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Quality Improvement Proposal

Susie Mayo

Capella University

MSN FP6612-Healthcare Models used in Care Coordination

Dr. Kimberly Sniffen

February 2021

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Quality Improvement Proposal

Since hiring as the new case manager with Sacred Heart Hospital(SHH), I have been

asked by Karen Dellington, Admissions and Discharge Director, to assist SHH in becoming an

Accountable Care Organizations (ACOs)(Capella University, n.d.). Vila Health recently took

over SHH, and Vila Health wants all its hospitals to be ACOs. The American Hospital

Association (AHA) defines ACOs as healthcare providers and hospitals who voluntarily provide

coordinated care to patients with select Medicare plans(American Hospital Association, n.d.).

The goal of participating in an ACO coordinated care is to avoid duplication of services, prevent

medical errors, and improve the quality and cost of care. At the same time, those participating in

the ACOs also receive a share of the savings they generated for Medicare as long as the quality

of care was maintained(American Hospital Association, n.d.). As a small rural hospital, we need

to improve our Health Information Technology (HIT) system to better track quality metrics data,

and to do this, our electronic health record system (EHR) needs to be also updated because we

are not gathering nearly enough data from patients)(Capella University, n.d.). ACOs are

primarily geared toward the 65 years and older population, and this is the population SHH

serves; and with the help of Vila Health, we can do better.

Today’s meeting will investigate strategies for expanding the HIT to better track quality

metrics, and we will recommend strategies for improving the tracking of quality metrics so SHH

can qualify to become an ACO.

Ways to expand HIT to Include Quality Metrics

Revitalizing healthcare is essential to achieve high quality, accessible, efficient, and

affordable healthcare for all. Utilizing HIT offers a wide range of sharing public and private data

collection, including health surveys, billing records, medical health history, and records available

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to healthcare professionals, hospitals, and insurance companies such as Medicare and Medicaid

(HealthIT.gov, n.d.). The Agency for Healthcare Research and Quality(AHRQ) reports that

effective and meaningful use of HIT and EHRs helps facilitate quality improvement (QI) that can

help practices improve their ability to deliver high-quality care, decrease the cost of care,

increase efficiency, reduce medical errors and improve patient satisfaction and patient outcomes

while raising reimbursement for healthcare providers(Higgins et al., 2015). First, SHH needs to

determine how to implement these changes to track quality metrics on patients who do not get

mammograms or colonoscopies. Being a small, rural hospital, SHH has expressed funding

concerns for implementing an upgraded HER system. The Office of the National Coordinator for

Health Information Technology (ONC) collaborates with the United States Departments of

Agriculture(USDA), Veterans Affairs(VA), Rural Development (RD), and The United States

Department of Health and Human Services(HHS) to support rural health, economic development

and help rural health care providers and hospitals in obtaining the necessary technology to

improve their health systems and patients quality of care (HealthIT.gov, n.d.). These agencies

assist in linking rural health clinics and hospitals to USDA grants and loans to help fund health

information technology(HIT) infrastructure, including hardware and software(HealthIT.gov,

n.d.). With the assistance of Pete Wade, SSH Director of Information Technology(IT), we will

reach out to these agencies for assistance with funding(Capella University, n.d.). In the

meantime, we can access our current EHR data to see what can be pulled from the data

warehouse concerning patient populations and mammogram and colonoscopy testing. Depending

on what EHR data we collect, we can reach out to local and community health departments to

assist with data collecting concerning our high-risk populations(Keller et al., 2018). SHH can

also start reaching out to those patients via a mailed survey to understand better healthcare

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attitudes and behaviors regarding lack of testing and follow-up(Keller et al., 2018). Once we

receive funding and establish better HIT, data metrics, and improved EHRs for staff charting and

patient record tracking, SHH will utilize computerized clinical reminders and alerts as reminders

for patient populations due for testing, medication refills, and procedures. Keller et al. (2018)

further report that evidence-based care management and follow-up care utilizing health

information technology such as electronic messaging to providers and patients regular reminders

of medications refills and appointments have shown a tremendous decrease in cost for patients

and the healthcare organizations(pp.85-86). Garcia-Dia (2018) reports, ‘informatics has changed

the nursing practice through documentation and is an integral part of care coordination in nursing

by tracking staffing, workflow, and communication to help nurses identify areas where current

processes can be improved’ (pp.485-487). Nursing informatics assists in data analysis to improve

patient care efficiency, assist in practical technical skills for developing or improving computer

systems, and effective communication skills between care coordination providers(Garcia-Dia,

2018).

Information Gathering in Healthcare

When data gathering information from patients is linked up and pooled, researchers and

doctors can look for patterns in the data to help them develop new ways of predicting or

diagnosing illness and identify ways to improve clinical care(Higgins et al., 2015). Electronic

healthcare information exchange(HIE) provides doctors, nurses, pharmacists, other health care

providers, and patients the ability to access and securely share a patient’s medical information

electronically by improving the speed, quality, security, coordination, and cost of patient

care(Higgins et al.,2018). However, when it is not used correctly, it leaves room for error, and

one of the complaints and concerns with SHH is using the current EHR system incorrectly and

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not thoroughly filling it out. Due to understaffing, patient documentation is incomplete, leaving

room for errors and inefficient patient records. Once the new HIE system is implemented, proper

employee education needs to occur to train staff to use the system correctly and become the norm

for people to use the system correctly. Since SHH is a rural hospital, the National Rural Health

Resource Center offers an HIE assessment framework that allows organizations to create

operationally sustainable plans to exchange clinical data seamlessly and lower overall costs.

Other benefits of HIE include enhanced patient safety and clinical outcomes eliminating repeat

testing and procedures by allowing exchanges of data to determine the level of care needed for

patients. Information gathering contributes to developing organizational practices by enhancing

care transitions, reducing potentially preventable readmissions, reducing administrative costs,

and increasing revenue from enhanced billings and collection(National Rural Health Resource

Center, n.d.). With data gathering and sharing, healthcare information systems need to be secured

and ensure employers are correctly trained when accessing sensitive patient information and not

leaving computers open in vulnerable areas. Using integrated health information would also

allow hospital staff and primary care physicians(PCP) access to care provided during visits. This

access can provide the case management team access to the PCP office records to assist in

discharge planning and collaboration with the PCP staff for better patient care.

Potential Problems with Data Gathering

There are many challenges and potential problems that can arise with data gathering.

Data and patient information are still entered into the healthcare system manually by humans.

This manual process leaves much room for error, such as typos, wrong forms being completed,

patient’s contact information entered incorrectly, overworked and understaffed employees in a

hurry, or internal resistance from employees who do not adapt well to change. Today’s society is

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inundated with computers, data gathering, and hackers. Utilizing EHRs is the only way forward

in improving healthcare, and unfortunately, EHRs have become a lucrative business for

hackers(Dash et al., 2019). According to the 2017 Thales Data Threat Report, 68 percent of

enterprises worldwide, healthcare included, experienced a data breach and estimates that data

breaches cost the healthcare industry $6.2 billion per year(Dash et al., 2019). Other problems or

barriers to data gathering include a lack of budget, too much data, lack of skilled employees, and

regulatory issues seen as equal current challenges(Keller et al., 2018).

Conclusion

After meeting with department leaders, we need to take steps and move forward with

improving our Health Information Technology(HIT) to include quality metrics to better care for

the rural population SHH serves. We have examined federal resources that specialize in assisting

rural healthcare entities with funding to establish the HIT infrastructure, including hardware and

software. Expanding our EHRs will assist SHH in meeting guidelines set by the Centers for

Medicare and Medicaid Services in becoming an ACO.

