Initiation and Preparation Phase of Final Project

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Review the attached case study and analyze the state of he unified health information management department of Gateway Healthcare Systems. The assignment should be a 3-4 page Microsoft Word Document, excluding the title and reference pages with double spacing.

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HIM 440 Milestone One Guidelines and Rubric Overview: For a healthcare organization to be effective in meeting information management needs, the Health Information Management (HIM) department must operate with a clear vision and purpose and be able to forecast needs across the continuum of care and healthcare enterprise. It is essential for the HIM department to run efficiently and effectively while maintaining the highest levels of quality and quantity set forth by preestablished standards and measurements. Health information managers are also charged with overseeing the training and development of staff to ensure compliance with rules, regulations, and organizational needs. This milestone covers the first section of the final project: Initiation and Preparation Phase. It provides you with an opportunity to receive early feedback from your instructor that you will incorporate into your final submission. Prompt: Review the Gateway Healthcare Systems case study and analyze the state of the unified health information management department of Gateway Healthcare Systems during the initiation of the merger. Identify the current position of the department to inform the key initiatives of the improvement plan. Specifically, the following critical elements must be addressed: I. Initiation and Preparation Phase: In this section, you will review the case study. You will analyze the current state of the health information management department during the initiation of the merger. You will identify the current position of the department to inform the key initiatives of the improvement plan. You will include the following elements: A. Using the details provided in the case study, summarize the issues for the health information management department during the merger. B. From a compliance standpoint, determine current challenges the health information management department is experiencing. C. Explain the impact of cultural diversity on the productivity and quality of the health information management department. D. Analyze the mission and vision of the organizations in the merger to inform and create a unified mission and vision for the health information management department. E. Using the provided SWOT matrix template, identify the strengths, weaknesses, opportunities, and threats facing the health information management department as a result of the merger. Rubric Guidelines for Submission: Your Milestone One paper should be a 3- to 4-page Microsoft Word document, excluding the title and reference pages, with double spacing, 12-point Times New Roman font, one-inch margins, and sources cited in APA format. The SWOT analysis should be submitted using the provided SWOT matrix template. Critical Elements Initiation and Preparation Phase: Summarize Proficient (100%) Summarizes the issues of the health information management department during the merger based on the details provided in the case study Initiation and Preparation Phase: Compliance Determines challenges the health information management department is experiencing from a compliance standpoint Explains the impact of cultural diversity on the productivity and quality of the health information management department Initiation and Preparation Phase: Cultural Diversity Initiation and Preparation Phase: Mission and Vision Analyzes the mission and vision of each organization involved in the merger to inform the mission and vision statement for the health information management department Initiation and Preparation Phase: SWOT Identifies the strengths, weaknesses, opportunities, and threats facing the health information management department using provided SWOT matrix template Articulation of Response Submission has no major errors related to citations, grammar, spelling, syntax, or organization Needs Improvement (75%) Summarizes the issues of the health information management department during the merger based on the details provided in the case study, but response contains inaccuracies Determines challenges the health information management department is experiencing from a compliance standpoint, but response is cursory or contains inaccuracies Explains the impact of cultural diversity on the productivity and quality of the health information management department, but response is cursory or illogical or lacks justification Analyzes the mission and vision of each organization involved in the merger to inform the mission and vision statement for the health information management department, but analysis is cursory or illogical or does not contain information about all three organizations Identifies the strengths, weaknesses, opportunities, and threats facing the health information management department using a SWOT matrix, but response contains inaccuracies, is incomplete, or is not contained in the provided SWOT matrix template Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas Not Evident (0%) Does not summarize the issues of the health information management department using the provided case study Value 18 Does not determine challenges the health information management department is experiencing from a compliance standpoint Does not explain the impact of cultural diversity on the productivity and quality of the health information management department 18 Does not analyze the mission and vision of each organization in the merger 18 Does not identify the strengths, weaknesses, opportunities, and threats facing the health information management department using the provided SWOT matrix template 18 Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas Total 10 18 100% Running head: TITLE OF PAPER IN CAPS Page # Instructions: Please format paper per APA guidelines: Include the title page requirements, the headings/subheadings already provided