As an advanced practice nurse, propose strategies you can implement to increase your participation in the health care policymaking in order to support patient advocacy NUR 514
A Sample Answer For the Assignment: As an advanced practice nurse, propose strategies you can implement to increase your participation in the health care policymaking in order to support patient advocacy NUR 514
Title: As an advanced practice nurse, propose strategies you can implement to increase your participation in the health care policymaking in order to support patient advocacy NUR 514
Challenges Posed by Current Reimbursement Models to Nurse Leaders
Many reimbursement models have been introduced into the healthcare system in the recent past to improve the quality, cost, and accessibility to care. However, nurse leaders have been facing challenges with the new healthcare bundled payment that was introduced to allow for coordination of care while improving the quality of care and reducing the costs (Brooks & Williams, 2015). The alternative payment method also requires nurse leaders and other healthcare providers to gather data of care cost and quality from across the care gamut to develop appropriate pathways of care for different episodes. Some of the top challenges encountered by nurse leaders as a result of this new payment model include achieving scale, managing uncontrollable costs and leveraging resources for post-acute care.
Challenges of Current Reimbursement Models
The healthcare bundled payment model tends to expand the healthcare providers financial accountability in creating an episode, which is far much opposed to a single procedure. Additionally, healthcare providers can only generate high profits upon providing services to a large number of patients, which will make them struggle to attain an appropriate scale of procedures for delivering quality care or condition treatment. Lastly, in the event of cultivating for post-acute care partnership in controlling care costs outside the healthcare facility walls, providers and nurse leaders have to deal with unexpected expenditure within their own patient groups or organizations (Lichkus et al., 2018). Medical complications and adherence are central factors which might lead to expensive and adverse healthcare events. Hence healthcare providers, even under the supervision of their leaders cannot predict if the patient will adhere to the proposed care plan or encounter adverse side effect from the drugs prescribed.
Strategies to Overcome Challenges
However, a clear understanding of the challenges faced by nurse leaders in implementing the healthcare bundled payment model should create an opportunity for developing appropriate strategies to overcome such challenges for substantial benefits to the providers and the patient. For instance, the issues on achieving scale can be resolved by nurse leaders making a proposition for the healthcare organization to join a health system, clinically integrated network or medical foundation so as to boost patient’s volume and medical facilities at the same time. To manage uncontrolled costs (outlier costs) nurse leaders can establish care protocols such that medically complex patients can be treated while maintaining cost efficiency (Baxter et al., 2015). Lastly, nurse leaders can overcome the challenges that result from leveraging post-acute care partnership in controlling costs by using other sources of data in identifying high-value post-acute care partners.
Example of an Instance
An excellent example of an instance that I encountered during my routine clinical rotations was the time when our leading nurse was trying to manage the healthcare cost for a patient who had breast cancer. The patient had been transferred from another hospital and came in complaining of painful lamps on her left breast. She was however afraid of the costs that might be incurred for her proper treatment, that might result in surgical removal of the painful lamp. To avoid unexpected financial risks, the nurse leader took the initiative of defining the patients bundled payment as the control of the cost of medication was not within her power. She also made it clear to the patient that sometimes, they must avoid contracting with payers especially when dealing with co-morbidities and complex surgical procedures.
Conclusion
The new bundled reimbursement model had been adopted by several health care facilities. However, the model has certain challenges that nurse leaders grapple with during payments. The alternative payment method similarly demonstrates some challenges. As a consequence, nurse leaders are compelled to become innovative in order to overcome them.
References
Baxter, P. E., Cleghorn, L., Elston, D., Hewko, S. J., Cummings, G. G., Pfaff, K. A., & Cunningham, B. J. (2015, August, 01). Leaders’ experiences and perceptions implementing activity-based funding and pay-for-performance hospital funding models: A systematic review. Health Policy, 119(8), 1096-1110.
Brooks, S., & Williams, L. (2015, January, 01). The Kindred Healthcare Model of Post-acute Care. Louisville, KY: The Kindred Healthcare.
Lichkus, J., Wolf, C., Hynds, R., Moorer, K., Bourgoine, D., Garabedian, N., & Eamranond, P. (2018, May, 29). Effect of Implementing a Bundled-Payment Program for Heart Failure at a Safety-Net Community Hospital. Population Health Management. doi: 10.1089/pop.2018.0001
As an advanced practice nurse, propose strategies you can implement to increase your participation in the health care policymaking in order to support patient advocacy NUR 514
Topic 4 DQ 2
As an advanced practice nurse, propose strategies you can implement to increase your participation in the health care policymaking in order to support patient advocacy.
A Sample Answer 2 For the Assignment: As an advanced practice nurse, propose strategies you can implement to increase your participation in the health care policymaking in order to support patient advocacy NUR 514
Title: As an advanced practice nurse, propose strategies you can implement to increase your participation in the health care policymaking in order to support patient advocacy NUR 514
Accountability, Responsibility, & Risk
How do you define accountability, responsibility, and risk? Using an advanced registered nursing position or advanced practice registered nursing position description from your health care institution, how could the language be altered to include the concept of accountability? How do you anticipate embracing the concepts of accountability, responsibility, and risk after graduation? ~ Dr. Hartje
I define accountability as taking ownership of your actions and words. In my opinion, accountability is the most important trait to possess. Whether the actions/words ended positively or negatively, you must assume responsibility and ownership. I view responsibility as a similar term to accountability, but there are some differences. I believe responsibility is the process of taking ownership of and completing a role or duty, whereas accountability is taking ownership of the actions you performed. I define risk as exposure to danger or negative outcomes.