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References

Accountable care organizations | aha. (n.d.). American Hospital Association.

https://www.aha.org/accountable-care-organizations-acos

American Hospital Association. (n.d.). Accountable care organizations | AHA.

https://www.aha.org/accountable-care-organizations-acos

Capella University. (n.d.). Quality Metrics Tracking. Vila Health.

https://media.capella.edu/coursemedia/msn6612element18001/transcript.asp

Dash, S., Shakyawar, S.K., Sharma, M., Kaushik, S. (2019). Big data in healthcare: management,

analysis and future prospects. Journal of Big Data 6, 54.

https://journalofbigdata.springeropen.com/articles/10.1186/s40537-019-0217-0#citeas

Garcia-Dia, M. J. (Ed.). (2018). Project management in nursing informatics. ProQuest Ebook

Central https://ebookcentral-proquest-com.library.capella.edu

HealthIT.gov. (n.d.). Resources for critical access hospitals and small rural hospitals |

HealthIT.gov. ONC | Office of the National Coordinator for Health Information

Technology. https://www.healthit.gov/topic/health-it-health-care-settings/resources-

critical-access-hospitals-and-small-rural-hospitals

Higgins, T., Crosson, J., Peikes, D., McNellis, R., Genevro, J., & Meyers, D. (2015, March).

Using Health Information Technology to Support Quality Improvement in Primary Care.

The Agency for Healthcare Research and Quality. https://pcmh.ahrq.gov/page/using-

health-information-technology-support-quality-improvemtn-primary-care

Keller, S., Nusser, S., Shipp, S., & Woteki, C. E. (2018). Helping Communities Use Data to

Make Better Decisions. Issues in Science & Technology, 34(3), 83–89.

http://web.a.ebscohost.com.library.capella.edu/ehost/detail/detail?vid=0&sid=a410f84b-

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9039-403d-aca9-70323887c72b

%40sessionmgr4008&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=ehh

&AN=129399645

National Rural Health Resource Center. (n.d.). HIE first considerations. National Rural Health

Resource Center | National Rural Health Resource Center.

https://www.ruralcenter.org/resource-library/hie-first-considerations

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I need this by Thursday

5/8/22, 4:42 PM Vila Health: Quality Metrics Tracking Transcript

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Vila Health ® Activity

Quality Metrics Tracking

Introduction

Challenge Details

Your Of�ce

Sacred Heart Hospital

Email

EHR Meeting

Conclusion

Introduction
An accountable care organization (ACO) is a
health care organization that follows a model
where reimbursements are directly tied to quality
metrics and reduced costs. Or, according to the
Centers for Medicare and Medicaid Services,
“Accountable Care Organizations (ACOs) are
groups of doctors, hospitals, and other health care
providers, who come together voluntarily to give
coordinated high quality care to their Medicare
patients.”

Not all health care organizations are ACOs. In order to become

an ACO, health organizations may need to make quality

improvements—and in order to make these improvements, they

may need to track their quality metrics better in order to

document the kinds of changes they need to make. This can be

a challenge at small rural hospitals where quality metrics have

not been tracked well in the past. Because care coordinators

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work closely with patients are aware of barriers to care and

other community issues, they may be asked to assist in the

process of helping to devise a better metrics tracking system so

that the hospital might qualify to become an ACO.

After completing the activity, you will be prepared to:

Investigate strategies for expanding the health information

technology (HIT) at a small rural hospital to better track

quality metrics.

Recommend strategies for improving the tracking of quality

metrics at a small rural hospital so that this hospital can

qualify to become an ACO.

Challenge Details
You continue your work as a newly hired case manager at

Sacred Heart Hospital, located in Valley City, North Dakota. As

you know, SHH was recently acquired by Vila Health, a large

health care system that operates hospitals and clinics in

several Midwestern states.

Vila Health wants all of its hospitals to be Accountable Care

Organizations. However, as a small rural hospital, SHH will

have to make many improvements in order to qualify for ACO

status. In order to develop a strategy for making these

improvements, the �rst step will be to track quality metrics

better so that the hospital will have data to work with to

measure problems and to track improvements. You, the new

case manager, will be asked to develop a strategy for tracking

quality metrics to help facilitate the hospital’s quali�cation for

ACO status.

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Your Of�ce
It looks like you have email from Karen Dellington, Admissions

and Discharge Director. Read the message, then review the

documents below.

Email
From: Karen Dellington, Admissions and Discharge Director

Subject: Quality Metrics Tracking

Hello! Thank you so much for all your hard work in helping SHH

to develop a strategy for achieving Triple Aim Outcomes. The

hospital has another, similar project, and we need your help to

complete it.

As you know, SHH was recently acquired by Vila Health. Vila

Health wants all of its hospitals to become Accountable Care

Organizations (ACOs). However, in order to qualify to become

an ACO, SHH will have to make a number of quality

improvements.The Center for Medicaid and Medicare Services

says that an organization has to show quality improvements in

the following areas in order to become an ACO:

1. Patient experience.

2. Care coordination/patient safety.

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3. Preventative health.

4. At-risk population health.

For more information on ACOs, please read the Accountable

Care Organizations: What Providers Need to Know document,

which I will be sending to you.

After reading through the Barnes County Community Health

pro�le, and after interviewing various stakeholders at the

hospital and in the community, I know you’re already aware of

some of these needed improvements. For example,

preventative care is an issue in this region. Patients are not

seeing their primary physicians often enough—or they don’t

have primary physicians—and they aren’t getting diagnostic

tests like mammograms or colonoscopies at a satisfactory rate.

Here’s where we need your help. In order to make the

improvements we need to qualify as an ACO, we need to

improve our Health Information Technology (HIT) system so

that we are tracking quality metrics data better. We are not

doing a good job with this. Our EHR is out of date, and we’re

not gathering nearly enough data from patients. We need you

to give us recommendations for how to improve our HIT so that

we track the information we need to understand fully how to

make the improvements we need to become an ACO.

So, here’s what I’d like for you to do:

1. First, I’d like for you to meet with a patient named Caroline

McGlade, who has recently been diagnosed with breast

cancer. Mrs. McGlade is a typical example of one of our

patients who hasn’t gotten enough preventative care. I’d

also like for you to look at her EHR—which, as you’ll see,

isn’t very thorough. As you think about this case, ask

yourself this: how could we be tracking data in cases like

this one better to help us to make the improvements we

need to qualify for ACO status?

2. Second, I’d like for you to interview a series of stakeholders

who can provide you with information about changes that

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need to be made in our HIT.

3. After completing these tasks, I need you to write

recommendations for how we can expand our HIT to better

include quality metrics—with the ultimate goal of qualifying

for ACO status.

This is a challenging assignment, but I know that you’re up to

it! Best of luck.

Thanks,

Karen

Accountable Care
Organizations: What
Providers Need to Know
The Centers for Medicare & Medicaid Services (CMS), an

agency within the Department of Health & Human Services

(HHS), �nalized regulations under the Affordable Care Act to

help doctors, hospitals, and other health care providers better

coordinate care for Medicare patients through Accountable

Care Organizations (ACOs). ACOs create incentives for health

care providers to work together to treat an individual patient

across care settings – including doctor’s of�ces, hospitals, and

long-term care facilities. The Medicare Shared Savings

Program (Shared Savings Program) will reward ACOs that

lower their growth in health care costs while meeting

performance standards on quality of care and putting patients

�rst. Provider participation in an ACO is purely voluntary.

In developing the program regulations, CMS worked closely

with agencies across the Federal government to ensure a

coordinated and aligned inter- and intra-agency effort to

facilitate implementation of the Shared Savings Program.

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CMS encourages all interested providers and suppliers to

review this program’s regulations and consider participating in

the Shared Savings Program.

This fact sheet provides an overview of ACOs.

Please download the PDF

(downloads/aco_providers_factsheet.pdf) for more information

from The Centers for Medicare & Medicaid Services (CMS).

Caroline McGlade-EHR
Patient Information – 04/24/19

Patient Name: Caroline McGlade

Patient ID:

DOB:

Gender:

Phone:

Address:

Insurance:

Primary Care Provider: Dr. Brown

Contact Permissions: Mike McGlade, husband

History – 04/24/19
H&P: Mrs. McGlade is a 61-year-old woman with a PMH of

breast cancer.

Family Hx Mother:

Father: Alive.

