Case Description - Mountain View Community Hospital (MVCH)

Mountain View Community Hospital (MVCH) is a not-for-profit, short-term, acute care general hospital. It is a relatively small hospital, with some 150 beds. Mountain View Community Hospital strives to meet the needs of a community of about 60,000 with an annual growth rate of 10 percent, a trend that is expected to continue since the surrounding area is attracting many retirees. To serve the health-care needs of this growing community, Mountain View Community Hospital plans to expand its capacity by adding another 50 beds over the next five years, and opening a managed care retirement center with independent apartments and assisted living facilities. The basic goal is to provide high-quality, cost effective health-care services for the surrounding community in a compassionate, caring, and personalized manner.

Mountain View Community Hospital provides a number of key services, including general medical and surgical care, general intensive care, a cardiology department, open-heart surgery, a neurology department, pediatric medical and surgical care, obstetrics, an orthopedics department, oncology, and a 24-hour emergency department. The hospital also offers a wide range of diagnostic services. A specialty service within the neurology department is the recently opened Multiple Sclerosis (MS) Center, which provides comprehensive and expert care for patients with multiple sclerosis in order to improve their quality of life. The trend toward managed care and the need to maintain costs while maintaining/improving clinical outcomes requires the hospital to track and analyze both clinical and financial data related to patient care services.

After completing a course in database management, you have been hired as a summer intern by Mountain View Community Hospital. Your first assignment is to work as part of a team of three people to develop a high-level E-R diagram for the hospital. You conduct interviews with a number of hospital administrators and staff to identify the key entity types for the hospital. As a result, your team has identified the following entity types:

CARE CENTERa treatment center within the hospital. Examples of care centers are maternity, emergency care, or multiple sclerosis center. Each care center has a care center ID (identifier) and a care center name. PATIENTa person who is either admitted to the hospital or is registered as an outpatient. Each patient has an identifier, the medical record number (MRN), and a name. The hospital also records the date of first contact with the hospital (Contact Date) PHYSICIANa member of the hospital medical staff who may admit patients to the hospital and who may administer medical treatments. Each physician has a physician ID (identifier) and name. BEDa hospital bed that may be assigned to a patient who is admitted to the hospital. Each bed has a bed number (identifier), a room number, and a care center ID. ITEMany medical or surgical item that may be used in treating a patient. Each item has an item number (identifier), description, and unit cost. EMPLOYEEany person employed as part of the hospital staff. Each employee has an employee number (identifier) and name. DIAGNOSISa patients medical condition diagnosed by a physician. Each diagnosis has a diagnosis ID/code and diagnosis name. Mountain View Community Hospital is using the HIPAA-mandated ICD-9- CM Volume 1 diagnosis codes1 for patient conditions (e.g., 00.50, STAPH FOOD POISONING, 173.3, BASAL CELL CARCINOMA, 200.2, MALIGNANT MELANOMA, BURKITTS TYPE, or 776.5. CONGENITAL ANEMIA).

TREATMENTany test or procedure ordered by and/or performed by a physician for a patient. Each treatment has a treatment ID/treatment code and treatment name using standard codes. HIPAA- mandated ICD-9-CM Volume 3 Procedure Codes are used for diagnostic and therapeutic procedures (e.g., 03.31, SPINAL TAP, 14.3, REPAIR OF RETINAL TEAR, 87.44, ROUTINE CHEST X-RAY, or 90.5, MICROSCOPIC EXAMINATION OF BLOOD).

ORDERany order issued by a physician for treatment and/or services such as diagnostic tests (radiology, laboratory) and therapeutic procedures (physical therapy, diet orders), or drugs and devices (prescriptions). Each order has an order ID, order date, and order time.

The team next recorded the following information concerning relationships: Each hospital employee is assigned to work in one or more care centers. Each care center has at least one employee and may have any number of employees. The hospital records the number of hours per week that a given employee works in a particular care center. Each care center has exactly one employee who is designated nurse-in-charge for that care center. A given patient may or may not be assigned to a bed (since some patients are outpatients). Occupancy rates are seldom at 100 percent, so a bed may or may not be assigned to a patient. A patient may be referred to the hospital by exactly one physician. A physician may refer any number of patients or may not refer any patients. A patient must be admitted to the hospital by exactly one physician. A physician may admit any number of patients or may not admit any patients. Prior to a patient being seen by a physician, a nurse typically obtains and records relevant information about the patient. This includes the patients weight, blood pressure, pulse, and temperature. The nurse who assesses the vital signs also records the date and time. Finally, the reasons for the visit and any symptoms the patient describes are recorded. Physicians diagnose any number of conditions affecting a patient, and a diagnosis may apply to many patients. The hospital records the following information: date and time of diagnosis, diagnosis code, and description. Physicians may order and perform any number of treatments for a patient or may not perform any treatment. A treatment or service may be performed on any number of patients, and a patient may have treatments performed or ordered by any number of physicians. For each treatment or service rendered, the hospital records the following information: physician ordering the treatment, treatment date, treatment time, and results. A patient may also consume any number of items. A given item may be consumed by one or more patients, or may not be consumed. For each item consumed by a patient, the hospital records the following: date, time, quantity, and total cost (which can be computed by multiplying quantity times unit cost).

3. Please make sure your E-R diagram is legible. You are not required to do the ER diagram using special software; however, cleanness and readability will be part of grading. If you choose to do it on a computer you can use any program of your choosing.
4. Submit a soft copy of your assignment (one submission for each group) from LMS (refer to the class syllabus for late submission penalties). If you do your diagram on paper, you may scan your diagram and submit the scanned document as a soft copy.
5. It is your responsibility to contact your group members in a timely manner to work on this assignment as a group. If any of the members does not respond or contribute to the assignment, as a group you may choose to expel that person from your group, informing me and the expelled person in a timely manner. If you are expelled from your group, you may do the assignment alone and submit your own copy.