Institute Healthcare Improvement http://www.ihi.org / familiarize nursing quality indicators. How quality indicators reflect quality nursing practice? #2) Visit a website Institute Healthcare Improvement http://www.
Nursing quality indicators

How quality indicators reflect the quality of nursing practice

The link between quality of nursing practice and patient outcomes has been demonstrated through research. Over 1,000 facilities in the U.S. have contributed to the growing database on nursing quality indicators in order to help improve the quality of nursing care given to patients. A review of the history and evaluation of nursing care quality has shown that the nursing indicators have helped to strategize patient outcomes to become nursing-sensitive and to measure the value of care provided to patients. Nursing in its professional definition and guidelines requires the nurses to evaluate and improve their practice. This helps the nurses to recognize the sufficiency of their practice and improve their role in patient safety and quality…...

Nursing doesn't work in an auxiliary role to medicine, but independent of medicine. Nurses provide both direct and indirect care and also manage cases, establish nursing practice standards and procedures for quality assurance and also direct various care systems. The number of nurses in the United States is four times that of physicians and they deliver a wide range of care services including preventive and curative care in such areas as women's health, erotological care, family health and pediatrics (Nursing Fact Sheet, 2017).
As Designers and Providers of Patient-oriented Healthcare

As regards healthcare innovation, cross pollination is necessary and does take place between the various sectors in healthcare. For instance, ideas developed by nurses don't only support nursing practice, but are also applied in various other disciplines within healthcare (Omachonu & Einsprunch, 2010). With increased innovation, patients suffer less and the complexity of healthcare provision is reduced. Further, innovations lead to optimizations…...

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References

Berwck, D., Nolan, T., & Whittington, J. (2008). The Triple Aim: Care, Health, And Cost. Health Affairs, 759 - 769.

Institute for Healthcare Improvement. (2017). The IHI Triple Aim. Retrieved from Institute for Healthcare Improvement:  http://www.ihi.org/Engage/Initiatives/TripleAim/pages/default.aspx 

Nursing Fact Sheet. (2017). Nursing Fact Sheet;. Retrieved from American Association of College of nursing:  http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-fact-sheet 

Omachonu, V., & Einsprunch, N. (2010). Innovation in Healthcare Delivery Systems: A Conceptual Framework. The Innovation Journal: The Public Sector Innovation Journal.

healthcare administration and governance is medical staff credentialing and "delineation of privileges." As a senior manager, you will be directly involved in making sure that physicians practicing in your organization are qualified for the services they offer and procedures they perform. You must protect patients' safety as highest priority in this regard. hat steps will you take in the process of physician credentialing and delineation of privileges for your hospital or clinic?
The delineation of privileges may be one of the most important aspects to healthcare management. If the professionals that are tasked with treating patients are not properly trained or qualified then it is likely that patient care will suffer. Therefore, credentials for the delineation of privileges must be designed individually based on the particular roles of the employees in the organization. They should also follow best practices and national standards. Each position in the hospital should be designed…...

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Works Cited

Haynes, D. (2008, September 13). What Nurses Want. Retrieved from The Washington Post:  http://www.washingtonpost.com/wp-dyn/content/article/2008/09/12/AR2008091203367.html

ICU Delirium -- Evidence eview and Synthesis
Evidence eview

Luetz et al. (2014) conducted a study in which they examined how delirium management is an important aspect of intensive care treatment alongside analgesia and sedation management. The main objective of the study was to examine the implementation rate of delirium screening by healthcare professionals in the intensive care unit. To achieve the study's objectives, the researchers utilized a multinational, two-part survey in which hospital and ICU data as well as patients' data was collected and analyzed. The study found that even though 44% of hospitals and ICUs reported using a validated screening assessment, only 27% of patients had been monitored using the instrument. Additionally, the researchers found that a validated screening instrument enhances the ability of healthcare professionals to identify ICU delirium. The study provides Level III evidence, which is essential for this study to promote the use of a validated ICU…...

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References

Filinson et al. (2016). Adoption of Delirium Assessment in the Acute Care Setting: A Tale of Two Hospitals. Best Practices in Mental Health, 12(2), 81-95.

Friedman et al. (2014). Delirium in Advanced Cancer: Screening for the Incidence on Admission to an Inpatient Hospice Unit. Journal of Palliative Medicine, 17(9), 1045-1048.

Ista et al. (2014, October 2). Improvement of Care for ICU Patients with Delirium by Early Screening and Treatment: Study Protocol of iDECePTIvE Study. Implementation Science, 9(143), 1-10.