Sister:

Meds on Adm:

Neuro:

Cardio: EKG Normal.

Respiratory:

GU: Menses have ceased.

GI:

POC:

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Allergies & Medication – 04/24/19
Allergies: NA.

Medication: Estrogen

Lab – 04/23/19
CBC:

RBC: 5.1

HCT: 38.8

HGB: 14.7

WBC: 11.1

MCV: 81

MCH: 31

PLT: 301

BMP:

Glucose: 399

BUN: 15

CR: 1.1

Sodium: 138

Potassium: 4.2Chloride: 106

Chloride: 106

Co2: 23

Calcium: 11

Protein: 7.9

CA-125-1700 U

Primary Care Notes – 04/24/19
04/21/19: Mrs. McGlade is a 61-year-old woman with a lump

that may be breast cancer. DX: Dr. McCall, suspected breast

cancer

Called Dr. Brown-GYN ONC. Consult expected for tomorrow.

Suggested CA-124, HCG, AFP prior to consult.

04/23/19:

04/24/19: MRI negative for spinal cord or brain lesions.

Plan of care: Breast oncology consult.

CBC, BMP, CA-125, HCG, AFP, Paracentesis, in am. PT, SW, CM

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consult.

GYN/ONC Note – 04/24/19
61-year-old woman with a possible PMH of breast cancer.

Her initial exam revealed an enlarged mass in right breast.

GYN/ONC physical exam. Based on physical presentation,

blood work and radiology studies, breast cancer is con�rmed.

Discuss with pt. treatment options such as surgery and/or

chemotherapy and radiation.

Barnes County
Community Health
Pro�le
Barnes County, North Dakota Community Health Pro�le by Age

Group, 2000 Census

Age Group: 0-9

Barnes County:

1288

10.9%

North Dakota:

82,382

12.8%

Age Group: 10-19

Barnes County:

1811

15.4%

North Dakota:

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101,082

15.7%

Age Group: 20-29

Barnes County:

1371

11.6%

North Dakota:

89,295

13.9%

Age Group: 30-39

Barnes County:

1303

11.1%

North Dakota:

85,086

13.2%

Age Group: 40-49

Barnes County:

1803

15.3%

North Dakota:

98,449

15.3%

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Age Group: 50-59

Barnes County:

1327

11.3%

North Dakota:

66,921

10.4%

Age Group: 60-69

Barnes County:

1057

9.0%

North Dakota:

47,649

7.4%

Age Group: 70-79

Barnes County:

998

8.5%

North Dakota:

29,492

4.6%

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Age Group: 80+

Barnes County:

817

6.9%

North Dakota:

29,492

4.6%

Total

Barnes County:

11,775

100%

North Dakota:

642,200

100%

Age Group: 0-17

Barnes County:

2624

22.3%

North Dakota:

160,849

25.0%

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Age Group: 65+

Barnes County:

2332

19.8%

North Dakota:

94,478

14.7%

Barnes County, North Dakota Community Health Pro�le by

Race, 2000 Census

Race: White

Barnes County:

11,775

97.9%

North Dakota:

593,181

92.4%

Race: Black

Barnes County:

53

0.5%

North Dakota:

3916

0.6%

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Race: American Indian

Barnes County:

90

0.8%

North Dakota:

31,329

4.9%

Race: Asian

Barnes County:

22

0.2%

North Dakota:

3606

0.6%

Race: Paci�c Islander

Barnes County:

0

0%

North Dakota:

230

0%

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Race: Other

Barnes County:

14

0.1%

North Dakota:

2540

0.4

Race: Multirace

Barnes County:

67

0.6%

North Dakota:

7398

1.2%

Total

Barnes County:

11,775

100%

North Dakota:

642,200

100%

Marital Status of Persons Age 15 and Older, 2000 Census

Marital Status: Total Age 15+

Barnes County:

9693

100%

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North Dakota:

512,281

100%

Marital Status: Never Married

Barnes County:

2565

26.5%

North Dakota:

141,300

27.6%

Marital Status: Now Married

Barnes County:

5486

56.6%

North Dakota:

290,833

56.8%

Marital Status: Separated

Barnes County:

69

0.7%

North Dakota:

3610

0.7%

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Marital Status: Widowed

Barnes County:

863

8.9%

North Dakota:

36,702

7.2%

Marital Status: Widowed-Female

Barnes County:

716

7.4%

North Dakota:

30,346

5.9%

Marital Status: Divorced

Barnes County:

710

7.3%

North Dakota:

39,836

7.8%

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Marital Status: Divorced-Female

Barnes County:

381

3.9%

North Dakota:

21,235

4.1%

Barnes County Community Health Pro�le (PDF)

(downloads/BarnesCoPro�le-20101208.pdf)

It looks like you have a challenging task! You need to �gure

out how to improve the collection of quality metrics at SHH

so that the hospital can become an ACO.

Sacred Heart
Hospital

It’s time to meet Caroline McGlade, a 60-year-old patient who

has breast cancer. Remember, you’ve been asked to talk with

this patient because she’s a typical example of someone who

hasn’t been getting preventative care—a factor that makes it

dif�cult for the hospital to qualify for ACO status. Be sure to

refer back to her EHR, and think about ways the EHR could be

modi�ed to better collect qualify metrics for patients like this

one.

Caroline McGlade
Patient, Sacred Heart Hospital

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Mrs. McGlade, how are you feeling?
Caroline: I feel just �ne. A little scared, I guess. But it’s hard to

believe I have cancer. I mean, I don’t feel sick at all. I guess I’ll

start feeling sick once they start giving me that chemo. I’m not

looking forward to that, believe me!

Can you tell me a little bit about
yourself?
Caroline: I guess you could say I’m a pretty typical lady from

Valley City—not very exciting! I’ve lived in this county all my life.

I grew up on a farm near Tower City. Then I got married to my

high school sweetheart and we live on a big plot of land about

45 minutes from here. I wouldn’t want to live anywhere else.

Sometimes I wish we had more neighbors, but Mike and I like

living in the middle of nowhere! I guess you could say we’re

independent spirits? That’s how we were raised—we don’t like

to be dependent on other people. We have four kids—our son

lives in Valley City and our three girls live in the Fargo-

Moorhead area. Nine grandkids so far.

How did you discover the cancer?
Caroline: I felt a lump. It wasn’t big and at �rst I didn’t think it

was anything to worry about. I don’t like running to the doctor

every time something feels weird in my body—I mean, that’s

just part of getting old, right? But my daughter �nally

convinced me to get checked. And I guess I’m glad I did. Stage

3 breast cancer—that’s pretty serious.

Have you ever gotten a
mammogram?
Caroline: Yeah. I think twice? Maybe three times? It’s been a

long time though. I don’t know…I guess they could’ve caught

the cancer earlier if I went more often. But I’ve heard that

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mammograms aren’t all that important. You can �nd a lump

pretty easy by checking your breasts, right? And I do that once

a month or so.

Do you regularly see a gynecologist?
Caroline: Well, I did when I was pregnant—but that was a long

time ago. My youngest daughter is 30 years old. And when I

needed birth control pills—then I used to go. But there’s no

reason for me to go at my age, right? It’s not like I need birth

control pills anymore—I mean, I �nished with menopause when

I was 47! I don’t know—I guess maybe I should have gone

more often. But I really hate … you know, putting my legs in

those icky metal things? I just don’t like having doctors poking

around my private parts. Maybe if there were a woman doctor

around here I might have gone more often, but around here

there’s not a lot of choice who you see. All the gynecologists

I’ve ever been to, they’re old guys who are kind of creepy.

Do you regularly see a primary care
physician?
Caroline: No, not anymore. When Dr. Tucker was alive my

husband and I used to go… but he died about seven, eight

years ago? And we’ve never bothered �nding a new doctor.

