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Interprofessional organization and sysyems leadership nurs6053

Wk2Assignment: Analysis of a Pertinent Healthcare Issue

No plagiarism.

The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.

Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.

In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.

To Prepare:

· Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.

· Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.

· Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.

The Assignment (3-4 Pages):

Analysis of a Pertinent Healthcare Issue

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

· Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).

· Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.

· Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.

Looking Ahead The paper you develop in Module 1 will be revisited and revised in Module 2.

RUBRIC

Name: NURS_6053

Readings

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

· Chapter 2, “Understanding Contexts for Transformational Leadership: Complexity, Change, and Strategic Planning” (pp. 37–62)

· Chapter 3, “Current Challenges in Complex Health Care Organizations: The Triple Aim” (pp. 63–86)

Read any TWO of the following (plus TWO additional readings on your selected issue):

Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians—Implications for the physician workforce. New England Journal of Medicine, 378(25), 2358–2360. doi:10.1056/NEJMp1801869

Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN-prepared workforce goal. American Journal of Nursing, 118(2), 43–45. doi:10.1097/01.NAJ.0000530244.15217.aa

Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231–245. doi:10.1097/NAQ.0000000000000303

Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner–physician comanagement: A theoretical model to alleviate primary care strain. Annals of Family Medicine, 16(3), 250–256. doi:10.1370/afm.2230

Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’ work settings, roles, and education preparation? Journal of Professional Nursing, 33(6), 400–404. doi:10.1016/j.profnurs.2016.11.005

Note: You will access this article from the Walden Library databases.

Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple Aim. Journal of the American Board of Family Medicine, 31(4), 588–604. doi:10.3122/jabfm.2018.04.170388

Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14(56), 1–15. doi:10.1186/s12960-016-0154-3. Retrieved from https://human-resources-health.biomedcentral.com/track/pdf/10.1186/s12960-016-0154-3

Poghosyan, L., Norful, A., & Laugesen, M. (2018). Removing restrictions on nurse practitioners’ scope of practice in New York state: Physicians’ and nurse practitioners’ perspectives. Journal of the American Association of Nurse Practitioners, 30(6), 354–360. doi:10.1097/JXX.0000000000000040

Ricketts, T., & Fraher, E. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874–1880. doi:10.1377/hlthaff.2013.0531

Running head: A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM 1

A REVIEW OF KEY CURRENT HEALTHCARE ISSUES: QUALITY AND VALUE IN THE U.S’S HEALTHCARE SYSTEM

A Review of Key Current Healthcare Issues: Quality and Value in the U.S’s Healthcare System

Student’s Name

Institution Affiliation

Date

A Review of Key Current Healthcare Issues: Quality and Value in the U.S’s Healthcare System

Healthcare regulations, funds, workload, and technology continue to complicate and inconvenient the U.S healthcare system. However, the quality and value of care tops. In the United States of America, despite significant healthcare transformation efforts, poor care lingers a considerable concern.

America is second to none in terms of healthcare expenditure across the globe. Ironically, evidence shows that its citizens do not receive the most appropriate care, or at least, which they need. For instance, Graban (2018) documents that preventive care is underutilized in the country, which is escalating the budget of managing advanced diseases. On the other hand, patients of chronic ailments such as diabetes, hypertension, and cardiac complications, do not also usually get treatments that are proven and effective (Wiler, Pines, & Ward, 2019).

According to Strome (2019), this case is particularly true and event rampant to the persons that insured, uninsured, or under-insured. The lack of proper coordination of chronic diseases patients’ care would only source more or exuberate poor healthcare. The unsurprising healthcare system’s underlying fragmentation only fuels the issue given that many health care providers hardly have the payment support such related gears, necessary for effective communication and coordination to improve patient care.

While a significant number of patients miss medically necessary care, other clients get unnecessary or even unsafe attention. Research depicts terrific variations in hospital inpatient lengths of stay, specialists’ visits, testing and procedures, and costs — not just by United States’ unalike geographic areas, but from one health institution to another in the same town (Wiler, Pines, & Ward, 2019). Though limited, evidence on the most effective treatments and procedures, on the best way of informing providers about the efficacy of different treatments, and on the failures of detecting and reducing errors further underwrite the gaps care’s quality and effectiveness (Strome, 2019). The concerns are especially pertinent to the Americans of the lower social classes as well as to those from diverse demographic and ethnic groups are usually frequent victims of a lot of incongruences in health and health care.

