(DRG’s) and Case Mix Index (CMI) Discussion
(DRG’s) and Case Mix Index (CMI) Discussion
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1. Calculate the number of full-time equivalents (FTEs) that would be needed. Show your calculations.
Guidance:
Describe your calculations and identify your result.
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2. Explain HPPD.
Guidance:
Calculating the direct care nursing staff hours within a 24-hour period is essential for administration (managers, directors) when reviewing productivity, forecasting staffing needs, and evaluation of nursing shortage.
To calculate the direct care hours per resident/day: Add the total number of direct care nursing staff hours for each 24 hour period, using the actual number of hours each person worked. Divide the total hours for each 24 hour period by the total census for each day to calculate the HPPD (also referred to as PPD) (Pennsylvania Department of Health, 2016)
a. How would the acuity of the unit affect HPPD?
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3. Explain how diagnosis related groups (DRG’s) and Case Mix Index (CMI) affects hours per patient day.
Guidance:
What this means is that when staffing a unit, a manager must evaluate the severity of illness, prognoses of patients’ conditions, the difficulty in providing treatment, and the resources needed. For this part of the paper, you will need to: 1) explain what a DRG is and what the CMI is (first two sentences or so), and 2) explain how the varied DRGS (or acuity levels) might impact the hours per patient day. Think of it this way, picture yourself as a nurse manager and think about the resources (staff, equipment, providing total care for a patient who cannot care for the self, etc.) needed to care for a varied mix of patients (low to high acuity). How do you think the varied acuity levels would affect your use of the resources?
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4. Review the staffing plan for last year. What outcomes would you use to evaluate this staffing plan? Based on this data, would you recommend any changes for the upcoming year?
Guidance: Review the staffing plan for last year. What outcomes would you use to evaluate this staffing plan? Based on this data, would you recommend any changes for the upcoming year? – For this question, think of different issues that might have occurred within a previous work year such as the most common nursing sensitive care measures identified by the National Quality Forum Report (2004): 1. Death among surgical inpatients with treatable serious complications (failure to rescue) 2. Pressure ulcer prevalence 3. Falls prevalence 4. Falls with injury 5. Restraint prevalence (vest and limb only) 6. Urinary catheter-associated urinary tract infection for intensive care unit (ICU) patients** 7. Central line catheter-associated blood stream infection rate for ICU and high-risk nursery (HRN) patients 8. Ventilator-associated pneumonia for ICU Think about the patient ratio on this unit (use the spreadsheet). – How would one plan staffing based on caring for patients with varied acuity levels. – What outcomes would you use to evaluate this staffing plan? (Hint: the outcomes related to the nursing sensitive indicators.) – Based on this data, would you recommend any changes for the upcoming year? If so, how would added resources used to treat patients on varied levels of acuity help?
Provide a reference pa
(DRG’s) and Case Mix Index (CMI) Discussion