NR 506 Week 5 DQ: Drivers of High Performance Healthcare Systems

Sample Answer for NR 506 Week 5 DQ: Drivers of High Performance Healthcare Systems Included After Question

NR 506 Week 5 DQ: Drivers of High Performance Healthcare Systems

NR 506 Week 5 DQ Drivers of High Performance Healthcare Systems

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Week 5: Drivers of High Performance Healthcare Systems

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Select two drivers (for example quality, cost, and access) of high performance healthcare systems and apply it to your current work situation. The application could demonstrate the presence of the driver in a positive manner or it could acknowledge the presence of a concern.

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A Sample Answer For the Assignment:  NR 506 Week 5 DQ: Drivers of High Performance Healthcare Systems

Title: NR 506 Week 5 DQ: Drivers of High Performance Healthcare Systems

Mar 25, 2018Mar 25 at 4:29pm

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Week 5: Drivers of High Performance Healthcare Systems

Select two drivers (for example quality, cost, and access) of high performance healthcare systems and apply it to your current work situation. The application could demonstrate the presence of the driver in a positive manner or it could acknowledge the presence of a concern.

In my opinion two drivers such as quality and cost are the most importance in high performance healthcare systems. However, it is hard for the two drivers to go hand in hand. One would think that in order to get high quality healthcare, it would cost more. In my current work situation there is always a staffing shortage in the ICU, probably because other departments RN cannot float to ICU since it is a specialty unit. It costs hospital to staff RNs in order to provide quality care and maintain the patients to nurse ratios. Not having adequate staff due to cost containment can jeopardize efficient quality healthcare. “Nurse staffing has a significant impact on both quality of care and cost due to nurses’ vital role as front‐line care providers, and insufficient staffing and unreasonable home healthcare costs can thus reduce health benefits through missed opportunities to improve patients’ health status” (Park, 2017).

People tend to associate things that are not costly with poor quality. Which comes to mind, the objective of the “Patient Protection and Affordable Care Act (ACA)” was to attain virtually worldwide health insurance coverage in the United States. ACA helped a lot of people get insurance for an affordable price. “On the supply side, concerns have been raised about whether there are sufficient numbers of primary care physicians to treat all of these newly insured patients” (Courtemanche et al., 2018). Now that everyone could be insured, the question is how will the quality of care be affected? What types of physicians will care for these patients. Time with patients will be compromised due to lack of time to see patients. I believe there must be a medium for quality of healthcare and cost.

References NR 506 Week 5 DQ: Drivers of High Performance Healthcare Systems

Courtemanche C., Marton J., Ukert B., Yelowitz A., & Zapata D. (2018). Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health. Southern Economic Journal. 84(3), p660-691. 32p. DOI: 10.1002/soej.12245.

Park, C. S. (2017). Optimizing staffing, quality, and cost in home healthcare nursing: theory synthesis. Journal of Advanced Nursing. 73(8): 1838-1847. 10p.

Mar 26, 2018Mar 26 at 8:58pm

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Jaemee, yes people tend to think quality or cost but how can it be both?  For example, how does the ACA address this through value based purchasing?

Mar 27, 2018Mar 27 at 5:22am

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“Value-based purchasing strategies, primarily (1) pay-for-performance (P4P); (2) accountable care organizations (ACOs), and (3) bundled payments, are geared towards achieving value by reducing costs while improving quality based on a predetermined set of performance standards including quality and cost measures” (Walter et. al., 2015). The government motivates hospitals by paying out incentives when quality care is met through patient satisfaction surveys or statistics. At our hospitals we have core measures sets, which are things to focus on such as CHF, sepsis, stroke, and etc. made by the The Joint Commission to provide quality care. Lowering the cost of health insurance makes it affordable for everyone, at the same time bringing more businesses to providers, and having incentives to motivate these providers to give great quality care.

Reference NR 506 Week 5 DQ: Drivers of High Performance Healthcare Systems

Walter A.W., et. al. (2015). The Affordable Care Act and Value-Based Purchasing: What’s at Stake for Children with Medical Complexity? The Catalyst Center. p1-13.

 

Mar 27, 2018Mar 27 at 8:46pm

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I agree with your comment about staffing being a major factor that affects cost and quality. I know in my hospital we too have a shortage of nurses. The hospital has resorted to hiring a large amount of travel nurses. There have been some units that most days they do not have any core staff members. This issue is costing the hospital in quality of care and cost. The cost of travel nurses is significantly more than staff nurses. This budget increase is going to make the hospital cut cost somewhere else. This cut usually affects the equipment we have available to us or other quality issues. Also, by not having core staff who understands the doctors and the patient population specific to the unit, the quality of the care for patients could also not be the best it could be. This ultimately will reflect in patient satisfaction scores which could also affect insurance and government reimbursements. Having the correct staffing can truly affect every aspect of the hospital system.

Rachel Sloan

 

Mar 28, 2018Mar 28 at 9:48am

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Rachel,

Thanks for your reply. Our hospital hired a lot of travel nurses for the holidays to cover for the staff nursing shortage and consequently, we had two sentinel events, the death of two patients. By not up fronting out money for staff nurses, the hospital compromised care and safety of our patients. One of the travel nurses bolus the patient with Levophed that lead to irreversible cardiac arrest. I agree with you that cutting cost compromises the quality of our patient care, and now with have constant visits from government agencies like The Joint Commission and Medicare/Medicaid.

Mar 28, 2018Mar 28 at 10:10am

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It is important to have clear data that indicates that staffing is a major issue in error.  One needs to look at error from a system’s perspective using Just Culture rather than individual blame.  I can’t even imagine how awful this error must have been for the travel nurse and the family and unit.  What investigation was done to look into the causes of the error and was one of the findings related to staffing?

Henny

Mar 29, 2018Mar 29 at 4:39pm

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The CNO gave us a handful about having to talk to the family of the deceased patient and I cannot even imagine the family’s shock and emotions. Yes there was an internal investigation that was done. We use what is called an Alaris pump, and all the high alert medications are programed into the pump such as Levophed, and there is a high alert alarm when someone overrides the intended maximum dose. Long story short, the travel nurse gave the patient the whole bag of Levophed at a much faster rate then she should have. I do feel like the travel RN gets less orientation days than the regular staff nurse and may be she was not ready or proficient in using the Alaris pump, at the same time if she was not ready she should have advocated for herself and asked for more orientation days. The outcome of this was the hospital will give travel RN more orientation days, and hopefully they will be more equip and make less errors. Nevertheless, this horrible incident that no one wanted to happen has taught all of us nurses to slow down, double check high alert medications with another nurse, and give quality care to all patients.

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NR 506 Week 5 DQ: Drivers of High Performance Healthcare Systems 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.

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