Assignment: Quality Healthcare: Measuring NP Performance

Quality Healthcare: Measuring NP Performance
Access to high-quality, safe, and efficient care is a right for all the Americans irrespective of their backgrounds. The government and different organizations in health constantly implement interventions that aim strengthening the quality and safety of care the public receives. Some of the interventions include those that rate health organizations based on the different domains of quality healthcare. The Healthcare Effectiveness Data and Information Set (HEDIS) is among the performance improvement tools that health organizations use to assess and improve on their quality metrics. Therefore, the purpose of this paper is to examine three patient interventions related to breast cancer screening measures, their implementation, effect on patient outcomes and healthcare costs savings and ways in which they can improve nurse practitioner patient ratings.

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Patient Interventions
The selected domain from HEDIS for focus in this project is effectiveness of care. The performance measure that is analyzed is on breast cancer screening (NCQA, n.d.). Breast cancer screening is a health promotion intervention that facilitates timely detection and management of breast cancer among the affected populations. Early detection through screening has been shown to increase the survival rate among patients and reduce the potential costs that patients and their families incur. The three patient interventions that can be adopted to increase the performance measures on breast cancer screening include the use of mobile mammography vans, educational outreach programs, and peer counseling.
Mobile mammography vans or units have been utilized in the United States to increase the access and availability of breast cancer screening services for all. The vans enable working and nonworking women to access breast cancer screening services at their convenience. Hospitals can acquire the mobile mammography vans for use in expanding the reach and uptake of mammography services for their populations(Trivedi et al., 2022). The effectiveness of mobile mammography vans can be measured based on data such as the changes in the rates of women that undergo breast cancer screening, cost of care, and survival rate among breast cancer patients.
Educational outreach programs are also effective in increasing the measures of breast cancer screening. Healthcare providers use the programs to raise awareness and increase the uptake of the screening services among the women populations. The programs also provide an opportunity to demystify the stereotypes and misinformation associated with breast cancer and breast cancer screenings(Nduka et al., 2023). Peer counseling is also an effective approach to increase the uptake of breast cancer screening services among the population. Peer educators can provide women with education on the importance of breast cancer screening. Peer counseling increases knowledge of the women and transforms positively their beliefs towards breast cancer screening(Atere-Roberts et al., 2020). The effectiveness of peer counseling and education outreach programs can be measured by changes in knowledge and beliefs of women towards breast cancer screening, uptake of breast cancer screening services, and cost of care incurred by those diagnosed with breast cancer.
Improved Patient Outcomes and Healthcare Cost Savings
The above primary care interventions to increase breast cancer screening measures improve patient outcomes and saves healthcare costs. Mobile mammography vans have been shown to reduce mortality due to breast cancer. An initial study conducted by Dr. Philip Strax in 1960 showed that there was a decrease in mortality through the 18 years of patient follow-up. Another study conducted in the 1970s revealed that mobile mammography vans reduce healthcare costs. This is despite the initial start-up costs being significant. Mobile mammography vans also assure women enhanced access and availability of breast cancer screening services. Both working and nonworking women can undergo the screening services conveniently and whenever scheduled for the tests. Mobile mammography vans also eliminate disparities in access to breast cancer screening services in the population. Accordingly, the vans reach women who may experience challenges in travelling to clinics for their routine screenings. In addition, it benefits women older than 60 years who may face hardships in visiting in-person clinics for screenings. Lastly, mobile mammography vans increase women participation in their health-related issues as compared to screening in radiologists offices(Trivedi et al., 2022). This raises women engagement and empowerment on issues related to reproductive health, hence, improved outcomes.
Educational outreach programs also improve patient outcomes and save healthcare costs. The education out-reach programs can be either one-on-one or group education. The programs convey information related to breast cancer such as benefits of screening and overcoming screening barriers, as a way of motivating the population to utilize the recommended screenings. Education outreach programs have been shown to increase the likelihood of the population being screened for breast cancer as compared to the usual interventions. Besides breast cancer screening, the uptake of cervical cancer screening services also increases with the use of outreach educational programs(Atere-Roberts et al., 2020; Nduka et al., 2023; Rakhshani et al., 2022). The effect of educational outreach programs can be sustained over a long period. For example, the study by Atere-Roberts et al., (2020) showed that 84% of the women aged 40 years and above received mammography screening services at six months and each follow-up following the provision of educational outreach services. There is also the reduction of healthcare costs with educational outreach programs. The increased uptake of breast cancer screening following the programs facilitates early diagnosis and treatment, which improves survival rates and reduces healthcare costs for patients and their families(Noman et al., 2021).