Like I said, there aren’t a lot of doctors around here, and we’d

have to drive 45 minutes to get to one. Gas is expensive, so we

don’t like to go on trips that aren’t necessary. And I don’t want

to go to someone I don’t know. Dr. Tucker, he was my doctor

since I was a teenager. I guess we ought to �nd a new doctor,

but we just don’t get sick very often. A few times we’ve gone to

Urgent Care, but we don’t like to go running to the doctor every

time we have some aches and pains. We can’t stand people

who do that.

Have you ever gotten a colonoscopy?

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Caroline: NO! No no no. Nobody’s sticking a camera up in there,

or whatever it is they do. My husband’s never gotten one

either–I’m pretty sure he’d rather die! Besides, those tests costs

a fortune.

How do you feel about preventative
care?
Caroline: You mean, like shots and such? We got all the

immunizations for our kids. Oh, do you mean, like preventative

care for adults? Like getting your cholesterol checked and all

that? I don’t know. I guess I kind of feel like that’s a waste of

time. And it’s expensive too. We just try to eat healthy and get

some exercise. Neither one of us is overweight, so it’s not like

we’re going to get diabetes or anything like that.

Why haven’t you gotten more
preventative care?
Caroline: Well, why would we? Like I said, we’re pretty healthy

and we don’t like to run to the doctor for every little thing. If

there were a doctor around who I trusted, I guess I would go

more often. Plus going to the doctor is expensive. It didn’t used

to be so bad when we were younger, but now going to the

doctor costs a fortune. My husband and I are doing okay, but

we de�nitely don’ t have money for extras.

Have you always had health
insurance?
Caroline: No, we’ve almost never had health insurance. Just

during this one period when my husband was working in town

for a factory that closed down. But we have health insurance

now, thanks to that Obama! We don’t have a choice anymore,

do we? Although much as I hate to admit it, maybe it’s a good

thing we have insurance. Otherwise I don’t know how we’d

pay for cancer treatments.

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Do you think your views about health
care and preventative care are typical
for people in this area?
Caroline: Yeah. I don’t know anyone who goes to the doctor a

lot. Most of the people I know, they have even less money than

we do. And like I said, people are independent around here.

People don’t like to ask for help unless we really need it. So

going to the doctor a lot… I guess that’s not something people

like to do around here.

Check Your Email

It looks like you have another email from Karen Dellington,

Admissions and Discharge Director.

Read the message below.

Email
From: Karen Dellington, Admissions and Discharge Director

Subject: RE: Quality Metrics Tracking

I see you’ve spoken with Caroline McGlade! I wanted you to

meet with her because her case is typical of so many that we

see around here. We need to address the types of issues you

encountered with this patient—especially regarding

preventative care—if we’re going to become an ACO. And

before we can do that, we need to gather data on these issues.

I’ve arranged for you to meet with a panel of four people at

SHH so you can ask them some questions about the strategies

we need to develop in order to better track quality metrics. The

panel will consist of:

1. Todd Chester, Director of Quality Assurance

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2. Mary Loudsinger, a social worker

3. Pete Wade, Director of Information Technology

4. Trish Walstrom, the Care Coordination Manager

Thanks again for your hard work!

–Karen

EHR Meeting

It looks like you’ll be listening in on the SHH panel meeting.

Read the discussion around each question below.

Panel Participants:

Todd Chester: Sacred Heart Hospital
Director of Quality Assurance

Trish Walstrom: Care Coordination
Manager

Mary Loudsinger: Sacred Heart
Hospital Social Worker

Pete Wade: Director of Information
Technology

What is your opinion of the hospital’s
EHR?
Trish: Um, well…

Pete: It’s okay, Trish. You don’t have to hold your tongue around

me. I know the hospital’s EHR has a lot of problems.

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Todd: In all fairness, Pete, it’s not worse than EHRs you’d �nd

at many small-town rural hospitals. We simply haven’t had the

budget to improve it.

Pete: That’s for sure. I don’t have the budget to do much of

anything.

Todd: We just haven’t made the EHR much of a priority. The

wish list of things we need at this hospital is pretty large, and

that’s always lower on the list than things like new equipment.

But now that there’s this push to become an ACO, we’re going

to have to �nd the funds to upgrade the EHR. Otherwise, we’re

never going to be able to track the metrics we need to make

improvements.

Trish: And that’s the problem with the EHR, in my opinion. It’s

not set up to track much of anything. Patients come in here

multiple times, and we have to ask them the same questions

over and over again because the EHR just isn’t comprehensive

enough. And if the EHR isn’t comprehensive enough to help

patients on an everyday basis, it sure isn’t comprehensive

enough to be used for data collection purposes.

How would you recommend updating
the hospital’s EHR?
Mary: Well, in my opinion, one of the biggest problems is that

there simply aren’t enough categories to enter information. I

wish there was a social work tab so that I could keep track of

visits with patients. If we had that tab, we could record things

like patient barriers to care, and other important information

that might impact their treatment.

Trish: Oh, I totally agree, Mary. There’s just not a lot of places to

add non-medical information.

Pete: I’m not sure what to do about that. it would be great if we

could add more categories, but that’s not easy. We’d have to

work with the vendor, and that could be expensive.

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Todd: Oh, I know, Pete. But if we’re ever going to become an

ACO, we might need to �nd a way to make this investment.

Trish: So, here’s a suggestion for you, since you’re the one

coming up with a strategy for tracking metrics. Why don’t you

take a good look at our EHR and think about places where we

could add more categories? And other updates too.

Are there changes that need to be
made in how the EHR is used?
Trish: I’ll say! The system takes a long time to navigate. It’s not

the least bit intuitive. And that means that nurses and case

managers sometimes don’t enter information as thoroughly as

they need to.

Pete: Aren’t they required to �ll it out in detail?

Trish: Well, yes. But this hospital is understaffed. Sometimes

the EHR isn’t �lled out as completely as it ought to be.

Pete: What? Now that sounds like a serious problem. How are

we ever going to use the EHR to track quality metrics if people

aren’t even using it correctly?

Todd: I’m really glad you brought that up, Trish. We should

discuss this further. I know that part of the problem is technical;

we’re going to need to spend some money to make the system

more user-friendly. But it sounds like we’re going to need a

change management strategy as well. We need it to be the

norm for people to use the system correctly.

Trish: I’m �ne with that. But are you going to address the

reasons why people aren’t �lling the EHR out completely? It’s

not because anyone is lazy. It’s because they’re busy.

Todd: I understand that. And we do need to be cognizant of

people’s schedules as we develop our change management

strategy.

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How can we better track issues
related to preventative care?
Todd: Well, like we’ve already discussed, we need to include

more �elds on the EHR so we can track more kinds of

information. Other than that, well, that’s something we’re really

going to need to discuss. I don’t have all the answers. But I

can’t emphasize enough what an important issue this is.

People are not getting the preventative care they need in this

county, and that’s driving up costs and driving down quality of

care.

Pete: But how do we measure that?

Todd: Well, we do have data from Barnes County that

measures some statistics. For example, the data shows that

women aren’t getting Pap smears and mammograms, and that

people aren’t getting enough colonoscopies. That’s a start. But

I think we need more nuanced data.

Trish: I agree. For example, the county data doesn’t track what

percentage of women are seeing gynecologists, or how often

they’re going. There’s data about how many people don’t have

a primary physician, but there’s not data about how many

women see a gynecologist. And I’d like to see more nuanced

data in relation to mammograms. The only stat they provide is

how many women over 40 have had a mammogram in the

past two years. I’d like to know how often they get

mammograms, and how many women have never had one.

Mary: And in addition to these numbers, I’d like to k

I need this by Thursday

NURS-FPX6612

Assessment 2 Instructions: Quality Improvement Proposal

Write a quality improvement proposal, 5-7 pages in length, that provides your recommendations for expanding a hospital’s HIT to include quality metrics that will help the organization qualify as an accountable care organization.

Introduction

Health care has undergone a transformation since the release of the Institute of Medicine’s 2000 report To Err Is Human: Building a Safer Health System. The report highlighted medical errors as a contributing factor leading to poor patient outcomes. The Institute of Medicine challenged organizations to implement evidence-based performance improvement strategies in order to improve patient quality and safety. Multiple governmental and regulatory agencies, such as the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Quality and Research (AHRQ), vowed to strengthen and improve incentives for participation, safety, quality, and efficiency in accountable care organizations (ACOs).

