Care Quality Journal

Managing Quality Safety and Individual Performance in Healthcare

With the ever-changing health care sector, reimbursement has increasingly been tied to care quality and health care outcomes. The Centers for Medicare and Medicaid Services (CMS) have particularly been changing the way hospitals are reimbursed, with hospitals that deliver high quality care and report better health outcomes getting higher reimbursements than those that perform poorly. This has led to increasing prominence of the pay-for-performance approach. Under this approach, hospitals that report greater patient satisfaction, reduced error rates, lower readmission rates, and higher recovery rates for chronic illness get higher reimbursements than their poorly-performing counterparts. The implication is that health care organizations must… Continue Reading...

Financial Strategies of Healthcare Organization

the hospitals (Dong, 2015). Many questions arise as to how the financial management culture in healthcare institutions can influence care quality. This research paper attempts to identify the global nursing strategies that would increase financial responsibility in healthcare institutions as well as the financial impact that hiring foreign healthcare providers into the financial organization has. According to Dong (2015) there is a significant statistical relationship between the financial performance of a hospital and the quality of healthcare the hospital provides. The profitability of the hospital, operating efficiency, asset liquidity, costs, and financial leverage are important determining factors to the quality of healthcare. Generally public hospitals offer lower quality healthcare… Continue Reading...

Healthcare Delivery System Model

and the patients alike. All decisions made should be in line with the intention of achieving the latter objective (AAFP, 2018). Measurement of care quality It is extremely important to measure and report on the quality of healthcare. Such practice enables employers and consumers alike to choose and decide, based on factual determiners, what care is suitable for them. However, assessment of healthcare is beyond simply informing consumers regarding their choices. Feedback to the plans for health is a central component in the whole process. Such feedback can be used by stakeholders to improve on the areas of need. There are several methods of assessing the quality of healthcare. Site surveys carried intermittently,… Continue Reading...

Trends in Healthcare

Healthcare Trends in regulation of Healthcare reform with the potential for the most positive effect on care quality, sustainability of organizations and why they are so important Reforms in payments, anchored on recent patterns in the private and public sectors are needed to support high quality interventions that matter to patients. Medicare has moved towards payments that are aimed at person-level healthcare. Such measures include DRG payments and penalties that have been recently applied for readmissions, person-level payment remissions in the Accountable Care Organization, Person level payment remissions in the Medicare Advantage program, reforms such as the Medicare Shared Savings Program, present and past pilot episode… Continue Reading...

Nursing Healthcare Balanced Scorecard

metrics including those that address quality of care such as lifestyle counseling and preventative interventions for at-risk patients. The workplace environment, job characteristics, and institutional supports all contribute to measurable performance outcomes. Quality Driving outcomes measures to improve quality of care requires a dependence on evidence-based practice, a reinvigoration of nurse training, and additional indicators to monitor outcomes such as patient family surveys to evaluate their perceptions of care quality. Quality of life factors including mental health and social functioning would also be additional indicators nurses could use on a qualitative level, with quantitative indicators including vital signs measurements including BMI/weight-related issues and heart health measures. Another additional indicator would be to quantify numbers of direct patient referrals: the critical word-of-mouth marketing the healthcare organization depends on for its long term success and financial performance. Driving quality of care, nurse leaders can make changes to institutional policies, technologies, and job characteristics. Patient Safety Patient safety remains one of… Continue Reading...

Value Based Reimbursement Models in Healthcare

Some of the most commonly used value-based reimbursement and payment models include Medicare Quality Incentive Programs, Pay for Performance, Accountable Care Organizations, Bundled Payments, Patient-Centered Medical Home, and Payment for Coordination (Pennic, 2014). More traditional reimbursement models include standard fee-for-service systems, which are woefully inefficient for patients with chronic conditions due to the large number and type of treatments needed (Sanghavi, George, Samuels, et al, 2014). While there is no one preferred approach to reimbursements, value-based models are clearly superior to fee-for-service models. One of the most promising value-based reimbursement models is the Patient-Centered Medical Home model. This model tends to be… Continue Reading...

Meaningful Usage of Health Information Technology HIT

in information interchange, and reporting on care quality measures indicated by the HHS (Health and Human Services) Departmental Secretary. The aforementioned “meaningful use” principles are detailed under the Medicaid and Medicare EHR Incentive initiatives under CMS (Centers for Medicare & Medicaid). More than Meaningful Use Meaningful use constitutes a key health information technology project driver as it impacts all players in the health care sector. Owing to meaningful use criteria’s extensive scope and complexity, its attainment offers realistic opportunities for the employment of project management techniques. By 2016, 95% of hospitals has demonstrated meaningful use of… Continue Reading...