for you, an introduction, the body of your paper using the headings/subheadings provided, a conclusion paragraph, a references page, and in-text citations to match the references. Please be sure to remove all of these instructional notes before submitting your finished paper. Title of Paper Your Name University’s Name TITLE OF PAPER IN CAPS Page # Title of Paper (Centered and not bolded) Initiation and Preparation In this section, you will write a brief introduction. Summary This section coincides with the first critical element on the rubric. You will summarize the issues in the HIM department related to the merger. Compliance This section coincides with the second critical element on the rubric. You will address the compliance issues noted in the case study in this section. Cultural Diversity This section coincides with the third critical element on the rubric. You will address the cultural issues impacting quality and productivity. Mission and Vision This section coincides with the fourth critical element on the rubric. You will analyze the mission and vision of each hospital. SWOT Analysis This section coincides with the fifth critical element on the rubric. You will analyze the strengths, weaknesses, opportunities, and threats facing the HIM department. You will complete the SWOT analysis matrix AND include a brief summary of your findings in this section. This section coincides with the third critical element on the rubric. You will explain the new standard process for delivering feedback to staff based on their performance appraisal using management strategies. Conclusion TITLE OF PAPER IN CAPS Page # In this section, write a brief summary of your findings above. Be sure to include references and the corresponding in-text citations. A reference page is located following this page. TITLE OF PAPER IN CAPS Page # References HIM 440 Gateway Healthcare Systems Case Study St. Catherine’s Medical Center recently announced it will be merging with St. Luke’s Hospital and Hickman Community Hospital to form Gateway Healthcare Systems, all located within the same metropolitan area in the Midwest. You have just been hired as the healthcare system’s HIM director overseeing all three hospitals. Each facility’s department manager or supervisor will report to you. Hospital Profiles St Catherine’s Medical Center HIM Department Mission: Grounded in the Catholic mission of service, we strive to provide accurate patient health information services to all patients with care, concern, and dignity. HIM Department Vision: Provide patients with their health information with sensitivity and respect to their privacy. Profile: St. Catherine’s is affiliated with the Catholic faith and includes an active convent on its campus. It is an 850-bed acute care level-one trauma facility located in the suburbs. The staff and patients come from a variety of ethnic backgrounds and are linguistically diverse. About 60% of St. Catherine’s staff is Catholic, but the hospital abides by legal hiring practices and insists that all employees are treated with respect, including those who fall outside the tenets of Catholicism. In fact, the HIM department has two staff members with hearing impairment who work in the coding section. They have been investigating ways to offer more opportunities to potential employees with physical needs, but with the high volume of reading and direct customer service provided to patients, it has been difficult to accommodate. St. Catherine’s has a reputation of providing quality care to all patients and will not turn away a patient based on ability to pay. It is located in one of the wealthier suburbs of the city and has a strong record of employment retention, even though the average salary level is lower than those of its competitors. St. Catherine’s implemented a new EHR last year and continues to work out new policies and procedures for the new system. Its dictation system was implemented seven years ago. The productivity level has been critically low since implementing the new system. Due to recent budget cuts, St. Catherine’s cannot offer overtime to staff. The HIM department has many long-term employees that do not have formal health information education or credentials. The current coding productivity level is, on average, two inpatient charts per hour per coder, and 10 outpatients (including ED patients) per hour per coder. The coding quality consistently exceeds 95%, per the internal coding auditor. Coding productivity standards were established six years ago using ICD-9 standards, at four inpatient charts per hour. The productivity standards remain at four inpatient charts per hour, despite complaints from coders that the standards are unreasonable. St. Catherine’s last TJC site visit was in October of last year. Overall, the hospital fared well on inspection; however, the HIM department was cited for not having a time stamp on orders in the EHR. (For more information, review regulations RC.01.01.01, EP19 in The Joint Commission E-dition Manual). There have been complaints in the department that some staff do not abide by the break schedule, and some take longer lunches than allowed. Management has not addressed this with staff for fear of losing some of their most knowledgeable and credentialed staff. It has been reported that some of the seasoned coders who have been on staff for more than 25 years are still using the manual coding book rather than the encoder that was implemented five years ago, stating that this saves them valuable time; however, the more recently hired coders are using the encoder system. St Luke’s Hospital HIM Department Mission: To provide providers, residents, and staff with timely access to patient health information for purposes of treatment, research, and reimbursement. HIM Department Vision: Promoting research through state-of-the-art health information management and technology. Profile: St. Luke’s, established in 1942 as a Methodist hospital but no longer a faith-based facility, is a very busy, 400-bed inner-city teaching hospital that provides critical care services to many patients without healthcare coverage. It services the most diverse patient population in the