Health care organizations are considered complex due the fact that there are various resources and different procedures being advanced regularly. The maximum performance of these organizations depends on a variety of reasons, including personal incentives, knowledge, and skills. For many years there have been discussions around the health service delivery for many Americans and necessary implementations of the affordable Medicare coverage for citizens. The discussions and debates have been as a result of today’s issues challenging the employees’ operations, support of these organizations, cost-effectiveness and delivery of health services. The task is up to the competent leaders to find solutions for the challenged areas for both the present and the future improvement of quality care and outcomes. The paper focuses on patient centered health care system, as a presently preferred solution.
Many health organizations and facilities are faced with challenges caused by the ever-changing expectations of clients, improvement in patient-centered care, health care safety and high demand for health care. Effective leadership is important as it helps in easier and effective managerial operations of a hospital setting. It has been recognized as the key to health service performance, of which can be boosted by including patients and clinicians into the reform process.
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Many health care organizations have shown their commitment to the patient-and family-centered care (PFCC). It is an approach necessitating the planning, delivery, and evaluation of health care, it is for solely for the mutual benefit between patients, families and health care providers. It creates a relationship and a good sense of communication between people of all ages, at various levels of care, and in the general setting of health care. The patients and families govern how they will be involved in the decision making and care by the promotion of their well-being, and health of families and individuals ( Kellermann et al., 2013) .
Business Practices
The patient-centered care being a new model in our health care system creates attention from both the policy advocates and industry experts. Will it fix the healthcare system? It is evident that it benefits the patients but what about the hospital administrators? Who plays vital roles in hospital administration? Patient-centered care also involves the hospital’s stakeholders which results in minimal hospital expenses, the hospital is able to uphold a better financial performance due to long earnings.
Americans are becoming more and more conversant about the patient-centered care, making them seek hospitals that use such a system since it offers additional value-per-cost and better quality. This leads to market share improvement, the hospitals with the patient-centered system are superior over those with traditional systems. For example, Reston Hospital increased its market share when it started using the new system into their business model. This was after it was made known that respondents were more than willing to change with the current trend.
With the success of quality service delivery to patients through the patient-centered system, it can be referred to as a profitable business. A patient’s outcome is improved as the patients are happy, in less pain, healthier and more satisfied, all out of the new strategy. With the achievements made, the hospital’s management reciprocates this by making the system more effective by minimizing on time wastage so as offer service to many clients as possible. Many hospitals aim at providing health care services to many patients as possible, where they determine the amount of money the hospitals get. It is up to the hospitals to adopt the new system so that they can get a high ranking from (CAHPs), this translates to more clients to adaptive hospitals.
Lastly, expenditure minimization greatly impacts on the patient-centered system. Many hospitals are likely to shift to this system as it reduces on the expenditures, for instance, less training costs and other related costs, as the new system incorporates efficiency, improves on staff relationships, improves patient-caretaker interactions and ensures zero employee burnout.
Health organizations reimbursements are connected to clinical outcomes together with patient satisfaction. Surveys that have been conducted in hospitals are important in the patient’s experience, they not only assess the hospitals but also the healthcare agencies. They affect the usage of patient-centered care in health organizations. Government dictates the assessment of all health organizations’ health systems to ensure a patients experience is satisfactory. If not, it applies reimbursement penalties to the affected hospitals ( Lindblad et al., 2017) .
The biggest gains are made by those organizations that engage their patients which is made possible through the patient-centered care. The capability of an organization to capitalize on the market share and its brand reputation is associated with patient the experience. Measuring patient experience and outcomes results in quality improvement, the higher the performance leads to lower readmissions. Furthermore, high performance better adheres to post-discharge procedures for patients and minimal utilization of avoidable health care services.
To end with, a patient’s voice in patient-centered care makes the patient experience more effective, less expensive and more tolerable. It is known that patients do not seek satisfaction by care provided but rather other expectations from the hospital, including, emotional support, not overcharging services, and not harming the patient (Bao et al ., 2013). Apart from the business activities patient-centered services are also impacted on by various reasons including, government policies, population, service provider power and politics ( Hargett et al., 2017).
