Assessing a Healthcare Program/Policy Evaluation
Healthcare Program/Policy Evaluation Analysis Template
Healthcare programs and policies form the basis of effective care provision for healthcare organizations and providers. Imperatively, assessing a healthcare program is a valuable tool that helps to strengthen its implementation and attainment of set goals. The assessment also ensures that such programs improve outcomes for the targeted populations. As a core part of healthcare provision, nurses play a critical role in evaluating the programs or policies to ensure that they meet patients’ and health population’s needs. Nurses bring insight and expertise based on their clinical experience as they interact with patients and health populations that benefit from such programs. The purpose of this paper is to evaluate the Centers for Medicare and Medicaid Services’ (CMS) hospital readmission reduction program (HRRP).
| Healthcare Program/Policy Evaluation | Hospital Readmission Reduction Program (HRRP) by the Centers for Medicare and Medicaid Services (CMS)
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| Description | At the core of the Hospital Readmission Reduction Program (HRRP) by the Centers for Medicare and Medicaid Services (CMS) is to lower the number of readmissions that facilities can have within 30 days after discharging patients. The CMS launched the program in 2012 with the aim of improving the healthcare provider’s quality of care to incentivize reimbursement. According to the American Hospital (AHA), the CMS penalizes hospitals when they have “excess” readmissions when they compare them to the expected numbers. Additionally, Figueroa et al. (2022) assert that the overall aim of the HRRP was to encourage hospitals in developing effective policies to enhance their discharge planning, care transitions and coordination of care after discharge to reduce the increased cost burden for patients and their families Under HRRP, the CMS tracks readmission of patients admitted for certain conditions that include heart attack, heart failure, chronic obstructive pulmonary disease (COPD) and pneumonia as well as elective hip and knee replacement.
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| How was the success of the program or policy measured?
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The success of this policy is critical to ensuring that patients get quality and safe healthcare services. Studies and reports have measured the success of the program by reporting on changes in the readmission rates and the amount in penalties that facilities have been fined for not complying with the provisions. The program’s success entails looking at the reduction in readmissions and improvement of quality for patients with the targeted conditions. The American Hospital Association (AHA) asserts that since its inception hospitals have prevented over 565,000 readmissions. Several studies have demonstrated that many patients have not had to get readmitted due to effective discharge planning and care provision |
| How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?
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The HRRP initially targeted individuals with three chronic conditions that include COPD, pneumonia, and heart failure. However, the program expanded to reach more people with other conditions like heart attack and elective hip and knee replacement. As such, a majority of Medicare patients have benefited from this program. In their study, Ibrahim et al. (2018) explores the effects of HRRP on readmissions in surgical settings among Medicare beneficiaries. The study show that HRRP is an effective program that has had significant impacts on quality of care and better patient outcomes. Gai et a; (2019) opine that the program has developed the right incentives for facilities to reduce readmissions not just for the targeted population but also for others leading to significant societal benefits. The impact of HRRP is substantial with reduced costs of care and better quality services for patients. |
| At what point in program implementation was the program or policy evaluation conducted? | The evaluation of the program is continuously and happened after its effective roll out by the CMS. The policy was evaluated after about 1 year of implementation to determine its effectiveness. The evaluation occurs each year and where there is a need for better information at any time, the evaluation of the policy happens to meet stakeholders’ needs. |
| What data was used to conduct the program or policy evaluation?
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Evaluation of the program used data from different entities to determine the credibility. Data from hospital records, especially admission records, was used in evaluating the policy. Using this approach, stakeholders can conduct the evaluation at different levels, from organizational to federal level. Again, the stakeholders used official government data and reports to evaluate the program. The evaluation is important as it illustrates areas working in the program and those that need corrective measures. |
| What specific information on unintended consequences were identified?
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The specific information about the unintended consequences of the program include penalties against healthcare organizations to encourage them to embrace the practice. Again, while the program targeted three chronic conditions, its unintended effects included having more individuals come for treatment as opposes to advice only. The other unintended effect is that healthcare organizations and facilities are concentrating on reducing readmissions instead of accepting patients and offering care as required. |
| What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
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The stakeholders in the evaluation process included patients and their families, healthcare providers like nurses and physicians, healthcare agencies, especially the CMS. The evaluation would benefit a host of stakeholders (Qiu et al., 1000). The results and reporting of the evaluation will benefit patients and their families since they will know that one can only be discharged based on the provisions of the act (Figuero et al., 2019). Again, healthcare organizations, especially those under CMS with benefit as it will mean that they would not incur addition costs for certain conditions and diseases. Again, reporting the findings will benefit healthcare agencies and non-profit organizations that are keen on providing quality care to their patients.
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| Did the program or policy meet the original intent and objectives? Why or why not?
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The HRRP program met the initially intention and objectives. The original intent of the program was to penalize facilities for having high readmission rates. Since its execution the rate of readmission has declined with more hospitals embracing its provisions to reduce their susceptibility to adverse outcomes. The number of penalized facilities have also increased leading to development of EBP interventions to reduce readmissions and offer quality patient care to all populations |
| Would you recommend implementing this program or policy in your place of work? Why or why not? | The model is a critical part of attaining quality patient outcomes and reducing readmissions. Imperatively, I would recommend implementing this program since it is effective in dealing with the increased rates of readmissions in hospitals. I would recommend the program to improve quality of care and patient safety. The program incentivizes facilities to develop effective quality measures to reduce readmission through better discharge plans and care coordination. Recommending this program will also help develop new approaches and measures to deliver quality care in the current workplace. |
| Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation.
