Program Capstone Unit 3 

Introduction

With the increasing pressures on the need to improve the quality of care, many healthcare institutions have adopted performance measurement as a strategy to oversee the transition from traditional healthcare provision to modern systems of healthcare delivery. According to Saxe-Braithwaite (2013), performance measurement is the gauging of the activities conducted by an organization using a specified guideline shaped by industrial demands, qualities and expectations. Therefore, the healthcare industry has different performance measurement benchmarks, which are used by healthcare institutions and professionals to determine the extent to which healthcare organizations meet the demands posed by the changing dynamics of healthcare delivery. 

This discussion expounds more on the significance of performance measurement. Rather than basing its arguments on the theoretical constructs surrounding the concept of performance measurement, this discussion presents an actual analysis of the performance measurement standards at John Hopkins Hospital, Baltimore. Besides, the strategic innovations used in the evaluation of the performance standards will be discussed in earnest. This discussion gives a detailed evaluation of the role played by the leaders of the healthcare institutions in ensuring that these performance measures are attained in accordance with the national benchmarks. 

John Hopkins Hospital

John Hopkins Hospital is a medical institution based and headquartered in Baltimore, Maryland. According to the institution’s website, it is an integrated healthcare enterprise worth $8 billion, and is regarded as one of the leading healthcare systems of the US (Hopkinsmedicine.org, 2017). Through the institution’s university school of medicine, scientists and physicians are united with the facilities and professionals of the healthcare system and the hospital. 

John Hopkins operates six community and academic hospitals, over 35 primary and specialty care outpatient sites and four suburban surgery and healthcare centers. Since its inception in 1889, John Hopkins Hospital has managed to attain the top spot on the indices of best hospitals according to the US News and World Report for over 20 year. The mission of the hospital, which is to improve the health of community and the world through setting standards of excellence in clinical care, medical research and education, drives the institution towards delivering the promise of medicine, which is the vision of John Hopkins Hospital. 

Performance standard measures at John Hopkins Hospital

At the John Hopkins Hospital, measures are taken to help the providers improve the health of the member communities, as well as set standards of excellence in the quality of care provided to the members. Consequently, there are certain sets of health care performance measures that are followed by the different business lines of the healthcare provider. Healthcare Effectiveness Data and Information is the main component of performance standard measurement employed by John Hopkins Hospital Employer Health Program.

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This component was developed by the National Committee for Quality Assurance (NCQA). At John Hopkins, through the EHP, physicians have discredited the notion that longer hospital stays translate to better quality of healthcare. At John Hopkins, the wait times across the different departments in the hospitals have been successfully cut. Looking at the national statistics in comparison to those of John Hopkins, significant trends are observable (Hopkinsmedicine.org, 2017). For instance, the number of days that patients with conditions such as congestive heart failure have been reduced by more than six days of the national average. The programs of the hospital, therefore, are designed to improve the quality of patient care, as well as minimize the wait times. 

John Hopkins Hospital, moreover, a strategy to lower the readmission rate has been launched. This was an initiative taken in April 2015, and aimed at minimizing the 30-day hospital’s readmissions rate. In accordance to the Cost Review Commission of Maryland, John Hopkins Hospital recorded an 8.6% drop in the readmission rates between July 2013 and July 2015 (Hopkinsmedicine.org, 2017). This marked barely three months into the launch of the ambitious strategy to minimize the readmission rates. 

The profitability index of John Hopkins is a significant performance standard measurement. The performance goal of the organization is to establish a transparent financial reporting system that is understood and available for all the constituencies of the hospital. The net revenue of the hospital stood at $7.177 billion in 2015. In the same year across the 5,600 hospitals in the US, the net revenue was $900 billion (Statista, 2016). This translates to approximate revenue of $165 million for each hospital. These statistics indicate that John Hopkins Hospital’s revenue is higher than the industrial average by nearly 70 times. However, as Saxe-Braithwaite (2013) writes, the operating expenses of the healthcare industry have limited the amount of profits enjoyed by these institutions. In 2015, for instance, John Hopkins Hospital had operating expenses totaling to $6 billion.  

As defined by Saxe-Braithwaite (2013), leadership is the behavior exhibited by an individual when directing the activities of a group towards attaining a shared goal. There are several aspects of leadership involved in the process of ensuring that healthcare organizations attain the performance measurement standards that are stipulated as per the national benchmarks. At John Hopkins Hospital, the role of the leader goes beyond overseeing the successes of the organization into influencing the activities of people in order to ensure that the organization copes with the changing dynamics of the healthcare industry.

In a bid to script the roles of healthcare organizational leader in spearheading the attainment of these benchmarks, it is inevitable that majority of the leadership theories involving the role of leaders in influencing the organizational performance were not crafted with the healthcare context in mind. However, across the diverse disciplines of healthcare delivery in which John Hopkins Hospital operates, the role of organizational leader is distinguished as that of improving the quality of patient care and the organizational outcomes in relation to ensuring that the health setting is accommodative enough to sustain the changes that test the flexibility of the organizational leadership structure (Hopkinsmedicine.org, 2017). 

Besides, the role of leaders is to ensure that the numerous professional groups and teams work in tandem towards realizing the common goal of the organization. The leadership, therefore, plays the role of capitalizing on the diversities of these professional groups, balancing the challenges to which they are exposed and minimizing the conflicts that may accrue from the multidirectional goals that characterize the different departments. 

Informed consent refers to the process by which health care provider allows the patient to make a voluntary choice of either accepting or refusing treatment after disclosing the appropriate information regarding the health condition. There are legal and ethical significances of informed consent, as Satyanarayana Rao (2008) explains. In the cancer hospital, informed consent comes in through the right to life and freedom of choice. The concept of informed consent views it illegal to treat another person without their permission as this translates to assault or battery, which are both punishable by law. The patient autonomy and the basic human rights are the ethical constructs of informed consent. Consequently, the freedom of the patient should be respected, as this is the ethical basis of medical practice. 

Informed consent is important to the patient as it reinstates the right of self-determination. The disclosure of information enables the patient to be at ease with the impending treatment procedures, as well as understand the burden of their health condition. Failure to administer appropriate informed consent can lead to discrediting of the license of medical practice. On the other hand, the legal consequences manifest through accusations of battery, assault and premeditated attempt to murder, which are punishable by law (Satyanarayana Rao, 2008). Clinical staff members and administrators have an ethical obligation to ensure that the guidelines of informed consent are followed. This is mainly because medical practice requires these professionals to be the custodians of the health and safety of the patient population, along with the demands to ensure patient-centered care is administered across the healthcare industry.