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

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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.

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
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

REPLY TO DISCUSSION

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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

REPLY

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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.

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

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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Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: 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

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Dr. Hartje,

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

REPLY

  • BI

Bimbo Ibitoye

replied toKaren Hartje

Dec 7, 2022, 4:08 PM

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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 easy15(6), 4.

Denis, J. L. (2014). Accountability in healthcare organizations and systems. Healthcare Policy10(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.

  • Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
  • Evaluates literature resources to develop a comprehensive analysis or synthesis.
  • Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
  • Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
  • Evaluates information from source(s) to develop a coherent analysis or synthesis.
  • Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
  • Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
  • Demonstrates little or no understanding of the topic.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) without any interpretation/evaluation.
  • The posting uses information that is not valid, relevant, or reliable
  • No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
  • Information is not valid, relevant, or reliable
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

  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
  • Applies concepts to personal experience in the professional setting and or relevant application to real life.
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
  • Applies concepts to personal experience in their professional setting and or relevant application to real life
  • Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
  • Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
  • Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
  • Posts are superficial and do not reflect an understanding of the lesson content
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
  • No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
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)

  • Exceeds minimum post requirements
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
  • Replies to a post posed by faculty and to a peer
  • Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • 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
  • Replies to a question posed by a peer

Summarizes what was learned from the lesson, readings, and other student posts for the week.

  • Meets expectations of 2 posts on 2 different days.
  • The main post is not made by the Wednesday deadline
  • Does not reply to a question posed by a peer or faculty
  • Has only one post for the week
  • Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
  • Does not post to the thread
  • No connections are made to the topic
  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

  • 2-3 errors in APA format.
  • Written responses have 2-3 grammatical, spelling, and punctuation errors.
  • Writing style is generally clear, focused, and facilitates communication.
  • 4-5 errors in APA format.
  • Writing responses have 4-5 grammatical, spelling and punctuation errors.
  • Writing style is somewhat focused.
  • 6-7 errors in APA format.
  • Writing responses have 6-7 grammatical, spelling and punctuation errors.
  • Writing style is slightly focused making discussion difficult to understand.
  • 8-10 errors in APA format.
  • Writing responses have 8-10 grammatical, spelling and punctuation errors.
  • Writing style is not focused, making discussion difficult to understand.
  • Post contains greater than 10 errors in APA format.
  • Written responses have more than 10 grammatical, spelling and punctuation errors.
  • Writing style does not facilitate communication.
  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
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.