This exercise allows you to examine how quality of hospital care is evaluated through data obtained from electronic health records. This exercise is discussed in several health administration courses, including courses on quality improvement, informatics, or statistics. In practice, the need to analyze these types of data arises in improvement teams, where managers, clinicians and sometimes patients work together to systematically improve healthcare processes.Part 1: In this assignment, you are asked to examine if prophylactic antibiotics are discontinued within 24 hours after end of surgery. Instead of providing you with the data, we ask that you download the data on the web so that you learn more about the source of the data and peculiar organization of the data. Hospital Compare provides information on many quality indicators. In this assignment, you are asked to focus on failure to stop use of antibiotics post surgery. The Hospital Compare web site provides the following rationale for why this measure of quality is helpful: "A goal of prophylaxis with antibiotics is to provide benefit to the patient with as little risk as possible. It is important to maintain therapeutic serum and tissue levels throughout the operation. Intra-operative re-dosing may be needed for long operations. However, administration of antibiotics for more than a few hours after the incision is closed offers no additional benefit to the surgical patient. Prolonged administration does increase the risk of clostridium difficile infection and the development of antimicrobial resistant pathogens." To complete this assignment complete the following tasks:Download Hospital Compare data for the years starting from 2015 till now. Merge the file "HQI_HOSP_TimelyEffectiveCare" across all databases for different years.Select measure ID "SCIP_INF_3"; this measure refers to prophylactic antibiotic use. Select to work with data from "Southeast Alabama Medical Center"; this is provider ID "010001".Calculate rate of overuse of antibiotics. In these data, the field "Score" refers to the number of patients with overuse of antibiotics. The field "Sample" refers to all selected surgical patients with no evidence of prior infection. The ratio of Score to Sample provides the rate of overuse of antibiotics. Construct a control chart showing rate of overuse of prophylactic antibiotic over time in Southeast Alabama Medical Center. Download the needed data using the following databases (if new data is available, please use them)You can find the solution here here - Alternative Formats .The student peer video shows that data across the years us merged using SQL. You can do the same merger without using SQL. Open the CSV files (you can ignore access files for old years.) Filter the data by the measure you are interested in Copy the sheet with the relevant filtered data from each CSV file into a single sheet within the new Excel file. In a sheet titles "ALL" inside the Excel file, use cell reference to bring the data in different sheets to the "ALL" sheet. Do your analysis on this sheet. Part 2: Nursing home and hospital administrators implement many initiatives to reduce falls. This problem shows how these initiatives can be measured and evaluated. Prepare a risk-adjusted control chart for dataon falls in a nursing homePlease use the following peer video as a reference for this assignment. You can find the solution here here - Alternative Formats .Part 3: The following data were obtained on post surgical infection rates. Are we having more infections than expected from the patients' conditions?You can find the solution here here - Alternative Formats .WeekRisk of Infection for each PatientNumber Infected10.90.80.70.80.90.85620.70.80.70.60.80.9530.80.950.920.87440.50.60.660.67350.30.40.50.40.50.34260.30.40.51Part 4: Download Hospital Compare data. In these files the denominator indicates the number of patients. Whether the hospital had above average payments are reported in different fields: [Compared to National], [Category], and [Payment Category]Select data that meet the following conditions:Select the "PAYM_30_AMI" measureSelect hospitals that in the denominator do not have "Not Available".Construct a control chart showing probability of change over time. To assist, we have download some of the necessary files. You can add to these additional more recent files from the Hospital Compare site. Since the data on AMI payments does not change in the files, you can save time and read only the following files into a new database:FileDatabaseFieldStartEndHQI_HOSP_AMI_Payment HOSArchive_20150122Compared to National20102013HQI_HOSP_Payment HOSArchive_20150716Category20112014HQI_HOSP_PaymentAndValueOfCare HOSArchive_20161110Payment Category20122015Include other data for more recent years after 2016You can find the solution here here - Alternative Formats and here here - Alternative Formats .Some of you do not have Microsoft Access. Early files in Hospital Compare used Microsoft Access and later files used CSV (a file format that opens with Excel.) To remedy this situation, I am replacing Microsoft Access files with Excel Files. If you have to look at only AMI quality measures you need to use the filter feature within Excel. Use these files: HQI_HOSP_PaymentAndValueofCare20161110 HQI_HOSP_AMI_Payment20150122 HQI_HOSP_Payment20150716

