HIM 690 Module 2 Final Project Milestone One Example

Final Project Milestone One: From Plan to Work. The Capstone Charter for the Cimarron Heights Flag Accuracy Capstone

[Student Name]

Southern New Hampshire University

HIM 690: Health Information Management Capstone

Final Project Milestone One

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Final Project Milestone One: From Plan to Work. The Capstone Charter for the Cimarron Heights Flag Accuracy Capstone

A proposal describes what a study intends to do. A charter commits to doing it within a set time, with named people and known risks. This charter governs the capstone study at Cimarron Heights, the composite Tulsa academic hospital, which will check admission flags on four tracked complications against the chart. It updates the proposal written in the methods course with what has changed since, including approvals, the sampling frame and the schedule, so that the capstone committee and the hospital's sponsors share one current description of the work.

Question and Objectives

The study asks how often coded admission flags for the four tracked complications, deeper pressure wounds, infections tied to urinary catheters, blood clots in the veins and injuries from falls, match a blinded second reading, which way the misses run and whether a missing structured skin and risk assessment in the first 24 hours is associated with disagreement. Its objectives are to report agreement overall and by condition with confidence intervals; to compare over- and under-reports; to estimate adjusted odds of disagreement associated with a missing assessment; to explain the patterns through interviews with coders and nurses; and to deliver recommendations to the quality committee and the chief nursing officer. Goldman et al. (2011) provide the main benchmark for interpretation.

Scope and Deliverables

In scope are adult inpatient discharges from fiscal 2026 with one of the four conditions coded as a secondary diagnosis, re-abstraction of a stratified random sample, eight interviews and a report with recommendations. Out of scope are pediatric records, conditions coded as the principal diagnosis, changes to coding or nursing practice during the study and any correction of individual claims, which will be referred to the compliance office rather than handled by the project. Deliverables are the final abstraction tool and rules, the cleaned data set with a data dictionary, the analysis, interview themes, the capstone report and a twenty-minute presentation to the quality committee.

Approvals

The hospital's institutional review board granted expedited approval in August 2026 and approved a waiver of HIPAA authorization for the record review, finding that the research poses minimal privacy risk, could not practicably be conducted without the waiver and includes a plan to protect and destroy identifiers, the conditions federal guidance sets for such waivers (U.S. Department of Health and Human Services, n.d.). Interview participants will give written consent. Two sponsors signed on, nursing's top executive and the head of the record department, and the privacy officer approved the data handling plan.

Changes Since the Proposal

Three changes were made, each approved by the capstone advisor. First, the sampling frame for fall injuries contains only 78 eligible records after exclusions, so all 78 will be reviewed and the total sample will be 318 rather than 320; Hulley et al. (2013) note that sample size plans should be revisited when the eligible population turns out smaller than expected, and the precision for falls will be reported accordingly. Second, the interview phase will begin two weeks earlier, overlapping the last weeks of abstraction, because preliminary counts already show which units have the most disagreement; Fetters et al. (2013) describe this kind of connection, in which early quantitative results shape qualitative sampling, as a form of integration. Third, a brief calculation of how misflagging changed payment has been added at the advisor's suggestion, kept separate from the accuracy findings.

Roles

The writer leads the study, conducts interviews and performs the analysis. Two credentialed coders from outside the inpatient coding team abstract records. The coding quality lead resolves abstraction disagreements. A hospital biostatistician reviews the regression model. The capstone advisor approves changes and reviews drafts. The two sponsors receive updates and remove obstacles.

Schedule

The fifteen-week schedule runs as follows. Weeks one and two finalize the sample and train abstractors. Weeks three through eight complete abstraction in three batches of about 106 records, with reliability checked after each batch. Weeks seven through ten complete interviews. Weeks nine through eleven complete the analysis and integration. Weeks twelve and thirteen draft recommendations and review them with the sponsors. Weeks fourteen and fifteen complete the report and presentation.

Risks

Four risks are logged with responses. Abstraction may run slow because scanned outside records take time to review; the response is a fourth batch week held in reserve. Reliability may fall below the 0.80 kappa threshold; the response is to pause and retrain. Interview recruitment may lag among night-shift nurses; the response is to offer early-morning sessions. And findings may suggest that some claims were paid incorrectly; the response, agreed with compliance in advance, is to report affected claims to the compliance office without delaying the study.

Data Management

The data will be handled under the plan the privacy officer approved. Abstractors enter results directly into a secured form on the hospital network that assigns each record a study number; the medical record numbers sit in a separate encrypted key file that only the writer can open. Coded flags, coder identifiers and admission details are pulled by the data integrity analyst into a second file and merged with abstraction results only after all abstraction is finished, which keeps abstractors blind. No study data leave the hospital network, the analysis runs on a hospital workstation and the key file will be destroyed within thirty days of the final report. A short handling log records each time the key is opened and why, and the log itself becomes one of the deliverables that shows the privacy competency.

Reporting

The writer will send a one-page update to the advisor and sponsors every two weeks covering records completed, reliability, interviews done, issues and changes. The capstone committee will receive the milestones on the course schedule.

Conclusion

The charter makes the proposal executable: approvals in hand, scope fixed, changes explained, people assigned and risks anticipated. Its success will be judged by whether the study finishes on schedule with the reliability it promised. If either slips, the biweekly update will say so plainly and propose a fix.

References

Fetters, M. D., Curry, L. A., & Creswell, J. W. (2013). Achieving integration in mixed methods designs: Principles and practices. Health Services Research, 48(6pt2), 2134-2156. https://doi.org/10.1111/1475-6773.12117

Goldman, L. E., Chu, P. W., Osmond, D., & Bindman, A. (2011). The accuracy of present-on-admission reporting in administrative data. Health Services Research, 46(6pt1), 1946-1962. https://doi.org/10.1111/j.1475-6773.2011.01300.x

Hulley, S. B., Cummings, S. R., Browner, W. S., Grady, D. G., & Newman, T. B. (2013). Designing clinical research (4th ed.). Lippincott Williams & Wilkins.

U.S. Department of Health and Human Services. (n.d.). Research. Health information privacy. https://www.hhs.gov/hipaa/for-professionals/special-topics/research/index.html