An analysis of how business practices, regulatory requirements, and reimbursement impact patient-centered care within a healthcare organization
Healthcare organizations that provide excellent services, personalized care as well as high quality care thrive in the area of business practices for a variety of reasons. These practices are inclusive of ensuring employee satisfaction, which is essential for improving patient satisfaction since the employees will be in a better position of providing patient-centered care. The retention and recruitment of highly skilled staff is the other element that might attract patients to use the services of the healthcare organization.
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In relation to the aspect of regulatory requirements, healthcare organizations follow regulations set forth by the governing professional bodies. For instance, the Joint Commission International (JCI) focuses on ensuring that healthcare organizations improve patient safety (The Joint Commission, 2010). To ensure that the healthcare facility meets the demands of the different bodies, they are required to get accreditation from institutions such as Centers for Medicare and Medicaid Services (CMS). The regulations of this entity require the healthcare organizations to comply with Medicare Conditions of Participation (COP) for the areas and services covered in the CMS certification number. These regulatory requirements are essential for ensuring that the healthcare organizations ensure the safety of healthcare delivery.
In relation to the concept of reimbursements, the consistency of healthcare organizational reimbursement contributes to the provision of high quality services. CMS developed Consumer Assessment of Health provider Systems (HCAPHPS) primarily to connect the element of reimbursement and the performance of the healthcare organization. In this regard, the organizations are required to meet the expectations set forth by the HCAHPS.
A description of the healthcare setting used in the PFCC
The healthcare setting selected is that of a healthcare organization that contains more than 1000 beds. The services offered at the facility are inclusive of cardiology, endocrinology, cancer, urology, and nephrology, among others. Conversely, the healthcare organization also provides outpatient services and supporting labs. The healthcare organization is also diverse in terms of employment. The employees are from different backgrounds and races, which is an element that assists in the provision of culturally competent care.
A description of the strengths and weaknesses of the organization for each domain
The domains showing the strengths of the healthcare facility using the PFCC tool are inclusive of the organization’s mission and values. By including patient-family centered care in their mission and vision, the healthcare organization ensures that the prioritize policies that focus on patient care. The other strong domain is the personnel domain. The employees in the facility focus on the provision of professional advice since they have the knowledge needed for supporting family and patient care practices.
However, the weaknesses emanate from the care support domain. In this case, one of the weaknesses includes the provision that the presence of family members was not allowed during rescue events, the patient/family ability to activate rapid response systems was low, which is also characteristic of the provision that family members of the care team were not allowed 24-hour access to the patients. Generally, the rapid response team is primarily responsible to handle everything that includes responding to emergencies as well as the provision of education to the ward staff. Conversely, the other weakness identified from the tool is the ineffectiveness of the charting and documentation process.
An area to be improved
The area that needs considerable improvement as identified in the PFCC tool is the charting and documentation process. Traditionally, this process is chronological. In this case, the concept of narrative charting relates to the documentation of patient information that is written in paragraph form. The information contained in the documents is inclusive of the client status, the interventions used by the healthcare practitioners, and the treatments applied. To improve the documentation process, it would be essential to shift from using the manual method and encouraging the adoption of electronic recording. Using electronic records is fundamental to hastening the access of patient information. The ease with which caregivers can access the information will assist in improving the efficiency of the care provision.
Improvement strategy
The strategy considered for improving the charting and documentation process is the problem-oriented medical recording (PMOR). The appropriateness of this strategy emanates from its ability to record information in a logical and structured manner, which is a provision the enables the healthcare providers to focus on the problems that the client might be undergoing. The components of the PMOR include a defined database, care plans, a list of problems as well as progress notes. In the implementation, it will be essential to organize the documentation process in a manner that would assist in the identification of the health issues of a patient, the care plan to be used and the progress notes.
Change theory
The fundamental focus of change theory is the alterations of an individual’s behavior, feelings, and thoughts. One of the change theory models is Lewin’s change model that provides nurses with a structured approach needed to achieve the desired outcome (Payne, 2013). In relation to the improvement of the charting and documentation process, it would be essential to use Lewin’s force field model that focuses on unfreezing, moving and refreezing. In this case unfreezing involves the recognition that improving the process is essential for the reduction of the time spent on the documentation process. The moving stage involves weakening the restraining forces that might be existing. Conversely, it would be vital to strengthen the driving forces that would allow the effective implementation of the strategy. Refreezing involves the integration of the developed routing practices in the facility.
