow the directions to review Patient Survey Results (HCAHPS survey results), Timely and Effective Care or Readmissions, Complications and Deaths.
Consider which organizations are most appropriate to compare for benchmarking purposes. Use the Hospital Compare website and compare your primary hospital's data with data from another hospital – either one in the same area or one across the country, as you think appropriate.
After comparing the data, assess which measures you think are of the greatest concern and in need of improvement in your primary/original hospital. What is your rationale for this assessment? Select two or three measures to focus on for this assignment. Consider which dimensions of quality they relate to (safety, effectiveness, patient-centeredness, timeliness, efficiency, and/or equity).
Review this week's Learning Resources, new the hospital's Web site, and consider what other steps you would take to get a clearer picture of these quality issues.

The Assignment

Write a 1- to 2-page paper that addresses the following:

Identify the primary hospital you have selected.
Identify the measures you have chosen to focus on (those that are most in need of improvement or that otherwise warrant attention). Compare and contrast the characteristics of structure, process, and outcome measures, and explain which category or categories your chosen measure relates to. Also, indicate the dimensions of quality with which these measures are associated.
Briefly summarize the data, including your benchmarking analysis.
Analyze the benefits and challenges of externally reported measures for health care providers and for patients. Also, explain why benchmarking can be useful for identifying areas for improvement.

Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from this week's Learning Resources and from additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure that your in-text citations and reference list are correct.

Required resources:
Article: Hughes, R., & Clancy, C. (2009). AHRQ commentary: Nurses' role in patient safety. Journal of Nursing Care Quality, 24(1), 1–4. Retrieved from
Read the entire article on the nurse's role in patient safety, but pay particular attention to the "Measurement, Research, and Science" section.
Article: Harrington, L. (2009, April). Hardwiring nursing quality. Nurse Leader, 7(2), 44-46. Retrieved from
This article addresses the importance of "hardwiring" nursing-sensitive quality indicators into the culture and practices of health care delivery.
Web Article: SQUIRE (Standards for Quality Improvement Reporting Excellence). (n.d.) SQUIRE guidelines. Retrieved from
In preparation for the Discussion, explore the various areas of this Web site; be sure to read the SQUIRE Guidelines and investigate terms in the glossary as necessary.
Web Article: The Commonwealth Fund Commission on a High Performance Health System. (2008). Why not the best? Results from a national scorecard on U.S. health system performance. Retrieved from
The National Scorecard includes 37 indicators in five dimensions of health system performance: healthy lives, quality, access, efficiency, and equity.
Web Article: The Commonwealth Fund. (2009). State data center. Retrieved from
Investigate your state's performance (or select a state of interest to you).
Web Article: The Joint Commission. (2010). NQF endorsed nursing-sensitive care performance measures. Retrieved from
This site provides an overview of the National Quality Forum (NQF) Endorsed Nursing Sensitive Care Performance Measures. Be sure to read the "Introduction and Background" section.
Web Article: U. S. Department of Health and Human Services (n.d.). Hospital compare: A quality tool provided by Medicare. Retrieved from
Use this Web site to complete this week's Application Assignment.

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