Health information technology (HIT) performs an essential role in improving health outcomes of individuals, the community, and populations. Health organizations, consumer advocacy groups, and regulatory committees have made a commitment to explore current and future opportunities that HIT offers to continue momentum to meet the Institute of Medicine’s goal of improving safety and quality.

Understanding HIT is important to improving individual, community, and population access to health care and health information. HIT enables quick and easy access to information for both patients and providers. Accessible information has been shown to improve the patient care experience and reduce redundancies, thereby reducing health care costs.

This assessment provides an opportunity for you to make recommendations for expanding a hospital’s HIT in ways that will help the hospital qualify as an ACO.

Reference

Institute of Medicine. (2000). To err is human: Building a safer health system. National Academies Press.

Preparation

In this assessment, you will again assume the role of case manager at Sacred Heart Hospital. This time, you are asked to develop a strategy for tracking quality metrics to help facilitate the hospital’s qualification for ACO status.

Before drafting your proposal, complete the following simulation exercise:

·
Vila Health: Quality Metrics Tracking
.

Note: Remember that you can submit all or a portion of your draft to Smarthinking for feedback before you submit the final version of this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Requirements

Develop a proposal to expand Sacred Heart Hospital’s HIT to better include quality metrics—with the ultimate goal of qualifying for ACO status. Use the following template for your proposal:

·
APA Style Paper Template [DOCX]
.

Writing the Proposal

The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that your proposal addresses each point, at a minimum. You may also want to read the Quality Improvement Proposal Scoring Guide to better understand how each criterion will be assessed.

· Recommend ways to expand the hospital’s HIT to include quality metrics.

. How will you collect information and solve the problem of coordinating care for patients who are not getting diagnostic tests, such as mammograms or colonoscopies?

. What can you do to track health information from the community or the target population to make necessary improvements?

. How can you most effectively and efficiently show the role of informatics in nursing care coordination?

. What evidence supports your recommendations?

· Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice.

. Provide examples to support your description.

· Identify potential problems that can arise with data gathering systems and output.

. What suggestions can you make for avoiding those problems?

· Write clearly and concisely, using correct grammar and mechanics.

. Express your main points and conclusions coherently.

. Proofread your writing to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.

· Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.

. Is your supporting evidence clear and explicit?

. How or why does particular evidence support a claim?

. Will your audience see the connection?

Additional Requirements

Proposal Format and Length

Format your proposal using APA style:

· Use the 
APA Style Paper Template [DOCX]
 provided. Be sure to include:

. A title page and references page. An abstract is not required.

. A running head on all pages.

. Appropriate section headings.

· See also the 
APA Style Paper Tutorial [DOCX]
 to help you in writing and formatting your proposal.

· Your proposal should be 5–7 pages in length, not including the title page and references page.

Supporting Evidence

· Cite at least six sources of credible scholarly or professional evidence to support your proposal.

· Apply APA formatting to all in-text citations and references.

Portfolio Prompt: You may choose to save your proposal to your ePortfolio.

·
ePortfolio
.

. This resource provides information about ePortfolio, including how to use the different features of the product.

·
Online ePortfolio Guidelines [PDF]
.

I need this by Thursday

1

11

Document Format: Margins are 1 in. (2.54 cm) on all sides.

All text in the document should be double-spaced.

The font is 12-point Times New Roman. Other choices are 11-point Arial and 11-point Calibri.

The title page is page 1.

There is no running head for learner assignments. (See Academic Writer: Publication Manual §§ 2.1–2.24 for paper requirements.)

Full Title of Your Paper Comment by Author: APA Style: Sample Papers shows the title page for a student paper.

Learner’s Full Name (no credentials)

School of Nursing and Health Sciences, Capella University

Course Number: Course Name

Instructor’s Name

Month, Year Comment by Author: The due date

Abstract

An abstract is useful in professional papers, but not always in learner assignments. In fact, unless you are instructed by your faculty or in the course syllabus, do not expect to use abstracts very often at Capella. If you are submitting for publication, remember to check with the journal or professional organization about their criteria for an abstract. The abstract tells your reader about the article, is brief, and stands alone, so no citations are included. The format for an abstract is a single paragraph (not indented on the first line) that follows the title page and is less than 250 words in length. A structured abstract will have a single paragraph without indentation but having labels (e.g., Objective, Method, Results, and Conclusions) on the same line as the text and bold. For published works, the publishing organization will give you guidance on these. However, for student papers, no abstract is needed unless the faculty request one or the assignment requires it. Remember, no citations. Comment by Author: See Academic Writer: Publication Manual §§ 2.9–2.10 (p. 38 in the APA manual) for more information on abstracts.

Keywords: include keywords in the abstract—they should be labeled like this, with the words all in lowercase and separated by commas. Only the first line is indented, like a regular paragraph. No period at the end.


APA Style Seventh Edition Paper Template: A Resource for Academic Writing Comment by Author: New in APA seventh style—this heading is a regular Level 1 and should be bold.

American Psychological Association (APA) style is one of the most popular methods used to cite sources in the social sciences, but it is not the only one. When writing papers in the programs offered at Capella University, you will likely use APA style. This document serves as an APA style resource for the seventh edition guidelines, containing valuable information that you can use when writing academic papers. For more information on APA style, refer to the Publication Manual of the American Psychological Association, also referred to as the APA manual (American Psychological Association, 2020b). Comment by Author: Another important resource for Capella learners is Academic Writer.

The first section of this paper shows how an introduction effectively introduces the reader to the topic of the paper. In APA style, an introduction never gets a heading. For example, this section did not begin with a heading titled “Introduction,” unlike the following section, which is titled “Writing an Effective Introduction.” The following section will explain in greater detail a model that can be used to effectively write an introduction in an academic paper. The remaining sections of the paper will continue to address APA style and effective writing concepts, including section headings, organizing information, the conclusion, and the reference list. Comment by Author: See also Academic Writer: Introduction.

Writing an Effective Introduction Comment by Author: Level 1 section heading

An effective introduction often consists of four main components, including (a) the position statement, thesis, or hypothesis, which describes the author’s main position; (b) the purpose, which outlines the objective of the paper; (c) the background, which is general information needed to understand the content of the paper; and (d) the approach, which is the process or methodology the author uses to achieve the purpose of the paper. This information will help readers understand what will be discussed in the paper. It can also serve as a tool to grab the reader’s attention. Authors may choose to briefly reference sources that will be identified later in the paper as in this example (American Psychological Association, 2020a; American Psychological Association, 2020b). The Writing Center has developed the acronym POETS to help describe the proper writing style for submissions. POETS is the acronym for purpose, organization, evidence, tone, and sentence structure (Capella Writing Center, n.d.). There will be more on this later. Comment by Author: This is the format for a complex list within a sentence. The items begin with lowercase letters and are separated by appropriate punctuation.

Related items can also be set off from the text and presented as numbered or bulleted lists. For more information on lists, see Academic Writer: Lists. Comment by Author: When you have two sources with the same author and date, use a lowercase a, b, c, after the year and alphabetize the sources in the reference list according to the title. For the same author but no date, use n.d.-a and n.d.-b as the date. See Academic Writer: Alphabetizing the Reference List for more information.

In an introduction, the writer will often present something of interest to capture the reader’s attention and introduce the issue. Adding an obvious statement of purpose helps the reader know what to expect, while helping the writer to focus and stay on task. For example, this paper will address several components necessary to effectively write an academic paper, including how to write an introduction, how to write effective paragraphs, and how to effectively use APA style.

Level 1 Section Heading Is Centered, Bold, and Title Case Comment by Author: Something new in APA seventh style—all headings are double-spaced, bold, and written in title case. See Academic Writer: Heading Levels.

