Category: Healthcare

Healthcare provision to the aged people forms one of the most important aspects that dictate the ability of the latter group to effectively carry out their task and continue living healthy lives. Its provision therefore requires careful consideration of their health status, inabilities and planning as well as provision of adequate resources to support the whole system. Due to the emergence of constraints arising from the high cost of providing the services and care to this group, it is critical for healthcare to be viewed as a necessity.

Though the concept of healthcare as a necessity to the aged has emerged to be highly contentious, some medical specialists indicate that it is the only way out in guaranteeing high quality healthcare provision. This paper is a commentary review on plaintiff life care plan to Attorney Martin on the need for adequate resources to support a 72 year old plaintiff.

From the letter to the attorney, the case which is exploring the burden of taking care of the plaintiff stands out quite strongly. The fact that she has to take care of hiring individuals to perform duties on her behalf since she is blind and deaf is indeed strenuous, tough and demanding.

It is critical to note that there are many factors in a community that determine health and well being of the aged as reflected by the tone of the letter. As such, circumstances and environmental factors such as place of residence, income, inabilities, relationships with family and friends, and the state of the environment determines their health status to a large extent

Some of the issues that the plaintiff is facing and that needs to be addressed include factors which are triggered by both social and economic factors he/she is living in.

The factors are mostly social determinants as reflected by economic status which determines whether she will be able to cater for the cost of $20 per hour for the many hours she will need the services in a day. This can be estimated to about $47,320 or more per year alongside buying other materials like reading machines, listening devices and replacement of grab bars and rails.

In my view, the elderly plaintiff requires legal assistance to remain safe, healthy and independent as long as it is possible, but to also curb issues on age discrimination, neglect, protective services, utilities, housing, nutrition, long-term care and income security. While the plaintiff reserves the right to choices concerning his/her healthcare, the situation of the case is indeed one where the plaintiff’s conditions render him/her unable to perform certain tasks.

There is need for the plaintiff to be covered by disability insurance policies or be provided by long term insurance plans or financial assistance under the federal medical assistance programs. According to Kapp (2008), the elderly with certain disabilities require hospitalization. This is because it is a viable option and limits the level of spending on home care.

Besides, the plaintiff can be supported by Medicaid which offers financial assistance for home care and nursing services for the aged. However, this may come with prohibitive asset and income limit as well as stringent eligibility requirements. Besides, the plaintiff can also seek long term care insurance which is also a viable option for covering his/her homecare expenses in the short or long term period of time.

Reference

Kapp, M. (2008). Regulating payment for home care companionship services: Legal authority and public policy. Care Management Journals, 9(3), 122-127.

Having read the article “Performance management at Intermountain healthcare” by Richard M. J. Bohmer and Alexander C. Romney from April 22, 2009, it becomes obvious that no matter which actions are provided improved quality often reduces revenues. There are a lot of different explanations to his fact and the authors of the article tried to explain the dependence of the improvement of the services quality and the revenue lowering.

The main purpose of this paper is to assess critically the mentioned article and to try to understand the reasons of revenue reduction in cases when it should increase as the services of the better quality presuppose more appreciation from the side of the customers.

Having considered the practical example with clinical programs, performance management, and physician incentives, Richard M. J. Bohmer and Alexander C. Romney in their article managed to draw the following conclusions. One of the main reasons of revenue reduction is an “inherent tension between financial performance and the provision of high quality clinical care” (Bohmer and Romney 8).

His tension is explained by the inability of all citizens of the country to use the services of the IHC. If everyone in the county referred to the services of the IHC, the expenses would reduce by 34% that would result in sufficient savings of about 500 billion dollars. Looking at the situation from another point of view, it is possible to predict the reduction of the revenue as the result of the increased costs of equipment, staff and other specific services.

It is rather difficult to deal with the problems which are based on the financial issues which do not depend on the manager. One cannot reduce the quality to reduce the expenses. People want more and more comfort and quality in services. Healthcare is the sphere which cannot be omitted.

Trying to deal with the problem of reduction of the revenue at the expense of the increase of the quality of the services, IHC and the field of healthcare management should increase savings to compensate he loss. Savings increase is possible with the increase of the visitors and clients of the healthcare establishments. There is another problem connected with the reduction of the revenues, IHC can increase savings and really notice that increase only if the staff is reduced and the capacity is removed.

Therefore, the increased quality if the health care establishments reduces the revenue. Those organizations which appear on the way of choice whether to increase the quality of the services or to leave the level of the revenue should remember about the savings which are possible in this case.

Quality increase is obligatory and the healthcare establishments should think about the ways how to increase the quality and to leave the revenue. The world is changing and all the changes are directed at the increase of the quality and timeline of the services provided. The capabilities should be developed and this may be one of the ways out of the situation, even though the future seems uncertain and unclear. He services quality improved today will bring the profit in another form in the future and this is one of the most important issues.

Works Cited

Bohmer, Richard M. J. and Alexander C. Romney. “Performance management at Intermountain healthcare.” Harvard Business School 22 Apr. 2009. Print.

Overview of healthcare information Technologies

Lack of relevant system-wide healthcare Information technology causes significant expenses that come in the form of the increased number of the workforce and wasted time. Research suggests that lack of appropriate IT platforms to deliver healthcare service contributes to over 10% increase in healthcare costs.

Therefore, IT systems are inextricably connected to healthcare costs for healthcare institutions, which trickle down to the population. Increased healthcare costs have prompted healthcare institutions to adopt cost-saving IT systems to optimize their returns while ensuring the delivery of quality service (Rodrigues, 2009).

There are many IT applications from which healthcare institutions can choose to improve the quality of service and reduce costs of delivering healthcare services. However, every institution must be able to select an IT base that is relevant and appropriate to its condition.

Improving the Quality of Medication

Information technology has the potential to improve the quality of healthcare services. Studies show that most healthcare providers believe that adopting clinical IT systems improve the extent to which they can deliver quality patient care. IT systems can solve some of the problems posed by fragmented IT systems. Computerized Physician Order Entry (CPOE) has become of the key clinical IT systems that have gained significant application in most clinical and medical institutions (Rodrigues, 2009).

Research shows that the application of CPOE reduces the frequency of repeat tests. The quality of healthcare service is connected with the number of repeat tests that a patient undergoes before a successful diagnosis is achieved. Surveys conducted on patients reveals that patients rated physicians based on the number of unsuccessful diagnosis or tests for their illness. The use of CPOE reduces turnaround times for laboratory, pharmacy and radiography request applications made.

Some medical studies have suggested that using CPOE reduces the error frequency during medical surgeries. According to a survey conducted by Bates et al. (1998), the application of CPOE systems had the ability to reduce medication errors by 55%. Out of 11 studies that aimed at estimating the accuracy of medication using CPOE, four studies showed that CPOE achieved to reduce errors, and improved the quality of medication and patient safety.

Studies show that the introduction of CPOE as an IT platform is a nonfinancial incentive for healthcare professionals. Surveys conducted in hospitals using CPOE shows that healthcare professionals are motivated to deliver quality service compared to hospitals that did not implement these technologies. It is significant to note that the professionals’ perception of quality service is inextricably linked to availability of alternative IT tools (Bates & Gawande, 2003).

Recent studies have surveyed the value of using CPOE in ambulatory procedures. These studies suggest that a worldwide application of CPOE can improve quality healthcare among patients while saving their money.

Reduction of drug events is a key focus by many physicians (Bates & Gawande, 2003). Given this need, many clinicians have indicated that CPOE helps to reduce adverse drug events and other related medication errors because it offers cost effective medications, drug prescriptions, and laboratory tests (Bates & Gawande, 2003).

Reducing the cost of healthcare

The use of Electronic Health Record (EHR) reduces the costs of handling medical records and increases the level of access. Studies show that the costs of collecting, storing, and retrieving medical records can have significant cost implication on institutional costs. One of the main problems facing healthcare professionals is the lack of access to centralized information sharing platforms.

Research has shown that the use of EHR has the potential of providing better documentation of patient histories (Bates & Gawande, 2003). The extent to which professionals can share medical information with ease enables physicians to use medical histories, which reduces the costs of beginning new diagnosis and medication (Scalet, 2003). Evidence suggests that reduced transcription and medical management expenses are linked with the physicians’ use of electronic health records.

