federal government, and the nursing profession
federal government, and the nursing profession
8 hours. Use the articles. I have all the articles for references
Discuss 1
Identify a current healthcare policy in your current role that you would like to see revised. Why? What would be the projected outcomes?
In our discussion question #1, we will be looking at current healthcare policies that need revision. As you are reflecting on your response, how does the healthcare policy affect you? How does it affect other stakeholders?
One of the primary things to consider is being a nursing advocate. We are taught to be patient advocates but how many of us are actually nursing advocates? In becoming a nursing advocate expert, it is very important to understand the different modalities needed to successfully analyze a health policy.
This week’s graded topics relate to the following Course Outcomes (COs).
4. Determine the effect of healthcare politics on the healthcare stakeholders, state and federal government, and the nursing profession (PO #9).
5. Analyze legislative process and the impact of special interest lobbies (PO #9
1. How have you seen the legislative process impact patient care in your nursing practice or in the practice of other nurse
2. Who are the stakeholders and how could they be used in political analysis that might be different from their use in political advocacy?
3. Can you discuss the strategies you could utilize for a stakeholder who might be utilizing illegitimate power instead of legitimate power?
Health Policy Brief use this policy
Improving Care Transitions
Rachel Burton
An example of a well-written policy brief is presented here. It was developed by Health Affairs and the Robert Wood Johnson Foundation. Website resource: www.healthaffairs.org/health policybriefs/brief.php?brief_id=76.
Improving Care Transitions: Better Coordination of Patient Transfers among Care Sites and the Community Could Save Money and Improve the Quality of Care1
What’s the Issue?
The term care transition describes a continuous process in which a patient’s care shifts from being provided in one setting of care to another, such as from a hospital to a patient’s home or to a skilled nursing facility and sometimes back to the hospital. Poorly managed transitions can diminish health and increase costs. Researchers have estimated that inadequate care coordination, including inadequate management of care transitions, was responsible for $25 to $45 billion in wasteful spending in 2011 through avoidable complications and unnecessary hospital readmissions.
Several new federal initiatives aim to encourage more effective care transitions. In addition, debate continues over how to restructure fee-for-service payments to motivate providers across care settings to work as a team to make transitions smoother.
This brief examines the factors contributing to poor care transitions, describes the elements of effective approaches to improving patient and family experience with transitions, and explores policy issues surrounding payment reforms designed to address the problem.
What is the Background?
For years, health policy experts have identified poor care transitions as a major contributor to poor quality and waste. The 2001 Institute of Medicine (IOM) report, Crossing the Quality Chasm, described the U.S. system as decentralized, complicated, and poorly organized, specifically noting “layers of processes and handoffs that patients and families find bewildering and clinicians view as wasteful.”
The IOM noted that, upon leaving one setting for another, patients receive little information on how to care for themselves, when to resume activities, what medication side effects to look out for, and how to get answers to questions. As a result, the conditions of many patients worsen and they may end up being readmitted to the hospital. For example, nearly one fifth of fee-for-service Medicare beneficiaries discharged from the hospital are readmitted within 30 days; three quarters of these 74readmissions, costing an estimated $12 billion a year, are considered potentially preventable, especially with improved care transitions.
Root Causes.
There are several root causes of poor care coordination. Differences in computer systems often make it difficult to transmit medical records between hospitals and physician practices. In addition, hospitals face few consequences for failing to send medical records to patients’ outpatient physicians upon discharge. As a result, physicians often do not know when their patients have been released and need follow-up care. Finally, current payment policies create disincentives for hospitals to invest in smoother care transitions. For example, although Medicare does not allow hospitals to bill for readmissions that occur within 24 hours of discharge, it does pay full price for most readmissions that occur after that time. This means that the prevailing financial incentive for hospitals is to not expend resources on improving care transitions because a poor transition often leads to readmission, which generates additional revenue.