Luetz et al. (2014, November). Delirium, Sedation and Analgesia in the Intensive Care Unit: A Multinational, Two-Part Survey among Intensivists. PLOS One, 9(11), 1-6.

MMC Case Study
Major Problems and Secondary Issues

Organizational Strengths and Weaknesses

Alternatives and ecommended Solution

Evaluation

In the early 1990's a new Medicaid managed care company, MMCC, set up shop in the neighborhood right across the street from a major medical center in downtown Baltimore that served many poor patients. The company seems to have embarked on a strategy to maximize its revenues without providing a value to their patients. They are compensated when they enroll new patients and thus they have an incentive to grow their client base. However, they are expected to provide services to the patients under their care. MMCC has taken steps to create bottlenecks for the patients to receive healthcare services so that they can maximize short-term profits.

Major Problems and Secondary Issues

All companies must have a strategy that creates a return on investment for their stakeholders. Some companies focus on maximizing profits in the short-term while others attempt to…...

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References

Bass, B. (1985). Leadership and performance beyond expectations. New York: Free Press.

Bass, B. (1999). Two decasdes in research and development in transformational leadership. European Journal of Work and Organizational Psychology, 9-32.

Kilburg, R., & Donohue, M. (2011). Toward a "Grand Unifying Theory" of Leadership. Consulting Psychology Journal, 63(1), 6-25.

Select a problem or issue in the healthcare industry that you know needs changing or improvement.One area within the healthcare industry that required change and improvement are costs. Costs relative to other developed nations is very high, without the corresponding benefits of such costs. Currently the Untied States spends roughly 18% of GDP on healthcare related expenditures. Many experts believe that healthcare expenditures as a percentage of GDP will rise to nearly 20% by the year 2030. This will equate to roughly $4 trillion dollars being spent on healthcare related expenditures. This however is in stark contrast to actual healthcare outcomes which are not manifesting in the manner commensurate with the increase in costs. Currently, the United States is ranked last out of the 11 wealthiest nations of earth as it relates to healthcare outcomes. As a result, the United States is spending more than any other country but has…...

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References 1. Badham, R, Mead, A, Antonacopoulou, A (2012) Performing change: A dramaturgical approach to the practice of managing change. In: Boje, DM, Burnes, B, Hassard, J (eds) Routledge Companion to Organizational Change. London: Routledge, 187–205.2. Beck, RN (1987) Visions, values, and strategies: Changing attitudes and culture. The Academy of Management Executive 1(1): 33–413. Brotman, R (1958) Review of The Dynamics of Planned Change by Ronald Lippitt, Jeanne Watson and Bruce Westley. American Sociological Review 23(3): 341–342

Healthcare Program Improvement
The purpose of the program or project.

The purpose of the quality program is to create a system that will better equip personnel in the workplace to identify barriers to patient flow, create pattern solutions to improve patient flow, and use measurement of data to evaluate the quality improvement plan and to support implementation of the improvement efforts. The patient flow improvement plan will be based on the proven methods of eal Time Demand-Capacity (TDC) management and planning.

The target population or audience.

The program is designed for the staff, practitioners, and clinicians who work within the environments that directly impact patient care and that require the movement of patients into and out of these contexts.

3.The benefits of the program or project

The patient flow quality improvement plan is based on learning outcomes and practices employed in other fields. A number of key concepts are found across these disciplines and they provide…...

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References

Sweeney, B., Meisner, H., Lovett, P.B., DeEugenio, L., Caliguri, D., DeAngelis, H., Johnston, M., and Premaza, M. (2013, February 26). Use of the Institute for Healthcare Improvement's (IHI) Real Time Demand Capacity model to promote organizational values and optimize patient flow. Philadelphia, PA: Thomas Jefferson University Hospital (TJUH). Retreived  http://www.ache.org/PUBS/Research/mgmtinnovationsPDFs13/IHI-RTDC-OrganizationalValuesPatientFlow.pdf 

Resar, R., Nolan, K., Kaczynski, D., and Jensen K. (2011, May). Using real-time demand capacity management to improve hospital-wide patient flow. Journal on Quality and Patient Safety, 37(5), 217-227.

Flow Seminar. Retrieved  http://app.ihi.org/marketing/program_documents/Flow_Seminar_Oct2014_InfoCall_FINAL.pdf

Healthcare
We can compare the healthcare workplace to what is seen by a person when he/she looks through a kaleidoscope: since there are numerous different patterns that appear as the moments pass by. The shortage of nurses which has been publicized widely and the high turnover rates amongst the nurses are some of the unwanted patterns which have occurred. The dependence of healthcare institutions on the nurse-managers for the retention and recruitment of nurses is steadily increasing (Contino, 2004).