According Bates & Gawande (2003), financial returns depend on the extent to which a medical organization adapts to effective use of EHR. The paths toward a cost-effective healthcare system stem from getting the critical mass of physicians choosing to use electronic health record systems.

Some studies suggest that the use of electronic health records can save up to $20,000 per healthcare professional. The adoption of electronic medical record (EMR) is a centerpiece in reducing the costs of providing healthcare services (Memorial Care, 2010). The use of traditional manila folders is believed to cost many hospitals millions of money due to loss or inaccessibility of critical patient and administrative records.

EMR transmits important medical records in real-time and helps medical practitioners to have access to information in a timely manner. This avoids waste of time, which reduces costs of searching and retrieving medical histories (Memorial Care, 2010). Lack of systemized record management increases clinicians’ time and workload, which exerts pressure and workload.

Studies content that it can cost a medical organization over $20,000 per clinician due to errors caused by increased workload and service time. Therefore, implementing electronic medical records has the potential of reducing workloads and extra working hours, which has a significant impact on the quality and cost of providing medical services to patients (Bates & Gawande, 2003).

References

Bates, D. W., & Gawande, A. A. (2003). Improving safety with information technology. New England Journal of Medicine 348(25), 2526-2534.

Memorial Care. (2010). How electronic medical records reduce costs and improve patient outcomes. Retrieved from https://www.memorialcare.org/about/pressroom/media/how-electronic-medical-records-reduce-costs-and-improve-patient-outcomes-2010

Rodrigues, J. (2009). Health Information Systems: Concepts, Methodologies, Tools and Applications. New York, NY: Idea Group Inc (IGI).

Scalet, S. 2003. Saving money, saving lives. CIO Magazine. Retrieved from https://www.cio.com/

Professional conduct within a health care setting is grounded in values that reflect the nature and the dynamics of the relationships between a provider and a patient. Because individuals who are facing illnesses are particularly vulnerable, they depend upon professionals in a health care setting to address their needs in a professional manner (the University of Arkansas for Medical Sciences, 2012). It is important to mention that the core values of professional conduct include but are not limited to moral values like trustworthiness and integrity, profession-specific values such as confidentiality, and humanistic values such as compassion and empathy.

Exhibiting professional conduct in a health care setting is important because of its alignment with such processes as decision-making, patient care, research, and public support. As for the process of decision-making, health care executives must be able to maintain ethical and professional conduct in order to serve as role models to ensure that other workers are complying with the proper standards and to create an environment in which decision-making aligns with the set standards.

The standards for professional conduct promote a critical concern for patient care. Such standards are likely to enhance the quality of health care by minimizing or even eliminating mistakes made by providers who act according to standards instead of complying with a set of guidelines created by the top administrators of the health care facility. Moreover, the promotion of professional conduct within health care settings increases the support of the public for the medical profession overall. For instance, if the general public trusts the medical community to be professional and comply with ethical standards, generous donors from the community are more likely to donate to medical research that could benefit the community.

Violations and boundary crossings in health care settings are issues that can significantly hinder relationships between providers and patients (Aravind, Krishnaram, & Thasneem, 2012). Among the reasons for boundary-crossing, several have been identified as the most prominent, including moral weakness, exploitative characters, and emotional vulnerability; when an individual is not completely mentally healthy, there will always be issues with his or her commitment to the ethical values of an organizational setting, as found by Aravind et al. (2012).

When professional staff members of a health care setting compromise the ethical boundaries that guide relationships between workers and patients, they risk patients’ wellbeing and health, especially in cases of unethical relationships between male doctors and female patients, where traditional gender roles contribute to the issue of exploitation (Galletly, 2004). Furthermore, patients who have reported instances of childhood abuse are much more prone to be subjected to a breach of ethical conduct by health care providers.

Apart from harming the wellbeing of a patient, the ramifications of boundary-crossing for health care staff can range from a verbal warning to termination depending on the severity of the violation. If the ethical breach is severe enough to be classified as an offense, the violator is highly likely to face charges and go to court, where the decision falls under punishment by law.

The four elements of medical malpractice (or negligence) include duty, breach of duty, damages, and causation (Owen, 2007). Since the burden of proof lies on the plaintiff, if a single element from the list is not satisfied, negligence cannot be proven. Duty refers to what a medical professional owes a patient (e.g. providing a safe environment), while a breach of duty occurs when the medical professional fails to provide what is owed to a patient.

Damages occur as the result of the duty breach; for instance, if a safe environment was not provided, a patient could have fallen on a wet floor and have been injured. Causation is the most complicated element to prove since there should be a direct cause of the patient’s injury. With the case of the wet floor, for example, the plaintiff must be able to show that had the floor not been wet, the patient would not have slipped and fallen. When a plaintiff knows the mentioned criteria, he or she will be better able to prove medical negligence in a health care setting. On the other hand, medical professionals should also be aware of the elements of medical malpractice in order to avoid unjustified claims of malpractice.

The governing board of a hospital is responsible for managing the performance of the hospital. The governing body is legally responsible for the quality of the provided services, the staff’s conduct, and the facility’s compliance with local, state, and federal law. As a first responsibility, the board must ensure the quality of care provided by professionals who have been given privileges at the facility (Dearmon, 2014) by overseeing the quality of privileging, credentialing, and the process of peer review. As the second responsibility, the board must hire a CEO to develop an administrative team that makes strategic decisions (Dearmon, 2014).

As for risk managers, they are responsible for developing resources presented to the board that is targeted at establishing patient safety, high-quality care, and improvement of the board’s effectiveness. A risk manager educates, informs, and supports the board regarding issues of patient safety and quality of care (Dearmon, 2014). Thus, risk managers can potentially limit the liability of the board as well as its exposure to losses. The two essential aspects to the functioning of the Well Care Hospital include the medical staff, who serve as community members with expertise in medicine (Dearmon, 2014), and laypeople from the community (e.g. business owners and bankers).

References

Aravind, V., Krishnaram, V., & Thasneem, Z. (2012). Boundary crossings and violations in clinical settings. Indian Journal of Psychological Medicine, 34(1), 21-24.

Dearmon, V. (2014). Risk management and legal issues. Web.

Galletly, C. (2004). Crossing professional boundaries in medicine: The slippery slope to patient sexual exploitation. Medical Journal Australia, 181(7), 380-383.

Owen, D. (2007). The five elements of negligence. Hofstra Law Review, 35(4), 1671-1686.

University of Arkansas for Medical Sciences. (2012). Policy on professionalism and professional conduct. Web.

The strategic training of employees in the health care organization is a priority. The research focuses on the reasons for the training of the health care employees. The study includes the different ways of training the employees to prioritize the patients’ benefits. The cost-effective strategic training of the health care organization’s employees should ensure evident dominance of the health care organization market segment.

The culture of the health care organization influences its ability to manage the employees. Likewise, health care management emphasizes all employees must implement a patient-based work attitude. Peter Ginter (2006) emphasized the employees’ prioritizing of the patient’s needs over the needs of the employees ensures a competitive advantage.

The healthcare organization would have an edge over the competitors in the same health care market segment. The clients would prefer to return to health care health care organization that pamper and prioritize the patients’ needs. For example, the Baptist Hospital in Pensacola, Florida, created its vision to be the best health care organization in the United States.

The chief executive officer revised the company’s organizational culture to achieve the challenging vision. Griffin Hospital in Derby, Connecticut engaged in the clients-based health care organization strategy successfully. The patient satisfaction of the health care organization services had soured to almost 98 percent.

In addition, the health care organization’ client-based culture translated to having more meaningful employees. The employees felt happy being an important part of the patient’s health-recovery program. Consequently, the employee turnover ratio had favorably dropped. The Derby hospital created a strong selling employee-based point that edged out the competitors in the community.

Management focused on enhancing employee teamwork. Each of the employees had been retrained in the art of health care servicing. The employees were taught to use teamwork in their aim to prioritize the clients’ health care needs. The employees were persuaded to contribute their share for the entire health care organization team to succeed.