The implication of Poor Patient Care

Poor quality care impacts both patients and providers negatively. For patients, it reduces their survival changes, aggravates illnesses, and leads to unnecessary mortalities (Graban, 2018). To providers, such issues are indicative of their failure both legally and ethically because their purpose is to increase survival chances, reduce illness severity and cure diseases and not the opposite. Usually, such outcomes are prospective of lawsuits, which may see a practitioner imprisoned and or fined alongside their institutions (Graban, 2018). Moreover, for private health institutions, poor care shuns away prospective clients, which means bad business.

How the Healthcare System Setting has responded to this Concern

The healthcare system has met with various reforms. Various delivery system reforms have are being adopted to improve care value and Chronic Disease Management, Primary Care Coordination, and Health Information Technology (HIT) is a good example alongside Comparative Effectiveness Research (CER) — Investment in CER holds (Wiler, Pines, & Ward, 2019). Evidence shows that the reforms have significantly enhanced care value.

There have also been interventions, which target treatments to the appropriate clients. They have come in handy in medical science, but principally in promoting care value and quality. For instance, as writes Strome (2019), using predictors such as high utilization or clinical and personal characteristics have pointedly enhanced returns from delivery system investments.

Conclusion

The U.S healthcare system is not static but dynamic. It will keep changing with time. However, this will come with complexities that will only add up to the already notorious issues inconveniencing the sector. Poor quality and value care is not a new concern. America has experienced its consequences from the past, and while its healthcare system is finding ways of beating it, it is a difficult and unpredictable battle.

References

Graban, M. (2018). Lean hospitals: Improving quality, patient safety, and employee engagement. Boca Raton: CRC Pres.

Phillips, R. A. (2019). America’s Healthcare Transformation. Rutgers University Press.

Wiler, J. L., In Pines, J. M., & In Ward, M. J. (2019). Value and quality innovations in acute and emergency care. Cambridge, United Kingdom; New York: Cambridge University Press.

Strome, T. L. (2019). Healthcare analytics for quality and performance improvement. Hoboken, New Jersey: John Wiley and Sons, Inc.

1 day ago

Respond to Chisom Okpara 

RE: Discussion – Week 1

COLLAPSE

Top of Form

The passage of the Affordable Care Act (ACA) created health reforms in the United States and affected nursing practice in many ways. The ACA, also known as Obamacare, is a law that was approved in 2010 and it aimed to ensure that more people in the United States had health insurance coverage, improve the quality of health care, regulate health insurance, and diminish health care spending in the country (Galan, 2018). Nine years after the passing of the law, it remains at the forefront of healthcare issues. With more people having health insurance, this health reform created a significant impact on the nursing workforce. Currently, the rate of uninsured in the country is steady at its historic low of 8.8 percent (Coombs, 2018). The ACA placed a high demand for nurses and nurse practitioners with more people having the means to seek for healthcare needs.

The Effect of the Affordable Care Act in the Organization

           In the past five years, Baptist Health System, the organization where I am currently employed has felt the impact of the ACA. The volume of the patients in the emergency department decreased, and acuity increased. The ambulatory services in the organization have greatly increased, so there is a shift of patient visits from the emergency rooms to urgent care facilities and primary care services. The expansion of health insurance led to improved access to health care services reducing the need to use the emergency rooms as a primary source of health care, especially for patients that received public insurance programs.

The Organization’s Response to the Effect of the Affordable Care Act

            Now that more people have increased access to health care, many organizations are making modifications in their healthcare system’s delivery of care. Pittman and Scully-Russ (2016) stated that in response to the ACA, healthcare organizations are adopting concepts of moving staff to ambulatory and home care settings, generating new jobs that involve care coordination, and developing new modes of healthcare delivery to address consumerism. Some of the said changes are evident in the organization where I currently work.