Using section headings can be an effective method of organizing an academic paper. Section headings are not required according to APA style; however, they can significantly improve the quality of a paper by helping both the reader and the author, as will soon be discussed. Comment by Author: In POETS, this is the O for organization. See Writing Center: Organization.

Level 2 Section Heading Is Aligned Left, Bold, and Title Case

The heading style recommended by APA consists of five levels (APA, 2020b, pp. 47–48). This document contains multiple levels to demonstrate how headings are structured according to APA style. Immediately before the previous paragraph, a Level 1 section heading was used. That section heading describes how a Level 1 heading should be written, which is centered, bold, and using uppercase and lowercase letters (also referred to as title case). For another example, see the section heading “Writing an Effective Introduction” on page 3 of this document. The heading is centered and bold and uses uppercase and lowercase letters. If used properly, section headings can significantly contribute to the quality of a paper by helping the reader, who wants to understand the information in the document, and the author, who desires to effectively describe it.

Section Heading Purposes Comment by Author: This is a Level 3 heading. Notice it is aligned left, bold, italic, and title case. The paragraph begins on a new line. See Academic Writer: Heading Levels.

Section Headings Help the Reader. Section headings serve multiple purposes, including helping the reader understand what is being addressed in each section, maintain an interest in the paper, and choose what they want to read. For example, if the reader of this document wants to learn more about writing an effective introduction, the previous section heading clearly states that is where information can be found. When subtopics are needed to explain concepts in greater detail, different levels of headings are used according to APA style. Comment by Author: This is a Level 4 heading—it is indented, bold, and title case. The heading ends in a period, and the text begins on the same line as the heading.

Section Headings Help the Author. Section headings not only help the reader; they also help the author organize the document during the writing process. Section headings can be used to arrange topics in a logical order, and they can help an author manage the length of the paper. In addition to an effective introduction and the use of section headings, each paragraph of an academic paper can be written in a manner that helps the reader stay engaged. Comment by Author: Level 4 heading

Section Headings Can Demonstrate Fine Detail. Short papers and assignments may not require or need a Level 5 heading, but these will be indented, bold, italic, and title case and end with a period. Note the text starts on the line at the end of the heading following the period. Comment by Author: Level 5 heading

How to Write Effective Paragraphs Comment by Author: The Writing at Capella multimedia presentation will help you understand the POETS model.

Capella University’s Writing Center (n.d.) has adopted a new set of writing standards to assist learners in their goals to improve their scholarly writing. It is based on five skills known by the mnemonic POETS. In other words, a well-developed Capella paper will demonstrate the following standards. The paper will have a clear purpose statement, be logically organized, utilize current and appropriate evidence that is properly cited, maintain a scholarly tone, and demonstrate proper grammar and writing mechanics in the sentence structure (Capella Writing Center, n.d.). Academic writing is sometimes considered dry and boring. A learning experience may need that formula to encourage learning in different ways as the learner moves from passive learner to active scholar. This growth, according to Gilmore et al. (2019), requires the writer to not only think but also to write differently. Comment by Author: Notice the et al. here—this article has four authors. In APA seventh style, any source with three or more authors will use et al. for every citation, eliminating the need to remember when this appropriate. For more information, see Academic Writer: Citing References in Text.

Bias-Free Language

In the seventh edition of the APA manual, another focus is on eliminating bias in language in order to provide a more inclusive tone in scholarly writing. While long considered a grammar issue, it is acceptable in APA to utilize they as a singular pronoun (APA, 2020b). In fact, there is an entire chapter of the manual dedicated to ways to reduce bias in scholarly writing. It is important to use an appropriate level of specificity in descriptions and use sensitivity with the use of labels. Other sections include guidelines on age, disability, gender, race and ethnicity, sexual orientation, socioeconomic status, and participation in research. Be aware of intersectionality, a term used to describe a person based on their identified multiple identities, interconnectivity, social context, power relations, complexity, social justice, and inequalities that can result in oppression (Cole, 2019; Hopkins, 2017). Comment by Author: See Academic Writer: Intersectionality for the guidelines. Comment by Author: Note the two citations—in a single set of parentheses and separated by a semicolon. The citations are listed alphabetically.

Considering Direct Quotations

Another important point to consider is the use of direct quotations in papers. While plagiarism is considered an academic integrity issue, many learners are concerned with issues such as self-plagiarism and unintentional plagiarism, and there are others who may go as far as purchasing papers for submission (Colella & Alahmadi, 2019). As a learner travels along their chosen academic pathway, their writing skills and mechanics are expected to improve. It is imperative that the learner transition from finding information and quoting the author word for word to using the information to support an idea, paraphrase, and then synthesize and express the findings in one’s own words. Having said that, there are situations in which quotations may be appropriate, so it is important to cite them properly. According to the seventh edition of the APA manual, “When quoting directly, always provide the author, year, and page number of the quotation in the in-text citation in either parenthetical or narrative format” (APA, 2020b, p. 270). If there are not page numbers, identify the location in another manner (such as a paragraph number). Comment by Author: Notice the quotation marks around the quoted text and the placement of the punctuation after the parenthetical citation. See Academic Writer: Quotation Marks for more on the use of quotation marks.

Notice that the above quote contains fewer than 40 words. There is a different style for quotes containing 40 words or more. These longer quotes use a block quotation format:

Do not use quotation marks to enclose a block quotation. Start a block quotation on a new line and indent the whole block 0.5 in. from the left margin. If there are additional paragraphs within the quotation, indent the first line of each subsequent paragraph an additional 0.5 in. Double-space the entire block quotation; do not add extra space before or after it. Either (a) cite the source in parentheses after the quotation’s final punctuation or (b) cite the author and year in the narrative before the quotation and place only the page number in parentheses after the quotation’s final punctuation. Do not add a period after the closing parenthesis in either case. (APA, 2020b, p. 272) Comment by Author: Notice there is no period after this citation in a block quote—it looks odd, but it is APA style. See Academic Writer: Quotation Marks.

Conclusion

A summary and conclusion section, which can also be the discussion section of an APA style paper, is the final opportunity for the author to make a lasting impression on the reader. The author can begin by restating opinions or positions and summarizing the most important points that have been presented in the paper. For example, this paper was written to demonstrate to readers how to effectively use APA style when writing academic papers. Various components of an APA style paper that were discussed or displayed in the form of examples include a title page, introduction section, levels of section headings and their use, the POETS format, bias-free language, in-text citations, a conclusion, and the reference list.

References Comment by Author: Remember all headings are bold.

American Psychological Association. (2020a). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). https://doi.org.apa.org/ethics/code/index.aspx

American Psychological Association. (2020b). Publication manual of the American Psychological Association (7th ed.). Comment by Author: This is something new in APA seventh style—you no longer need the location of the publisher for print books. Also note that if the author is the publisher, it is only listed as the author. This guideline is found on page 324 of the APA manual.

Capella University. (n.d.). Writing Center. https://campus.capella.edu/writing-center/home

Cole, N. L. (2019, October 13). Definition of intersectionality: On the intersecting nature of privileges and oppression. ThoughtCo. https://www.thoughtco.com/intersectionality-definition-3026353

Colella, J., & Alahmadi, H. (2019). Combating plagiarism from a transformation viewpoint. Journal of Transformative Learning, 6(1), 59–67. https://jotl.uco.edu/index.php/jotl/article/view/184

Gilmore, S., Harding, N., Helin, J., & Pullen, A. (2019). Writing differently. Management Learning, 50(1), 3–10. https://doi.org/10.1177/1350507618811027

Hopkins, P. (2017). Social geography I: Intersectionality. Progress in Human Geography, 43(5), 937–947. https://doi.org/10.1177/0309132517743677

Appendix Comment by Author: See Academic Writer: Publication Manual § 2.14 for more on appendices.

Tips for the Reference List

· Always begin a reference list on a new page. It should be placed before any appendices, figures, or tables and titled References.

· Set a hanging indent that starts with the second line and is double-spaced. You can look in the Paragraph menu of Microsoft Word for formatting the hanging indent so that you will not have to tab the indent. It gives the text a smoother look that remains consistent, even if you make edits.

