Attachment E

SUNY CANTON
HEALTH CARE MANAGEMENT-HSMB
Student Weekly/40 hour report

Name of student: Bryan A. Tirado Robles Date submitted: 02/24/2019

Organization: Crouse Hospital

Period worked - days & times: Monday-Friday, 8:00 - 3:30 or 5:00 Total hours: 40 Week #:2

Name and title of person directly supervising you at any time during this reporting period:
Ms. Shepard Director of Risk Management and Compliance & Ms. Filipovich Manager of HIM

(Save as word document and type responses into this document for each week)
Respond thoroughly to each of the following: Number and letter each as it is listed
here:

1. Description of activities you engaged in this period.

My second week was composed of meetings, working on my project, and, for first
time, I went for two days to the HIM Office Department and shadowing the
Environmental Services Department.

a) Describe your activities in some detail.

The first meeting was with the IT team to talk about how HIPPA laws are been
followed and where the hospital should enforce these laws. Also, they talked about the
monitoring system that they have to see if someone is not fulfilling the requirements that
the hospital has to meet in order to achieve the entity's goals and to avoid any potential
problems with the HIPPA laws. In addition, I went to another meeting where the
employees talked about the National Integrated Accreditation for Healthcare "NIAHO".
In addition, I was shadowing the Supervisor of the Environmental Services Department
where the Supervisor is responsible for managing the department of employees in
maintaining clean and safe surroundings for the patients, visitors and hospital staff. Also,
I was shadowing the Quality Improvement Office Department and talked with the
employee in charge of that office. Now, the last meeting that I attended was to the
Critical Event Review "CER". In this meeting, the employee talked about some bad
events that the hospital has encountered in the past and the meeting purpose was in order
to figure out where the system failed and provide solutions to those gaps that led the
hospital to have those bad events. Finally, I went to the HIM Office Department.

b) Include your reactions to these activities and to your clients and peers.
My reactions were very professional, but internally I was so happy for all the
process that I was watching and involved in; it was very exciting to actually see what the
real world of my major was like.

c) Were you supervised during these activities?

 Yes, I was supervised during these activities. The majority of the time Ms.
Shepard was with me, but if I was in an employee’s office or in my office, then I was
without supervision. Additional supervisions were with the Environmental Services
shadowing and in the HIM office by the current supervisors that those departments have
at the time.

1. If yes, describe the supervision and include your reaction to your

supervisor and supervision.
The supervision was very professional, and, at the same time, I felt
their supervision was great since they always made me feel so welcome.
My reaction to Ms. Shepard’s supervision was professional and very
friendly and always made sure I was understanding everything. The same
behavior I had with the Environmental Services and HIM Department
supervisors.

2. If no, describe your activities when you were not supervised and
your reactions. When I was without supervision, I had the same behavior
as if I was being supervised because I wanted to make sure everything I
did was done effectively and responsibly. I had a great respect for Ms.
Shepard and it was never my intention to lose the trust and faith that she
gave to me.

2. What did you expect to learn through these activities?

Related to:
a. Your specific organization?
What are the requirements that NIAHO have In order to be eligible to receive
Medicare and Medicaid funds for the hospital. In addition, I expect to learn how the
hospital's cleaning system works in order to maintain a low bacteria and viruses percentage
In the hospital environment. In addition, I expect to learn about the system that the
hospitals use In order to Improve their quality services. Also, I expect to learn more about
the Risk Management process which I got In the Critical Event Review meeting. Finally, I
expect to learn what are the responsibilities that the HIM Department have where the HIM
office is responsible for assuring that all patient records and loose documents are scanned
into the Horizon Patient Folder with the highest level of quality possible to keep track of
every situation and every individual of the hospital's community and to update it as well.
The HIM office is also responsible for indexing all documents to the appropriate patient
folder and for ensuring each document is assigned the appropriate document name. The
HIM office will review each discharged patients' records for incomplete or missing items,
in order to be able to identify the responsible practitioner for each of these items, link the
deficiencies to the appropriate physician for completion, verifying chart completion and
monitor the reanalysis queue to ensure all records are completed appropriately. In
addition, HIM office is also in charge of billing and coding in order to collect the money
incurred and earned of the hospital.

b. Other “professionals” with whom you had contact?

N.A

c. Your clients?
N.A

3. What exactly did you learn through these activities?

Related to:

a) Your specific organization?

