Impact of Business Practices, Regulatory Requirements, and Reimbursements on Patient-Centered Approach in HealthCare Organizations

Healthcare organizations are diverse institutions whose major goal is to provide patients and others in need with high-quality care and services. Patient-centered care is a type of managed care that emphasizes the need of prioritizing patients’ needs in order to improve quality of care. However, because managing health care is a hard job, controlling such an organization is frequently different from running other for-profit organizations. Commercial practices are frequently profit-driven, but health agencies profit from value-based quality services. The three components of business practices, regulatory requirements, and reimbursement have spurred good improvements in the health industry in a variety of ways. The healthcare organization used in this essay is a county hospital that admits a large population because the hospital services cost is assumed to be subsidized to accommodate all.

Business practices have enabled health organization to formulate a competitive edge approach through the patient-centered model of nursing. It is through stakeholder participation integrated with managed care which leads to decreased overall expenses. Hospitals have become more aware on leveraging their spending through better resource management by making fewer process delays, reducing waste of staff members and hospital materials as well. All this has contributed to the improvement of managed care systems in health institutions. These business practices have been put in place because the health care center discussed in this context deals with a highly populated community that upholds Hispanic cultures. Also the community is mainly composed of individuals with low socioeconomic status who are not able to afford costly services especially for persons suffering multiple health complications such as kidney dialysis and renal failures which is common amongst the aged population

Regulatory requirements such as individual level patient-clinician interactions, quality improvement activities such as evidence-based medicine and practices as well as Governance level requirements have all brought positive changes in patient-centered care. Hospitals adhering to these regulations can incorporate values of transparency, recognition, respect, cultural competence, and leadership all of which add on to the principles of managed care (Greene, 2012).

Tying patient satisfaction to reimbursement plans has allowed more healthcare organizations become more accountable and efficient in disseminating services. Managed care entails provision of exemplary services to satisfy customer’s needs without asking for additional. This reimbursement plan has helped to improve services since patient experience is directly related to the organizational reputation (Rosin, 2015). All the above tripartite factors have created room for positive changed in managed care and patients are now able to get the quality treatment they deserve.

Patient and Family-Centered Care (PFCC)

Description of Healthcare Setting Applied in PFCC

The Patient and Family-Centered Care (PFCC) organization of my choice is an acute care setting. The acute care center is located within county hospital in an area dominated by Hispanic cultures

l. The health care serves a large population as such its facilities have been designed to accommodate 1000 inpatient users and 2500 outpatient services. It facilitates a quick service for patients with severe injuries, trauma, episodes of illness, urgent medical interventions, are just some of the treatment options available in the setting. PFCC’S respects the values of the patients, provides the information that peopleⁿ0p a need, guarantee physical comfort and more importantly, provide transformational change in healthcare. The main aim of the setting is to offer suitable active treatment and in the shortest time possible then discharging of the patient. To help promote Patient and Family Centered care, Universities and Hospitals train, hire and place caregivers and the patients to serve as advisors on clinical boards alongside with the staff, administration and the faculty of a university involved. The advisors chosen may share opinions, personal experiences and stories in order to champion initiatives that improve the safety of the patients involved while creating more patient related programs.

Strengths and Weaknesses of Acute Care Setting for Each Domain Applied in PFCC

The acute care setting has been well rated by users. It has a number of strongholds that enables the organization to carry out its operations effectively.

Leadership / Operations

First the organization enjoys a great leadership team that unites all staff towards the same goals of offering better services for all. Leadership under such a setting adopts teamwork which is significant in policy formulation and treatment methods. Second, the acute center has recruited skilled professionals and experts who have been able to deal with emergencies which only focus on patient care without too much indulgence of family propositions. In addition, the organization has a well-established quality of standards whose primary aim of acute care organizations. Strength of an acute setting is personnel efficiency. Staff members rely heavily on the partnership with patients and their families to offer the best possible care on a small window of opportunity to minimize risk.

Mission / Vision/ Values

The primary mission and vision for acute care are to give the best emergency care for the patients through meeting their immediate needs thus a high point for the model. Due to the nature of medical injuries and intervention plans adopted by acute settings, planning clinical designs is essential to improve quality. The organization also offers management specialized training sessions for different stakeholders such as managers, health specialists and other employees who maintain signals within the health care setting.

Advisors

Advisory councils between patient/family and hospital committees are generally ignored in acute care settings. Although care is upheld, most patients and their families do not have a lot of say-so when it comes to pressing matters of the hospital. It is imperative to select a liaison or a coordinator who will be able have the passion for the Patient and family- Centered care and have enough time for PFCC activities. Sometimes committees lack such a coordinator and the entire exercises are put under great jeopardy. Another weakness lies behind the management control of employees. Most PFCC’S lack the guiding vision, the right organizational culture and organizational leadership. PFCC’S more often than not initiate partnership without putting efforts to build staff commitment.