· The reference list is in alphabetical order by the first author’s last name. A reference list only contains sources that are cited in the body of the paper, and all sources cited in the body of the paper must be included in the reference list. If you did not cite it, do not list it.

· The reference list above contains an example of how to cite a source when two documents are written in the same year by the same author.

· The lowercase letters are used after the date to differentiate the sources. The “a” reflects the alphabetical order in the reference list—not whether it appeared first in the text.

· The year is also displayed using this method for the corresponding in-text citations, as in the following sentence: The author of the first citation (American Psychological Association, 2020b) is also the publisher; therefore, the word Author is no longer used in the seventh edition.

· DOI is the digital object identifier.

· It can be found on the first page of an article, on the copyright page of a book, in the database record of a work, or by searching Crossref.

· Even if the book is in print, if there is a DOI, use it.

· Always use the hyperlink format for a DOI—it will always start with https://doi.org/ and will be followed by a number. If the DOI is not in this format, convert it. Do not alter this format, and do not add a final period.

· There is a short DOI service at http://shortdoi.org/.

· URL is the uniform resource locator.

· If there is no DOI, the URL should be used in the reference.

· Copy and paste the URL directly into your list.

· Do not add a period at the end.

· Do use “Retrieved from” before a URL.

· The Colella and Alahmadi reference is an example of how to cite a source using a URL. Please note that you will not use the Capella link that is often provided in the courseroom. If the URL contains a database title, such as EBSCO or ProQuest, or the name Capella, do not use that in your citation as it will only work for Capella learners and faculty.

· For examples and further information on references go to:

· Academic Writer: Sample References.

· Academic Writer: Reference List.

I need this by Thursday

1

11

Document Format: Margins are 1 in. (2.54 cm) on all sides.

All text in the document should be double-spaced.

The font is 12-point Times New Roman. Other choices are 11-point Arial and 11-point Calibri.

The title page is page 1.

There is no running head for learner assignments. (See Academic Writer: Publication Manual §§ 2.1–2.24 for paper requirements.)

Full Title of Your Paper Comment by Author: APA Style: Sample Papers shows the title page for a student paper.

Learner’s Full Name (no credentials)

School of Nursing and Health Sciences, Capella University

Course Number: Course Name

Instructor’s Name

Month, Year Comment by Author: The due date

Abstract

An abstract is useful in professional papers, but not always in learner assignments. In fact, unless you are instructed by your faculty or in the course syllabus, do not expect to use abstracts very often at Capella. If you are submitting for publication, remember to check with the journal or professional organization about their criteria for an abstract. The abstract tells your reader about the article, is brief, and stands alone, so no citations are included. The format for an abstract is a single paragraph (not indented on the first line) that follows the title page and is less than 250 words in length. A structured abstract will have a single paragraph without indentation but having labels (e.g., Objective, Method, Results, and Conclusions) on the same line as the text and bold. For published works, the publishing organization will give you guidance on these. However, for student papers, no abstract is needed unless the faculty request one or the assignment requires it. Remember, no citations. Comment by Author: See Academic Writer: Publication Manual §§ 2.9–2.10 (p. 38 in the APA manual) for more information on abstracts.

Keywords: include keywords in the abstract—they should be labeled like this, with the words all in lowercase and separated by commas. Only the first line is indented, like a regular paragraph. No period at the end.


APA Style Seventh Edition Paper Template: A Resource for Academic Writing Comment by Author: New in APA seventh style—this heading is a regular Level 1 and should be bold.

American Psychological Association (APA) style is one of the most popular methods used to cite sources in the social sciences, but it is not the only one. When writing papers in the programs offered at Capella University, you will likely use APA style. This document serves as an APA style resource for the seventh edition guidelines, containing valuable information that you can use when writing academic papers. For more information on APA style, refer to the Publication Manual of the American Psychological Association, also referred to as the APA manual (American Psychological Association, 2020b). Comment by Author: Another important resource for Capella learners is Academic Writer.

The first section of this paper shows how an introduction effectively introduces the reader to the topic of the paper. In APA style, an introduction never gets a heading. For example, this section did not begin with a heading titled “Introduction,” unlike the following section, which is titled “Writing an Effective Introduction.” The following section will explain in greater detail a model that can be used to effectively write an introduction in an academic paper. The remaining sections of the paper will continue to address APA style and effective writing concepts, including section headings, organizing information, the conclusion, and the reference list. Comment by Author: See also Academic Writer: Introduction.

Writing an Effective Introduction Comment by Author: Level 1 section heading

An effective introduction often consists of four main components, including (a) the position statement, thesis, or hypothesis, which describes the author’s main position; (b) the purpose, which outlines the objective of the paper; (c) the background, which is general information needed to understand the content of the paper; and (d) the approach, which is the process or methodology the author uses to achieve the purpose of the paper. This information will help readers understand what will be discussed in the paper. It can also serve as a tool to grab the reader’s attention. Authors may choose to briefly reference sources that will be identified later in the paper as in this example (American Psychological Association, 2020a; American Psychological Association, 2020b). The Writing Center has developed the acronym POETS to help describe the proper writing style for submissions. POETS is the acronym for purpose, organization, evidence, tone, and sentence structure (Capella Writing Center, n.d.). There will be more on this later. Comment by Author: This is the format for a complex list within a sentence. The items begin with lowercase letters and are separated by appropriate punctuation.

Related items can also be set off from the text and presented as numbered or bulleted lists. For more information on lists, see Academic Writer: Lists. Comment by Author: When you have two sources with the same author and date, use a lowercase a, b, c, after the year and alphabetize the sources in the reference list according to the title. For the same author but no date, use n.d.-a and n.d.-b as the date. See Academic Writer: Alphabetizing the Reference List for more information.

In an introduction, the writer will often present something of interest to capture the reader’s attention and introduce the issue. Adding an obvious statement of purpose helps the reader know what to expect, while helping the writer to focus and stay on task. For example, this paper will address several components necessary to effectively write an academic paper, including how to write an introduction, how to write effective paragraphs, and how to effectively use APA style.

Level 1 Section Heading Is Centered, Bold, and Title Case Comment by Author: Something new in APA seventh style—all headings are double-spaced, bold, and written in title case. See Academic Writer: Heading Levels.

Using section headings can be an effective method of organizing an academic paper. Section headings are not required according to APA style; however, they can significantly improve the quality of a paper by helping both the reader and the author, as will soon be discussed. Comment by Author: In POETS, this is the O for organization. See Writing Center: Organization.

Level 2 Section Heading Is Aligned Left, Bold, and Title Case

The heading style recommended by APA consists of five levels (APA, 2020b, pp. 47–48). This document contains multiple levels to demonstrate how headings are structured according to APA style. Immediately before the previous paragraph, a Level 1 section heading was used. That section heading describes how a Level 1 heading should be written, which is centered, bold, and using uppercase and lowercase letters (also referred to as title case). For another example, see the section heading “Writing an Effective Introduction” on page 3 of this document. The heading is centered and bold and uses uppercase and lowercase letters. If used properly, section headings can significantly contribute to the quality of a paper by helping the reader, who wants to understand the information in the document, and the author, who desires to effectively describe it.

Section Heading Purposes Comment by Author: This is a Level 3 heading. Notice it is aligned left, bold, italic, and title case. The paragraph begins on a new line. See Academic Writer: Heading Levels.

Section Headings Help the Reader. Section headings serve multiple purposes, including helping the reader understand what is being addressed in each section, maintain an interest in the paper, and choose what they want to read. For example, if the reader of this document wants to learn more about writing an effective introduction, the previous section heading clearly states that is where information can be found. When subtopics are needed to explain concepts in greater detail, different levels of headings are used according to APA style. Comment by Author: This is a Level 4 heading—it is indented, bold, and title case. The heading ends in a period, and the text begins on the same line as the heading.

