Value-Based Programs in Healthcare, Exams of Nursing

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NUR-514 Topic i1 iDQ i1 Value-based iprograms ireward ihealth icare iproviders iwith iincentive ipayments ifor ithe iquality iof icare ithey igive ito ipeople iwith iMedicare. iThese iprograms iare ipart iof ia ilarger iquality istrategy ito ireform ihow ihealth icare iis idelivered iand ipaid ifor. iValue-based iprograms ialso isupport iour ithree- ipart iaim iof ibetter icare ifor iindividuals, ibetter ihealth ifor ipopulations iand ilower icost i(Centers ifor iMedicaid iand iMedicare iServices). iThese imodels iimpact ilots iof iroles iand iresponsibilities ito ithe iadvance iregistered inurse iby iway iof ishowing, ihelp iof iexperienced inurse ileadership, iredefined ithe istructure iof ia ipatient’s iprimary icare iteam, idynamically iidentifying ithe icare iteam imember ineeded ifor iany igiven ivisit. iFor iexample, ia ipatient imay ineed ito isee ionly ithe inurse iand inurse iassistant ifor ione ischeduled ivisit ibut ion ianother ivisit ineeds ito ibe iexamined iby ithe iphysician iand iprovided itraining iby ithe inurse. i("Value-based icare," i2017). iThis itype iof ihealth icare iwill ihopefully ibring idown ithe istaggering icost iof icurrent ihealth icare iand iimprove ihow ihealth icare iis idelivered. With ithis inew imodel iintergrading iits iway iinto iour icurrent ihealthcare isystems iI ican isee ithe iadvancement iof itelehealth iexpanding. iTelehealth iwas imaking iits iway islowly iinto ihealth icare ibut, iafter iCOVID-19 ihit iAmerica iand iother icountries iaround ithe iworld ithe iuse iexploded ilike inothing iever iscene ibefore. i What iwill ivalue ibased ihealth icare imean ito ime iand ithe iprofession iof inursing iin ithe ifuture? iWell, iI isee inurses itaking ion ia imuch ilarger irole ithan iwhat ithey iare itaking ion iright inow. i I ialso isee inurses ineeding imore iadvanced idegrees ias ithis ibegins ito irole iout. Furthermore, iI isee imore ibusiness iopportunities ifor inurses iin ithe ifuture ias ithey ilook ifor iways ito iexpand itheir icontributions ito icommunities. References Centers ifor iMedicaid iand iMedicare iServices. ihttps://www.cms.gov/Medicare/Quality- Initiatives- iPatient-Assessment-Instruments/Value-Based-Programs/Value-Based- Programs Value-based icare ielevates ithe irole iof ithe iregistered inurse iin iprimary icare. i(2017, iMay i26). ihfma. ihttps://www.hfma.org/topics/blog/54348.html Topic i1 iDQ i2 When iit icomes ito ihealthcare iin itoday’s itimes, iinterprofessional icollaboration iis ivital ifor iholistic icare. iDeveloping istrong iinterprofessional irelationships iincrease icollaboration iand ibenefit ipatient ioutcomes iby iseeing ithe ipatient iin imore ithan ione idisciplinary iaspect. iWhen iI ithink iof inursing, irespiratory itherapy, iphysical itherapy iand ioccupational itherapy ias iseparate idisciplines ithey iare ionly iseeing ia ione-dimensional ipatient. iNow itake iall iof ithese idisciplines iand ihave ithem iwork iin ione icohesive iunit iand ithe ipatient inow ibecomes ithree idimensional iwith ieach idiscipline iseeing iwhat ithe iother iis ilooking iseeing. i The ipatient ireceives iexceptional icare iwhen ithey ican icollaborate iamongst ieach iother iand ihave ia ibetter iunderstanding iof ithe ioutcomes ithat ieach idiscipline iis itrying ito iachieve. i This iforms ithe iInterprofessional iEducation iCollaborative ior iIPEC. iThe iInterprofessional iEducation iCollaborative i(IPEC) icompetencies iconsist iof ifour icompetencies ithat ican ibe iused ito iincrease ithe iquality iof ipatient icare iand ihave ian ioverall ibetter ioutcome. iCompetency ione iincludes iworking iwith ipeople ifrom idifferent iprofessions iwhile imaintaining imutual irespect. iThese iprofessions icould ibe ithose istated iabove isuch ias irespiratory itherapy, ioccupational iand iphysical itherapy iand iothers. iCompetency itwo iencourages iusing ione’s iown iknowledge iand ithe iknowledge ifrom iothers ito iaddress ithe ineeds iof ithe ipatient. iCompetency ithree iencourages iresponsive icommunication ibetween ithe ipatient, ithe icommunity, itheir ifamily iand ipeople ifrom iother ihealth iprofessions ito itreat iand iprevent idisease iin ithe ipatient iin ia iteam iapproach. iWhen iIPEC iis inot iused ithe icommunication ithe ipatient, ifamily iand iother ihealth iprofessionals ineed ito ibe isuccessful iis ino ilonger ithere. iCompetency ifour iencourages ieveryone ito iwork itogether ias ia iteam ito itake icare iof ithe ipatient i(Interprofessional iEducation iCollaborative, i2016). i In isome iaspects iwe ias inurses ialready icollaborate iwith iother inurses iin ia ihospital. i If iI ihave ia ipatient iin ithe iICU ithat ihas icancer iand iis ireceiving ia ichemotherapy imedication ian ioncology inurse iwill icome idown iand iadminister ithe imedication iand igo iover iwith ithe idoctor ibarriers ithat imay