The teamwork-based retraining of the health care organization’s employees is grounded on consensus. Consequently, each employee contributed his or her share to the success of the health care organization’s health care program. Each employee is normally proud to go out of one’s way to give excellent health care services to both the inpatient and outpatient clients.

The employees are persuaded to cooperate as well as coordinate with the other health care workers for the quicker recovery of the patients. However, the patients are taught that hastening the recovery of the patients must not result to lesser quality health care services.

For example, the medical technologists must reduce the time needed to come up with the medical exam results. The medical exam results include the patients’ blood type, stool exam, urine exam, and other related exams. The health care organization’s nutritionist generates a report of the diverse food needs of the health care organization’s patients.

Likewise, the nurse spends more quality time beside each patient. Quality time does not mean the quantity of time spent. Rather, quality time means the quality of each time used on each time period spent with the inpatient and outpatient health care organization clients.

The health care organization’s employees are trained to implement human values within the entity’s premises. To ensure success, the health care organization pampers its health care employees. However, the pampering of the employees must be within allowable cost containment limits. The health care organization is like any other organization; it needs revenues to pay for the cost of running a health care facility.

The health care employees are given an above average salary in order to ensure loyalty. Loyalty translates to a reduction in the number of employees resigning from the health care organization. Loyalty includes giving more than 100 percent of the health care employees’ quality services. Loyalty entails observing the employees showing their loyalty by pampering the patients with above-industry services (Blum, 1996).

Further, the organization must hire employees who are loyal to the health care organization’s goals and objective. Study conducted showed that absenteeism translates to poor work output in the health care setting. A study conducted at the Veterans Affairs Medical Center outpatient clinic indicated there is an inverse correlation between a health care worker’s sick leaves and work output.

However, employees having red flags of continuous Monday absences and Friday absences result to poor health care organization work output. Management must strive to resolve the absenteeism issue to increase the workers’ overall performance results.

Employees who refuse to comply with the entity’s client-based work priorities must be removed from the organization. The employees who refuse to decrease their lackluster service quality during their stay in the health care organization must be retrenched.

The employees showing unabated laziness in the performance of their health care organization duty shall be unceremoniously. The employees who refuse to comply with other client-based policies of the health care organization shall be dismissed from the health care organization (Libet, 2001).

James Johnson (1995) proposed the health care organization should train the employees to adhere to the health care organization’s total quality management. Total quality management is grounded on patient-centered culture. The company must hire the new employees based on their capacity to tow the line or obey the current and prospective policies and procedures of the organization.

The right employees shall be those who help in the organizations creation of value through patient health care activities. The leaders must impose on the employees that the organizational culture must be implemented at all times, without exception.

Mary Richardson (1999) theorized the leaders of the health care organization must be examples of organization’s culture. The leaders implement a variety of value enhancing strategies. The leaders, including shift supervisors, shall show loyalty to the company. The same leaders must show a patient-centered health care work attitude. The leaders must be accessible to the subordinates for advice or help.

The leaders serve as guides for the current and future subordinates in terms of complying with all patient-centered health care responsibilities. The leaders must confront and even reprimand each subordinate who violates the company’s patient-based health care procedures.

The leaders must focus on determining if the health care procedures are being done with an eagerness to help, not an eagerness to finish the job. Consequently, most of the patients can easily see if the nurse or other health care professional love their job or simply going through the motions of health care services without any concern for the patients’ present health condition.

The leader must immediate move to stop a nurse or other health care organization worker who refuses to change one’s behavior to what is expected of them. The leaders must also monitor each employee to ensure no one steps out of line. There are times when the nurse is too busy.

Such times tempt the nurse or other health care professional to violate the health care organization’s work benchmarks. The leader will roam the shift in order to deter the subordinates from thinking of violating any health care organization policies and procedures.

The health care organization must focus on its employees aiming for health care awards. The SSM Health care is sponsored by the Franciscan Sisters of Mary in St. Louise, Missouri. The SSM health care organization is one of the biggest Catholic health care delivery systems in the United States. It has a huge 4,500 inpatient health care bed capacity.

The same SSM Health care enjoined its employees to strive to do their best in their duty to bring back the patients to their prior fully recovered health status. Consequently, the SSM Health care won the prestigious Malcolm Baldrige Quality Award in the area of health care organization. The said award is offered to organizations that excel the best quality service in separate categories.

The said SSM Health care’s aim is to work for excellence in all facets of the health care organization. Excellence, in the SSM Health care tradition, is focused on striving to improve whatever has been improved. Improvement is a continuous process.

Further, the secret to SSM Health care’s winning the prestigious Malcolm Baldrige Award can be divided into four areas. First, the SSM Health care organization set up a framework for analysis, decision, making, and action. The setup resulted to the entity’s focusing on the more important areas for improvement. The SSM Health care organization sets up a set of criteria to determine the prioritization of activities.

Next, the SSM Health care organization’s leaders draw up several alternatives to resolve each employee- related and patient-related case. Taking into consideration all the alternatives, SSM health care organization’s management chooses and implements the chosen recommendations for implementation. The implementation is classified as the action plan.

Second, SSM health care organization’s management instructs its employees to do their share to accomplishing the organization’s mission. The management designs and implements its patient-based mission by taking all inputs from the affected employees. The employees’ inputs include their opinions, suggestions, recommendations, and complaints.

The integration of the employees’ inputs is a good management strategy. The patients will be more than willing to comply with management’s mission strategies if their inputs are included in the crafting of the organization’s mission statement.

Some of the employees may be resistant to the company’s instructions to implement its mission statement if their inputs were not asked. One good reason is that the mission statement may be too high for the employees to implement. The employees’ inputs are necessary in order for health care organization to realize that the employees’ inputs are needed to make the mission statement more realistic.

Third, the SSM health care organization’s management impress on its employees that it is the results that counts most. The setting of the company’s goals will serve as a guide for the employees to pursue. However, the actual outcome of the employees’ outputs will translate to the employees’ performance grade. Each employee is made accountable for one’s individual actions.

The action accountability includes one’s compliance with the overall team performance. This means that the employee’s performance is a failure if each t employee’s team’s overall performance score is a failure. The purpose is to ensure that everyone in the team cooperates with the other members of the team.

Team scoring is grounded on the theory of synergy. Under the synergy theory, one employee’s output plus anther employee’s output is equal to more than two person’s outputs. This means that the team effort is more important compared to the performance of each team member’s performance.

Going back to the organizational goal issue, the accomplishment of organizational goal is grounded on the synergy contributed by each member of the team. The goal is significantly influenced by the capacity of each employee to contribute their optimum share to the achievement of the organizational goal.

In the case of SSM health care organization’s management, the health care organization implements different goals for different activities. The management ensures that all activities can geared towards accomplishment of the preset goals and objectives.

After each activity, the SSM health care organization’s management compares the actual health care organization output against the preset benchmarks. The SSM health care organization’s management adjusts the benchmarks in relation to the actual health care organization output.

For example, management will increase its periodic goals or benchmarks if the goals are easily reached. However, SSM health care organization’s management will lower the prior period’s benchmark or goal if the employees find it very difficult to comply with the prior period’s goals, benchmarks, and objectives.

The goal setting and achieving is very important to both health care organization’s management and the affected health care employees. Both management and the employees will feel proud when they reach the health care organization’s benchmarks, goals, or objectives.

On the other hand, both management and the employees will be disheartened when the actual work performances do not reach the established benchmarks, goals and objectives.

Fourth, the SSM health care organization’s management implements a dedicated leadership stance. The employees are welcomed by all leaders of the health care organization. The employees can approach their supervisors, managers, and other higher ranking officers.

The employees are encouraged by management to voice their complaints, suggestions, recommendations, and other inputs. Management impresses on the employees that their inputs are very important to the overall health care organization’s continued leadership in the health care organization market segment. Management immediately acts on the employees’ inputs.

The employees are happy with the current management-employee relationship. In return, the employees feel they are a much-needed part of the health care organization’s success. The employees contribute by placing the patient’s interest over the employees’ own individual interests.