Section Headings Help the Author. Section headings not only help the reader; they also help the author organize the document during the writing process. Section headings can be used to arrange topics in a logical order, and they can help an author manage the length of the paper. In addition to an effective introduction and the use of section headings, each paragraph of an academic paper can be written in a manner that helps the reader stay engaged. Comment by Author: Level 4 heading

Section Headings Can Demonstrate Fine Detail. Short papers and assignments may not require or need a Level 5 heading, but these will be indented, bold, italic, and title case and end with a period. Note the text starts on the line at the end of the heading following the period. Comment by Author: Level 5 heading

How to Write Effective Paragraphs Comment by Author: The Writing at Capella multimedia presentation will help you understand the POETS model.

Capella University’s Writing Center (n.d.) has adopted a new set of writing standards to assist learners in their goals to improve their scholarly writing. It is based on five skills known by the mnemonic POETS. In other words, a well-developed Capella paper will demonstrate the following standards. The paper will have a clear purpose statement, be logically organized, utilize current and appropriate evidence that is properly cited, maintain a scholarly tone, and demonstrate proper grammar and writing mechanics in the sentence structure (Capella Writing Center, n.d.). Academic writing is sometimes considered dry and boring. A learning experience may need that formula to encourage learning in different ways as the learner moves from passive learner to active scholar. This growth, according to Gilmore et al. (2019), requires the writer to not only think but also to write differently. Comment by Author: Notice the et al. here—this article has four authors. In APA seventh style, any source with three or more authors will use et al. for every citation, eliminating the need to remember when this appropriate. For more information, see Academic Writer: Citing References in Text.

Bias-Free Language

In the seventh edition of the APA manual, another focus is on eliminating bias in language in order to provide a more inclusive tone in scholarly writing. While long considered a grammar issue, it is acceptable in APA to utilize they as a singular pronoun (APA, 2020b). In fact, there is an entire chapter of the manual dedicated to ways to reduce bias in scholarly writing. It is important to use an appropriate level of specificity in descriptions and use sensitivity with the use of labels. Other sections include guidelines on age, disability, gender, race and ethnicity, sexual orientation, socioeconomic status, and participation in research. Be aware of intersectionality, a term used to describe a person based on their identified multiple identities, interconnectivity, social context, power relations, complexity, social justice, and inequalities that can result in oppression (Cole, 2019; Hopkins, 2017). Comment by Author: See Academic Writer: Intersectionality for the guidelines. Comment by Author: Note the two citations—in a single set of parentheses and separated by a semicolon. The citations are listed alphabetically.

Considering Direct Quotations

Another important point to consider is the use of direct quotations in papers. While plagiarism is considered an academic integrity issue, many learners are concerned with issues such as self-plagiarism and unintentional plagiarism, and there are others who may go as far as purchasing papers for submission (Colella & Alahmadi, 2019). As a learner travels along their chosen academic pathway, their writing skills and mechanics are expected to improve. It is imperative that the learner transition from finding information and quoting the author word for word to using the information to support an idea, paraphrase, and then synthesize and express the findings in one’s own words. Having said that, there are situations in which quotations may be appropriate, so it is important to cite them properly. According to the seventh edition of the APA manual, “When quoting directly, always provide the author, year, and page number of the quotation in the in-text citation in either parenthetical or narrative format” (APA, 2020b, p. 270). If there are not page numbers, identify the location in another manner (such as a paragraph number). Comment by Author: Notice the quotation marks around the quoted text and the placement of the punctuation after the parenthetical citation. See Academic Writer: Quotation Marks for more on the use of quotation marks.

Notice that the above quote contains fewer than 40 words. There is a different style for quotes containing 40 words or more. These longer quotes use a block quotation format:

Do not use quotation marks to enclose a block quotation. Start a block quotation on a new line and indent the whole block 0.5 in. from the left margin. If there are additional paragraphs within the quotation, indent the first line of each subsequent paragraph an additional 0.5 in. Double-space the entire block quotation; do not add extra space before or after it. Either (a) cite the source in parentheses after the quotation’s final punctuation or (b) cite the author and year in the narrative before the quotation and place only the page number in parentheses after the quotation’s final punctuation. Do not add a period after the closing parenthesis in either case. (APA, 2020b, p. 272) Comment by Author: Notice there is no period after this citation in a block quote—it looks odd, but it is APA style. See Academic Writer: Quotation Marks.

Conclusion

A summary and conclusion section, which can also be the discussion section of an APA style paper, is the final opportunity for the author to make a lasting impression on the reader. The author can begin by restating opinions or positions and summarizing the most important points that have been presented in the paper. For example, this paper was written to demonstrate to readers how to effectively use APA style when writing academic papers. Various components of an APA style paper that were discussed or displayed in the form of examples include a title page, introduction section, levels of section headings and their use, the POETS format, bias-free language, in-text citations, a conclusion, and the reference list.

References Comment by Author: Remember all headings are bold.

American Psychological Association. (2020a). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). https://doi.org.apa.org/ethics/code/index.aspx

American Psychological Association. (2020b). Publication manual of the American Psychological Association (7th ed.). Comment by Author: This is something new in APA seventh style—you no longer need the location of the publisher for print books. Also note that if the author is the publisher, it is only listed as the author. This guideline is found on page 324 of the APA manual.

Capella University. (n.d.). Writing Center. https://campus.capella.edu/writing-center/home

Cole, N. L. (2019, October 13). Definition of intersectionality: On the intersecting nature of privileges and oppression. ThoughtCo. https://www.thoughtco.com/intersectionality-definition-3026353

Colella, J., & Alahmadi, H. (2019). Combating plagiarism from a transformation viewpoint. Journal of Transformative Learning, 6(1), 59–67. https://jotl.uco.edu/index.php/jotl/article/view/184

Gilmore, S., Harding, N., Helin, J., & Pullen, A. (2019). Writing differently. Management Learning, 50(1), 3–10. https://doi.org/10.1177/1350507618811027

Hopkins, P. (2017). Social geography I: Intersectionality. Progress in Human Geography, 43(5), 937–947. https://doi.org/10.1177/0309132517743677

Appendix Comment by Author: See Academic Writer: Publication Manual § 2.14 for more on appendices.

Tips for the Reference List

· Always begin a reference list on a new page. It should be placed before any appendices, figures, or tables and titled References.

· Set a hanging indent that starts with the second line and is double-spaced. You can look in the Paragraph menu of Microsoft Word for formatting the hanging indent so that you will not have to tab the indent. It gives the text a smoother look that remains consistent, even if you make edits.

· The reference list is in alphabetical order by the first author’s last name. A reference list only contains sources that are cited in the body of the paper, and all sources cited in the body of the paper must be included in the reference list. If you did not cite it, do not list it.

· The reference list above contains an example of how to cite a source when two documents are written in the same year by the same author.

· The lowercase letters are used after the date to differentiate the sources. The “a” reflects the alphabetical order in the reference list—not whether it appeared first in the text.

· The year is also displayed using this method for the corresponding in-text citations, as in the following sentence: The author of the first citation (American Psychological Association, 2020b) is also the publisher; therefore, the word Author is no longer used in the seventh edition.

· DOI is the digital object identifier.

· It can be found on the first page of an article, on the copyright page of a book, in the database record of a work, or by searching Crossref.

· Even if the book is in print, if there is a DOI, use it.

· Always use the hyperlink format for a DOI—it will always start with https://doi.org/ and will be followed by a number. If the DOI is not in this format, convert it. Do not alter this format, and do not add a final period.

· There is a short DOI service at http://shortdoi.org/.

· URL is the uniform resource locator.

· If there is no DOI, the URL should be used in the reference.

· Copy and paste the URL directly into your list.

· Do not add a period at the end.

· Do use “Retrieved from” before a URL.

· The Colella and Alahmadi reference is an example of how to cite a source using a URL. Please note that you will not use the Capella link that is often provided in the courseroom. If the URL contains a database title, such as EBSCO or ProQuest, or the name Capella, do not use that in your citation as it will only work for Capella learners and faculty.

· For examples and further information on references go to:

· Academic Writer: Sample References.

· Academic Writer: Reference List.