city in terms of ethnicity, religion, class, ability, sexuality, and age; however, its staff diversity is low except in the area of age diversity. The youngest employee is 19 years old and the oldest is 72. St. Luke’s has experienced a high volume of staff turnover during the past three years and does not currently have a HIM manager or director on staff. While it does have credentialed HIM staff, it has difficulty keeping them on board for more than two years. St. Luke’s is using a first-generation EHR that was implemented seven years ago and has difficulty communicating with the other systems in the department and organization. Because of the issues with interoperability, the lab sends down daily batches of paper lab reports that are scanned into the EHR. The encoder was just implemented last year; however, only one coder was thoroughly trained on the new encoder, and she resigned over a year ago. Coding staff frequently use the manual coding books because they cannot seem to find the accurate codes with the encoder. They spend a great deal of time looking up codes in the coding book, then going to the paper binders with the coding clinics to ensure that they are assigning the correct codes. Coding productivity standards were revised after the implementation of ICD-10. Current productivity standards are set at two inpatient charts per hour. The coding supervisor is a new graduate with less than a year of inpatient coding experience. She does not get along well with her subordinates, who are older and have much more experience. Coding productivity is being met per the performance expectations established ten years ago; however, coding quality is consistently rated at 85%, per the external auditing firm. Hickman Community Hospital HIM Department Mission: To assure protection of patient health information at all times. HIM Department Vision: Committed to serving the local community’s health information needs and ensuring patient information is secure. Profile: Hickman is a non-faith-based, 90-bed community hospital located in the oldest part of the city. It has historically served a predominantly low-income, Caucasian patient population, which is comprised mostly of Medicare and Medicaid payers. It has recently been seeing a rise in Muslim patients due to a new mosque in the neighborhood. Hickman Community Hospital has provided services to its local community since 1922, and it is the oldest facility of the three merging organizations. This facility has accessibility issues and was deemed noncompliant with ADA guidelines during the last Joint Commission accreditation survey. Since the hospital staff and patient population are primarily of one ethnicity, the hospital has not seen the need to address cultural diversity training, and therefore it was found noncompliant with TJC standards on leadership. The employees of Hickman are like family—they stick together. While Hickman is the lowestpaying hospital in the area, the family culture has contributed to the longevity of its staff. The HIM department does not currently have any AHIMA-credentialed staff members and does not have any coding quality or quantity expectations in place for the part-time staff members responsible for coding the charts. Hickman is still using paper-based records and manual coding books and resources for coding and billing resources. Hickman currently has a ten-day turnaround time from discharge to final bill dropped, and there is currently no specified number of charts that should be completed on an hourly or daily basis by coders. The acting HIM manager has been employed by Hickman for 35 years and is very fond of her staff; she insists they do the best job in town. Her job as acting HIM manager was meant to be temporary while Hickman searched for a credentialed replacement. The one candidate who met all qualifications was determined “not a good fit” by the hiring committee. He was a 32- year-old African American male and a wheelchair user. Currently, the HIM department does not have any diversity in ethnicity or physical ability among staff members. Preliminary Observations During the first month in your new position as HIM director of Gateway Healthcare Systems, you spent a week at each hospital getting to know staff, reviewing policies and procedures, and making general observations. While visiting with staff at St. Catherine’s, you noticed a few staff members were discarding paper forms with patient-identifying information into the trash can underneath their desks, instead of disposing of the forms in the document shredder located in the front office. You also noticed that the “release of information” staff did not log out of their computers when they were away from their desks. At St. Luke’s, you overheard a discussion in the main lobby elevator between two nurses discussing patient Mary Smith’s prognosis. When you arrived in the HIM department, there were stacks of paper forms and old paper records scattered throughout the department with the patient information openly displayed. In the connecting hallway that patients frequently travel through, you found several carts of records that revealed patient-identifying information. At Hickman Hospital, you arrived to find the staff sitting around having coffee while several patients were waiting to be assisted with obtaining copies of their health records. The releaseof-information clerk came running into the office with a paper copy of a record to hand to one of the patients in line, and said, “Here you go, Mrs. Brown; here’s the copy of your record from Dr. Taylor’s office. He’s our best psychiatrist on staff! You’re in good hands!” Once all of the patients had been waited on, the staff began discussing each patient’s requests along with their diagnoses, medical treatment, and prognosis. At this point, you called an urgent staff meeting. Current Facility Staffing Name of Facility Number of FTEs/PTEs St. Catherine’s St. Luke’s Hickman 55 FTEs/15 PTEs 40 FTEs/5 PTEs 3 FTEs/10 PTEs Number of Management Staff 5 10 1 Number of Credentialed Coders 4 10 0 Number of Transcriptionists 6 8 2 Number of ROI Staff 6 1 0 National Performance Measurement Standards   ICD-10 Coding Productivity