There are laws that rise new mandates to put specific patient-centered practices into place, they include, the Health Information Technology for Economic and Clinical Health Act (HITECH). Since 2014 hospitals have received about $28 billion incentives because of embracing and making use of electronic health records. This marked completion of stage 1 and 2 of MU regulatory standards. Patient involvement in health care is in stage 3, the MU sets the goals for a number of patients who must view their data and take delivery of the clinical message of hospital discharge. This is a form of patient’s contribution to their own data whereby service providers are required to make use of the patient-generated health data. There was a draft rule back in 2018 where all health organizations to meet not less than 25% of their patients transmitting their own health information.
The patient-centered is repeatedly involved in the Affordable Care Act, the law’s primary objective is to reorganize care delivery particular by use of initiatives. For instance, patient care experience shared decision making and patient satisfaction. This has led to the patient-centered care as a parameter by the accountable care organization (ACO). This impacted many Medicare Shared Savings Program (MSSP) to adapt the parameter, with many assigned beneficiaries. Hospitals willing to join ACO are expected to identify how the patient-centered care would be incorporated into their system, and to account on quality delivery, necessary measures and care coordination (Carman et al., 2013).
The regulatory guidance presses for a three-level patient-centered care, for instance, Governance-level, requires an appeal for patient-centered care to be advocated by the ACO’s principal body and its integration into usage by leadership and management. The second level is Clinical-level requires advocacy on clinical policies, including patient communication about evidence-based medicine, clinical remainder systems or health data management. Lastly, an individual level which involves patient-clinician interactions in the aim of promoting patient-family medical decision making and allowing patients to access a variety of treatment options. Factors like income status, gender, race, and orientation are additional requirements in the care plan.
The Medicare Access and CHIP Reauthorization Act (MACRA) is an initiative that assigns precedence to outcome measures such as functional status measures and patient-reported outcome, care coordination measures and measures of appropriate use of services. It advocates a Merit-Based Incentive Payment System (MIPS). A MIPS performance will determine the penalties or bonuses the provider gets which are out of quality measures, electronic health records, efficiency measures, and clinical activities. There are those providers who feel that the MIPS is not quite rewarding, they are forced to search for an alternative system such as patient-centered medical home (PCMH) or ACO which also have a performance metrics.
Setting Description
The task focused on Reston Hospital as my healthcare setting in answering my PFCC tool Reston Hospital Center associates with various community and arts organizations around the Reston region throughout the year. Furthermore, it helps enhance the citizens’ quality of life. The center is a medical and surgical facility with top-quality professionals specialized in various fields that include cancer care. It serves the population of eastern Loudoun and western Fairfax counties. A caring organization enhances health and life quality across the region. It upholds a top priority in the safety of patients and medical excellence due to its quality care philosophy, having over 1200 full time and part time employees and an unspecified number of volunteers. It has an active health and wellness outreach program that delivers many free or cost-effective screenings that emphasizes early detection of diseases. The facility adheres to all human resource policies and assists the development of individual plans. In addition, it ensures transparency in the patient-clinician medical practices. There are also fluid communication networks between departments, clients, and staff. The facility plays a role in the overall community health through research and education; in addition it is able to meet the needs of special groups.
It is popular because of its nursing excellence and attentive patient care and other prestigious accreditations. There is a wide range of medical services with 24-hour emergency care plus competent medical specialists such as orthopedics who deal with joint replacements. There are also radiological intervention and diagnostic imaging capabilities, rehabilitation programs, robotic surgical interventions, and maternal health. The convenience is facilitated by personal attention, private rooms and accessibility of the location. The facility consistently develops and implements assessed surgical service programs which assure quality patient care.
The hospital shows concern for the neighborhood by being actively involved in community care. Furthermore, it offers sponsorship to events concerning health awareness and impacts the region’s economy. Through the organization’s charity care and financial discount policy, it is able to address the patient’s financial responsibility in a fair manner. Its mission is the Caring and improvement of human life. It is motivated by a passion for clinical excellence and unparalleled customer care.