The financial implications
In spite of the idea that the federal stimulus package with assist the healthcare facility to reimburse clinicians, it would be necessary to avail resources needed for the implementation and maintenance of the electronic devices to be used for the documentation process. For this reason, the healthcare institution would be required to set aside resources needed for the implementation and maintenance of the system.
Evaluating the effectiveness of the strategy
The evaluation process will focus on the usability of the new documentation system. In this case, the threshold that should be considered in determining the effectiveness of the strategy should be the ease with which the users of the system can access patient information. The other element to consider is the user-friendliness is the other element that should be considered in evaluating the effectiveness of the strategy. Based on these provisions, the best way for determining the effectiveness of the strategy is through the identification of whether it improves patient care. In this case, it would be vital to analyze the efficiency of the workflow for a particular period, which is essential for the determination of whether the new system has improved care delivery.
The multidisciplinary team members and their roles
|
Team member |
Role |
|
Lead physician |
The responsibilities of this member include linking the administrative, technical, and front-line users of the implementation team. |
|
Project manager |
This member is responsible for managing issues of the implementation process, which requires him or her to work closely with the vendor. |
|
Lead user (IT professional) |
The primary responsibility of the IT professional is the reconfiguration of the software needed and the templates that would be used for the documentation process. |
How cultural diversity within the team supports patient-centered, culturally competent care
Valuing diversity in the team is essential for ensuring that the healthcare personnel treat their patients individually. For this reason, a culturally diverse team will ensure that the patient’s beliefs and values are met since they will work with individuals that are aware of their set of values and beliefs. a diverse team will assist in the understanding and integration of cultural, ethnic, and racial factors in the delivery of healthcare services, which is essential for the provision of high quality care to clients regardless of their different backgrounds. A diverse team will also improve the quality of interactions between the patients and the healthcare professionals.
The leadership style to use in developing the team
The most appropriate leadership style to use in the implementation of the considered model is transformational leadership. This leadership style is essential for inspiring the team members to achieve exceptional outcomes. In this case, the model is essential for assisting the members to develop their leadership skills since it focuses on the element of empowerment. Conversely, the model enables the members to align their individual objectives with that of the team and the entire organization as well. In this case, transformational leadership will enable the individuals in the team to surpass the demands expected of them, which will ensure the satisfaction of each person. Conversely, transformational leadership enhances the need for individuals to act as role models, which will create an atmosphere that encourages the commitment of each member to the shared vision.
How the team will work together to implement the strategy to address weaknesses identified
The initial step in the implementation process will involve the completion of the PFCC. From the identification of the weaknesses, the other step would involve the identification of the responsibilities that the members will take to implement the strategy. Conversely, the members will involve themselves with the determination of the manner in which the team will include input from the families that have patients in the healthcare institution. In this case, it would be vital to engage the family members in the decision-making process that would ensure the adequacy of care to the patients.
The communication processes
It would be essential for the team leader to call for a physical meeting with the members. On the other hand, the team leader should communicate with the organization’s senior leadership through email. The training sessions considered will be in the form of a town hall meeting. While conducting the training, the IT supervisor will be responsible for providing the members with the knowledge needed for implementing the new documentation system. Conversely, the IT supervisor will be responsible for providing the team leader with weekly reports on the implementation process.
Tools to be used for developing the team’s self-assessment skills
The tool considered for developing the team’s self-assessment skill is the Clinical Leadership Competency Framework (CLCF). This tool has a number of domains needed to take care of the operations in the healthcare organizations depending of the context experienced. For instance, the tool contains questions regarding the personal qualities of the members as well as their sense of management and their ability to set a specific course that will ensure the success of the organization. Conversely, the tool contains questions regarding the manner in which the members would develop their self-awareness, the way in which they manage themselves, the determination of whether they are acting with integrity, and the continuation of their personal development. The scores they obtain from the tool will assist them in determining their different areas of weaknesses, consequently enabling them to identify some of the areas needed for their development.
References
Payne, S. (2013). The Implementation of Electronic Clinical Documentation Using Lewin’s Change Management Theory. Canadian Journal of Nursing Informatics , 8 (1). Retrieved from http://cjni.net/journal/?p=2882
The Joint Commission. (2010). Advancing effective communication, cultural competence, and patient - and family-centered care: A roadmap for hospitals. ABNF Journal , 26 (2), 33-39.