1. A trucking company continuously monitors the tread remaining on its fleet of truck tires. The firm knows that standard deviation is 0.1 cm. Suppose a sample of 80 tires were obtained, and the mean tread was 2.2 cm. Construct a 99% confidence interval. The company's operations manager knows that flat tires occur more often when the tread is below 1.0 cm. At what sample mean (and higher) should the company reasonably expect minimal flat tires, based on a 95% confidence interval?2. Monthly expenses for an advertising agency were obtained for the previous year. The sample of 12 expenses showed a mean of $196,000, with a standard deviation of $45,000. The office manager is budgeting for monthly expenses, and would like to know if it is reasonable to expect expenses to be below $250,000. Construct a 95% confidence interval to justify if $250,000 is reasonable.3. An online business consulting firm provides its service on a hourly basis. In the previous 15 months, the business had the following number of hours billed for its services.( Hours billed: 212 389 457 505 740 678 987 573 761 812 933 691 558 575 872)a. What is the point estimate of the population mean? b. Construct a 90% confidence interval.4. As the operator of an e-commerce web site, you are interested in monitoring the average time spent on the site. How large of a sample of usage times should be obtained, provided your allowable error is 30 seconds. Based on a long history, you know the standard deviation of usage times is 5 minutes. Assume a 90% level of confidence.

Question 1 Recently, Australian researchers conducted a study of the relationship between optimism and colon cancer survival. Their hypothesis was that colon cancer patients who had a positive outlook on life would have a lower five-year cumulative incidence of mortality. The study included 100 recently diagnosed colon cancer patients who underwent psychological testing and were found to have a optimistic outlook on life and 100 recently diagnosed colon cancer patients who underwent the same psychological tests and were found to have a pessimistic outlook on life. By the end of five years of follow-up, 50 of the 100 patients with the optimistic outlook and 75 of the 100 patients with the pessimistic outlook had died from colon cancer. • Set up and fill in the two by two table using these data. • What is the prevalence of colon cancer in the study population? • Compare the cumulative incidence of mortality in the optimistic group to the cumulative incidence of mortality in the pessimistic group using a ratio measure of association. • State in words your interpretation of the result you found in part c.  Question 2 A cohort study of smoking and bladder cancer was conducted in a small island population. There were a total of 1000 people on the island. Four hundred were smokers and 600 were not. Fifty of the smokers developed bladder cancer. Ten of the non-smokers developed bladder cancer. Construct a two by two table using the data given above. Be sure to label the cells and margins. Which measure of comparison would you use to describe the relative effect of smoking on the risk of bladder cancer? What is the formula for this measure of comparison? Calculate this measure of comparison using the given data. State the meaning of your answer in one sentence. Question 3 For this problem, note the following chart: For this problem, note the following chart:Age Group(in years)% of Population in Age GroupInfluenza Rate per 1,000 person-yearsCITY ACITY BCITY CMassachusettsCITY ACITY BCITY CYOUNG40%50%80%60%21030OLD60%50%20%40%701105There are 10,000 individuals in City A, which is located in Massachusetts. Eight young individuals and 420 old individuals develop the flu over the course of a year.Use these data to calculate the crude influenza rate per 1,000 individuals per years in City A.What is the crude rate of influenza in City B?What is the crude rate of influenza in City C?Calculate an age-adjusted influenza rate for each of the cities. Use the age distribution for the State of Massachusetts (shown in the table) as the standard.