Strengths and Weaknesses of the Organization
|
Domain |
Strength |
Weakness |
| Leadership/Operations |
Commitment to patient centered care Involvement in policy making |
No weakness |
| Mission, Vision, Values | Improved human life | No weakness |
| Advisors | There are patient and family advisory councils | No weakness |
| Quality Improvement | Active participation of patients on task forces | Participation in quality, safety and risk meetings |
| Personnel |
Included in committees Interview orientations |
No weakness |
| Environment & Design | Patients are fully involved in clinical design projects | No weakness |
| Information/Education | Resource rooms are availed | No weakness |
| Diversity & Disparities | Education materials available | No weakness |
| Charting & Documentation | Patient-family are able to chart | No easy access to health records |
| Care Support | 24/7 access is provided | No update of medication history |
| Care | Patient partnership in care. | Involvement of patients in care planning |
Area of Improvement
From the results in the PFCC it is clear that there is a problem in accessing health records. To achieve the goals of attaining better patient care the hospitals need to adopt technological strategies that will help in facilitating the access of health records. The hospital needs to embrace health IT innovations so that the health records are easily accessed. Electronic health records are crucial in the management of health information, in the accessibility of information and lastly in the communication between patients and health providers. There are zero or rare cases of medical record misinformation if at all there is an all-time accessible system in clinician’s notes and health information. Furthermore, they are able to spot inaccuracies in prescription errors or medication errors when they look at their medical data. This is crucial as it ensures patients’ safety. By the adoption of the EHR system, it will help relieve unnecessary waiting time for medical appointments and most importantly the easier access of clinical protocols and guidelines.
System Theory
The purpose of the system theory in regard to the EHR implementation is to completely change the earlier record system to a new system; to involve the addition of new elements into the general hospital system which will result to completely new system behavior. The health care system incorporates various medical care, making it a complex system that comes with changes at every level of health disciplines. System theories help in the better understanding of human interaction between patients and health providers, additionally; it ensures a faster and easier implementation of changes in organizations.
A patient-centered health care system is defined as appropriate when its main focus is on the patients’ needs and preferences. It’s a system that mainly dwells in the patient-family by incorporating their needs into care. The current trends in health care rely more on patient-driven health care. The availability of information and other related measures reveals an increased expectation of a patient involves system changes that lead to improved quality, effectiveness and efficiency. The patient is deemed as an active participant in the health care delivery but not as a passive recipient. For the patients to be actively involved in health care, they must have access to inpatient forms that provide evidence-based, efficient care and incorporates the patient’s medical record. An interdisciplinary team is required to put the strategy into practice.
Financial Implications
There are both direct and indirect financial implications the hospital will likely incur. For the direct cost, the hospital will incur the cost of a perpetual license which is relatively expensive. There will also be an additional cost of managing all back-office technology but these costs can be reversed back due to the benefits that come alongside EHR, for instance, cost reduction, increased revenue and enhanced service delivery. The cost of staff training is also an expense the hospital will incur, however indirectly it is. Moreover, during the implementation period, physicians’ production is expected to be lower than usual. Other costs include projected maintenance, labor including overtime, hardware installations, decreased patient visits and loss of productivity. Coming onto my multidisciplinary team, we will require a substantial amount of money due to skilled expertise. This process requires at most seriousness, in terms of planning and revenue allocation.
Methods
The method to assess the effectiveness of the strategy is geriatric quality-of-life (QOL) using the Roter Interaction Analysis System (RIAS). The module comprises of health related quality of life items that include physical health, physical functioning, emotional health and related limitations. Before implementing of the strategy QOL is to be provided to patients, service providers and the general staff to decide whether the strategy is beneficial or not.
Multidisciplinary Team
Project manager
Application analyst
Application developer
Quality assurance test engineer
|
Team Member |
Role on the Team |
| Project manager (PM) | Choosing of a vendor and ensuring overall project success |
| Application analyst | Connects with the development team through shared ideas |
| Application developer | Designing of various applications for various hospital departments |
| Quality assurance test engineer | Checking on the system |
S
As the PM of the EHR project, I will select the most suitable vendor to work with to prevent nuisances that are caused by non-friendly vendor interfaces. I will also oversee the management of the overall project. The application analyst will search and connect appropriate ideas the hospitals want to be put into the system. Furthermore, the analyst will put the gathered information into a technical form. It is also crucial that the analyst is conversant about medical practices. The technical form is then passed on to the application developer who designs the required applications for the various departments in the hospital. Finally, a quality assurance test engineer is on the go to test the system’ performance. Quality tests can now be performed to assess the system.