Study Highlights Emerging Standards New Study Illuminates the Ongoing Road to ICD-10 Productivity and Optimization Number of Support Staff FT/PT 49 16 10 Top Five Diagnoses by Hospital St. Catherine’s Diagnoses Average Length of Stay (ALOS) Average Time to Code in Minutes Chronic Obstructive Pulmonary Disease (COPD) with Major Complication/ Comorbidity (MCC) 10 39 Gastrointestinal (GI) Hemorrhage with Comorbid Condition (CC) 11 45 Pulmonary Edema and Respiratory Failure 9 43 Septicemia or Severe Sepsis without Mechanical Ventilation (MV), 96+ Hours with MCC 17 53 Spinal Stenosis, Lumbar Region with Combined Anterior/Posterior Spinal Fusion with MCC 12 130 St. Luke’s Diagnoses ALOS Average Time to Code in Minutes Intracranial Hemorrhage or Cerebral Infarction with Comorbid Condition (CC) or Tissue Plasminogen Activator (tPA) in 24 hours 6 38 Renal Failure with MCC 8 42 Spinal Stenosis, Lumbar Region with Combined Anterior/Posterior Spinal Fusion with MCC 10 121 Sepsis, Unspecified 18 Organism, Tracheostomy with MV > 96 hours or Principal Diagnosis Excludes (PDX EXC) Face, Mouth & Neck without Major O.R. 65 Septicemia or Severe Sepsis without Mechanical Ventilation (MV), 96+ Hours with MCC 43 13 Hickman Diagnoses ALOS Average Time to Code in Minutes COPD with MCC 8 46 Heart Failure and Shock with MCC 10 55 Normal Newborn 1.5 30 Renal Failure with MCC 10 62 Vaginal Delivery w/o Complicating Diagnoses 2 45 SWOT Analysis Strengths The members of staff are diverse in both culture and language. Staff members are treated fairly regardless of any physical impairment. High rate of staff retention. Highly rated on coding productivity standards by external auditors. A qualified coding supervisor on staff. Weaknesses EHR productivity is low. Lack of confidentiality of patient information. Lack of cultural diversity among staff. EHR systems not integrated with other department. Low staff pay. Opportunities Meeting ICD standards of encoding four patients per hour. Use of encoder systems. Presence of multiple facilities. ‘Use of modern technology. Threats Serving low-income patients who have limited funds. Patients receiving service on credit could result in limited source of funds. Employee turnover due to mismanagement. SMART Goals Cultural Diversity Attract and retain qualified employees from different cultural backgrounds. Human Resources Provide employees with continuous internal and external training in their particular job classifications. Compliance By January 2019, the Unified Gateway Healthcare Systems will comply with all legal and standardization requirements. SWOT Analysis Strengths The members of staff are diverse in both culture and language. Staff members are treated fairly regardless of any physical impairment. High rate of staff retention. Highly rated on coding productivity standards by external auditors. A qualified coding supervisor on staff. Weaknesses EHR productivity is low. Lack of confidentiality of patient information. Lack of cultural diversity among staff. EHR systems not integrated with other department. Low staff pay. Opportunities Meeting ICD standards of encoding four patients per hour. Use of encoder systems. Presence of multiple facilities. ‘Use of modern technology. Threats Serving low-income patients who have limited funds. Patients receiving service on credit could result in limited source of funds. Employee turnover due to mismanagement. SMART Goals Cultural Diversity Attract and retain qualified employees from different cultural backgrounds. Human Resources Provide employees with continuous internal and external training in their particular job classifications. Compliance By January 2019, the Unified Gateway Healthcare Systems will comply with all legal and standardization requirements. 1 Running Head: Gateway Health System Gateway Health System Olawunmi Odusanya HIM-350 Professor Dana Brenda November 11, 2018 2 The mission and vision statements of the three hospitals are tailored towards showing how they strive to provide accurate information for use by the patient. They all carry out their operations without discriminating based on the patients’ background of gender, age, religion or ethnicity. All of the hospitals consider health as a sensitive issue which means that the three hospitals are doing well in providing universal health information management. This is crucial for providing both accurate diagnosis and treatment for patients. Accurate information is a common outcome from the health information systems department of the three hospitals. In addition, these hospitals also seek to provide their patients with accurate information. Saint Catherine’s Hospital and Saint Luke’s Hospital’s mission and vision statements do not have information pertaining to security or timeliness included. While St. Luke’s Hospital talks about timely access to information, there is no mention of secure information. It is important that both of these factors be included in the mission and vision statements for the Unified Gateway Healthcare System. Saint Catherine’s Hospital is the only one of the three hospitals that has a religious base, which is based on the Catholic mission of service. Hickman Hospital does not include much information pertaining to the patient’s protection. From the vision and mission statement of Hickman Hospital, there is not much information regarding how the hospital plans to protect patient information. Saint Catherine’s Hospital is sensitive to customers’ needs as indicated by the statement of concern, care and privacy in their vision and mission statements, unlike the statements of the two other hospitals. 2 Unified Gateway Health System Mission Statement: We strive to provide our patients, providers, and staff with accurate, timely, and secure health information, based on care, concern, and dignity, at all times. Unified Gateway Health System Mission Vision Statement: Committed to serving our patients and the local community with secure health information that is sensitive and respectful, by promoting research and using state-of-the-art health information management and technology.
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Explanation & Answer