            Baptist Health System, in response to the increasing demand for nurses, created a nursing residency program. As the clinical educator of the emergency department in one of the hospitals of Baptist Health System, one of my roles is to facilitate the training of the resident nurses. The residency program sponsors the training of new graduates with their choice of nursing specialty where they are given didactic and clinical training within 22 weeks and providing them basic salary during the program. The program helped encourage new nurses to work within the organization, allowing them to work in specialty areas even without prior experience, and promoted retention due to the contract of three years that they have to fulfill after graduating from the program. Many of the new nurses were employed in urgent care settings.

            With regards to adopting of new healthcare settings, Baptist Health System, within the last five years, opened ten urgent care facilities, six primary care centers and recently opened a free-standing emergency department to help cater to the increasing needs of patients to access health care. Current staff nurses of the organization were prioritized to transfer to the new ambulatory care settings.

            ACA also resulted to generating new jobs that involved care coordination (Pittman & Scully-Russ, 2016). In Baptist Health System, new nursing positions like case management and transfer center nursing coordinators were opened to serve as care coordinators to the new healthcare settings.

            Moreover, to support the new ambulatory settings, the organization granted scholarships and tuition reimbursement programs for current employees interested in furthering their education with masters and doctorates in nursing for family or acute care nurse practitioner track. Graduates of the program are then hired in any facility within the organization to work as nurse practitioners, also encouraging retention of nurses within the organization.

Response to chisom

Response 1

Hi Stephanie,

In support to your write up, hospital falls is a major safety issue in most organizations. “Approximately 70% of all hospital related injuries come from falls and 30% of falls result in injury (Anderson, Postler, & Dam, 2015). “Risk factors for falling include age-related changes such as sensory alterations, muscle weakness, gait and balance disturbances, use of four or more prescription medications, alteration in activities of daily living, depression, and history of falling” (Trepanier & Hilsenbeck, 2014). As a nurse leader, the best way to continue improving is to enforce the Fall Prevention Protocol (FPP) to make sure every patient continues to be safe and free of injury. The nurse leader is responsible for inspiring and encouraging the team to adhere to the organizations policies.

(Solomon, 2010) defines inter-personal collaboration as “interaction between two or more professions, organized into a common effort to address common issues, with the participation of the patient”. Preventing falls throughout the organization is a multi-disciplinary task. Pharmacy, physical therapy, occupational therapy, providers, nursing staff, and nutrition staff collaborate across disciplines to prevent patient falls. Pharmacy alerts nursing/providers of medications with high fall risk values, physical therapy strengthens the patient and educates the patient on safety and how to use ambulation equipment. Occupational therapy helps the patient safely carry out activities of daily living. Nursing administers medications and monitors patients to prevent injury and nutrition services provides balanced meals to promote healing and increase mobility. Every department collaborates to keep the patient safe, free of injury.

Thanks for sharing.

References

Anderson, D. C., Postler, T. S., & Dam, T. (2015). Epidemiology of hospital system patient falls. American Journal of Medical Quality, 31(5). doi.org/10.1177/1062860615581199

Solomon, P. (2010). Inter-professional collaboration: Passing fad or way of the future? Physiotherapy Canada, 62(1).

Trepanier, S., & Hilsenbeck, J. (2014). A Hospital system approach at decreasing falls with injuries and cost. Nursing Economic$, 32(3).

Response 2

Healthcare-associated infections, such as ventilator-associated pneumonia (VAP), are the most common and most preventable complication of a patient’s hospital stay. Their frequency and potential adverse effects increase in critically ill patients because of impaired physiology, including a blunted immune response and multi-organ dysfunction.

The most important evidence-based practice for reducing VAP risk is minimizing a patient’s exposure to mechanical ventilation, which can be achieved either by the use of noninvasive ventilation approaches or to minimize the duration when mechanical ventilation can’t be avoided. (Boltey, Yakusheva, & Costa, 2017).

Another evidence-based practice nursing practice for reducing VAP risk in critically ill adult is by provision of excellent oral hygiene. Oral health quickly deteriorates in mechanically ventilated patients. (Li Bassi, Senussi, & Aguilera, 2017). Some patients sustain injuries to the oral mucosa during the intubation procedure, and after intubation, patients are prone to dry mouth. These factors, in addition to a severely compromised immune system, can cause an increase in bacteria colonization in the oral mucosa, with the endotracheal tube serving as a direct route to the lungs. Healthy work environments and interprofessional collaboration have been associated with lowering the risk for VAP. Thanks for sharing. I enjoyed your write up.