Peer counseling also improves patient outcomes and reduces healthcare costs. Evidence shows that peer consoling is highly effective in conservative communities where speaking about issues related to breast is considered a taboo(Nayyar et al., 2023). Peer counseling has been demonstrated to increase the knowledge, skills, and regular use of breast self-examination and use of breast cancer screening services among women. Peer counseling and training also act as structured models of behavioral change. They transform the attitude, behavior, and beliefs that women have towards breast cancer, breast cancer screening, and breast self-examination(Mboineki et al., 2022). Consequently, a positive change in these measures results in increased numbers of women diagnosed early with breast cancer and initiated on treatment. This reduces the overall burden of breast cancer in the population.
Improved NP Patient Ratings
The above interventions to increase measures on breast cancer also improve nurse practitioner patient ratings. Patient ratings provide insights into the subjective experiences of the patients with the healthcare providers and healthcare services. When patients visit healthcare settings for their routine breast cancer screenings, they have expectations that must be met for their satisfaction with the care services. Their level of satisfaction and engagement in the care process can be assessed through their ratings. A high patient rating implies that the care given to patients goes beyond their expectations (Takeshita et al., 2020). It also translates into the increased potential of subsequent utilization of other screening services by the patients in an organization.
High patient satisfaction, as reflected in patient rating has been associated with improved health outcomes. Accordingly, satisfied patients are highly likely to adhere and comply with the recommended treatments for their health problems. Their utilization of health promotion interventions such as routine screenings also goes up. Breast cancer screening is a routine process that relies largely on patient’s compliance. However, dissatisfaction with screening services can potentially lower the subsequent utilization of breast cancer screening services among women. Factors such as lack of empathy, negative provider attitude, and delays in the delivery of healthcare services may result in dissatisfaction among patients and poor rating (Takeshita et al., 2020). Therefore, implementing interventions such as peer counseling, mobile mammography vans, and educational outreach programs may increase patient satisfaction with breast cancer screening services, hence, increased NP patient ratings in clinical practice.
Conclusion
The selected HEDIS domain for focus in this essay is effectiveness of care. The measure to be improved is breast cancer screening. The three patient interventions that have been proposed to increase breast cancer screening are peer counseling, mobile mammography vans, and educational outreach programs. The reviewed evidence shows that the patient interventions are effective in improving patient outcomes. They are also cost-effective in healthcare. NP patient rating are crucial in nursing practice. Nurse practitioners should adopt interventions that increase patient satisfaction for improved patient ratings and outcomes in their practice. The identified patient interventions can improve NP patient rating. Therefore, they should be incorporated into practice to improve measures related to breast cancer screening.
References
Atere-Roberts, J., Smith, J. L., & Hall, I. J. (2020). Interventions to increase breast and cervical cancer screening uptake among rural women: A scoping review. Cancer Causes & Control : CCC, 31(11), 965. https://doi.org/10.1007/s10552-020-01340-x
Mboineki, J. F., Wang, P., Dhakal, K., Getu, M. A., & Chen, C. (2022). The Effect of Peer-Led Navigation Approach as a Form of Task Shifting in Promoting Cervical Cancer Screening Knowledge, Intention, and Practices Among Urban Women in Tanzania: A Randomized Controlled Trial. Cancer Control : Journal of the Moffitt Cancer Center, 29, 10732748221089480. https://doi.org/10.1177/10732748221089480
Nayyar, S., Chakole, S., Taksande, A. B., Prasad, R., Munjewar, P. K., Wanjari, M. B., Nayyar, S., Chakole, S., Taksande, A. B., Prasad, R., Munjewar, P. K., & Wanjari, M. (2023). From Awareness to Action: A Review of Efforts to Reduce Disparities in Breast Cancer Screening. Cureus, 15(6). https://doi.org/10.7759/cureus.40674
NCQA. (n.d.). HEDIS. NCQA. Retrieved July 28, 2023, from https://www.ncqa.org/hedis/
Nduka, I. J., Ejie, I. L., Okafor, C. E., Eleje, G. U., & Ekwunife, O. I. (2023). Interventions to increase mammography screening uptake among women living in low-income and middle-income countries: A systematic review. BMJ Open, 13(2), e066928. https://doi.org/10.1136/bmjopen-2022-066928
Noman, S., Shahar, H. K., Abdul Rahman, H., Ismail, S., Abdulwahid Al-Jaberi, M., & Azzani, M. (2021). The Effectiveness of Educational Interventions on Breast Cancer Screening Uptake, Knowledge, and Beliefs among Women: A Systematic Review. International Journal of Environmental Research and Public Health, 18(1), 263. https://doi.org/10.3390/ijerph18010263
Rakhshani, T., Dada, M., Kashfi, S. M., Kamyab, A., & Jeihooni, A. K. (2022). The Effect of Educational Intervention on Knowledge, Attitude, and Practice of Women towards Breast Cancer Screening. International Journal of Breast Cancer, 2022, 5697739. https://doi.org/10.1155/2022/5697739
Takeshita, J., Wang, S., Loren, A. W., Mitra, N., Shults, J., Shin, D. B., & Sawinski, D. L. (2020). Association of Racial/Ethnic and Gender Concordance Between Patients and Physicians With Patient Experience Ratings. JAMA Network Open, 3(11), e2024583. https://doi.org/10.1001/jamanetworkopen.2020.24583
Trivedi, U., Omofoye, T. S., Marquez, C., Sullivan, C. R., Benson, D. M., & Whitman, G. J. (2022). Mobile Mammography Services and Underserved Women. Diagnostics, 12(4), 902. https://doi.org/10.3390/diagnostics12040902