iprevent ia ifaster irecovery. References Interprofessional iEducation iCollaborative. i(2016). iCore icompetencies ifor iinterprofessional icollaborative ipractice: i2016 iupdate. iWashington, iDC: iInterprofessional iEducation iCollaborative. Topic i2 iDQ i1 When iit icomes ito ileaders iand imanagers imany itend ito ithink ithey iare ione iin ithe isame ibut ithey iare inot. iWhile ithey ido ihave isome icommon igoals iwithin ithe iorganization isuch ias imaking isure iit iis isuccessful, iefficient iand ioptimal ithey ijust ihave idifferent iways ito iof iachieving iit. i A inurse imanager ispecializes iin ithe ifield iof inursing iand ihas ian iunderstanding iof iall ithe ifacets iof inursing. iThis iunderstanding ihelps ithe inurse imanager ifocus ion idaily ioperations iand isupervising ithe istaff ion ithe iunit. iA inurse imanager imay ihave iroles iand iresponsibilities ithat idiffer ifrom ithat iof ia ileader. iA inurse imanager iis iresponsible ifor ioverseeing ithe iday-to-day ioperations iin ithe ihealthcare isetting, isupervising iand iproviding itraining ito iteam imembers, ihandling iescalating isituations ibetween ipatients iand ihealthcare iproviders, ihiring iand ievaluating inursing istaff iand icollaborating iwith iother imanagers ito iachieve ioptimal ipatient ioutcomes ijust ito iname ia ifew. iA inurse ileader ion ithe iother ihand ioversees ia iteam iof inurses, imaking idecisions iand idirecting ipatient icare iinitiatives. i They ihave iadvanced iclinical iknowledge iand iare ifocused ion iimproving ipatient ihealth ioutcomes. iA inurse ileader ifinds iways ito iinspire iand imotivate ithe iteam ihe ior ishe iis iworking iwith iby iselecting ithe ileadership istyle ithat isuits ithe iteam ibeing ilead. iThe ileaders iconcern iis idriving ithe iteam iwith iforward imomentum iwhile ithe imanager ikeeps ithe iteam ion itrack. Advanced ipractice inurses imust ibe igood iat iboth ileading iand imanaging. iAn iadvanced ipractice inurse imust inot ionly ilead ia iteam iof inurses ibut ialso ilead ithe ipatients ithey isee ito isuccessful ioutcomes. iAdvance ipractice inurses ilead iand imanage iby idoing ithe ifollowing; istaying iup ito idate ion ithe ilatest ihealthcare iresearch, iworking ito ishorten ithe iaverage ilength iof ipatient ihospital istays iand ireduce ireadmission irates, iaiming ito ireduce ihealthcare icosts iby iimproving iefficiency, ideveloping itreatment iplans ito iimprove icare iand ipatient ioutcomes iand iprovide icare idirectly ito ipatients. i A inurse iis ialways ileading iand imanaging iwhile iat iwork iwhether ithey irealize iit ior inot, iit imay ijust ibe ion ia ivery ismall iscale ias iopposed ito ithinking iabout ithe ientire iorganizations. References: The iUniversity iof iSt. iAugustine ifor iHealth iand iSciences i(n.d) iA iBreakdown iof iNursing iLeadership i& iManagement iRoles, iRetrieved iJanuary i7, i2021 ifrom: iA iBreakdown iof iNursing iLeadership i& iManagement iRoles i| iUSAHS i| iUniversity iof iSt. iAugustine ifor iHealth iSciences Selina, It isounds ilike iyou idid ian iamazing ijob imanaging iand ileading ithose ipeople iduring ithat idifficult itime. iSometimes ithe ibest imanagers iare ithe iones ithat iare ijust ithrust iinto ithe iposition. iBeing ia inurse ileader irequires iyou ito ihave iextensive iknowledge ion ipolicies iand ithe iway iin iwhich iyou ipractice iat iyour iorganization. i All iother inurses iare igoing ito icome ito iyou iwith iall idifferent itypes iof inursing iquestions, iits iparamount ithat iyou ias ithe inurse ileader ieither ihave ithe ianswer ior ia iway ito iget ithe icorrect ianswer. iYour iteam irelies ion iyou iand iexpects iyou ito ihave ithe ianswers ito iall ithe iquestions, iwithout ithe icorrect ianswers iyour iteam iwill ibegin ito ilose ifaith iin iyour iability ito ilead ithem. i I ionce ihad ia inurse imanager ithat inever iwas iaround iwhen iyou ineeded iher iand iwhen ishe iwas iaround, ishe inever ihad ithe ianswers ito iany iof ithe iquestions ithat iwhere iasked. i The istaff ion ithe iunit ibegan igoing ito ithe idirector iwith itheir iquestions. iAfter imonths ihad ipassed ithe idirector iwas itired iof ithe istaff igoing ito iher iwith ieverything iand iskipping iover ithe imanager. iThe imanager iwas ilater ilet igo iand ia inew imanager iwas ibrought iin. iThis ijust isolidifies ithe ifact ithat ia inurse ileader ineeds ito ieither ihave ior iobtain ithe ianswers ior ithe iteam iloses ifaith iin ithe iability ito ilead iand imanage. Topic i2 iDQ i2 The ivocation iof ithe inurse iis isimilar ito ithat iof ia iservant ileader ibecause ithe inurse iembraces ithe isame ifundamentals ias ia iservant ileader. iThe iservant ileader ileads iby iplacing ieveryone’s ineeds iabove ihis ior iher iown. iFurthermore, ithe iservant ileader iensures ithat iall iof ithe iteam ihas iwhat ithey ineed ito ibe isuccessful iand ireach ithe iend igoal. iThe ivocation iof ithe inurse iis iidentical