Quality Improvement

A number of PFCC quality assessment team are well informed on the standards used to assess the quality requirements in the health sector. Also the PFCC quality improvement has been backed up with great technological innovations designed by creative technocrats. Their weaknesses lies when the quality team members are absent or when client’s feedback fails to match the organizational expectations. Government polies adjustments has also posed a weakened the Quality assurance team

Personnel

Strengths: Creativity levels are high because the PFCC personnel team are equipped with great skills throughout their training sessions. Also the number of the personnel is adequate ensuring that all the patients are well taken care of. The experience that personnel team gathers from the health care center is also effective in managing other related tasks. Their weaknesses lies in being too critical to their achievements, attempts to please their employers and clients and inadequate familiarization with latest software’s required in their job.

Environment and Design

The environment and design domain that exists within the PFCC is quite flexible to handle any anticipated changes. It is also easy to learn and maintain while managing the organizational objectives at hand. One weaknesses of the Environment and design team in poor skills in creating personalized services. Also the available design does not recognize data entry to all attributes that was used in the past decade.

Information/Education

The ministry of health has increased awareness on acute treatment and diagnosis over years. The education offered is free because it is delivered to the community by volunteers. However, Information/education is very poor. Most people do not plan to visit acute care hospitals since they are meant for emergencies for PFCC. The cultural beliefs of many of the community members has also made it impossible to ensure satisfactory services as some individuals are reluctant to conform to the offered solutions in their treatment such as dialysis and organ transplant.

Diversity & Disparities

The organization has achieved diversity goals through recruitment of a vast exerts in health care. They have contributed to the organizational success using their skills and talents. However, disparities on the field of knowledge has brought about conflict of interest on major activities.

Charting and Documentation

The acute care center has been able to maintain history and assess their progress through computerized data analyzed and saved in safe drives in form of progressive charts and documentation. This domain has however faced a number of distortion especially damages resulting from virus attack and malware actions that tempers with their accuracy.

Care Support

The organization has a well-informed customer care support available for 24 hours. Customers are able to present their queries through emails, short messages or through phone calls. However I cases whereby the number of causalities are many the care support may be unresponsive as attention is diverted to the emergency sector. This is a weakness to the organization.

Care

Care has its own strengths, first because of the maximum care and protection of client’s privacy and confidentiality is highly provided to all customers. However, there is no privatized or special treatment for delegates who may visit the organization for treatment and diagnosis purpose.

Improving Advisory Councils between Patient/Family and Health Organization

Advisory between patients and hospital committees is an essential part of PFCC. Patient and Family Advisory council is comprised of staff, family members, clinicians and administrators. It is a voice to the patients and family members who would otherwise be voiceless. The patients and family members collectively work to deliver the highest quality services for patients while providing shared expertise. The domain allows for communication, transparency, accountability and meeting the needs of the patients themselves. Most emergency cases are usually traumatizing and caution ought to be taken to improve on offering better services. Learning opportunities and sharing experiences between hospital leadership structure and the patients is an improvement that needs to be embraced.

Area of Improvement

Increasing Patient-Centeredness in the Organization through Addressing Advisory Weakness

One basic are of improvement would be strategic increase of advisory organs for centeredness at different levels within the acute setting. This improvement would be helpful in solving communication gaps that exists between the health professionals and the patients. I would also seek to address patient’s complains through creation of an effective communication in an atmosphere of evaluating patients feedback response in the hospital to improve services. This can be made possible through conducting interviews and surveys on the both the physician’s part and the service users to create patient centered services. Further, I would seek to handle the patient’s complaints with much understanding to ensure that the gap that exists between us is bridged. Altering expectations of healthcare professionals and becoming comfortable with uncertainties will further increase patient- centeredness in the organization.

Applying Change Theory in Strategy Development to Address Advisory Shortcomings in the Organization

In this section Lewins change theory will be used in change management towards the improvement of the advisory councils.

Application of Lewin’s Change Theory

Stage/Step

Description of Stage/Step

Application of Stage/Step

to this Change

Stage 1: Unfreezing

Reduction or suppression of forces, alteration of the existing attitudes and all present Behaviour. Determining the need for change

Allow health professionals who have not been performing well to work under probation.

Ask all stakeholders their opinions on change anticipation

Analyze organizational Behaviour and culture.

