MGMT Hospital Inc is a private concern that recently opened it doors to the public in the suburbs amidst heavy traffic. There are hardly any quiet nights. Sirens are a constant feature. However, once inside, there is just the hustle and bustle of hospital staff going back and forth. A hospital readmission is when a patient who is discharged from the hospital, is re-admitted again within a certain period of time. Hospital readmission rates for certain conditions are now considered an indicator of hospital quality, and also affect the cost of care adversely. For this reason, Centers for Medicare & Medicaid Services established the Hospital Readmissions Reduction Program (HRRP) which aims to improve quality of care for patients and reduce health care spending by applying payment penalties to hospitals that have more than expected readmission rates for certain conditions. Although diabetes is not yet included in the penalty measures, the program is regularly adding new disease conditions to the list, now totaling 6 for FY2020. In 2014, Hospitals in surrounding cities spent over $41 billion on patients who were readmitted within 30 days of discharge. Being able to determine factors that lead to higher readmission in such patients, and correspondingly being able to predict which patients will get readmitted can help hospitals save millions of dollars while improving quality of care.
DESIGN and DRAW a high level “as-is” swim-lane process diagram depicting the readmission of patients to the hospital. Examples include but are not limited to: on-boarding a new patient; discharging a patient; readmitting a past patient; retiring an old computer which has sensitive information on the hard drive e.g. summary data for patients. The process must show the bands, process flows, roles and/or cross functional interactions and must show where two (2) or more decisions are made.
Summarise the information shared thus far, and discuss TWO findings about your analysis from your management level that can be used to justify the acceptance/implementation of the HRRP program. Make TWO recommendations for MGMT Hospital Inc. to either reduce readmissions, lower health care costs or improve patient safety and outcomes.
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