The APRN position description for Sanford Health touches on accountability but could go into further detail. The roles and duties are outlined, but I believe language could be altered to include the need of taking ownership of your actions. As a provider, you must take accountability for the care provided to patients. Obviously, the goal is to provide high-quality care at all times and to avoid mistakes, but when mistakes are made, it is crucial to have a provider who is accountable for their actions.
After graduation, I plan to embrace the concepts of accountability, responsibility, and risk by utilizing critical thinking skills. Before making decisions, it is crucial to weigh out benefits and risks. I personally try to avoid risky situations when able, but in certain circumstances risks must be made. In these situations, it is important to utilize critical thinking to assure the benefit is worth the risk. When dealing with risks, I will take responsibility for the actions that I will perform. Additionally, I will take accountability for the actions that I have completed, whether the outcome was positive or negative.
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As a hiring manager, I appreciate the question and find that these three traits are essential considerations when looking for a new employee. I define accountability as taking ownership of your errors (perceived or actual) and mistakes. Responsibility is a duty or commitment to a task or a role. Lastly, the risk is a danger that we seek to mitigate as healthcare providers. At my site, no language highlights these traits in the APRN postings.
At Mayo Clinic, they practice a value system called RICH TIES (Respect, Integrity, Compassion, Healing, Teamwork, Innovation, Excellence, Stewardship) (Brown Jr & Trumen, 2022). The values set an example of traits that all Mayo Employees should reflect. I believe that the organization should use these values and RICH TIES statements in all job posting to set expectations on the desired traits of an APRN at Mayo Clinic.
I plan to continue to reflect these values in my practice by keeping in mind that I need to be responsible for providing the best care for my patients and staff by taking accountability and minimizing risk through providing resources and support.
Reference
Brown Jr, R., & Trumen, T. (2022). Mayo Clinic Values. Mayo Clinic History & Heritage. https://history.mayoclinic.org/impact/mayo-clinic-values.php
The common understanding of accountability is one in which a governing body (e.g., government, regional health authority, healthcare board, professional association) is in a position to mandate providers or organizations to meet certain goals or objectives. Denis (2014) posits that a culture of accountability in healthcare improves doctor-patient trust, reduces the misuse of resources, and helps organizations provide better quality care. With accountability comes responsibility. Responsibility is the obligation to perform duties, tasks, or roles using sound professional judgment and being answerable for the decisions made. On the other hand, risk refers to the chance or likelihood that something will harm or otherwise affect a patient’s health or a healthcare organization’s effectiveness.
Advanced registered nurses are mandated to demonstrate accountability in all their professional dealings. Thus, implementing mandatory policies for accountability would change advanced registered nurses’ language and requirements. According to Davis (2017), they need to be accountable for themselves and others’ actions as stipulated by the American Nursing Association’s code of ethics. They need to meet the growing needs and demands of patients and the rapidly evolving healthcare sector. They are also professionally accountable for expanding their clinical skill set and implementing evidence-based solutions.
After graduation and assuming my nurse leadership roles, I will highly consider the concepts of accountability, risks, and responsibility. As Little et al. (2018) state, I would assume the responsibility and become accountable for excellent day-to-day operations. With the same mentality, I will ensure that everyone assumes their roles and works toward achieving the common healthcare goal. Also, having a risk assessment model in place is critical in outlining any gaps and potential problems and opportunities available for my healthcare organization. As a visionary nurse leader, I will manage the three issues to strengthen positive outcomes and ensure that all stakeholders are satisfied.
References
Davis, C. (2017). The importance of professional accountability. Nursing made incredibly easy, 15(6), 4.
Denis, J. L. (2014). Accountability in healthcare organizations and systems. Healthcare Policy, 10(SP), 8.
Little, L., Wagner, J., & Boal, A. S. (2018). Responsibility and Authority of Nurse Leaders. Leadership and Influencing Change
Grading Rubric Guidelines
| Performance Category | 10 | 9 | 8 | 4 | 0 |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic decisions. |
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| Performance Category | 10 | 9 | 8 | 4 | 0 |
| Application of Course Knowledge –
Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations |
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| Performance Category | 5 | 4 | 3 | 2 | 0 |
| Interactive Dialogue
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread) |
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Summarizes what was learned from the lesson, readings, and other student posts for the week. |
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| Minus 1 Point | Minus 2 Point | Minus 3 Point | Minus 4 Point | Minus 5 Point | |
| Grammar, Syntax, APA
Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition |
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| 0 points lost | -5 points lost | ||||
| Total Participation Requirements
per discussion thread |
The student answers the threaded discussion question or topic on one day and posts a second response on another day. | The student does not meet the minimum requirement of two postings on two different days | |||
| Early Participation Requirement
per discussion thread |
The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. | The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT. |