ito ithat iof ia iservant ileader iin ithat ithe inurse iputs ithe ipatients’ ineeds iwell iabove itheir iown. iAn iexample iof ithis iby ithe iservant ileader iwould ibe inot itaking ia ilunch ibreak ito iensure iall ithe iother istaff ihas ihad itheirs ifirst, ipassing imedication ion ia istaff imembers ipatient ibefore ipassing ia imed ion iyour iown iand/or ibeing ithe ilast iperson ioff ithe ifloor iwhen ithe iend iof ithe ishift iroles iaround ibecause iyou istay iand ihelp iif isomeone ihad ia icomplicated inight. i I itruly ibelieve ithat iin iorder ito ibe ia igreat inurse iyou imust ibe ia iservant ileader iin iyour iheart. iNursing iis iall iabout iputting ithe ineeds iof ithe iperson iyou iare icaring ifor iwell iabove iyour iown. iThere iis ian iexample iI ilike ito iuse iand ithat iis iwhen inatural idisasters istrike ia itrue iservant ileader/nurse istays iwith ithe istaff ior iwith ithe ipatients ithey iare icaring ifor. iHurricanes istrike ithe isouth ifrom iTexas iall ithe iway iaround ito iNew iYork, itrue iservant ileaders iand inurses istayed iwhile ithe istorm iraged ion ito icare ifor ithe ipatients iwith iwhat ilittle iresources ithey ihad. iBeing ia iservant ileader iis isomething iI ibelieve iyou iare itaught iat ia ivery iyoung iage ifrom ithe imother. i The imother iis igenerally ithe iparent ithat iputs iher ineeds isecond ito ithat iof iher ichild’s. References: Mind iTools. i(n.d.). iServant ileadership: iPutting iyour iteam first. ihttps://www.mindtools.com/pages/articles/servant-leadership.htm. Amy, It iis ia itrue itestament ito ibeing ia igreat ileader iwhen iyou iare iplaced iin ia isituation iwith itremendous iamounts iof istress. i When iyou istated iyou irecently ihad ia ipatient iwho ihad ia icarotid iendarterectomy iperformed iand iwas iin ithe iCCU ifor ithe inight. iThe inext iday ithe ipatient ihad icoughed ihard ienough ito icause iinternal ibleeding ifrom ithe isight. iAs ithe iprimary inurse ikept ithe isurgeon iinformed iand ikept ia iwatchful ieye ion ithe ipatient’s iever-increasing ineck isize, ithe iCRNA iwas icalled ito ievaluate ithe iairway. iThe iprimary inurse iwas iunderstandably, iunder istress, iand ipanicky. iHowever, ithe iCRNA itook iimmediate icontrol iof ithe isituation iin ia icalm iand idirect iway, iwhich ithen iallowed ithe inurse ito isettle iin iand ihelp. iThis iis ia iprime iexample iof iwhat ia itrue ileader ican ido iin ia istressful ienvironment. iNot iall ipeople iput iin ileadership ior imanagement ipositions ican ipreform iunder istress imaking ithe isituation imore ichaotic ifor iall ithose ithat iare iinvolved. Edyta, After ireading iyour ipost iI icould inot ihelp ibut ithink iof ihow iaccurate iyour istatements iwhere. iWhen iyou istated ithat ithe imain igoal iof ia isuccessful iservant ileadership iis ito iserve. iThe iright iquality ito ibe ia iservant ileader iis ito iempower iothers. iA iservant inursing ileader ilooks iat ithe istaff’s ineeds/issues iand icontinuously iinvolves istaff iin iresolving iand isolving iproblems iin iorder ito ipromote itheir ipersonal igrowth. iServing imeans icaring iand itaking icare iof iothers. iNursing iprofession iis ithe iheart iof ithe iAmerican iHealthcare isystem iwhere iwe iserve iothers iwith iall iof iour ihearts iand icompassion. iServant ileaders iget imore idone iwhen ileading iin ithis istyle ithan iany iother iway iof ileading iand ithat ihas ibeen iproven iin iall idifferent itypes iof ireadings. i I ireally ienjoyed ireading iyour ipost iand iinspired iby ithe iextra iwork iyou iput iin ito ikeep ithe ipatients iand ithe istaff ihappy iand iworking itogether. Ruth, I ireally ienjoyed ireading iyour ipost ibecause iI ifeel iI icould ireally irelate ito ieverything ithat iyou iwrote iabout. iI iwas ireally idrawn ito iwhat iyou iwrote iwhen iyou istated ithat iA itrue ileader iis inot iselfish, ihe/she iwill ihelp iyou ieven iif iin iturn iit imight inot ibenefit ihim/her. i Such ileaders isee ithe igreater igood iin ieverything, ithey iare inot iselfish. iThe ivocation iof ia inurse iis isimilar ito ithe igoals iof ia iservant ileader. iIn ia ilot iof isense. iA inurse iis ithe ibridge ibetween ifamily imembers iand iother idisciplines, ia inurse iis ian iadvocate. iI itruly ibelieve ithat iall inurses iand inot ijust ileaders ineed ito ipossess ithese igreat itraits. iA ileader ithat iis iselfish iand idoes inot iunderstand ithe imeaning iof ihow ipeople iare ifeeling iat iany igiven imoment ishould ireally inot ibe iin ia ileadership iposition. iall itogether. iThis itactic ionly ilead ito imore isignificant iproblems. Vinita, I iread iyour ipost iand iI imust isay igoing ithrough ia ichange ilike ithat iis ipretty ijuristic. iThat iwas ithe itype iof ichange ithat irequired ithe inurse ito idive iright iinto. iThere iare itimes iwhen iindividual ico- iworkers igrumble iabout ithe ichange icoming ior ithe ichange ithat ijust itook iplace ibut iit iappears ithis