Because of management’s attitude towards their employees, the employees do not have second thoughts on transferring to other health care organizations. Because of the employees loyalty and dedication to the health care organization’s policies, procedures, goals, benchmarks, and objectives, there is lower management restructuring.

Further, the success of the SSM health care organization’s management’s employee strategy influences the employees’ eagerness to excel in all their assigned health care tasks. Both management and employees contribute to the streamlining of the organization’s overall health care activities.

The employees contribute to the streamlining in terms of faster issuances of mammogram results, allowing the patients a round the clock visiting privilege, as well as approving the inpatient’s ordering meals from outside the hospital any time of the day or night.

Such patient- pampering activities are grounded on the organizations’ stance to give the patients full allowable control of the patients’ life while recuperating inside the health care organization. However, the patients’ control is limited by the health care organization’s policies. Thus, the patients cannot violate any of the entity’s policies.

Furthermore, the organization pampers the employees. Normally, a pampered employee will return the favor to management. Offering the employees above-average salary will persuade the employees to work more quality hours. The offer of other benefits like paid leaves will encourage the employees to stay with the health care organization longer.

Offering better working conditions will convince the employees to spend more hours beside the patient and lesser time idling around in the health care organization’s nurses’ station reading newspapers or pocket books.

Management takes care of its health care organization employees’ welfare to increase employee loyalty. A study had been conducted on the health care needs of the National Health Services employees. The management of many health care organizations includes the caring for the health of its employees. The caring part includes giving affordable salaries and benefits to the employees.

However, management must have enough cash inflows to pay for the budgeted employee salaries and other benefits. A study was conducted on 2,300 health care workers generated a 44 percent response. The findings of the research indicated that most of the health care organization’s management persuades their employees to have a healthy lifestyle.

Consequently, a majority of the health workers are physically healthy. In addition, a majority of the health care organization employees surveyed were focused on improving their current health care status. In addition, a majority of the surveyed health care organization employees do not smoke. Likewise, it is normal for the health care organization employees to drink intoxicating liquor or drinks within the recommended levels.

Further, most of the health care organization employees exercise to keep themselves healthy. The managers or leaders of the health care organization were very instrumental in persuading their employees to prioritize having a healthy body so the can continue in the health care organization’s efforts to aid in the recuperation of its inpatient and outpatient clients (Jinks, 2003).

Primarily, management must base their employee benefits on their resources. Basically, all businesses are engaged for a profit. The health care organization sets up its operations to generate cash inflows. Cash inflows are generated from selling its health care services. The patients pay for the services offered by the health care organization.

Consequently, an increase in the health care organization’s patients translates to an increase in the company’s cash inflows. An increase in the organization’s cash inflows precipitates to an increase in the health care organization’s capacity to increase the health care employees’ salaries and wages. The health care organization’s services include all physical exam services.

The physical exam services include mammograms. The services also include blood pressure monitoring. Other health care services include X ray of different patient body parts. Likewise, the health care services focus medical advices. The heart doctor offers medical advices and prescribes medicines for the recovery of the heart patient.

The diabetes doctor offers medical advice and recommends medicines to be taken to relieve the symptoms and to help in the recuperation of the diabetes patient. The surgeon is hired by the health care organization to help in the surgery of its patients.

The surgeon also offers advice and dictates the medicine intake schedule of the surgery patient. The revenues are needed to pay for the salary and other benefits of the health care organization patients (Besley, 2008).

However, the hospital administration should not exceed its budget. The health care organization must achieve its bottom line. All organizations are required to achieve their bottom line in order to avoid bankruptcy. The bottom line occurs when the company, especially the health care organization, generates net profits.

A net profit occurs when the health care organization’ total revenues exceed the total expenses of running the daily operations of the business. The employees’ salaries and other benefits are included in the company’s total expenses.

An increase in the salaries and benefits precipitates to a decrease in the company’s net profit figure. If necessary, it is very evident that the health care organization must retrench its employees to order to achieve a bottom line financial status (Brigham, 2001).

Based on the above discussion, the strategic training of employees in the health care organization is of prime importance. There are several reasons for the training of the health care employees. Some of the reasons include prioritizing filling the needs of the health care organization patients. Another reason is ensuring employee loyalty to the health care organization.

Another reason is to ensure employees prioritize achievement of the health care organization’s goals, benchmarks, and objectives with flying colors.

The organization must ensure that its employee salaries and benefits are not significant enough to remove the health care organization’s necessary bottom line financial status. Indeed, the cost-effective strategic training of the health care organization’s employees should ensure significant dominance of the health care organization market segment.

References

Besley, S. (2008). Essentials of Managerial Finance. New York: Cengage Press.

Blum, T. (1996). Workplace Characteristics and Health Care Cost Containment Practices. Journal of Management, 22, 675-701.

Brigham, E. (2001). Fundamentals of Financial Management. London: Harcourt Press.

Ginter, P. (2006). Strategic Management of Health Care Organizations. New York: J. Wiley & Sons.

Jinks, A. (2003). A Survey of the Health Care Needs of Hospital Staff: Implications for the Health Care Managers. Journal of Nursing Management, 11, 343-350.

Johnson, J. (1995). Total Quality Management as a Health Care Corporate Strategy. International Journal of Health Care Quality Assurance, 8, 23-28.

Libet, J. (2001). Absenteeism and Productivity Among Mental Health Employees. Administration and Productivity Among Mental Health Employees, 29, 41-50.

Richardson, M. (1999). Contemporary Organizational Strategies for Enhancing Value in Health Care. International Journal of Health Care Quality Assurance, 12, 183 -189.

Why businesses were motivated to offer healthcare

American businesses were motivated to offer healthcare for their employees because of various factors. Healthcare for employees was not given the seriousness that it deserved because many organizations were not keen on this. As much as this situation started changing slowly, there are certain aspects that made it necessary for different businesses to offer healthcare for employees.

The most notable healthcare service that was offered by different business was accident insurance that took off in the early 1990s (Lane 2003, p. 23). This has been improving and nearly all businesses in America offer healthcare for employees. The motivation to offer employees healthcare could have been as a result of the changing business environment that has ultimately had an impact on healthcare in America today.

This means that the changing business world as far as technological advancements are concerned made it necessary to provide healthcare for employees. In this case, such an aspect motivated business to offer healthcare because employees were supposed to be safe.

In a broad perspective, it can be said that American businesses were originally motivated to offer healthcare for employees because they were supposed o give them a reason to do some tasks.

Businesses saw the need to motivate their employees to be committed to what they were doing which could only be enhanced through healthcare (Lane 2003, p. 45). This means that retaining employees was becoming a hard task without offering them healthcare.

In this case, businesses were motivated to offer healthcare to employees because it was an emerging and necessary competitive advantage for success in the business world that was changing. Healthcare was necessary to engage and keep employees motivated as the key for sustainable growth (Jacobs 2008, p. 63).

The strength of healthcare could not be underestimated because it was proving to be an asset in other countries which motivated businesses in America to follow suit. As a matter of fact, it can be said that the need to keep happy employees originally motivated businesses to offer healthcare.

How does this choice influence healthcare in America today?

The choice that was taken by different businesses has greatly influenced healthcare in America today. Most notably, it has become a necessity for businesses to offer healthcare for employees. This is because the business world is competitive based on the fact that every organization is competing for the best employees in the market.

There is no business that can attract the best talent in the market without healthcare for employees which has changed as time goes by. This choice has influenced healthcare in America as far as spending is concerned (Jacobs 2008, p. 71). In this case, many businesses are now spending a lot of money on healthcare for employees and this has helped in improving the sector for long term sustainability.

This choice has meant that any business that wants to attract the best talent should offer healthcare for employees. In this case, the business community has ended up keeping motivated employees who have improved productivity in different ways.

Healthcare in America today has been influenced by this choice because the country ranks well when compared with other countries that offer health benefits (Jacobs 2008, p. 88). Because employees are always motivated, they have effectively contributed to the growth of small businesses.

The most outstanding aspect is the fact that many healthcare organizations have grown tremendously because of an increase in demand for healthcare services for employees (Jacobs 2008, p. 93). This is as far as growth of the healthcare industry in America is concerned.

