Response 2

Peers Response to --- How do you see current trends and changes in healthcare models impacting the delivery of healthcare? Consider the impact of these trends on your own practice setting. Also consider how these trends and changes have impacted your own leadership style or your supervisor’s leadership style.

Taimi Dudley posted Subscribe

          My name is Taimi (pronounced ty-mee). I have worked as a registered nurse with an associate of science degree for over 24 years. Across these years, I have practiced nursing in the states of New Jersey, Pennsylvania, and my home state of Massachusetts, to which I returned two years ago. When I graduated from a hospital-based nursing program, I took a job as a Post-Acute/Rehab Care staff nurse. After two years as a staff nurse, I was promoted to a clinical management position in a Post-Acute Care (PAC) facility. Since then, I have worked in a variety of milieus, including both free-standing and hospital-based facilities and served as a corporate nurse, a traveling nurse, and a private consultant. My nursing specialty has grown exponentially over the years. My role now encompasses reporting to many governmental agencies, on both a state and federal level, and most recently, I am involved in mandated Quarterly Reporting Program (SNF QRP). I am currently working as a Regional Clinical Reimbursement Specialist for a major Post-Acute Care Company.

          I have been in the healthcare field since I was a junior in high school, working as a candy striper, certified nursing assistant, and home health aide before becoming an RN. So, I have been both exposed to and used critical thinking for a lot of years. Nevertheless, I am excited to broaden my understanding, experience, and critical thinking skills with new and fresh information on the best practices approach of nurse leaders in today's healthcare environment.

          How do you see current trends and changes in healthcare models impacting the delivery of healthcare? In the recent past, the fee for service healthcare trend generated money through the volume of patients or census levels and viewed the patient as a source of revenue. Whereas, the new trend of value-based healthcare has changed healthcare, particularly in my industry of post-acute care. Our patients have now become an expense versus a source of revenue. This change has made it necessary for different types of healthcare providers to stop working in silos and instead communicate and collaborate with care providers across the continuum.  Each provider will need to leverage each other’s strengths to provide the best possible outcomes for the patient. Also, with this new value-based payment model system, providers, and doctor’s need to begin to see cradle to grave care within a fixed premium payment.  

          What is the impact of these trends on your own practice? These emerging trends are having an impact on my industry by implementing electronic medical records (EMR), nurses now charting on wheels (COW) at the bedside, and utilizing more types of technology than ever before. Doctor’s offices are beginning to use telemedicine, (much like Facebook or Skype only there is peripheral technology which can monitor things like vital signs, O2 sats, etc.). The (EMR) can help manage chronic patients without them having to leave their homes — enabling the patient to be pro-active in their healthcare. Thus saving time and money for the patient and trending toward earlier intervention versus having the patient show up at the emergency room because they waited for symptoms to get worse. As we move forward, we will be looking at population health outcomes, including health care resources being used more effectively and more efficiently to improve lifetime health and well-being of a specific population. 

          How have these trends and changes have impacted my leadership style? My leadership style has always been democratic, as it has always led to great ideas, more productivity, and a greater buy-in by staff. However, moving forward as a Regional Clinical Reimbursement Specialist for a post-acute care provider and with the October 1st rollout of the Patient-Driven Payment Model (PDPM), I feel my management style may change and become a combination of several management styles, which I will discover as the rollout occurs and I take this class.

Ashley O'Connor posted

Hello class. My name is Ashley O’Connor, and I am a Registered Nurse at an endosurgery center and gastroenterology office. I work full-time as I work toward my Bachelor of Science in Nursing degree. I hope to use this degree to advance my career and improve my knowledge of nursing. My husband and I live in Basking Ridge, NJ. We just moved here and are still getting familiar with the area. In my spare time I like to exercise, read, and I enjoy learning Spanish with my Rosetta Stone app.

 

The value-based purchasing model is a healthcare model that is leading change in the delivery of healthcare. According to Roussel et al. (2020) “the jury is out” (p. 316) on the effects of the model on the quality of care, however it is definitely having an impact on the way that administrators in healthcare facilities run their nursing departments. The value-based purchasing model must impact the leadership style of nurse administrators by affecting the way that they lead their units toward improvement in outcomes. A nurse administrator acknowledges that their reimbursement from government funded health insurance is based on the quality of care rather than the quantity of care. In order to maximize reimbursement and meet the requirements set by government health insurers, the nurse administrator evaluates the quality data while setting goals for improvement of quality and safety in their healthcare setting. The nurse leader can look to improve the quality of healthcare in areas including: fewer hospital readmissions, fewer medical errors, and a safer healthcare environment for patients.

 

Government funded health insurance measures the quality of healthcare by evaluating the improvement in outcomes based on the healthcare system and medical condition (Roussel et al., 2020). Process measures improvement in quality of healthcare by decrease in medical costs, increase in access, and increase in efficiency and effectiveness of the delivery of healthcare (Roussel et a., 2020). The value-based purchasing model prioritizes quality of healthcare delivery by incentivizing healthcare systems to improve quality to maximize their reimbursements. The purchasing model impacts the way that nurse administrators evaluate and manage their hospital units to optimize quality, not quantity of health care.

 

References

Roussel, L., Thomas, P., & Harris, J. (2020). Management and leadership for nurse administrators (8th Ed.). Burlington, MA: Jones and Bartlett Learning.