Improvement in The Healthcare Legacy Presentation
Question Description
Please see attachment: Project Plan
Assignment Instructions
Goal: Demonstrate the ability to create a field of study project that uses both research-based and personal content while using presentation software to communicate with an intended audience.Improvement in The Healthcare Legacy Presentation
Course Objective: CO3
Instructions:
During the first six-weeks you formulated a project plan, researched the content of the plan, and collected quality academic and non-academic sources. For the week 7 Field of Study Project you will create a PowerPoint presentation that builds upon the week 2 Project Plan and the week 4 Location and Access (Source Organization worksheet) that effectively communicates the knowledge you have gained during COMM110.
Please consider the following:
Presentation will include an introduction, body, conclusion, and properly formatted reference/work cited slide in the citation style of your degree program (APA, MLA, Chicago).
Clear evidence that the topic was researched and expanded upon the week 2 Project Plan.
Presentation provides audience with information to increase their knowledge of the topic presented.
Presentation engages the audience by using elements such as images, graphs, and charts. Appropriate citations must be included.
Three (3) vetted credible sources. One (1) of the sources must be scholarly and from the library.
Appropriate length 7-9 slides.Improvement in The Healthcare Legacy Presentation
Schifferdecker, K., Yount, S., Kaiser, K., Adachi-Mejia, A., Cella, D., Carluzzo, K., … Fisher, E. (2018). A method to create a standardized generic and condition-specific patient-reported outcome measure for patient care and healthcare improvement. Quality of Life Research, 27(2), 367–378. https://doi.org/10.1007/s11136-017-1675-5
Clinton: “innovation, science and technology” are fundamental to development work. (2010). Foreign Policy Bulletin, 20(4), 72-91. doi:http://dx.doi.org.ezproxy1.apus.edu/10.1017/S10527…
Galloro V. Health Care Hall of Fame. A voice unsilenced. Bays built healthcare legacy on foundation of tireless innovation. Modern Healthcare. 2001;31(7):22-24. http://search.ebscohost.com.ezproxy1.apus.edu/login.aspx?direct=true&AuthType=ip&db=mdc&AN=11234229&site=ehost-live&scope=site. Accessed September 20, 2019.
attachment_1
Public Health Administration
Part I
Scope and Value
The assignment scope is to examine how the knowledge and experience gained from pursuing Public Health Administration will enable one to offer services that are quality to the patients who visit the healthcare center to receive medical services. The value is to ensure that proper strategies as implemented to guarantee that patients are gratified with the medical services offered to them which will contribute to a positive influence on the future of healthcare services.
Method of Presentation
PowerPoint
Topic and Theme
Topic: Improvement in the healthcare legacy in terms of services offered.
Theme: The expertise and know-how gained from undertaking Public Health Administration as a course can be put into practice while being a health care administrator.
Questions/Statements
What can be done further in the healthcare sector to improve the face of healthcare?
What should be done to contribute to further healthcare researches?
What can be done to improve the efficiency and effectiveness of financial issues in the health sector?
Subtopics
Healthcare legacy.
Financial constraints in health care.
Strategies to improve the legacy and financial losses in healthcare.
Brainstorming
How will my expertise assist in ensuring patients are happy with the offered services in healthcare centers? Are there any possible solutions to ensure patients’ experience is top-notch services? What are some of the lessons gained from a patient who is well satisfied with the hospital services offered to them?
Part II
The best possible sources for this project plan include peer-reviewed articles on patient satisfaction in-hospital services. Undertaking an in-depth analysis of previously done researches on patient satisfaction will ensure that I get a glimpse of some of the issues patients face while getting healthcare services in hospitals. Not only will I get to learn about the main issues on patient satisfaction but also possible solutions on how to tackle the same problems.
attachment_2
A method to create a standardized generic and condition-specific
patient-reported outcome measure for patient care and healthcare
improvement
Karen E. Schifferdecker1,2 • Susan E. Yount3 • Karen Kaiser3 • Anna Adachi-Mejia1,2,4 •
David Cella3 • Kathleen L. Carluzzo2 • Amy Eisenstein3,5 • Michael A. Kallen3 •
George J. Greene3 • David T. Eton6 • Elliott S. Fisher4
Accepted: 29 July 2017 / Published online: 9 August 2017
Springer International Publishing AG 2017
Abstract
Purpose Patient-reported outcome measures (PROMs),
which are generic or condition-specific, are used for a
number of reasons, including clinical care, clinical trials,
and in national-level efforts to monitor the quality of health
care delivery. Creating PROMs that meet different purposes without overburdening patients, healthcare systems,
providers, and data systems is paramount. The objective of
this study was to test a generalizable method to incorporate
condition-specific issues into generic PROM measures as a
first step to producing PROMs that efficiently provide a
standardized score. This paper outlines the method and
preliminary findings focused on a PROM for osteoarthritis
of the knee (OA-K).