ihappens ibecause ithey ihave izero iknowledge ibase iof ithe ichange iitself. iI ihave iseen iso imany itimes inurses ithat icomplain iabout ia ichange itaking iaffect iand iwithin ia imonth ior itwo iafter ithe ichange iare ihappy iwith ihow ieverything ifell iinto iplace. iYour ilittle isummary iof ichange isaid iit ibest iwhen iyou istated, ichange iis ithe iprocess iof ialtering iand ireplacing iprior iand iexisting iknowledge, iskills, iattitudes iand iprocedures iwith inew iones. iIn iyou iinstance ithe ichange iwas itwice ias ihard ibecause inot ionly idid iyou ideal iwith ithe istressors iof ilearning ia inew icomputer isystem ibut, iyou ihad ito icontend iwith iCOVID-19 iand iensuring ithat iyou iand ithe irest iof iyour iteam iare inot icutting icorners. iI ireally ienjoyed ireading iyour ipost, iyou ihave isome igreat iideas iand iI ilove iwhen inurses ishare itheir iexperiences iso iothers imay ilearn. Topic i4 iDQ i1 When iit icomes ito inursing ithere iwas, iis iand ialways iwill ibe ibarriers ito ibeing iinvolved iwith ithe ilegislative iprocess. iThere iare iseveral ireasons ifor ithis, ione iis ithe ifact ithat iwe iall ihave ipersonal iopinions. i These iopinions ishared iinside iand ioutside ithe iorganization. i Outside ithe iorganization iis iwhere ithe iproblems ican icome iinto iplay. iIf iI iam ipart iof ia inursing iorganization iand iexpress imy ithoughts iand ifeelings iabout ia icertain iissue ithat iorganization ican ichoose ito ieither iescalate ithe iissue ior iessentially ikill iit ion ithe ispot iall iin ipart ibecause ithey ido inot ibelieve ior isupport imy iissue. iThis ican ibe ivery idiscouraging ito inurses ibecause iit ifeels ias ithough iyour iviewpoints iare imeaningless. iI iwould iencourage ievery inurse ithat iruns iinto ithis ibarrier inot ito igive iup. iAnother iexample iis inursing iunions. iI iam inot ifor iunion inursing ior iany itype iof iunion ifor ithat imatter ibut ithey iare isuccessful ifor ionly ione ireason iand ithat iis inumbers. iIf ia iworkplace idecides inot ito iaccommodate ithe iunion’s idemands ithey iwalk iout iand istrike, inow iyou ihave ia ilarge ivolume iof iworkers ino ilonger iworking iwhich imeans ino imore irevenue. iThe iworkplace ialmost ihas ino ichoice ibut ito ifold iand igive iin. iA iunion ican ibe idetrimental ito ian iorganization iwith ilarge inumbers iof iemployees. iNurses imust ialso iremember ithat ithe imedia iis ialso ia ibusiness ithat iworks itoward iratings iand irevenue iso iif iyou ithink iexpressing iyour iviews ito ithem iwould ibe ibeneficial ithink iagain. References: Leadership iin iNursing iPractice: iChanging ithe iLandscape iof iHealth iCare. iRetrieved iFrom: ihttps://www.gcumedia.com/digital-resources/jones-and- bartlett/2018/leadership-in-nursing- ipractice_changing-the-landscape-of- healthcare_3e.php Advanced iPractice iNursing: iEssential iKnowledge ifor ithe iProfession. iRetrieved ifrom: ihttps://www.gcumedia.com/digital-resources/jones-and- bartlett/2016/advanced-practice- inursing_essential-knowledge-for-the- profession_3e.php Edyta, I ireally ienjoyed ireading iyour ipost ibecause iyou iare iabsolutely icorrect iin istating ihow iwe ias inurses irun iinto ibarriers ion ia idaily ibasis. iYou istated ithere iare imany ibarriers ithat iwe ias inurses iare ifacing idaily, iespecially iprofessional ibarriers. iProfessional ibarriers iand ifacility’s ipolicies imake iit ivery idifficult ifor inurses ito iadvocate iand ispeak iup ifor itheir ipatients. iVery ioften iwe imust iovercome ibarriers ito ibeing ian ieffective iadvocate. iYou ifurther istated ithat ias ia ihead inurse iyour imain ifrustration iwas iwith ithe imanagement iand ilack iof istaff i(current inursing ishortage), iunrealistic iexpectations, icollective ibargaining, iand ithe ilack iof iempathy/understanding itowards imy istaff. There iare itimes iwhen iwe iadvocate ifor ithe ipeople iunder ius ibut ifeel ilike iwe iget iknow iwhere. i To ime ithat iis ione iof ithe ihardest ithings, ithat ifeeling ithat iknow ione iis ilistening iin imanagement. iI ireally ifelt ia iconnection iwhen ireading iyour ipost. Topic iDQ i2 After ireading ichapter i14 iin ithe itextbook iand iconducting ia ismall iamount iof iresearch iI ifind iit ihard ifor ime iexcept ithat igender iinequality iis ithe inursing iprofession's ilack iof irepresentation iin ihealth icare ipolicymaking, ieven ithough inurses icurrently irepresent ithe ilargest iprofession iwithin ithe ihealth icare iindustry. i I itruly ido inot isee igender iplaying ia ilarge irole iin ithe ilack iof irepresentation. iIn ithe ipast i100 iyears ithe irights iof iwomen ihave iadvanced itremendously igiving ithem ia imuch ilarger ipositions iand iresponsibilities. iFurthermore, iif iwoman imake iup iroughly i90% iof inurses iin ithe ifield itoday ithat iwould ialso iput ithem iin ia imajority iof ileadership iroles iall ithroughout inursing. iWeberg iet. iAl i(2019) istates ithat