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In my current internship, I am directly involved in a “provider-selection process” for nursing homes and healthcare agencies wishing to partner with . The quality metrics rating is, for example, one criterion for the nursing homes and healthcare agencies to associate with YNHH. Facilities are expected to be above four stars to participate in the selection process.

One of the subtopics of quality metrics analyzed is abuse allegations. Usually, the abuse report is very subjective, describing a situation involving patients, caregivers, and the facility. These reports give you a general idea about one case, but they are hard to translate into more objective data.

In order to analyze the abuse report from an objective perspective, my supervisor and I discussed some strategies for translating descriptive statements into objective data that could be utilized as a part of a rating system. I found this task challenging but very interesting.

‘A tremendous opportunity for me’

After reading a few dozen abuse reports, I realized most of the abuse allegations resulted from either a specific flaw in the healthcare facility structure or from a clinical outcome that the patient or their family members did not anticipate. These variables can be measured in terms of "mild," "moderate," or "serious."

I created a “severity score toll” in a 3x3 matrix format. On the "Y" axis, we can classify the “unexpected patient outcome” as mild, moderate, or severe. On the ''X" axis, we can also rank the systematic facility issue as mild, moderate, or severe. The higher the final score, the more serious the allegations regarding the institution. This strategy serves as a screening process that allows us to identify certain institutions that need to undergo a serious evaluation regarding abuse allegations.

My direct supervisor has appreciated this scoring system, and I recently presented it to the entire project team, who analyzed it and gave me feedback. While it is still uncertain if this screening system will be permanently adopted by YNHH, the process of creating the scoring system was a tremendous opportunity for me to contribute directly to the project. It was also a pleasant assignment to complete.

Gabriel Caldato Barsotti ’23 MHA is a candidate in the University’s Master of Healthcare Administration program. He is completing an internship with Yale New Haven Health.