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The National Committee for Quality Assurance (NCQA) was formed to ensure the quality of patient care and measurement of patient outcomes with set standards.

Healthcare Effectiveness Data and Information Set (HEDIS) is a performance measurement tool used by millions of health insurance plans. There are 6 domains of care:

Effectiveness of Care

Access/Availability of Care

Experience of Care

Utilization and Risk Adjusted Utilization

Health Plan Descriptive Information

Measures Collected Using Electronic Clinical Data Systems

You may access the 6 domains of care by clicking this link:

(NCQA, n.d. https://www.ncqa.org/hedis/Links to an external site.)

As an APN, productivity will be an important measurement for the practice to determine reimbursement and salary. Fee-for-service practices will require a set number of patients per day to maintain productivity. A capitated practice will require the APN to have a large panel of patients but also will focus on controlling costs. This can be accomplished through effective primary care that is accessible, convenient for the patients, and has a method of measuring the quality of care.

Write a formal paper in APA format with a title page, introduction, the three required elements below, conclusion, and reference page.

You are now employed as an NP in primary care. Choose one performance measure from one of the six domains of care,

Please do it on : Breast Cancer Screening (BCS)

Develop three different patient interventions for that one performance measure and how you would specifically implement the intervention and measure the outcomes for that particular performance measure in clinical practice.

How would these primary care interventions result in improved patient outcomes and healthcare cost savings?

How can these interventions result in improved NP patient ratings?

Include as a reference: https://www.ncqa.org/hedis/measures/

May use more than 5 references if needed. Please use references that I don’t need a subscription to access. Thanks