Methods We used a mixed-methods approach and
PROMIS measures to test development of a combined
generic and OA-K-specific PROM. Qualitative methods
included patient focus groups and provider interviews to
identify impacts of OA-K important to patients. We then
conducted a thematic analysis and an item gap analysis:
identified areas covered by existing generic PROMIS
measures, identified ‘‘gap’’ areas not covered, compared
gap areas to legacy instruments to verify relevance, and
developed new items to address gaps. We then performed
cognitive testing on new items and drafted an OA-Kspecific instrument based on findings.
Results We identified 52 existing PROMIS items and
developed 24 new items across 14 domains.
Conclusions We developed a process for creating condition-specific instruments that bridge gaps in existing generic measures. If successful, the methodology will create
instruments that efficiently gather the patient’s perspective
while allowing health systems, researchers, and other
interested parties to monitor and compare outcomes over
time, conditions, and populations.
Keywords Patient-reported outcome measure Healthcare
quality Mixed methods Osteoarthritis of the knee
Purpose
Calls continue to mount to establish common standards for
measures of quality, including the incorporation of
patients’ health status and values via patient-reported outcome measures (PROMs) that ‘‘matter to patients’’ [1, 2].
Although PROMs have been used for a number of years in
clinical trials and some registries [3], their use is growing
in clinical care settings for patient care and shared decision
& Karen E.
karen.e.schifferdecker@dartmouth.edu
1 Community and Family Medicine, Geisel School of Medicine
at Dartmouth, Lebanon, NH, USA
2 Center for Program Design and Evaluation at Dartmouth,
Geisel School of Medicine at Dartmouth, 21 Lafayette Street,
#373, Lebanon, NH 03766, USA
3 Department of Medical Social Sciences, Northwestern
University’s Feinberg School of Medicine, Chicago, IL, USA
4 The Dartmouth Institute for Health Policy and Clinical
Practice, Geisel School of Medicine at Dartmouth, Lebanon,
NH, USA
5 Leonard Schanfield Research Institute at CJE SeniorLife,
Chicago, IL, USA
6 Department of Health Sciences Research, Division of Health
Care Policy and Research, Mayo Clinic, Rochester, MN,
USA
123
Qual Life Res (2018) 27:367–378
https://doi.org/10.1007/s11136-017-1675-5
making [1] and for managing population health at a
national level [3–7]. As such, creating instruments that
meet different purposes in varying contexts without overburdening patients, healthcare systems, providers, and data
systems is paramount.
When considering current PROMs, two basic approaches exist to assess patient health: generic and conditionspecific [8]. Generic measures allow for comparability
‘‘across patients and populations,’’ while condition- or
disease-specific measures tend to provide improved relevance and responsiveness, including the potential to better
differentiate groups by clinically salient symptoms or
concerns [6, 8, 9]. Measures are identified as being condition-specific if they include items relevant for patients
with the condition and, for some measures, specifically
specify the condition (e.g., ‘‘do you have trouble walking
because of OA-K?’’) [10]. Although generic and conditionspecific measures may be more or less useful depending on
the purpose, the potential of providing ‘‘the most complete
assessment of patient-reported health’’ [11] relevant to uses
ranging from direct patient care to ‘‘driving improvement,
outcomes measurement’’ [2] increases if both types of
measures are
Efforts to create comprehensive instruments focus primarily on identifying [2, 12] and combining existing
measures [11, 13, 14]. Some generic measures have used
condition- or treatment-specific modules or subscales that
can be added to core items to enhance the relevance of the
measure to a specific population [15–17]. The patient-reported outcomes measurement information system
(PROMIS), which provides item banks of generic measures that are applicable across populations and chronic
conditions [18–20], serves as a prominent potential
resource in these efforts. At the same time, PROMIS has
focused on achieving more precise measures and efficiencies for individuals using item response theory (IRT) for
the development of computerized adaptive testing (CAT)
administration [21–23]. While these efforts are commendable and have their advantages, a condition-specific
assessment that builds on a generic framework may produce PROMs that offer both increased relevance for capturing the health burden imposed by specific problems and
the ability to compare across diseases, conditions, populations, and systems.Improvement in The Healthcare Legacy Presentation
The objective of this study was to test a generalizable
method to incorporate condition-specific issues into generic PROM measures as a first step to producing PROMs
that efficiently provide a standardized score. The overall
study focuses on testing the method using PROMIS with
two high impact conditions: osteoarthritis of the knee (OAK) and heart failure (HF). Since the methods are identical,
this paper focuses on our methods and preliminary findings
for OA-K only.
Methods
We used a longitudinal transformation mixed-methods
design [24] at four sites to develop the instruments and built
upon PROMIS methods and the International Society for
Pharmacoeconomics and Outcomes Research’s task force
recommendations for developing PROM items [19, 25–27].