Improving Health Welfare for a Vulnerable Population Community

available care (Aday, 2001). There is a need to support the development and evaluation of health care quality measures and measurement methods for the vulnerable population. In addition, there should be a focus on the vulnerable population as it may provide new insights on a variety of problems. In the general quality measurement strategies, we should also integrate vulnerable population details to tailor the measurement methods (Aday, 2001). Promotion of quality health care and payments to health plans should be functionally available to all patients including the vulnerable populations. Individuals with chronic illness or disability should be provided with adjusting payment plans such as Medicare, Medicaid,… Continue Reading...

Health Industry Professional Boards

them. Lastly, it assumes a vanguard position in improving healthcare quality for all citizens of the nation (American Nurses Association, 2016) The organization plays a central role in healthcare reform-related policy initiatives. Priority issues for the organization include: a streamlined health infrastructure and process capable of effectively delivering primary care within community settings; facilitating the transformation of and improvements to the overall healthcare atmosphere; a bigger RN and APRN (advanced practice RN) role in primary and basic healthcare delivery; and securing federal grants for nursing education/training (American Nurses Association, 2016). AMA Among the responsibilities of the AMA is: petitioning… Continue Reading...

SWOT Analysis

qualified staff • Care affordability • Robust commitment to health care quality and safety • High patient volume • Relatively high patient satisfaction levels • Advanced health care technology • Online presence • Strong partnerships with the community • Regional recognition • Good location Weaknesses: • Inadequate staffing • Excessive workloads • Extended working hours • High staff turnover • Staff management problems • Organisational politics • Ineffective utilization of health informatics • Inadequate integration of evidence into practice • Financial constraints External Opportunities: • Demographic shifts • Increased demand for health care • Partnerships • New care delivery models… Continue Reading...

Pay for Performance

to compromised quality and put some strain on patients. Come 2000, the US was experiencing serious deficiency in health care quality. The Institute of Medicine wrote a detailed report on this. Thus pay-for-performance became a valid option for quality health care. (Vogenberg & Smart, 2018) Who is affected by pay-for-performance? A number of studies have been conducted to evaluate adherence to medication versus medication subsidies, but no valid conclusions have yet been made. Medication adherence was shown to improve with higher drug coverage, reduction of cost-sharing and prescription cap. Poor adherence to medication was observed for patients with full medication subsidies. Such non-detailed conclusions show the need for further… Continue Reading...

Personal Professional Development Plan in Nursing

Member • I will work with my colleagues to improve healthcare quality through delivery of individualized care that meet patients' needs. My SWOT Analysis STRENGTHS WEAKNESSES Personal Strengths/Talents • My personal strengths/talents include honesty, persistence, kindness, attention to detail, and taking responsibility. Professional Interests • My professional interests include making positive contributions to enhance healthcare quality and commitment to lifelong learning. Personal Characteristics • My personal weaknesses include tendency to dominate, aggressiveness, and being overly task-oriented. Professional Development Areas • Financial limitations to meet the financial needs required for lifelong learning in nursing. OPPORTUNITIES THREATS Learning Experiences • Numerous lifelong… Continue Reading...

Nurses and the Twelve Hour Shift Work

My opinion is this: all healthcare institutions need to keep track of performance measures and patient perceptions of care. Whenever care quality decreases, or signs of burnout increase, the nurse leadership team needs to step in and reduce the number of hours on the nursing shift. This way, nurses who can somehow cope with the longer hours may do so but those who have less tolerance for the twelve-hour shift do not cause adverse effects. References Stimpfel, A.W., Sloane, D.M. & Aiken, L.H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Aff (Millwood). 2012 Nov; 31(11): 2501–2509. Continue Reading...

Lateral Violence

individual nurse's mental and physical health. The incident of lateral violence compromises the healthcare quality within a facility where it occurs. Consequently, poor patient health outcomes are observed (Hill, 2014). This study aims at exploring the effects of lateral violence on healthcare, and establishing its relevance to nursing practice. In precise terms, lateral violence is disruptive. It is a phenomenon that destroys the people and objectives of healthcare provision. Lateral violence is inappropriate and disruptive conduct by an employee within a healthcare environment. Such behavior may be directed towards an employee at the same level or a junior member of staff. Although, sometimes,… Continue Reading...