Team Diversity
Building of a multicultural team is important as there is creation of conversancy in ethnic and cultural practices or certain religious beliefs. Through the members’ culture diversity, opportunities for improvement of quality care for patients under different cultural backgrounds are plentiful. My team supports patient care in a cultural perspective by various ways, including, promotion of health equality for all clients by advocating the implementation of policies and practices that promote equality. Equipping the system with a translator service to cater for those with a limit knowledge of English. Additionally, continuous updates of demographic data from the surrounding regions to help ensure the overall health care process to be transparent, hence accountability in patient care (Wick et al ., 2015).
Emotional Leadership
Management of oneself emotions or being able to influence others towards an accomplishment of a certain goal requires an important leadership skill. I would use emotional leadership to develop my team so that am able to fully engage the reasoning of my team members so that we as a team are able better advance solutions that exceed expectations. Without emotions I as a leader would find it hard to connect with my teammates, additionally, emotions motivate the team and make it comply towards a goal. In health organizations, it is well known as Emotional intelligence which is important in delivering patient-centered care.
Implementation of Strategy
Implementation of the electronic health record is a long process due to the involvement of multiple departments, to ensure that it is fully integrated and working as expected, a work plan is crucial. The work plan is facilitated by a timetable that puts the team’s objectives in a timely manner. Before launching the new system we will first get support from the hospital leadership, we will also submit requests for proposals, choose the vendors, plan implementation and access the ongoing medical record system. On the second phase of the project, together with my teammates we are to assign ourselves roles, as mentioned earlier on. Develop the necessary workflows, review databases, define data templates and lastly provide necessary software and hardware needs. On the third phase, we will install hardware, customize and review templates, facilitating the training of staff, reconcile vendor’s timeline with the installation timeline and finally notify patients of the new system and afterward get their feedback. In case of any adjustments we will provide time for that, we also recheck the system.
Communication to Organization
As the team leader, I will create a network for support and comments regarding the new system, this is from the patients and the health providers. On the other hand, the Application Analyst will communicate with vendors about concerns, bugs or questions. My team will represent the organization’s leadership, including IT and administrative. These strategies will create transparency between the teammates, staff, and patients. We will then position ourselves to administer different user groups, for instance, clinical documentation by assuring intergroup communication that optimizes an individual’s effort. For the organization to consistently get quality outcomes out of the strategy, we will advocate on regular meetings between patients and health providers as it helps in preventing future errors.
Tools for the Team
I would opt for a Leading From Your Strengths Assessment Tool, the reason why it’s the best for my team members is it helps us, as the team members in finding our natural strengths, value each member adds to the team, impact of environment towards our strength and lastly in knowing how others perceive us.
References
Bao, Y., Casalino, L. P., & Pincus, H. A. (2013). Behavioral health and health care reform models: patient-centered medical home, health home, and accountable care organization. The journal of behavioral health services & research , 40 (1), 121-132.
Carman, K. L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C., & Sweeney, J. (2013). Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Affairs , 32 (2), 223-231.
Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., & Specchia, M. L. (2015). The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. The European Journal of Public Health , 26 (1), 60-64.
Hargett, C. W., Doty, J. P., Hauck, J. N., Webb, A. M., Cook, S. H., Tsipis, N. E., ... & Taylor, D. C. (2017). Developing a model for effective leadership in healthcare: a concept mapping approach. Journal of healthcare leadership , 9 , 69.
Kellermann, A. L., & Jones, S. S. (2013). What it will take to achieve the as-yet-unfulfilled promises of health information technology. Health affairs , 32 (1), 63-68.
Lindblad, S., Ernestam, S., Van Citters, A. D., Lind, C., Morgan, T. S., & Nelson, E. C. (2017). Creating a culture of health: evolving healthcare systems and patient engagement. QJM: An International Journal of Medicine , 110 (3), 125-129.
Miotto, R., Li, L., Kidd, B. A., & Dudley, J. T. (2016). Deep patient: an unsupervised representation to predict the future of patients from the electronic health records. Scientific reports , 6 , 26094.
Wick, E. C., Galante, D. J., Hobson, D. B., Benson, A. R., Lee, K. K., Berenholtz, S. M., ... & Wu, C. L. (2015). Organizational culture changes result in improvement in patient-centered outcomes: implementation of an integrated recovery pathway for surgical patients. Journal of the American College of Surgeons , 221 (3), 669-677.