inursing iis ithe ilargest ihealth iprofession iin ithe icountry iand iyet inursing iis inot ia ikey iplayer iin idecision imaking. iTo ichange ithis imentality, iwe imust igive ius ia inew ilook, iwhen iit icomes ito ihealthcare ipeople isee ia inurse ias ia ihealthcare iworker iwho ifollows ithe iorders iof ithe idoctor. iI ialso ithink ithat iwith ithe ishortage iof inurses iit ican imake ithings idifficult iwhen ilooking ifor irepresentatives iin ithe ifield. iWith inurses iworking ijust ito icover itheir ishifts ion itheir iunit ithey iwould ialso ihave ito ithen ivolunteer itime ioutside iwork. iI iwould ilove ito isee imore irepresentation iin igovernment iwhen iit icomes ito ithe ifield iof inursing. References: Weberg, iD., iMangold, iK., iPort-O’Grady, iT., iMalloch. iK. i(2019). iLeadership i n iNursing iPractice: iChanging ithe iLandscape iof iHealth iCare. i(3rd ied.) iJones iand iBartlett iLearning. Topic i5 iDQ i1 Before istarting ithis idiscussion iquestion, iI ibegan ireading iabout idifferent iorganizations iand itheir iinnovations iand iit igot ime ito ithink iwhat iwas ibest ifor ithe ipatient. i Is ian iorganization iwith ione igreat iinnovation ibetter ithan ian iorganization iwith imultiple ismaller iinnovation? i To ime ithe ianswer ilies iwith ithe isatisfaction iof ithe ipatient. i I iwas inot idrawn ito iany iof ithe iorganizations iwith ione ilarge iinnovation ionly ibecause iit iseems ias ithough iit istopped iwith ithat iparticular iinnovation ito ibuild iupon iit. iOrganizations iwith iseveral ismaller iinnovations iseemed ito ifoster iand isupport ian ienvironment iof iexcepting igreat inew iideas ifrom iall istaff iand iwhile ibuilding iup ia ismaller iinnovation ithey ibegan iworking ion ithe inext igreat iidea. iHospital iCorporations iof iAmerica i(HCA) ireally istood iout ito ime ias ia ileader iin iinnovation. iThe imindset ithat idrives iinnovations ireflects iour icore imission, isays iDr. iMichael iSchlosser, iNational iGroup ichief imedical iofficer iand ivice ipresident iof iclinical iexcellence iand isurgical iservices. i“As ia ilearning ihealth isystem, iwe iuse iour idata ito iconduct iresearch iand icreate iinnovative itools ithat iimprove ipatient ioutcomes.” When iwe ithink iabout ior ieven ihear ithe iwords iCOVID-19 iit itakes ius ito ia iplace iwhere inegatives ithoughts iare icultivated ibut, irarely ido iwe itake iinto iaccount iall ithe iinnovations ithat ihave icome iin ithe iwake iof iCOVID-19. iHospital iCorporations iof iAmerica i(HCA) ione iof ithe ilargest iemployers iof ihealthcare iprofessionals iin ithe iUnited iStates iwith iapproximately i280,000 idedicated icolleagues, iHCA’s icollective iknow-how ihas ifueled ia inumber iof iinnovations ithat ibenefit ipatients iand icaregivers. iWith ithe iworst ipandemic iin iover i100 iyears iHCA ihas iused ithis ito iaccelerate iforward iin inew idirections. iOne iinnovation ito icome iout iof ithis ipandemic iwas ithe iidea ito iuse iPre- i ntubation iand iintubation itents. iTo ilimit ipotential iexposure iduring iairway imanipulation, ianesthesia iproviders ihave ideveloped iseveral idevices ito ireduce iaerosolization. iOne iis ian iintubation ibox icreated iby ithe istaff iat iTriStar iCentennial iMedical iCenter iin iNashville, iTenn. Another iand iprobably ithe ibiggest iinnovation iis ithe iuse iof iTelehealth ior iTelemedicine. iWhile iHCA iwas inot ithe ioriginator iof ithis iidea, ithey idid ipropel iits iuse iduring ithis ipandemic. iPPE isanitation iduring ithis ipandemic iwas itop ipriority iwith ithe ishortages iall iover ithe iworld. iOne isolution iwas ireprocessing ithe imasks ito iallow imultiple iuses ithrough ithe iuse iof ia ipilot iprogram iusing iultraviolet igermicidal iirradiation ior iUVGI. i All iof ithese igreat iinnovations ihave ione ithing iin icommon iand ithat iis itheir iroot. iThe iroot ito ithese iinnovations iis ithe ipatients iand ithe icare ithey ireceive. iHCA ihad ibeen ian iinnovative ileader iin ithe iworld iof ihealthcare iand iI idon’t isee ithis ichanging ianytime isoon. i With ithe ivision iof ibeing i“World iClass” ithey iare iwell ion itheir iway. References: HCA iHealthcare iMagazine, iEmphasis ion iInnovation i(2020) iRetrieved ifrom: ihttps://magazine.hcahealthcare.com/care/in-our-hospitals/emphasis- on-innovation/ Topic i5 iDQ i2 ACO’s iare iseveral idifferent igroups ithat iconsist iof idifferent ihealth icare iproviders, idoctors, iand ihospitals. iACOs ihave ithe ipotential ito itransform ihow icare iis idelivered iand ipaid ifor iso ithat ipatients ireceive ihigher iquality, ipatient-centered, itimely, iand iwell- coordinated icare. iMedicare ibeneficiaries iby icoordinating icare iand iillness imanagement iand ilowers icosts. iACO’s igoals iare: idelivering ihigh iquality icare iand ilowering idirect iand iindirect icosts. iThe iAccountable iCare iOrganizations ideliver ihigh iquality icare ito iMedicare iclient i(CMS.2015). iThis itype