Gateway Healthcare Systems HIM Department

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Question Description

(1) Write a short paper that evaluates the mission and vision of each hospital's HIM department. Then take the best from each of the three mission and vision statements to develop a new mission statement and new vision statement for the unified Gateway Healthcare Systems HIM department. The specific elements of the assignment are attached.

(2) Using a SWOT matrix, conduct a SWOT analysis on the Gateway Healthcare Systems HIM department. You will need to analyze each of the three hospitals and consider their workflow processes, as well as the current state of EHR, cultural diversity, staffing issues, and compliance issues. Once the SWOT analysis is complete, write at least three SMART goals addressing cultural, diversity, human resources, and compliance. The specific elements of the assignment are attached. Please put this part of the assignment on separate pages.

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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 HIM 440 Module Two Assignment I Guidelines and Rubric Overview: Almost every organization has a mission statement and vision statement. But how does each department manager ensure that the departmental strategic plan is working toward the stated mission and vision of the organization? One way is to ensure that each department has its own mission and vision statements that align with those of the organization. You will be faced with this question as a new manager, and you are also, in the case study, tasked with making strategic decisions that will unify the mission and vision of the three hospitals under one HIM department. Prompt: Write a short paper that evaluates the mission and vision of each hospital’s HIM department. Then, taking the best from each of the three mission and vision statements and adding whatever you believe needs to be added, develop a new mission statement and new vision statement for the unified Gateway Healthcare Systems HIM department. Specifically, the following critical elements must be addressed: I. II. III. Evaluate the mission and vision statements of the HIM departments for each of the three hospitals: A. What elements do they have in common that might help you move toward a unified mission and vision for the merged HIM department? B. What are they missing? What improvements do you suggest? Develop a mission statement for the Gateway Healthcare Systems HIM department. Develop a vision statement for the Gateway Healthcare Systems HIM department. Rubric Guidelines for Submission: Your paper should be a 1- to 2-page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins. All sources should be cited in APA format. Critical Elements Evaluate: Common Proficient (100%) Analyzes mission and vision of each organization and determines common elements that will inform the mission and vision statement for unified HIM department Needs Improvement (75%) Analyzes mission and vision of each organization, but analysis is cursory or illogical or does not specifically identify common elements Not Evident (0%) Does not analyze the mission and vision of each organization Value 22 Evaluate: Improvements Mission Statement Vision Statement Articulation of Response Analyzes mission and vision of each organization and determines needed improvements that will inform the mission and vision statement for unified HIM department Develops a mission statement for the unified HIM department Develops a vision statement for the unified HIM department Submission has no major errors related to citations, grammar, spelling, syntax, or organization Analyzes mission and vision of each organization, but analysis is cursory or illogical or does not specifically outline improvements Does not analyze the mission and vision of each organization 22 Develops a mission statement for the unified HIM department, but statement is illogical and/or incomplete Develops a vision statement for the unified HIM department, but statement is illogical and/or incomplete Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas Does not develop a mission statement for the unified HIM department Does not develop a vision statement for the unified HIM department 22 Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas Total 12 22 100% HIM 440 Module Two Assignment II Guidelines and Rubric Overview: Moving more deeply now into the scrutiny of your final project case study, you will complete a SWOT analysis, a commonly used strategic planning tool that allows managers to consider both internal and external factors in their department’s organizational strategy. Prompt: Using a SWOT matrix, conduct a SWOT analysis of the Gateway Healthcare Systems HIM department. To compile your unified SWOT analysis, you will need to analyze each of the three hospitals. Your SWOT analysis should consider current workflow processes, as well as the current state of EHR, cultural diversity, staffing issues, and compliance issues. Once your SWOT analysis is complete, write at least three SMART goals addressing the following areas: cultural diversity, human resources, and compliance. Note: Section 4-3g of your textbook outlines the steps for a SWOT analysis, as does the SWOT: The High-Level Self Exam that Boosts Your Bottom Line resource. Use the provided SWOT matrix template to complete this assignment. Specifically, the following critical elements must be addressed: I. II. III. IV. V. Identify the strengths of the unified HIM department. Identify the weaknesses of the unified HIM department. Identify opportunities for the unified HIM department. Identify threats to the unified HIM department. Formulate at least three SMART goals, one in each of the following areas: cultural diversity, human resources, and compliance. Rubric Guidelines for Submission: Your SWOT analysis and SMART goals should be submitted using the provided SWOT matrix template. References should be in APA format. Critical Elements Strengths Proficient (100%) Accurately identifies the strengths of the health information management department Weaknesses Accurately identifies the weaknesses of the health information management department Needs Improvement (75%) Identifies the strengths of the health information management department, but response contains inaccuracies or is incomplete Identifies the weaknesses of the health information management department, but response contains inaccuracies or is incomplete Not Evident (0%) Does not identify the strengths of the health information management department or does not utilize the case study Does not identify the weaknesses of the health information management department or does not utilize the case study Value 18 18 Opportunities Accurately identifies the opportunities of the health information management department Threats Accurately identifies the threats to the health information management department SMART Goals Formulates relevant SMART goals in the areas of cultural diversity, human resources, and compliance Articulation of Response Submission has no major errors related to citations, grammar, spelling, syntax, or organization Identifies the opportunities of the health information management department, but response contains inaccuracies or is incomplete Identifies the threats to the health information management department, but response contains inaccuracies or is incomplete Formulates SMART goals, but response is illogical and/or irrelevant or does not cover the areas of cultural diversity, human resources, and compliance Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas Does not identify the opportunities of the health information management department or does not utilize the case study Does not identify the threats to the health information management department or does not utilize the case study Does not formulate SMART goals in the areas of cultural diversity, human resources, and compliance 18 Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas Total 10 18 18 100% ...
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DrWood
School: New York University

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Gateway Health Systems
Among the mission and vision statements of the three hospitals, what comes out is that the
three strive to provide accurate information for use by the patient. The three hospitals carry out
this exercise without discriminating the patients’ background on gender, age, religion or ethnicity.
Health is a sensitive issue. Therefore the three hospitals are doing an excellent job by providing
universal health information management that is crucial in providing diagnosis and later treatment
for the patient. Accurate information is a common outcome from the health information system
department of the three hospitals. The three also seek to provide the patient with information but
is not just any information, and it must be accurate.
Saint Catherine Hospital and Saint Luke Hospital...

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