Reference List

Jacobs, P. (2008). Wages and Benefits: A Long-Term View. Chicago: Chicago University Press.

Lane, B. (2003). The Art & Science of Pricing Small Group Medical Coverage: From Debits to Risk Factors. New York: Routledge.

Introduction

Mobile computing can be defined as the use of portable computers connected to the internet to receive and store information. According to Kumar (n.d.), mobile computing is a discipline that involves creation of information in an organization platform.

The mobile computing device helps a person to access, process and retrieve information from anywhere at any time. Such devices are connected to wireless transmission, cables, telephone wire, or any other internet connection. Whether stationed at one place or moving, the information being processed or managed is not interfered with.

According to Hagan School of Business (2005), mobile computing can be used by patients to monitor the situation of a disease they are suffering from. Mobile computing can also be used in transmission of information to nurses wherever they are stationed, for example, in hospitals.

Hagan School of Business (2005), further states that the monitoring tag which acts as transceiver stores information on medical and diagnostic updates besides receiving. This technology is capable of improving resource management and logistics via more timely and precise information. According to Shahriyar et al. (2009), the main goal of mobile computing is to provide health care services to any person at any time irrespective of the constraints of time, place, or character.

Mobile Computing in Monitoring Patient versus In-Patient Visit to Hospitals

According to the Royal Melbourne Institute of Technology (RMIT University) (2012), mobile computing gives a patient the required necessary information that could take time for nurses to explain to a patient. In this case, mobile computing devices are considered appropriate compared to a patient visiting a hospital since they (patients) can get information which the nurses might not have time to explain to them (patients) due to workload.

Comparing the use of mobile computing devices with visiting the hospitals, mobile computing can be considered efficient in terms of receiving and storage of a patient’s information compared to individuals in a hospital. However, entering information to these devices can be time consuming compared to recording the same manually.

On the other hand, since the patient records have not evolved it has become a challenge for some of the things to be done over the chosen device (RMIT University, 2012). Along this line of thought it becomes necessary for one to visit a hospital or doctors since it will be possible clarify what is not included in the monitoring devices.

With the use of mobile computing devices, patients are in a position to monitor the progress of their condition unlike when one is visiting a hospital and does not rely on mobile computing because in such a situation the only information a patient will have is what the doctor chooses to give share. Therefore mobile computing encourages self-monitoring of the patient. This assists the patient to know where to go and visit the doctor even if they were not supposed to at a particular point depending on their condition.

Advantages

According to RMIT University (2012), mobile computing devices reduce medical errors. They also increase the chances of giving a patient the appropriate prescription through the suggested drugs and frequency of taking a dosage.

This is a great move in the medical field since patients are assured to get the right drugs and the right dosage even when the clinicians are overwhelmed by work at the hospitals. Mobile computing also helps clinicians to get practical audit and analysis through the use of data from these devices to revisit clinical practical patterns (RMIT University, 2012).

Mobile computing reduces the time that nurses use for administrative work hence increasing the efficiency of attending to the patients. It is also noted that since using mobile computing is easier compared to patient queuing, it then acts as a motivation to clinicians as it creates more time for them thus reducing the possibility of being overworked.

Mobile computing in medical field reduces costs through cheap tests and drugs and less medication errors. This is so due to the easier way of getting relevant and necessary information related to the patients unlike other old machines that were traditionally used.

Disadvantages

Mobile computing reduces person-to- person interaction between a patient and a doctor. This is a disadvantage compared to visiting a doctor whereby a doctor can ask and clarify any question unlike mobile computing which is sometimes limited to the information that it provides. Failure to know the command might equally mean that no information will be received.

According to RMIT University (2012), some screens are too small to write in excel. This is a challenge since information is well and easier interpreted when it is put in excel rather than Microsoft word. It therefore becomes hard for information to be put in some devices which do not have enough screens to accommodate the required information. It is argued that mobile computing can sometimes be time consuming as one enters the required details into the devices.

Security of a Patient’s Medical Information Transmitted over Wireless Networks

According to Stanford University (2012), mobile computing devices carry huge amount of data and since they are portable it becomes difficult to keep this information secure. If these devices are stolen or get lost, whoever picks them can access a patient’s medical information. It is further argued that even if they are left somewhere else with no one observing them, intruders can access the information stored in them hence not being secure especially when they are not protected.

If the data links in the air during the wireless transmission, it can result to loss of one’s data. This is a disadvantage since one is not sure who can access the information concerning his or her health or when he or she can lose this vital device that helps in monitoring his or her health condition. It is suggested that a user of the device should be alert in the operation and also ensure that the information is protected against any other unauthorized person.

Mobile Computing and Support Groups for Patients Suffering from Similar Diseases

Gasca (2009) highlights that mobile computing gives many people an opportunity to share experiences with others in different areas. These support groups are designed to reduce stress to patients, increase communication between one patient and others who are suffering from the same disease and also with the doctor monitoring them. Support groups also help the patients to access relevant information from the support group members that can be important for their improvement.

Support groups through mobile computing create an interactive system for patients to change their behaviors and attitude towards diseases they are ailing from. Through learning how other patients are dealing with the same diseases an individual is encouraged and motivated to try the same procedures.

Conclusion

Mobile computing in the medical field has contributed to improvement in the care of patients especially for those patients suffering from chronic diseases and need to be monitored from time to time. This a great progress in the medical field, however, it is also a challenge to those who may not afford such gadgets since they cannot access such services.

Given that these devices can help individuals to monitor their health, it is possible that many people using such devices may live longer than they were to live without them. This is because they access the right information even without having to visit hospitals at the time they cannot reach there.

References

Gasca, E. (2009). Assisting Support Groups of Patients with Chronic Diseases through Persuasive Computing, Journal of Universal Computer Science, 15(16), 3081-3100.

Hagan School of Business: Mobile Computing for Hospitals: Transition Problems. (2005). Web.

Kumar, V. (n.d.). Mobile Computing. Web.

RMIT University: Mobile Computing. (2012). Web.

Shahriyar et al. (2009). Intelligent Mobile Health Monitoring System (IMHMS). Web.

Stanford University: Guidelines for Securing Mobile Computing Devices. (2012). Web.

Even though the United States spends more on healthcare than any other developed nation, the quality of health care remains low. One of the areas of concern is patient safety and the potential role of risk management. The authors of the video Surfing the Healthcare Tsunami: Bring Your Best Board suggest leadership and technology can be used to expand the current safety net and reduce the number of medical errors.

In the program, healthcare experts discuss the way medical errors contribute to lower quality of care and lead to unfavorable outcomes. One of the experts mentions that 100,000 lives are lost annually as a result of medical errors (Surfing the Healthcare Tsunami: Bring Your Best Board, 2016). At 1:30 the authors of the video compare the healthcare industry to the aircraft industry (Surfing the Healthcare Tsunami: Bring Your Best Board, 2016).

They argue that high fatality rates prompted aircraft manufacturers and policymakers to take action and improve the safety net, which made airplanes one of the safest means of transportation in existence today. The authors claim that the current situation in health care is the result of mismanagement and at 8:30 one of the experts argues that 95% of all medical errors happen at the system level (Surfing the Healthcare Tsunami: Bring Your Best Board, 2016). The experts argue that organizational factors do influence patient safety and that a change in organizational conditions can contribute to the reduction of medical errors.

The authors of the video emphasize the role of communication and information play in the context of patient safety. In particular, at 17:00 mark one of the experts mentions the lack of information about the patient as one of the reasons why medical errors occur (Surfing the Healthcare Tsunami: Bring Your Best Board, 2016). The right information at the right time can improve the decision-making process and lead to better outcomes.

At 17:30 mark in the video, the authors suggest leadership, safe practices, and technology can be used to transform healthcare (Surfing the Healthcare Tsunami: Bring Your Best Board, 2016). The experts claim that engaged leadership can help unite people and bring joy into their work. Leadership education in the context of healthcare is, therefore, important, since leaders have to possess certain knowledge and qualities to be successful. As the experts put it at 34:52, the culture where loved ones are caring for loved ones is the foundation of better-quality care (Surfing the Healthcare Tsunami: Bring Your Best Board, 2016).