References:

Boltey, E., Yakusheva, O., & Costa, D. E. (2017). 5 Nursing strategies to prevent ventilator-associated pneumonia. American Nurse Today, Vol. 12 No. 6. Retrieved from

https://www.americannursetoday.com/5-nursing-strategies-prevent-ventilator-associated-pneumonia/

Li Bassi, G., Senussi. T., & Aguilera, X. E. (2017). Prevention of Ventilator-Associated Pneumonia. Curr Opin Infect Dis; 30(2), 214-20.

Respond to Christine

2 hours ago

Respond to Christine Pillitiere 

RE: Discussion – Week 1

COLLAPSE

Top of Form

Wk. 1 Initial Post – C. Pillitiere

Falls among hospitalized patients has been a significant concern across the national healthcare system. Falls can result in severe injury or even death.  The World Health Organization (2018) stated the second leading cause of death worldwide are accidental or intentional falls.  The Joint Commission (2016) estimated that there were between 700,000 and 1 million patient falls each year within U.S. hospitals. The World Health Organization (2018) stated that unintentional falls can cost more than $50 million annually. 

Preventing falls should be our top priority. In our organization, we must aim to have comprehensive fall prevention programs so we can reduce falls and injuries within our organization. “Prevention strategies should emphasize education, training, creating safer environments, prioritizing fall-related research and establishing effective policies to reduce risk” (WHO, 2018). It is estimated at least one-third of all in-hospital falls result in injuries. These injuries could lead to additional hospitalization. Medicare and Medicaid will not give reimbursements to hospitals for any additional costs that may be associated with a patient fall during admission (AHRQ, 2019). “Inpatient harm has negative financial outcomes for hospitals and negative clinical outcomes for patients” (Alder, et al., 2018).

 Fall prevention programs have been at the forefront with intense research and quality improvement efforts. As an organization, we must remain active in research by using evidence-based practices to improve patient safety measures and reducing falls. Our organization is active in fall prevention by providing employee training on patient safety and has developed a hospital safety committee made up of administrators, nursing and axillary staff.  The safety committees’ purpose is to encourage a culture of vigilant safety consciousness through feedback and lessons learned from adverse events.

 Our organization has adopted strategies to reduce falls. First, patients are identified if they are at high risk for falls after a fall risk assessment is completed at the time of admission. High fall risk patients have both a yellow wrist band placed on their arm along with yellow socks. Bed alarms are another safety feature used for high fall risk patients. There are signs posted throughout the unit and in-hospital rooms that state “Call! Don’t Fall”. Also, hourly rounding is done on each of the nursing units to make sure no patient is at risk.

 Rewritten

Falls among hospitalized patients has been a worry over the national medicinal services framework. Falls can bring about severe injury or even demise. It is true that the Joint Commission (2016) indeed assessed that there were somewhere in the range of 700,000, and 1 million patients fall every year inside U.S. medical clinics. Health care organizations should plan to have far-reaching fall counteraction programs so we can lessen falls and wounds inside the organization. Almost half of the in-medical clinic falls bring about injuries. These wounds could prompt other hospitalization. Fall avoidance programs have been at the cutting edge with extreme research and quality improvement endeavors. Health care professionals should stay dynamic in investigating by utilizing proof-based practices to improve persistent security measures and lessening falls.

References

Adler, Lee; Yi, David; Li, Michael; McBroom, Barry; Hauck, Loran; Sammer, Christine; Jones,

Cason; Shaw, Terry, Carson; Classen, David (2018). Impact of Inpatient Harms on hospital Finances and Clinical Patient Outcomes. 
Journal of Patient Safety: 

June 2018 – Volume 14 – Issue 2 – p 67-73

 doi: 10.1097/PTS.0000000000000171

Agency for Healthcare Research and Quality (AHRQ) 2019. Falls. Retrieved from:

http://www.psnet.ahrq.gov/primer/falls

Joint Commission (2016). Sentinel Alert Event. Preventing Falls and Falls-Related Injuries in health care facilities. Retrieved from: 

https://www.jointcommission.org/assets/1/18/SEA_55