Stage 2: Moving

strategizing new attitudes or behaviors for change implementation

door to door campaigns on acute diseases

an increased patient satisfaction scores

increased customer preparedness

allow patient satisfaction scores through customer awareness programs

Stage 3: Refreezing

Consolidation of new change by reinforcing all the proposed mechanisms, policies and organizational norms

Used Quality assurance on managing patients safety and quality of services

Another strategy is publication of customers feedbacks

Make the acute health services more affordable

Multidisciplinary Team Development and Roles Allocation

Implementation of policies requires a lot of workforce output, participation, and consultation. The process is often rigorous and requires hands-on teams of members that offer a broad range of skills, knowledge, and discipline in different roles. Hence, in implementing the above strategies, the following officers are required.

Chief Physician: to offer leadership qualities and share intellectual advice to other stakeholders.

Former Patient committee of at least five members based on demographic factors: This is an important aspect since their contribution and understanding of patients needs is exceptional and unprejudiced.

External Consultant: to mediate and streamline the work output of the implementation team as well as offering skilled advice.

Hospital Managing Partner/CEO: To provide guidance on the scope of the process with regards to budget concerns, administration, and prospects

Nursing Chief: To link the needs of the top management and the patients to offer a diplomatic way forward.

Meeting Cultural Competency in the Team through Cultural Diversity

The decision to choose former patients on the panel based on demographic factors such as age, gender, race, ethnicity, and religion allows for a culturally competent outcome. A patient-centered outcome is not based only on quality services but also the ability to embrace and appreciate cultural competencies of all patients irrespective of the differences noted.

Benefits of having cultural diversity within the teamwork in the Acute Health care setting

Enhancing the team’s competency through cultural diversity will benefit the acute health care with a number of benefits. First, innovation and creativity levels will be high because people will use their background experiences and working styles to offer great solutions to the organizational needs. Also cultural diversity will open doors for all practicing officials to improve work performance through utilization of the different talents and skills that the team have in achieving the set goals. Cultural diversity in teams is a great tool in improving teammate’s talents and enhancing language skills. Team members will learn from one another and develop their talents and skills which will boost their performance in offering effective patient-centered services

Transformational Leadership Implementation

Transformational leadership will allow the healthcare organization to radically change its direction and perspective on how to achieve its goals and objectives towards one purpose, which is patient-centered which is much more efficient. This implies that the organization’s outlook will ultimately shift and its reputation redirected to the doctrines and principles of managed care from top management to the subordinate staff.

Implementation of Strategy

Implementation Step

Responsible team member

Complete PFCC tool

Nursing Chief

Discuss PFCC tool with Manager

External Consultant

Create a Multidisciplinary team

Hospital Managing Partner/CEO

Conduct first team meeting

Chief Physician

Develop plan

Hospital Managing Partner/CEO

Develop budget

Hospital Managing Partner/CEO

Create educational materials

Nursing Chief

Develop implementation time line

Nursing Chief

Implement project

Hospital Managing Partner/CEO

Collect post-implementation data

Former Patient committee

Make any adjustments needed.

Chief Physician

Self-Assessment Tool

The Kerisey Temperament Sorter will be used to allow each team member to assess their individual skills for working in teams. The team members will complete the Kerisey tool at the first organizational team meeting. This will allow each team member to identify their strengths and weaknesses in dealing with other team members.

Communication in Healthcare Organization

Communication is critical for the growth and development of any organization. It is through sharing information values of transparency, respect, honesty, and goodwill. Conducting an all involved meeting with stakeholders of the organization will help pass the desired outcomes and identified strategies information along. Also, the health organization staff members will also get an opportunity to learn what is expected of them and ways to meet these targets.

Two tools will be used to measure the team’s self-development. The Mayo High Performance Teamwork scale will be used in this case to assess the effectiveness of team in implementation of the agreed strategies throughout the training session organized by the organization. This tool will enhance teamwork rating using explicit descriptors teams Behaviour as a way of self-assessment using video reviews or report writing. The second tool that will be used after the SWOT Analysis will be TeamSTEPPS. TeamSTEPPS is a unique tool for training intervention designed as self-report. Team members will be given such report cards to record their self-development process to the multidisciplinary healthcare professionals for further improvements.

References

Clancy, C. (2008). AHRQ: How Patient-Centered Healthcare Can Improve Quality. Psqh.com. Retrieved 28 February 2017, from http://www.psqh.com/marapr08/ahrq.html

Forman, H. (2011). Nursing leadership for patient-centered care (1st ed.). New York: Springer Pub. Co.

Greene, S. (2012). A Framework for Making Patient-Centered Care Front and Center. The Permanente Journal, 16(3). http://dx.doi.org/10.7812/tpp/12-025

Rosin, T. (2015). Patient experience and quality impacts on reimbursement: 5 things to know. Beckershospitalreview.com. Retrieved 28 February 2017, from http://www.beckershospitalreview.com/hospital-physician-relationships/patient-experience-and-quality-impacts-on-reimbursement-5-things-to-know.html