Safe practices can be established through technology such as digital medical records and computerized prescription order medical systems (Surfing the Healthcare Tsunami: Bring Your Best Board, 2016). Such technology can help minimize expenditures and improve patient outcomes. Reducing duplicate tests allows reducing healthcare expenditures since they are one of the contributing factors to rising healthcare costs.

In addition, technology enables information flow between medical personnel and allows practitioners to make informed decisions about the diagnosis and treatment. Digital medical records and computerized prescription order medical systems allow different clinicians to access patient records in a timely manner and make it easier to monitor treatment progress.

Even though a lot of governmental effort is currently focused on improving the quality of care, the issue of medical errors remains underrated. It is important to consider the role of leadership, safe practices, and technology to improve current systems and minimize the number of medical errors.

References

Surfing the Healthcare Tsunami: Bring Your Best Board. (2016). Web.

The role of nurses in the modern healthcare setting is increasingly becoming critical as they find themselves in a situation where they have to be involved in decision-making processes to save lives of patients. Unlike before when nurses had to wait for directives from the doctors, nurses in the modern society are expected to have skills that can enable them to help save the life of a patient, especially in emergency cases when a medical doctor is not around. Information is critical in the work of nurses today.

To deliver quality services to their patients, they must be equipped with the right information about the patient. They should know what should be done at specific intervals (Dua, Acharya, & Dua, 2014). That is why when handing over a patient from one nurse to another, there is always a record that is often left so that the incoming nurse can know how to handle the patient. In this project, the focus will be to improve data management system and communication among the nurses at ABC Healthcare Center as a way of enhancing smooth handover of patients from one nurse to the other and reducing the workload of the nurses.

Long and Short-Range Objectives

When undertaking a project, it is important to outline the objectives to make it possible to assess whether the outcome meets the desired standards. It is important to outline both the short and long-term objectives for this project. The long-term objectives for the project are as stated below.

• To help solve the problem of understaffing of nurses without necessarily hiring new nurses at ABC Healthcare Center.
• To transform data management processes and communication among the nurses as a way of enhancing quality of service delivery.
• To empower nurses at ABC Healthcare Center by providing them with the right information and making consultation among nurses simple and efficient.

To achieve the above long-term objectives, a number of short-term goals will have to be accomplished. The following are the short-term objectives for this project.

• To phase out the current ineffective communication systems used by nurses at ABC Healthcare Center to ease their work.
• To train the nurses on how to use the new data management and communication system to enhance the quality of their work.
• To inculcate team spirit and commitment towards having a united approach of handling their duties.

Purpose

The current data management and communication system at ABC Healthcare System is partially computerized. Although there are computer systems used to record and transfer patient’s data, there are instances where nurses opt to use paper records, which they consider more efficient in their work.

The purpose of this project is to completely computerize the system at this facility and eliminate the paperwork. The project seeks to ease the work of nurses so that the burden they have can be reduced to enable them deliver quality services. The expected outcome is a platform where nurses would find it easy making electronic records of their observation and storing them in databases where other nurses and doctors can have access at any time and without strain. The new system is expected to make the process of handing over patients from one nurse to the other simple and effective.

Environmental Assessment

This project seeks to introduce a change in the manner in which data is managed and how medical staffs communicate within this hospital. It is expected that there will be both internal and external factors in the current environment that may facilitate or inhibit the change. It is important to look at these factors.

External Environmental Factors

Facilitating factors

President George W. Bush signed an Executive Order 13335 in 2004 that created ONCHIT (Office of the National Coordinator for Health Information Technology) (Tavana, Ghapanchi, & Talaei-Khoei, 2015). This was a direct commitment of the political leaders to support automation of the healthcare sector in the country. The emerging technologies have also facilitated automation of healthcare records by introducing gadgets and programs for data management and communication.

Inhibiting factors

The high cost of some of the gadgets needed for the automation process sometimes slows down the automation process as the stakeholders struggle to fund such processes. Another big inhibitor in the external environment is the hacking problem. Some hospitals are slow when it comes to automating their systems because of the fear of possible hackers that may steal important data or interfere with it in a way that may have devastating consequences.

Internal Environmental Factors

Facilitating factors

In the firm’s internal environment, the biggest facilitating factor is the commitment by the top management of the facility to embrace the emerging technologies. Employees of this firm are often taken through regular trainings, which means that they will find using the new systems easy. The institution also has regular funding from the government and other charitable institutions that it can use to support the project.

Inhibiting factors

The biggest inhibitor within the internal environment is the employees’ reluctance to embrace the emerging change. The fear of the unknown often makes employees resist change (Nelson & Staggers, 2014). The project may also be affected if the targeted health experts fail to learn how to use the new system as soon as possible. Existence of other equally important projects may strain the resources needed to fund this project. The management may opt to fund those other projects, especially if they are considered more important.

Current Workflow

Nurses at ABC Healthcare Center often find themselves under pressure and overstretched trying to meet the increasing needs of the patients. Currently, the records of the patients are taken electronically when they visit this facility. For patients in the wards, nurses often take records of their observations, using a paper and pen, before transferring their data to the system’s database after every round. They consider that process simple, but the truth is that they end up doing the same job twice. Sometimes the paper records may be dropped and lost, forcing them to go and redo the observation or make up data based on the past records.

According to Hoyt and Yoshihashi (2014), there are cases when incoming nurses find absolutely no data left by the nurses who were in the previous shift, making their work very complex. It is disastrous making up patient’s data because they may be subjected to wrong medication that may worsen their conditions. The new system seeks to eliminate such problems. Nurses will take their records electronically, and the information will be transferred to the database in real time. Accuracy of the data will be improved and the work of the nurses will be simplified.

Options for Improving the Process

The management can decide to address the current problem using two options. The first option would be to hire more nurses at this facility to ensure that the workload on the individual nurse is significantly reduced. The main benefit of this option is that patients will be given personalized attention. Nurses will feel relieved, as the number of patients they will be taking care of per a given shift will be reduced. Coordinating teamwork under such an environment will be easy because these nurses will understand their patients at a personal level. However, the cost of hiring new nurses will be high. It is more costly to hire more nurses than to embrace the emerging technologies.

The second option will be to automate the system as recommended in this project. This option emphasizes on the need to automate the entire system of data management to ease the pressure on the nurses (Braunstein, 2015). Nurses will be recording their observation electronically at the wards when observing the patients, eliminating the need to redo that work after making their rounds of observation. This method is less costly compared to the above option. It also enhances accuracy in data management. However, the initial cost of installing the required gadgets may be high.

Preferred Option and Rationale

The two options discussed above have their advantages and disadvantages. However, the preferred option is the automation of the system. The rationale of choosing this option is that it allows this facility to maximize the resources it has to deliver high quality services to the patients. Instead of spending more money by hiring new nurses, this approach makes the work of the current nurses easy, eliminating the pressure they had in meeting the expectations of the patients (Maeder & Martin-Sanchez, 2012).

The approach is also in line with the government policies that require healthcare institutions to automate their systems. When implemented appropriately, it will ensure that there is accurate recording of patients’ information and efficient storage and sharing of patients’ data by the medical staff.

Implementation Plan

Implementation of this plan is very critical in ensuring that it achieves the targeted goal. The table below is a summary of the timeline of various activities and the stakeholders responsible.

Table 1: Timeline of the scheduled activities.

As shown above, the first step will be proposal development that will be done by the project leader. Within the month of March, the proposal should be fully developed and ready for presentation before the management of this facility. The management will go through the proposal and make its approval in the month of April. The management can suggest changes, which may be necessary to make the project more efficient.

If the management makes the needed approval, the next stage will be for the project leader and project members to identify the vendors who can offer the needed system at the best price. Identifying a number of vendors may be necessary so that the most qualified vendor is selected. After identifying a number of vendors, the project leader will present the options to the management, clearly outlining the cost of their services and value offered.

The management will then select the most appropriate vendor based on the value offered. The process of identifying and selecting the most appropriate vendor is expected to last for two months, from the beginning of May to the end of June. The next phase will be the installation of the system. After making the purchase, the vendor will be expected to install the system that the nurses will use. The installation process can take about two weeks before these vendors can embark on training the staff.

