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Question: Your hospital's quality scorecard shows that the facility had a lower rate of compliance for the following quality measures compared to other hospitals in the area:

- Percent of heart failure patients with left ventricular systolic dysfunction (LVSD) who are prescribed an ACEI or ARB at hospital discharge

- Number of acute myocardial infarction (MI) patients who are prescribed a beta-blocker at hospital discharge

- Percentage of ischemic stroke patients administered (given) anti-thrombotic therapy by the end of hospital day 2

Hospital administration wants the performance improvement team to research the possible causes for these rates and to develop some potential solutions that will help improve compliance. Select the components of the processes evaluated in these measures that you think may affect compliance. (You may want to review the measure definitions and content quality measure at AHRQ's website, which explain the processes and outcomes involved). Then, develop one or two ideas for solutions for each measure, such as educating staff or changing a workflow.

Using APA format, write a 3 page proposal to the performance improvement team that details the clinical and administrative processes which you believe are involved that the team should address in creating an improvement plan. Be sure to identify the clinical and administrative data that will be needed to analyze processes and determine how they affect outcomes (mortality).

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