Assignment
Your readings should give you an appreciation of the level of detail and sophistication some organizations apply to their quality improvement activities. The question may arise: are these efforts " worth it"? Is there a business case to be made for committing extensive time and financial resources to becoming a high quality, high value institution? This assignment asks you to consider these questions and then provide a justification for why an organization should or should not make substantial investments in its quality infrastructure.
Your CEO has just read Case 5 describing Intermountain Healthcare's (IH) pursuit of quality. He wants you to prepare a short brief (2-3 pages maximum, 850 words maximum) on the strengths and weaknesses of adopting a similar philosophy for your 250-bed community hospital operating in a small market environment. Your payer mix is dominated by fee for service Medicare and your case mix is weighted heavily towards cardiovascular services and you do not own any freestanding ancillary facilities. This suggests that your facility is overly reliant on government level prospective payment rates (which have been trending lower than private insurance rates over time), that many of your services are already subject to CMS scrutiny by way of reporting on many cardiovascular related quality indicators, and that there are limited opportunities to offset any revenue shortfalls by offering more ancillary services. In contrast, the IH system has 24 hospitals, more than 130 outpatient facilities and more than 750 physicians.
Begin your brief by contrasting the quality needs of a small facility such as yours and a health system like IH. At a minimum you should address the issues of the financial environment faced by your facility, the practical aspects of investing in health information technology given your hospital's size and case mix, and the required infrastructure (staff and resources) to begin such an effort.