Dashboards are a vital source of data that can inform leadership about how well the organization meets the local, federal, and state requirements. For Mercy Medical Center (MMC), meeting these standards is crucial to ensure medical care quality and control the institution’s financials. This report is targeted at the MMC’s senior leadership and it aims to explain underperformance and the overall evaluation of dashboard metrics.
Mercy Medical Center Dashboard Metrics
The benchmark data shows that the MMC is developing, and the number of private rooms, surgical rooms, operating rooms, and emergency treatment rooms has increased from 2018 to 2019. Moreover, considering Shakopee, MN has a population of 36,192, and the majority of the population is aged from 22 to 44 years old. However, most of the population that uses the services of the medical center is aged 45-64, accounting for 38% of new patient cases, which is one area of concern. Other population characteristics are consistent with the new patient cases.
Some dashboard metrics that are not meeting the standards set by the US government are connected to the number of exams, including HgbA1c, eye, and foot examinations provided to patients with diabetes. For example, in the US, hospitals should aim to provide eye exams to people with diabetes to 67% of the population over the age of 18 annually, while the current rate is 63% (“Diabetes,” n.d.). At MMC, only 9% of patient visits are attributed to individuals aged 22 and older, and the number of eye exams has fluctuated throughout 2018 and 2019, for instance, in the fourth quarter of 2018, the hospital had 33 eye exams, while in the third quarter of 2019 only 3.
Although there is no data that would allow calculating the percentage of patients with diabetes who have an annual eye exam and their age, the small number of new patient cases in the age group of 22 and older and fluctuations in the number of eye exams suggest that this is an area for improvement. Other issues include a fluctuating number of HgbA1c tests and foot exams, which present a similar issue of potential complications as with eye exams.
The state laws that establish these metrics are the insurance regulations and the Affordable Care Act (ACA), which require the provision of care to all people and reimbursements under Medicare. However, this dashboard lacks information about Medicare enrollment and insurance payments. Another statewide benchmark is the Healthy People 2030 initiative by the CDC, which aims to set data-driven objectives for the performance of medical organizations (“Healthy people 2030,” n.d.). The issue of diabetes and early detection of complications is one of the core problems that this initiative highlights and the MMC falls behind on this metric because the number of diabetes-related examinations fluctuates severely from one quarter to another.
Based on the evaluation, the conclusions are that MMC pays particular attention to the provision of diabetes care, and this hospital needs to offer more examinations to its diabetes patients to improve the detection of complications. The unknowns include the financial information and information that would allow determining whether Mercy receives insurance reimbursements. Also, there is no data for readmission rates, medical errors, or patient satisfaction scores that would determine the quality of MMC’s performance. Also, kidney failure is a common complication for diabetes patients, but MMC does not collect benchmark data for this metric.
One challenge posed before Vila Health’s team in meeting the dashboard requirements is financials, operational, and capital funding since additional examinations will require the hospital to spend more money. However, Medicare Part B covers the expenses for these examinations for patients with diabetes. Hence, MMC can leverage the ACA to provide the necessary screenings to the community members (“Eye exams (for diabetes),” n.d.). Many patients may be unaware that Medicare covers these examinations or, one underlying assumption is that they are not eligible for the coverage, which contributes to MMC’s underperformance.
Underperformance and Ethical Action
This evaluation shows that the number of foot and eye exams and HgbA1c testing are decreasing substantially. The number of patients screened for these complications is underperforming to the greatest degree. Also, the Black and Asia population are disproportionately affected by diabetes. At the same time, at MMC, the percentage of these patients is only 4% and 10%, suggesting that this population does not receive enough diabetes complications screenings. The percentage of white patients is the most widespread underperformance area throughout MMC and affects the greatest number of patients. The metric that affects the greatest number of staff is the ratio of physicians per population, in this case, it is 433 per 32,192 citizens.
Underperformance in the provision of diabetes complications screenings can lead to serious health problems and result in vision loss or amputations for this community’s members. According to the Healthy People 2030 initiative, the goal of measures taken to improve diabetes care is to “reduce the burden of diabetes and improve quality of life for all people who have, or are at risk for, diabetes” (“Diabetes,” n.d., para. 1).
Diabetes is the seventh most common cause of death in the state, and therefore prevention of this condition and its complications is of utmost importance. Leg or foot amputations and deterioration or loss of vision are common complications with diabetes, and the target for Mercy Medical Center should be to provide more exams to prevent these issues.
An ethical action to address this underperformance is to raise awareness among the vulnerable populations about the ACA and Medicare coverage and the need to undergo yearly screenings. The potential for improving the MMC’s quality of care on a performance dashboard is by offering patients who have diabetes regular foot and vision exams to prevent potential issues, such as amputation or vision loss since current poor performance within these metrics is linked to a lack of awareness about the complications and screenings.
The appropriate group of stakeholders for improving diabetes complications screening are patients diagnosed with diabetes and medical personnel who will perform these examinations. The first group should take action to improve their well-being, while the second should act to improve the health of Shakopee’s community. Moreover, other metrics such as rates of readmission, number of complications, and patient satisfaction should improve as well.
The best ethical action for patients with diabetes is to get information regarding Medicare coverage and check if they are eligible for free evaluations. For physicians, ethical action is to communicate with patients and examine the potential risks and prevention measures. Also, the personnel of MMC should collect more benchmark data for this metric.
Overall, this report focuses on MMC’s benchmark performance in comparison to the standards set by local and state agencies. Despite the opportunities for patient care brought by ACA and Medicare, many people in Shakopee do not undergo eye, foot, and HgbA1c screenings, with the number of cases fluctuating each quarter. Hence, the stakeholders should work towards increasing the number of patients undergoing these examinations, especially from the groups susceptible to diabetes.
Diabetes. (n.d.). Web.
Eye exams (for diabetes). (n.d.). Web.
Healthy people 2030. (n.d.). Web.