Isabella Geriatric Center
Isabella Geriatric Center is located in upper Manhattan and has been providing long-term care services to the surrounding neighborhood since 1875. Isabella engaged the Capstone team to identify resident data that is pertinent to specific departments and recommend a mechanism for presentation and dissemination of this data. The team developed a needs assessment for resident data by interviewing key management staff and identified relevant examples of content, collection techniques, presentation styles, and dissemination methods. During the course of the project, Isabella attempted to develop a mechanism to house data reports in their intranet based on information obtained from the Capstone team. In an effort to further develop this reporting mechanism, the Capstone team compiled a gap analysis between the original needs assessment and the current reporting mechanism. In addition, the team compared it to a best practice reporting dashboard at a comparable organization to demonstrate how it can be further improved. Although Isabella now had a mechanism to disseminate reports, it did not give the staff the ability to trend and compare data. To address this issue, the team created a sample of trending data elements and definitions and worked with the senior staff to determine their importance and the best definition for each element. Furthermore, the team developed and instituted an assessment tool to help Isabella obtain feedback from the staff on the reporting tool. The tool will be used for future training purposes so that resident data can be accessed appropriately and presented effectively to all department heads via Isabellas intranet.
Family Health Centers Supply Chain
The purpose of this project was to research Lutheran Health Cares Family Health Centers (FHCs) supply chain, find inefficiencies in this system, and make recommendations to improve these inefficiencies. The goal was to identify and address breakdowns in the system that led to increases in supply costs, delivery time to end-users, and increased personnel time needed to accommodate the current system. Methods used included multiple interviews with individuals from the FHCs, Purchasing Department, Department of Safety, and Finance Department. Analysis of objective data, including check requests, purchase orders, purchase requisitions, and delivery schedules obtained from the above departments was performed. These results were benchmarked against other organizations and compared with supply chain practices recommended in healthcare managerial literature. Recommendations to the client included standardization of the supply requisition process, increased compliance with policies and procedures, and ways to increase the accountability of users within the supply chain process.
Managed Care Organizations and the Improper Denial of Claims to Healthcare Providers in the New York Metropolitan Area
New York State Attorney General, Health Care Bureau
The Capstone team was asked to evaluate the validity of complaints that the client has received from health care providers regarding the improper administration of claims by managed care organizations (MCOs). Providers have alleged that claims are arbitrarily being denied or delayed and that provider appeals of such denials are not being administered in accordance with State mandates. An extensive review of relevant laws that apply to the administration of claims by MCOs was completed. The team narrowed its focus to the legal requirements of the New York State Utilization Review laws that govern the appeals processes between health care providers, enrollees, and payers. Two years of data from several different health care facilities was comprehensively reviewed and analyzed. The initial findings confirm that a number of managed care organizations are in violation of State law. The team ultimately quantified the damages that resulted from the violations.
Implementing an Electronic Medical Record for Village Care Nursing Home
Village Care New York Nursing Home
The Capstone team was assigned the project of developing a technology implementation plan to help Village Care New York Nursing Homes employees meet the regulatory challenges posed by the dispersion of the nursing home. The tasks of Phase I included identifying the major regulatory compliance issues, interviewing key staff members, and conducting an investigation of the relevant technology in the long-term care market. After completing Phase I, Village Care shifted the projects focus towards the implementation of an Electronic Medical Record (EMR). In Phase II the team became familiar with the components of a Village Care Nursing Home residents chart; interviewed key staff members to determine what components of the chart would be essential for inclusion in an EMR for communication between remote settings; reviewed industry literature on EMR; and visited similar organizations currently using an EMR. The teams research-based recommendations to Village Care included listing top priorities for implementation of an EMR; describing necessary mobile technologies used to support an EMR system; listing expected challenges and obstacles for implementing the new system; explaining strategies to gain staff support for the EMR; and providing vendor quotes for software and hardware of the EMR system.