As soon as the system is installed, the vendor will train the nurses, doctors, and other relevant members of the staff on how to use the system to make their work easy. These activities will take two months, from early July to end of August. By October, everything should be ready for the official commencement of the use of the new system to manage data and communicate within the firm. All the stakeholders will have their different roles in ensuring that the new system delivers the desired value.

Evaluation Methodology

As mentioned in the introduction, the current data management approach and communication among the nurses is time consuming, creating pressure among the nurses in terms of delivering their services to their clients. The current system also makes the process of handing patients from one nurse to the other at the end of the shift ineffective. Once the new system is introduced, the challenges identified should be addressed. The evaluation method should focus on how well the objectives were met when the change was introduced. When the outcomes of the project meet, the set objectives, then the identified problems will be addressed (Berkowitz & McCarthy, 2013).

One method of evaluating the outcome of the project will be to determine the ease with which nurses can record data when observing patients in the wards. The new method must make the process of recording the observation easier and less time consuming. It should eliminate cases where nurses are forced to go back to the wards and observe again because of lost or misplaced paper records. It should also eliminate instances where nurses guess patients’ data, based on previous records because of time constraint (Braunstein, 2013). The workload of individual nurses should be reduced once the system is introduced.

When conducting the evaluation of the new system, it should be determined whether communication between nurses and doctors and among nurses is improved. These are the premises upon which the evaluation will be based.

Conclusion

Data management and communication among the medical staff are critical activities in healthcare institutions. With the emerging technologies, pressure is mounting on healthcare institutions to embrace the emerging technologies as a way of reducing pressure on the medical staff and improving quality of the services offered. This project focused on eliminating paperwork completely at ABC Healthcare Center.

The project seeks to reduce the workload of nurses by improving the efficiency of their work. The project seeks to ensure that when nurses are leaving at the end of their shifts, they leave detailed and relevant information about their patients to ease the work of the incoming nurses and eliminate mistakes that are often related to miscommunication or provision of wrong data about a given patient. It is expected that this project will transform the quality of services at this institution.

References

Berkowitz, L., & McCarthy, C. (2013). Innovation with information technologies in healthcare. London, UK: Springer.

Braunstein, M. L. (2013). Health informatics in the cloud. New York, NY: Springer.

Braunstein, M. L. (2015). Practitioner’s guide to health informatics. Hoboken, NJ: Wiley & Sons Publishers.

Dua, S., Acharya, U. R., & Dua, P. (2014). Machine learning in healthcare informatics. Berlin, Germany: Springer.

Hoyt, R. E., & Yoshihashi, A. (2014). Health informatics: Practical guide for healthcare and information technology professionals. New York, NY: Cengage.

Maeder, A., & Martin-Sanchez, F. J. (2012). Health Informatics: Building a healthcare future through trusted information; selected papers from the 20th Australian National Health Informatics Conference (HIC 2012). Amsterdam, Netherlands: IOS Press Inc.

Nelson, R., & Staggers, N. (2014). Health informatics: An interprofessional approach. Hoboken, NJ: Wiley & Sons.

Tavana, M., Ghapanchi, A. H., & Talaei-Khoei, A. (2015). Healthcare informatics and analytics: Emerging issues and trends. New York, NY: Springer.

VBP Degree of Implementation

Value based purchasing (VBP) is a healthcare system that ties Medicare payment incentives to specific quality measures categorized into domains (CMS, 2016). Unlike the FFS system that focuses on quantity, the Medicare VBP plan rewards providers meeting the predefined set of measures on quality care and best clinical practices. Hospital performance is evaluated based on measures that fall into four domains: clinical process, patient experience, outcome, and efficiency. Providers are awarded achievement and improvement points for every VBP indicator using the 50^th percentile as the threshold.

My organization runs various VBP projects, mainly in the finance and clinical support departments, to align its clinical processes with the quality and patient safety goals. The initiatives entail active participation of the medical staff and partnerships with state/national institutions on quality programs. The hospital participates in the ‘Every Patient Counts’, an alliance that promotes quality care delivery and safety to all patients. The hospital has adapted the ‘improvement map’ of the Institute for Health Improvement (IHI) to align healthcare costs with quality through lean practices (Tompkins, Higgins, & Ritter, 2009). The institution has also deployed EHRs for clinical documentation to provide actionable real-time data. The rationale is to satisfy the indicators related to the clinical process and efficiency domains.

The facility has established linkages between finance department and quality care staff. Departmental restructuring saw the quality director reporting to the hospital’s chief finance officer. Other VBP initiatives involve stroke prophylaxis projects, free dental/medical clinics to reduce readmissions, and the adoption of telemedicine. These VBP initiatives support quality-finance alignment and measurable progress in the four domains.

Departments Impacting VBP

The three departments with the most impact on VBP in the hospital are clinical support (ER), nursing, and physician services departments.

Explanation of Roles and Functions

Emergency room (ER)

The ER department promotes the clinical process of care domain (preventive care) and related hospital VBP measures. My rationale for selecting the ER is that the department provides medical and surgical care to patients with a broad spectrum of complications and trauma. Thus, implementing a preventive measure to promote safety and quality in this department, minimize hospitalizations, and lower costs for CMS and the provider would lead to better clinical process outcomes (Cox & Link-Gelles, 2011).

Nursing

The nursing department promotes patient experience of care domain and related measures. My rationale for selecting the nursing department is that the patient-clinician contact hours is high for the nursing staff (RNs and nurse aides). They provide bedside care and communicate with the patient throughout the hospitalization period; thus, they influence patient satisfaction or care experience.

Physician services

The physician services department supports the outcomes domain of a VBP initiative. My rationale for choosing this department is that physician services influence key quality indicators, including hospitalizations, readmission rates, and post-discharge morbidity and mortality. For the hospital, readmission rates and mortality rates could be reduced significantly through post-discharge follow-ups, especially for patients with chronic illnesses.

Goals

ER department

• The department will formulate assessment protocol guidelines for the vaccination of influenza patients by the end of year 1.
• The ER will immunize 80% of adults and children admitted with influenza meeting the protocol guidelines by the end of year 2.

According to Cox and Link-Gelles (2011), Influenza accounts for 200,000 hospitalizations and 36,000 deaths annually in the US. Chronic episodes of the nosocomial influenza increase healthcare spending due to high length of stay. Pneumococcal vaccines, such as PPV, can reduce hospitalization rates due to related comorbidities. Therefore, a timely assessment of vaccine needs implemented through an ER policy and protocol can reduce hospitalizations and healthcare costs to meet the SMART goals indicated.

Nursing department

• The nursing department will initiate hourly bedside rounding for each shift in each unit by year 1.
• The department will require nurses to leave the shift report at the patient side by shift end by year 3.

Research indicates that systematic rounding improves patient satisfaction (Blakley, Kroth, & Gregson, 2011). Thus, in VBP, incentive payments are connected to patient satisfaction scores. Nursing responsiveness and communication with patient/family determines the rating on the patient experience of care domain.

Physician services

The department will initiate transition care guidelines to reduce 30-day mortality rate due to heart failure by 50% by end of year 1.

In the US, heart failure has a prevalence of 5.8 million and accounts for one in eight deaths nationally (Bui, Horwich, & Fonarow, 2011). The High HF morbidity is ascribed to inadequate transition to community-based care after discharge. In addition, the 30-day risk of death is related to gaps in care continuity. Thus, outcome measures for HF are a good indicator of an organization’s performance or quality of care.

Attaining Quality

ER department

Goal 1: The department will formulate assessment protocol guidelines for the vaccination of influenza patients by the end of year 1.

Goal 2: The ER will immunize 80% of adults and children admitted with influenza meeting the protocol guidelines by the end of year 2.

Nursing. Goal 1: The nursing department will initiate hourly bedside rounding for each shift in each unit by year 1.

Goal 2: The department will require nurses to leave the shift report at the patient side by shift end by year 3.

Physician services. Goal: The department will initiate transition care guidelines to reduce 30-day mortality rate due to heart failure by 50% by end of year 1.