iof icare iis idelivered ito imillions iof iAmericans ithrough imultiple ihealthcare iorganizations iin ithe iUnited iStates idue ito ithe iadaption iby iMedicare. iWith ithe imove itoward ivalue-based icare, iit ipromotes ia imore ipreventative icare iand ilowers ihospital istays, ireadmissions, iand iER ivisits. iThis itype iof icare ialso ipromotes ia idifferent itype iof ipayment iplan, ithis iplan iis iknown ias iadapt irisk-based ipayment icontracts, ithis igrants imore iresponsibility iand ifinancial iincentives ifor idoctors ithat iare icaring ifor ithese ipatients. iImplementing ia icomprehensive ipayment ireform iand ihealth icare iplan isystem iwill ihave iAOC’s icontinually ilooking ito iinvest iin inew ialternative ipayment iarrangements iand imove iaway ifrom itraditional ifee-for-service ireimbursement. i In ithe iend ithis iwill ihelp idrive idown icurrent icosts iin ihealthcare igain ia ibetter ivalue ifor ithe ihealthcare ithey iare ireceiving. References: Accountable iCare iOrganizations i(ACOs), iby iDewey, ifrom iSalem iPress iEncyclopedia iof iHealth i(2016).https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx? i direct=true&db=ers&AN=113931243&site=eds-live&scope=site Edyta, After ireading iyour ipost iI imust isay iyou ihave isome ireally igood iinformation iand iinsight ion iinnovative icare. iWhen iyou istated ihow iinnovative icare iis ibeneficial ifor ithe ipatients iin iorder ito ipromote iand isupport ipatient’s iwell-being. i The iopportunity ito iincorporate inew iand icost-effective ilevel iof icare idelivery imodel iis icontinuously ievolving. iInnovative imodel iof icare iis ian ialternative ito iprovision iof icare iin iacute iand isubacute ihealth icare ifacilities. iThe itrend ihas ichanged ifrom iusing ihome ihealth icare iafter ihospitalization ito iusing iit ito iavoid ihospitalization. iAs ia iresult, ithe imain igoal iof ithe iinnovative imodel iof icare iwith ithe isupport iof ithe iinterprofessional icollaboration i s: ienhanced icare, iimprove iclinical ioutcomes, iand ireduced icost. iUnique iapproach iand iinnovative imodels iof icare ishould ibe iimplemented iin iclient’s icare iplan iand ishould iinclude ia ivariety iof iinnovative istrategies ito imanage ihigh irisk iclients, ibundled ipayments, icare itransition, iand icare imanagement iat ihome. iThis itype iof icare ifocusing ion ithe ipatient iwill ibring idown icosts iand itruly ifocus ion ithe ireal ioutcomes. iYou iseemed ito ihave ia igood iamount iof iknowledge iwhen iit icomes ito i nnovative icare. Talin, I ireally ienjoyed ireading iyour ipost ibecause iwe iare iexperiencing ithe isame iat iour ihospital. iWhen iyou istated ithat iyour iplan ididn’t ireally ihave iname ibut iwe ilike ito icall iit i"30 iminutes ior iless". iFor ithose ipatients iadmitted iin ithe iemergency iroom iIt iused ito itake ihours isometimes idays ito ihave ia ibed iupstairs. iThis idelay iof icare icauses imany iproblems iincluding ia igreat ideal iof istress ifor iour ipatients, iand ithe ibacklog iin ithe iwaiting iroom. iThis ibacklog icaused imany ipeople ito ileave. iThis, iin iturn, iwas icausing ithe ihospital ito ilose ia igreat iamount iof imoney. iIn ithis imodel, idaily imeetings iare iconducted iwith imanagers ifrom iall idepartments iand ithe imedical idirectors. iIn iour ihospital iif ithe ipopulation iin ithe iER iis igreater ithan i15 iwith ino ibeds ithey icall i“Surge” iwhich iis ia iplan ipretty imuch ithe isame ias iyours. iWe ihave imeetings ievery i2-3 ihours iwith iall i8 ifloors iof ithe ihospital iand idiscuss ihow imany ipatients iare igoing ito iD/C iand ithe ibarriers iof ithe iones ithat iare iwaiting ito iD/C i(for iexample iMOT, iHome iHealth, iO2 ifor ihome iuse). iI ireally ilike ithis isystem ibeing iin iplace ibecause iit iprevents ifloors ifrom isitting ion ipatients iinstead iof igetting ithem iout. iI ihave iseen iall ito ioften inurses ihold ia ipatient iuntil ithe iend iof ishift ibecause ithey idid inot iwant ia inew ione. iThat iis ione iact iI iwill inot itolerate, iif iyour ipatient iis iready ito iD/C iget ithem iout iso iothers iin ithe iER ican iget ithe icare ithey ideserve. It iComprised iof ia iteam ithat iincluded ia irepresentative ifrom iAdmissions, iclinical ioperations, iand iBed iboard. iDuring ithese imeetings, imanagers ifrom ieach idepartment iwould ihave ia ispreadsheet iready ilooking iat iwhich ibeds iare iavailable iin ithe idepartment icollaborating iwith ibed iboard. iOnce ia ibed iis iavailable ia irepresentative ifrom iEnvironmental iServices iis iappointed ithe itask iin imaking ithe irooms iready ifor ithe ipatients. iNurses ion ithe ifloor iare inotified, ias iwell ias ithe iER inurse itaking icare iof ithe ipatient ithrough iour icomputerized isystem. Amanda, You istate ithat iThe iMayo iClinic, ia iworld-renowned ihospital isystem, iutilizes itheir iown iinnovative imodel iof icare. iThis imodel iis icentered iupon ipatient icare