Hospitals often formulate organizational goal statements to find means of achieving healthcare improvements (Secunda et al., 2020). In the following paper, the corporate goal statements utilized to create AMI healthcare improvements will be analyzed for gaps that could have created differentiated modifications between CHF and pneumonia treatment and AMI treatment.
The first goal statement is “Improve performance in all the CMS disease-specific indicators” (Spath et al., 2017). In terms of the SMART goals, this goal statement is relevant, achievable, and measurable. Improvement of disease-specific indicators is appropriate and realistic to the field, and it is possible to measure improvements by comparing current data to previous data. However, this goal lacks specificity, and it lacks time sensitivity. This means that it is not clear how and where the disease-specific indicators will be addressed and by when they will be improved. This could have contributed to the CHF and pneumonia versus AMI results. The lack of a unified or determined approach across the board would mean that each disease indicator was being dealt with differently at the time for improvement evaluations.
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Another goal statement is “Ensure all patients admitted to the ED with the diagnosis of AMI receive aspirin within ____ minutes of admission” (Spath et al., 2017). This is a clear and specific goal. Analysis with the SMART concept shows that the goal is specific, time-sensitive, achievable, measurable, and relevant. The statement is specified in the criteria for the patients and the department. It also incorporates time and therefore allows the results to be measured. Overall, this goal statement would not have contributed to the AMI improvements lagging, as it is a clear, specific, and achievable goal.
The third goal statement is “Improve performance on the following AMI indicators – timeliness of administration of aspirin, prescribing aspirin at discharge, smoking cessation counselling” (Spath et al., 2017). The goal statement is specific in regards to the indicators and the healthcare strategies for use. However, it lacks time sensitivity. The statement mentions time but fails to specify what particular timeframe for administering aspirin should be observed. This makes that indicator challenging to measure, compromising the measurability of this goal. However, the other elements of the statement – prescribing aspirin at discharge – are time-sensitive, specific, relevant, measurable, and achievable. The final part – smoking cessation – is not time-sensitive either. Overall, this goal could have contributed to AMI's varying results versus CHF and pneumonia results through the lack of attention paid to time-sensitivity.
“ Research the available clinical guidelines on care of the patients with AMI and implement a guideline that – demonstrates a strong degree of evidence, ensures meeting all regulatory and payer requirements, permits ease of documenting, retrieving, and reporting the necessary performance indicators” was another goal statement for AMI (Spath et al., 2017). This statement is specific, measurable, achievable, and relevant. However, it is not time-sensitive, which means that its achievement benefits may only be realized much later. This could contribute to the lag noticed with AMI improvements in comparison to CHF and pneumonia improvements.
“ Reduce the number of patients with AMI who are discharged without smoking cessation counselling and a prescription for aspirin” was the final goal statement (Spath et al., 2017). This goal statement is measurable, as the number of AMI patients receiving this treatment can be evaluated using current and previous statistics. The report is also achievable and relevant. Regarding time-sensitivity, the point of patient discharge can be considered the time indicator for when the intervention should be done. However, the overall goal does not indicate a specific percentage for reduction or a deadline for implementation. Such a vague goal statement could contribute to AMI improvements lagging behind other disease-specific indicators.
References
Secunda, K., Wirpsa, M. J., Neely, K. J., Szmuilowicz, E., Wood, G. J., Panozzo, E., ... & Kruser, J. M. (2020). Use and meaning of “goals of care” in the healthcare literature: a systematic review and qualitative discourse analysis. Journal of general internal medicine , 35 (5), 1559-1566.
Spath, P., & Kelly, D. L. (2017). Applying quality management in healthcare: A systems approach . Chicago: Health Administration Press.