Critical Key Points

The nurse leader should promote good patient communication practices among the nursing staff for better patient experience of care scores. According to Sullivan (2013), the nurse leader is a coach, teacher, facilitator, and motivator. The critical components to understand that are derived from this goal include:

• The significance of bedside reporting/documentation at the end of each shift.
• Effective clinical communication process and implementation plan.
• Clinical collaboration.
• Patient/family involvement in care planning.
• Impacts of patient satisfaction scores on organizational growth.
• Patient health information confidentiality/privacy.

Marketing the Key Points

The marketing of the critical components of the communication goal to the nursing staff will involve various tactics. Quarterly training programs for the nursing staff will be established to communicate clinical communication guidelines and promote buy-in. Further, an incentive program will be initiated to reward nurses who create bedside reports at the end of each shift. Another tactic will involve monthly staff meetings to sell ideas on clinical collaboration and patient confidentiality. The nurses will also share their views on the practices challenges faced.

The messages will be placed in framed posters displayed in strategic places within the facility. The posters will be placed near the reception desk. Postcards containing the messages will also be sent to all staff members via email. The information will also be shared on blogs and hospital sites that nurses can access and learn about patient/family communication. Another marketing tactic will involve sharing the components through short videos uploaded on the blogosphere. Short brochures with the information will also be distributed to the nurses.

Ethical Clinical and Ethical Business Practices

The ethical principles guiding clinical practice include beneficence, nonmaleficence, autonomy, justice, and fidelity (Goold & Lipkin, 2009). Justice in clinical practice demands that the hospital offers “minimum level of care” to all patients regardless of their socioeconomic status (Goold & Lipkin, 2009, p. 29). A just distribution of care should be integrated into the hospital’s health care plans. Further, the hospital should emphasize on autonomous choices and involvement of patients in healthcare planning. The support for the patient’s right to self-determination should be demonstrated by a full disclosure of healthcare options, sentinel events, and patient satisfaction scores.

Business practices relate to the fiduciary responsibility of hospitals. Business ethics in clinical settings should balance between returns on investment and the ethical conduct. The hospital should promote an ethical corporate culture through the establishment of a code of business conduct. In addition, the hospital should built accountability systems to instill ethical practice in line with regulatory and community expectations. Evidence-based practice is a pillar of managed care. Clinicians need to acquire skills to understand the impact of patient beliefs and values on patient experience of care (Peil, 2013). Therefore, the hospital should integrate evidence-based medicine into care management and treatment to observe the bioethical principles in managed care plans.

Coordinating Events

The events will be coordinated for the ER, nursing, and physician services departments based on the identified goals as follows:

ER

The department aims to formulate assessment protocol guidelines for the vaccination of influenza patients by the end of year 1. I would take two actions to coordinate information and educational events for year 1, namely, conducting a skills audit on influenza vaccination and involve staff in protocol development and organizing educational meetings aimed at policy development. Staff education/training will involve multiple channels, e.g., video demos and pamphlets, to build capacity.

By the end of year 2, the vaccine will be administered to 80% of patients diagnosed with influenza based on the guidelines. In this respect, I would release quarterly reports with immunization statistics. In addition, I would engage experienced staff to train others on this protocol.

By the end of year 3, the ER will assess, screen, and vaccinate all admitted patients in line with the protocol guidelines. My actions in this period will involve sharing monthly statistics and ratings based on hospital compare data to promote compliance.

Nursing

The goal of nursing is to initiate hourly bedside rounding for each shift in each unit by end of year 1. First, I would involve the nursing staff in creating the hourly rounding guide for RNs/LPNs through workshops. Other activities will involve educating the nurses on how to complete the rounding log through video demos and brochures.

By the end of year 2, the shift report for 80% of patients in Medical Surgical areas will be placed at the bedside. I will continue with staff training on round log completion and introduce incentives, e.g., recognition awards, for complying staff.

By the end of year 3, the shift report for all patients will be placed at the bedside. My action during this period is to survey patient/nursing satisfaction to reinforce or change the guide.

Physician services

The goal is to reduce 30-day mortality rate due to heart failure by 50% by end of year 1 through effective transition care. My actions in year will involve developing and implementing a physician-community transition/follow-up policy. Roussel (2015) states that improvement in healthcare quality and safety requires a framework for predicting and managing healthcare risk. Physician training on this policy will involve formal training on risk identification and management.

By end of year 2, the 30-day mortality rate will be reduced by 70% through a physician follow-up framework. I will document community visits by physicians and coordinate transition to outpatient care based on availability.

By end of year 3, the 30-day mortality rate will be reduced by 90%. Again, my activities will involve coordinating post-discharge follow-ups and home visits by physicians to promote patient outcomes.

Timeline

Executive Summary

The hospital actively participates in CMS reimbursement through the adoption of VBP in its clinical processes. The components of VBP that are most pertinent to the hospital include nursing staff communication to improve HCAHP scores, reduction of 30-day HF mortality rates, and quality-driven care (Rodak, 2013).

The ER department serves as the first point of contact with the patient. Therefore, patient experience of the hospital’s care begins at the ER department. ER is an important department preventive medicine through outreach programs that enhance community health outcomes. The department should lead vaccination campaigns because it admits patients with varied medical illnesses that require emergent care.

Preventive initiatives at the ER can significantly reduce morbidity and mortality rates. The hospital launched an interdisciplinary program that brings together physicians and nursing staff to manage patients presenting with HF symptoms. Thus, clinical initiative would reduce mortality and improve the quality of life of HF patients. All levels of hospital administration will participate in the preparation of the nursing department for the implementation. The leadership involvement will be based on the concepts of participatory leadership style. The staff will be involved in developing effective nurse-driven communication strategies and tactics. The department will also strive to promote nurse-patient communication through greater bedside care and rounding to impact on satisfaction and quality of care offered. As a result, the overall outcomes and the patient experience will improve, leading to better HCAHP scores.

In order to be successful, education, training, and reinforcement of best practices is foundational. The staff will engage in online web activities (training packets), monthly meetings providing information, support and data evaluation. The nursing units will engage in mock communication sessions that will help them engage even with the most difficult of patients, as well as HIPAA training. Using multiple learning methodologies will have a greater impact on staff to use the training and education most effective.

With regard to the physician services department, the hospital’s physician champion will spearhead the physician services initiatives. A multidisciplinary approach will be adopted to manage the change and promote implementation. The initiatives will bring together nursing educators, clinical nurse specialists, case managers, and other professionals. Using specialists as consultants, this team will create efficient order sets for the HF clinical pathway in an effort to improve patient outcomes thus reducing mortality and the sequalae related to chronic morbidities. Educational updates will continually be provided to staff at the Hospital as well as physicians receiving privileges to treat their patients here. Marketing to the community regarding the importance of this will also be included in the training for all staff.

References

Blakley, D., Kroth, M. & Gregson, J. (2011). The impact of nurse rounding on patient satisfaction in a medical-surgical hospital unit. Medical surgical Nursing, 20(6), 327–332.

Bui, A., Horwich, T., & Fonarow, G. (2011). Epidemiology and risk profile of heart failure. National Review of Cardiology, 8(1), 30-41.

Centers for Medicare & Medicaid Services [CMS]. (2016). Hospital Value-Based Purchasing. Web.

Cox, C., & Link-Gelles, R. (2011). Manual for the surveillance of vaccine-preventable diseases. Web.

Goold, S., & Lipkin, M. (2009). The doctor–patient relationship: challenges, opportunities, and strategies. Journal of General Internal Medicine, 14(1), 26–33.

Peil, E. (2013). Evidence-based medicine and values-based medicine: partners in clinical education as well as in clinical practice. BMC Medicine, 7(1), 65-72.

Rodak, S. (2013). 4 components of an OR optimized for value-based purchasing. Web.

Roussel, L. (2015). Management and leadership for nurse administrators. Burlington Jones and Bartlett Learning.

Sullivan, E. (2013). Effective leadership and management in nursing. New York: Prentice Hall.

Tompkins, C., Higgins, A., & Ritter, A. (2009). Measuring outcomes and efficiency in Medicare value-based purchasing. Health Affairs, 28(22), 251–261.