iand ithe ienvironment. iIt iis idefined iby ithe ifollowing, i“high iquality, icompassionate imedical icare idelivered iin ia imultispecialty, iintegrated iacademic iinstitution”. iLater iin iyour ipost iyou ialso istate ithat ithis igoal iencourages iall ifacets iof ithe i nterdisciplinary iteam ito iplace ithe ipatient iat ithe iforefront iof icare iprovided. iIt ileans iupon ia iphysician ilead iteam. iThis ifact imay ibe iproblematic ibecause iother ispecialties ihave ithe iability ito iprovide ileadership ias iwell. iI idon’t ithink iI ireally isee ithat ias ia iproblem ibecause iyou isee iall ito ioften iplaces iand ispecialties ithat ido inot iwant ito istep iup iand itake ithe ilead iin icertain isituations. This itype iof ileadership iis ifocused iaround ithe ipatient iand inothing ielse. Maureen, Great ipost. iI ifound iit ivery iinteresting iwhen iyou istated ithat iin ia istudy iby iForrester iet ial. i(2014) irecognizes ithat i“Published isystematic ireviews isuggest ithat iCPOE iis iassociated iwith ia i13% ito i99% ireduction iin imedication ierrors iand ia i30% ito i84% ireduction iin iadverse idrug ievents i(ADEs) i[4, i5]. iIn ithe iambulatory isetting, iour igroup ifound ithat iCPOE, ieven iwith ilimited iclinical idecision isupport ialerts ito iguide iordering, iis iassociated iwith ia i55% ireduction iin ierrors.” iThis iinformation ialone ilends iitself ito ifurther istudy iand imeasurements iof isuccess. iI iwas itruly iamazed ithat iCPOE icould ibring idown ierrors ithat imuch iwhether iit iwas imedication ierrors ior iclinical ierrors ia ireduction iof ithat iamount iis isubstantial. iIt ialmost imakes ime ia ilittle icurious ias ito ithe inumber iof ierrors ihealthcare ifacilities iconsidered ito ibe inormal iand ithe iimpact iit ihad ion ithe ipatients iand ihealthcare iworkers. i I ireally iliked ilooking iat ithe istatistics iyou iposted iin iregards ito iCPOE. Mariam, You ibring iup igreat ipoints. iYou istated ithat iSome iof ithe ioncology ipatients iI iwork iwith iare ivery iill iand ido ineed ito icome ito iclinic ievery iday ifor isupportive icare ior itreatment. iOther ioncology ipatients iare imore istable iand iif ithey ido inot ineed iblood iwork ior iother itests, ithey iare iable ito ijust iset iup ivideo ivisits iwith itheir ioncologists iand istay isafe iat ihome. iCPOE ihas imade isignificant istrides iin ithe iimprovement iof isafe iquality icare. iCPOE idecreases ierrors iby iensuring ilegibility, istandardization, iand icompleteness iof iorders. iThere ican ialso ibe iorder isets imade ifor icertain iconditions isuch ias iSepsis, iCHF iexacerbation, iand imore. iHaving ia ipreset iorder iset iallows iproviders ito ihave ia igood ifoundation ito istart ifrom. iAn iadvantage iof ithese isystems iis ithe idecrease iin imedication ierrors iand iincreased ipatient isafety iand iquality iof icare. Topic i7 iDQ i1 There iis imore idata icollection iand iinformatics iin inursing ithan ipeople irealize. iIn ieveryday icare ion ithe ifloor idata iis ibeing iretrieved iand ianalyzed iin isome iway iby isome ientity. i iQuality icore imeasures iare iput iin iplace ito iensure isafe, iefficient, ipatient- centered, iequitable iand itimely icare i(CMS.gov.). iAny inurse ithat iworks ion ia icertified ifloor iwhether iit ibe ia icardiac ifloor ior ia ineurological ifloor ithat ispecializes iin istroke icare, ithese ispecialties ihave iquality imeasures ithat imust ibe imet iin iorder ito ikeep itheir idesignated icertification. iMedicaid iand iMedicare iservices ialso ihave iquality icore imeasures ithat imust ibe imet. iThe iquality iof ithese iservices iis igoverned iat ia ifederal ilevel iby ithe iCenters ifor iMedicaid iand iMedicare iServices i(CMS.gov in.d.) ithis isection iof ithe igovernment iprovides iquality imeasures ithat iuse itools ito ihelp imeasure ihealthcare iservices, iresults iand ipatient iunderstanding. iThe iobjectives iof ithe iagency iare irelated ito ieffective, iefficient, ipatient icentered, ifair iand iprompt icare. iThe iuse iof iinformatics ithrough iquality imeasures iwill ialways ibe iin inursing ito iimprove ion istrategies ithat iare icurrently iin iplace idesigned ito iimprove iupon ipatient iperceptions, ipatient ioutcomes, iand imore. iThey ihelp iensure ithat ihealthcare ifacilities iare iproviding ithe ibest ihigh iquality iand isafe icare iamongst iall ihospitals i(Centers ifor iMedicare i& iMedicaid iServices, i2018). iInformatics ihelps iwith ithe iinformation iobtained ibuild iupon igood iquality icare ithat iis ialready iin iplace iit ilooks ifor iways ito iimprove. References Centers ifor iMedicaid iand iMedicare i(CMS in.d.) ihttps://www.cms.gov/Medicare/Quality- iInitiatives-Patient-Assessment- Instruments/QualityMeasures/index Edyta, Sorry iI iknow ithis iis ia ilittle ioff itopic ibut, iyou iare iabsolutely icorrect. iInsurance icompanies iall iacross ithe iUnited iStates iare imaking imillions iof idollars ievery iyear