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Nurses as patient advocates are a core part of the healthcare system. As a nurse, one can be becoming involved in evaluating a program within one year after its implementation by conducting surveys and documenting data about the changes in their settings. The second way is to be a member of the review team and participate in the evaluation of all aspects of the program (Qiu et al., 2022). AS patient advocates, nurses can lobby for the program’s increased deployment in healthcare facilities.
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| General Notes/Comments | The HRRP by the CMS demonstrates that hospitals can reduce the associated costs of readmissions by having sufficient resources and investing in facilities, especially the expansion of existing ones. The implementation of the HRRP will lead to better interactions among healthcare providers. Therefore, while it incentivizes facilities for treating patient and reducing admissions, the program is delicate but superb for end users. |
Conclusion
Policy valuation is an important part of understanding program’s efficacy as it allows stakeholders to assess the influence or impact of their suggested solutions. Policy evaluation leads to changes and ensuring that facilities focus on quality care as opposed to having patients who return. The implication is that policy or program evaluation enables organizations to identify possible areas that require interventions.
References
American Hospital Association (n.d). Hospital Readmission Reduction Program.
ttps://www.aha.org/hospital-readmission-reduction-program/hospital-readmission-reduction-program
Figueroa, J. F., & Wadhera, R. K. (2022). A decade of observing the Hospital Readmission Reductions Program—time to
retire an ineffective policy. JAMA Network Open, 5(11), e2242593-e2242593. DOI:10.1001/jamanetworkopen.2022.42593
Gai, Y., & Pachamanova, D. (2019). Impact of the Medicare hospital readmissions reduction program on vulnerable
populations. BMC Health Services Research, 19(1), 1-15.
Ibrahim, A. M., & Dimick, J. B. (2019). A decade later, lessons learned from the hospital readmissions reduction program.
JAMA network open, 2(5), e194594-e194594. DOI:10.1001/jamanetworkopen.2019.4594
Qiu, L., Kumar, S., Sen, A., & Sinha, A. P. (2022). Impact of the Hospital Readmission Reduction Program on hospital
readmission and mortality: An economic analysis. Production and Operations Management, 31(5), 2341-2360.
https://doi.org/10.1111/poms.13724
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Assessing a Healthcare Program/Policy Evaluation
Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.
Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
Learning Resources
Required Readings
- Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
- Chapter 7, “Health Policy and Social Program Evaluation” (pp. 116–124 only)
- Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition
- Links to an external site.. American Journal of Public Health, 93(8), 1261–1267.
- Shiramizu, B., Shambaugh, V., Petrovich, H., Seto, T. B., Ho, T., Mokuau, N., & Hedges, J. R. (2016). Leading by success: Impact of a clinical and translational research infrastructure program to address health inequities
- Links to an external site.. Journal of Racial and Ethnic Health Disparities, 4(5), 983–991.
- Williams, J. K., & Anderson, C. M. (2018). Omics research ethics considerations
- Links to an external site.. Nursing Outlook, 66(4), 386–393.
- Document: Healthcare Program/Policy Evaluation Template (Word document)
Required Media
- Walden University, LLC. (Producer). (2018). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.
- Walden University, LLC. (Producer). (2018). Peter Beilenson: Ethics and advocacy [Video file]. Baltimore, MD: Author.
To Prepare:
- Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
- Select an existing healthcare program or policy evaluation or choose one of interest to you.
- Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
The Assignment: (2–3 pages)
Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:
- Describe the healthcare program or policy outcomes.
- How was the success of the program or policy measured?
- How many people were reached by the program or policy selected?
- How much of an impact was realized with the program or policy selected?
- At what point in program implementation was the program or policy evaluation conducted?
- What data was used to conduct the program or policy evaluation?
- What specific information on unintended consequences was identified?
- What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
- Did the program or policy meet the original intent and objectives? Why or why not?
- Would you recommend implementing this program or policy in your place of work? Why or why not?
- Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.
By Day 7 of Week 10
Submit your completed healthcare program/policy evaluation analysis.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
- To submit your completed assignment, save your Assignment as WK10Assgn+LastName+Firstinitial
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6050_Module05_Week10_Assignment_Rubric
| Criteria | Ratings | Pts | ||||
|---|---|---|---|---|---|---|
| This criterion is linked to a Learning Outcome Program/Policy EvaluationBased on the program or policy evaluation you seelcted, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:· Describe the healthcare program or policy outcomes.· How was the success of the program or policy measured?· How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?· At what point in time in program implementation was the program or policy evaluation conducted? |
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35 pts | ||||
| This criterion is linked to a Learning Outcome Reporting of Program/Policy Evaluations· What data was used to conduct the program or policy evaluation?· What specific information on unintended consequences was identified?· What stakeholders were identified in the evaluation of the program or policy? Who would benefit the most from the results and reporting of the program or policy evaluation? Be specific and provide examples.· Did the program or policy meet the original intent and objectives? Why or why not?· Would you recommend implementing this program or policy in your place of work? Why or why not?· Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation. |
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50 pts | ||||
| This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, low logically, and demonstrate continuity of ideas.Sentences are carefully focused– neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. |
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5 pts | ||||
| This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation |
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5 pts | ||||
| This criterion is linked to a Learning Outcome Written Expression and Formatting:The paper follows correct APA format for title page, font, spacing, parenthetical/in-text citations, and reference list). |
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5 pts | ||||
| Total Points: 100 | ||||||