Check the answer the attached.

1
Running Head: GATEWAY HEALTH SYSTEM

Gateway Health System
Name

HIM-350

Professor
Date

GATEWAY HEALTH SYSTEM

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Introduction
The purpose of merging the three hospitals i.e. Hickman Community Centre, Saint
Catherine’s Hospital and Saint Luke’s Hospital is to integrate the Gateway Health System in effort
of establishing a comprehensive information system that is accurate towards improvement of
healthcare services. All the healthcare facilities provide quality services without discrimination on
the basis of age, gender, religion, race or ethnicity. They have displayed quiet a level of sensitivity
which is clearly recognized in the focus to giving universal health information management in
consideration of privacy of patient’s health information. A comprehensive health management
through the deployment of a HIM within the Gateway Community will help to assist in proper and
accurate diagnosis and administering right treatment for the patients. Accurate information is a
common outcome from the health information systems department of the three hospitals. In
addition, these hospitals also seek to provide their patients with accurate information.
Summarize
Saint Catherine’s Hospital and Saint Luke’s Hospital’s mission and vision statements do
not have information pertaining to security or timeliness included. While St. Luke’s Hospital talks
about timely access to information, there is no mention of secure information. It is important that
both of these factors be included in the mission and vision statements for the Unified Gateway
Healthcare System. Saint Catherine’s Hospital is the only one of the three hospitals that has a
religious base, which is based on the Catholic mission of service.
On the other hand, Hickman Hospital mission fails to mention the importance of protecting
the patient’s information which is integral and should be treated as integral (Kemkarl & Dahikar,
2012). Drawing from the vision and mission statement of Hickman Community Center, very little

GATEWAY HEALTH SYSTEM

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is there to say about the commitment of the fa...


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