Steps included patient focus groups, expert interviews, item
gap analysis, new item development to address gaps, cognitive interviews, and development of the draft instruments.
The institutional review boards of Dartmouth College, Mayo
Clinic, Oregon Health and Science University Hospital, and
Northwestern University approved this study.
Qualitative data collection
Patient focus groups and provider interviews were conducted to identify potential items for inclusion in an
instrument for OA-K. Eligible patient participants were
identified via medical record review or via physician recommendation at Dartmouth-Hitchcock Medical Center,
Mayo Clinic, Northwestern Medicine, and Oregon Health
and Science University Hospital. Criteria included being
diagnosed with OA-K, being a candidate for elective total
joint arthroplasty (TJA) or having undergone TJA within
the previous 12 months, at least 18 years old, and Englishspeaking. Potential patient participants were contacted
either via phone or in clinic by a study coordinator and
received $40 in the form of a gift card for their time.
Providers were recruited based on their experience working
with patients having OA-K. Potential provider participants
were contacted either in person or by email.
Patient focus groups
Two focus groups at each of the four participating clinical
sites were conducted for a total of eight focus groups.
Focus groups were led by an experienced focus group
moderator, audio recorded, and transcribed. The semistructured focus group guide began with an open-ended
question asking participants to describe in their own words,
first on paper and then as part of the group discussion, how
their condition has impacted their life. The facilitator then
prompted participants with questions about aspects of their
lives that had changed the most since developing their
condition and since surgery for those who had surgery.
Over the course of the focus group discussion, a trained
observer took notes using a list of pre-selected and
potentially relevant domains from PROMIS (pain interference, physical function, fatigue experience, fatigue
impact, participation in social roles, satisfaction with social
roles) to note what domains participants had discussed and
to help determine if additional follow-up questions were
368 Qual Life Res (2018) 27:367–378
123
needed to clarify a particular domain or if participants had
not yet discussed a particular domain. The observer sat
next to the moderator to enable quick exchange of information so that the moderator could ask additional questions
as needed. Participants were then asked to describe the
most important impact of their condition on quality of life.
Following the group discussion, participants were given an
opportunity to individually write down any additional
comments that they wanted to expand upon or did not feel
comfortable mentioning in the group.
Provider semi-structured interviews
Healthcare provider interviews were conducted via telephone by an experienced qualitative interviewer, audio
recorded, and transcribed. The interviews focused on their
perspective on the most important impacts OA-K had on
their patients’ daily lives. Prompts included asking about
how the condition affects their patients physically, emotionally, and socially and how it impacts their ability to
function at home and at work. Providers were then asked to
identify the impacts that were most important for the
healthcare team to know about.
Qualitative data and item gap analysis
Focus group transcripts were coded in Dedoose by two
team members using a thematic analysis approach [28, 29].
A team of qualitative researchers then reviewed the coded
data results and conducted an item gap analysis to identify:
(a) codes/themes that were consistent with existing PROMIS domains (e.g., pain interference) and existing items in
the domains, and (b) codes/themes not covered by existing
PROMIS domains and items (i.e., gap items). Further
details of the process are provided below.
Provider interview data were reviewed after focus group
analyses were completed to compare and contrast with
focus group findings to identify any potential additional
domains or items. As no new domains or items were
identified, subsequent analyses only included the focus
group data.
Identifying existing PROMIS domains and items
Qualitative codes were independently reviewed by three
members of the research team (KK, AA, AE) who grouped
codes within PROMIS domains. The content of those codes
(i.e., all patient quotations for each code) was reviewed by
two members of the research team (KK, AE) in an iterative
process, whereby some items were revisited and either
eliminated or added back for reasons and criteria listed
below. For the sake of simplicity, the process is described
linearly:
1. The team matched codes to domains and potential
items in the domains. They then reviewed selected
items for subjective item quality, taking into consideration a number of factors, including item clarity,
gender or opportunity bias (e.g., not everyone has the
opportunity to climb flights of stairs), and adequate
specificity of the item. Low-quality items were
removed.
2. Next, because a larger number of items remained than
were targeted for use, psychometric item quality was
considered to help reduce item counts. PROMIS item
parameters (i.e., slopes and category thresholds) in
current use by assessment center [30] were obtained;
the slopes for all items, as determined previously from
PROMIS calibration testing [31], were added to the
item spreadsheets as a first point of focus. Any item
with a slope \2.0 was considered a potentially lesser
quality item from a psychometric perspective and
considered for elimination from the item pool if other
existing items remained to measure the item’s content.
Item slope is also known as the item discrimination
parameter. Items with steeper slopes are more helpful
in separating persons into differing ability or trait
levels than items whose slopes are less steep. Thus,
items with low discrimination (less steep slopes) are
less able to do a good job distinguishing between
persons at differing score levels of the trait (e.g.,
fatigue) being measured.