Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
What is the current benchmark for the organization and the numeric score for the underperformance?
How is the benchmark underperformance potentially affecting the provision of quality care or the operations of the organization?
What are the potential repercussions of not making any changes?
What evidence supports your conclusions?