I learn that The program NIAHO is an accreditation in which every hospital in the
United States should successfully fill out and meet all the requirements in order to receive
federal funds such as Medicare and Medicaid. In addition, I learn that to maintaining
clean and safe surroundings for the patients, visitors and hospital staff the supervisor have
a computer system where he/she can see what beds, rooms, and facilities are in need of
cleaning process. Also, I learn that the Environmental Services Department is only in
charge of the hospital surroundings and not the cleaning of the medical equipment. In
addition, I learn that all the hospitals have a different way or form of evaluating their
Quality of services in a hospital. Furthermore, the employee showed me some graphics
that the office does in order to figure out their current quality providing services and
contrast which services have good quality and which services have poor quality. Once
they review all of those graphics, they can proceed to set a meeting with the staff who is
in charge of those services in which the quality was poor in order to make a plan and
improve those quality services in the most effective way possible. Finally, in the HIM
Department I learn that where the HIM office is responsible for assuring that all patient
records and loose documents are scanned into the Horizon Patient Folder with the highest
level of quality possible to keep track of every situation and every individual of the
hospital's community and to update it as well. The HIM office is also responsible for
indexing all documents to the appropriate patient folder and for ensuring each document
is assigned the appropriate document name. The HIM office will review each discharged
patients' records for incomplete or missing items, in order to be able to identify the
responsible practitioner for each of these items, link the deficiencies to the appropriate
physician for completion, verifying chart completion and monitor the reanalysis queue to
ensure all records are completed appropriately. In addition, HIM office is also in charge
of billing and coding in order to collect the money incurred and earned of the hospital.

b) Other “professionals” with whom you had contact?

N.A
 c) Your clients?
N.A

4. Can you identify any initiatives as required by the organization’s performance

improvement planning or as required by the regulatory bodies, such as CMS?

Yes, I Identify some Initiatives of Crouse Hospital organization In order to Improve

their performance and CMS as well.

a) If so, what are they and who is requiring them?

For example, the daily meetings that the Ms. Shepard staff do In order to talk about
how they can make better their HIPAA policies and with this avoid get sued. Also, I weent to
a meeting where the staff were talking about their next NIAHO audition that the hospital
will have and cheking that they will fillout all the requirements that they need to receive
Medicare and Medicaid funds.

b) If you can't identify do you see an opportunity for performance improvement?

Yes, I do saw an opportunity for performance Improvement because the Risk Management
staff do a weekly meeting to maintain an aggressive monitoring system about what could be
fix and how they will fix those Issues.

5. What activities do you expect to be engaged in during the next 40 hours of internship
work?
I am expecting to be engaged in a speech that the Crouse Nursing School where providing to
the healthcare professionals about patient-doctor- relationship importance. In addition,
Visit the 410 building or "opioid treatment building". In addition, I will visit the Security
office, and Patient Access as well. Finally, I will be with the Human Resources Director and
working with my project.

6. What do you expect to learn during the activities of the next 40 hours of internship work?
In the IT meeting I hear that IT will talk about some hackers’ attacks that the IT department
had in the last month. Therefore, I want to learn about what are those attacks been and
what information the hackers were trying to steel. Also, Katie told me that for the next week
I will go with her to the Crouse Nursing School to hear an MD speech about the importance
of the patient and Doctor relationship to have a successful medical treatment. Therefore, I
want to learn about why does the patient and the Doctor should have an excellent
relationship to have a successful medical treatment. In addition, I will go to visit the 410
Crouse Building. Katie told me that 410 is in charge of the opioid treatment for the
community. Therefore, I want to learn about this service and how many patients the
currently have.

7. What do you WANT to learn? Have you communicated this to your supervisor?
I want to learn about what actions IT could take in order to avoid those attacks. In addition,
I want to learn about those techniques that will help to stablish a better communication
with the patients. Also, I want to learn how many patients does the 410 program have and
how the treat them. Finally, I want to learn how the security cameras works in order to
monitor the activities within the hospital. Finally, I want to learn about the Human
Resources system.
A 40 HOUR REPORT IS DUE IN THE HANDS OF YOUR FACULTY MENTOR
WITHIN SEVEN DAYS OF COMPLETION OF REPORTING PERIOD. THE REPORT MUST
ADDRESS THE AREAS ABOVE AND MUST BE REFLECTIVE IN NATURE.

This form must accompany your progress report each week!