ioff ipeople iwith imedical ineeds. iOn itop iof ithat ithese iinsurance icompanies iare idictating iwhat itype iof iprocedures iyou iare igoing ito iget. iThe idoctor imay isay iyou ineed ia icertain iprocedure iand ithe iinsurance icompanies icome ialong iand itell iyou ithat iyou ican’t ihave iit idone. i We ihave isome iof ithe ibest ihealth icare iin ithe iworld. People ifrom iall iover icome ito ithe iU.S. ito ihave ioperations iand iseek itreatment. iWe ilook iat ihealthcare ireform iall iwrong iand iI ihave ibeen isaying ithis ifor ithe ilongest itime, iwe idon’t ineed ihealthcare ireform iat iall iwhat ineed iis iinsurance ireform. i When iinsurance icompanies iare itelling ithe idoctors iwhat ia ipatient ican iand ican’t ihave ithere iis ia imajor iproblem. i Insurance icompanies iare idriving iup ithe icost iof ihealthcare ito iunimaginable iprices imaking iit idifficult ito ipay iout iof ipocket, ithis ithen ihas ipeople irunning ito iobtain iinsurance ijust ito ipay ifor ithe iprocedure. iIt’s ia iwin iwin ifor ithe iinsurance icompanies. i In imy ieyes ithey ineed ito istop itaking iadvantage iof ipeople. Technology iis iextremely iimportant iin ithe ihealthcare isector, iwe iwere iintroduced ito ithe iI-mobile iphone. iThe iI-mobile ilets ithe inurse ianswer iincoming icalls ifor ihim ior iher iand imost iimportantly imake icalls ito ithe idoctor iright iat ithe ibedside iif ineed ibe. iThese iphones ialso ihave ithe iability ito iassign ia iset iof ipatients ito iyou iand ifrom ithere ithe iuser iis iable ito ianswer icall ilights idirectly ifrom ithe iphone ibringing idown iresponse itimes iand imost iimportantly ianswering ia ipatient iemergency ia ilot ifaster. iThese iphones ialso ihave iother igreat icapabilities isuch ias ilooking iup ia ipatient’s ilabs iright ifrom ithe iphone iand itexting ithem ito ithe iphysician. iOf icourse, iwith ithe ichange iof itechnology iand ithe iuse iof isomething inew imost iof ithe inurses ihad ito ivoice itheir iopinion ion iwhy iwe idid inot ineed ito ichange iwhat iwe ialready ihad. References: Mayo iClinic iStaff, i(2020, iMay i15). iTelehealth: iTechnology imeets ihealth icare: iSee ihow itechnology ican iimprove iyour ihealth icare. iRetrieved ion iFebruary i20, i2021 from ihttps://www.mayoclinic.org/healthy-lifestyle/consumer-health/in- depth/telehealth/art- i20044878#:~:text MIT iTechnology iReview iInsights i(2020, iSeptember). iSmaller, iSmarter, iHealthier. iSmart iDevices iRevolutionize iChronic iCare iproduced iin iassociation iwith iMedtronic. iRetrieved ion iFebruary i20, i2021 ifrom: ihttps://www.medtronic.com/content/dam/medtronic- com/global/transforming- ihealthcare/documents/smaller-smarter-healthier-smart- devices-revolutionize-chronic- icare_paper_mit_mi_corpmark.pdf Reeves, iS., iet.al. i(2017). iInterprofessional icollaboration ito iimprove iprofessional ipractice iand ihealthcare ioutcomes. iThe iCochrane idatabase iof isystematic ireviews, i6(6), CD000072. ihttps://doi.org/10.1002/14651858.CD000072.pub3 Wildevuur, iS.E., iet. iall i(2017, iJuly i7). iInformation iand iCommunication iTechnologies ito iSupport iChronic iDisease iSelf-Management: iPreconditions ifor iEnhancing ithe iPartnership iin iPerson- iCentered iCare. URL: ihttps://participatorymedicine.org/journal/evidence/research/2017/07/07/information- and- icommunication-technologies-to-support-chronic-disease-self-management/ Halamka, iJ. i(2020) iHealth iAffairs. i Electronic iHealth iRecord iStandards. iRetrieved ifrom: iElectronic iHealth iRecord iStandards i| iHealth iAffairs “New imedical itechnologies iare imaking ichronic-care imanagement imore iconsistent iand ieffective ireducing ihealth-care icosts iand itransforming ilives.” i(MIT iTechnology iReview iInsight, i2020) According ito iWildevuur, iS.E., iet. iall i(2017, iIntroduction), i“Information iand iCommunication iTechnologies i(ICT) iare iconsidered ian iimportant ienabler iof isuch ipartnerships, ias iICT ican ioffer iways ito iconnect ichronic ipatients iand itheir ihealth icare iproviders iaround ithe iclock iand iat ia idistance, icontributing, ifor iexample, ito imore iself- monitoring iand ishorter ihospital istays.” Bar iCode iMedication iAdministration i(BMCA) iand iscanners ito iprevent imedication ierrors iand life-threatening imistakes. iA imedication inurse iwill iscan ia ipatient iID iband iand imedication ito imake isure ithat ithere iis ino imistake ibeing imade. iAdvanced isystem iwill inotify inurse iif ithe iright imedication, idose, iroute, itime, iand ipatient iis ibeing imedicated. iAlso, ithe isystem iwill inotify ithe inurse iif ithe ipatient ihas iallergies ito ischeduled imedication ior iif ithe iroute ior idose iis iwrong. Moreover, ibarcode idirectly icommunicates iwith ithe ipharmacy ias iwell. iProper iscanning iis ivery iimportant ito ipromote iand iimprove iclient’s icare, imainly ibecause ithe isoftware iis iable ito icorrectly iverify ithe icorrect imedication.