There are a number of routes through which the critical care nurses have become the leaders. Most of these routes don't have any educational or managerial training as a part of the process. There is a need for effective strategies for the care leaders who provide critical care in order to inspire the staff and manage the departmental operations in an effective manner to get positive results. One of the strategies that are…...

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References

Adams, J., Erickson, J., Jones, D., & Paulo, L. (2009). An evidence-based structure for transformative nurse executive practice, Nursing Administration Quarterly, 33(4), 280-87

Advisory Board Web site. (2004). Available at:  http://www.advisory.com .

Ales, B.J. (1995). Mastering the art of delegation. Nurs Manage. August; 26: 32A, 32E.

American Organization of Nurse Executives (2005). AONE Nurse Executive Competencies. Nurse Leader, 3(1), 15-22.

Healthcare/Statistics/Human esources Leadership
Human esource Management in Healthcare

The article taken into consideration in this assignment is Home Care: The Fastest Growing Low-Wage Industry by Candace Howes. In accordance to Howes (2015), essentially all the growth and development in the Long-standing Services and Supports industry is encompassed in home and community-based services that are progressively being more subjugated by the fast-growing for-profit home care agency industry where charters are making considerable and noticeable progress (Howes, 2015). In contradiction of nurses' aides in hospitals and nursing homes, who are undertaking, in fact, similar jobs, home care workers employed by these agencies and by public entities are not covered under the FLSA (Fair Labor Standards Act). In turn, this makes it prohibitive for them to link with unions and repudiating them the right to minimum wage and overtime protection (Howes, 2015).

I agree that home-care health nurse aides ought to be eligible for minimum wage…...

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References

Casto, R. (2015). Why Are Statistics Important in the Health Care Field? Livestrong. Retrieved 11 January, 2016 from:  http://www.livestrong.com/article/186334-why-are-statistics-important-in-the-health-care-field/ 

Curtis, E. A., de Vries, J., & Sheerin, F. K. (2011). Developing leadership in nursing: exploring core factors. British Journal of Nursing, 20(5), 306.

Giltinane, C. L. (2013). Leadership styles and theories. Nursing Standard,27(41), 35-39.

Howes, C. (2015). Home Care: The Fastest Growing Low-Wage Industry. New Labor Forum 2015, Vol. 24(2) 98-10.

Health Care
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).

Identify the milestone you chose in the history of quality improvement in the first…...

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References:

1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81

2) Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.

3) Kelly, D.L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press

4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1

Healthcare spending by the New York State persistently surpasses its earnings. That difference continues to be expanding and is also anticipated to broaden unless of course there happen to be severe, continuous modifications in spending budget actions. Lieutenant Governor ichard avitch, in "A 5-Year Strategy to Deal with the State of New York's Spending budget Deficit" released during March 2010, approximated this structural disproportion within the state's spending budget to become no less than $13 billion. The structural inequality isn't simply the consequence of the economic downturn that started during 2007, and a commonly strengthening economic climate is not going to get rid of it.
To help the State of New York in providing the solutions and dedication to quality that its residents rely on, structural modifications are needed. The aim of this paper is actually to summarize one particular realignment - solving an outright inequity involving the state as well…...

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References

California Public Employees' Retirement System, "Facts at a Glance: Health," September 2010,  http://www.calpers.ca.gov/eip-docs/about/facts/health.pdf .

Citizens Budget Commission, Out of Balance: A Comparison of Public and Private Employee Health Benefits in New York City, December 2009,  http://www.cbcny.org/sites/default/files/REPORT_Survey_12162009.pdf .

City of New York Office of Labor Relations, "New York City Summary Program Description, Health Benefit Program," 2010, http://www.nyc.gov/html/olr/downloads/pdf/healthb/full_spd.pdf.

Government Finance Officers Association, "Recommended Practices, Health Care Cost Containment 2004,"   .http://www.gfoa.org/downloads/corbaHealthCareCostContainment.pdf 

Health Care Reimbursement and Billing
Both Mrs. Zwick and Mr. Davis face significant issues in the presented scenarios. Mrs. Zwick has multiple considerations under Medicare Parts A, B and D, in addition to her hospital-acquired urinary tract infection. Meanwhile, Mr. Davis must address the severe time constraints and costs of COBRA in light of his job termination. These two scenarios underscore current difficulties and complexities of current health care in the United States.

Discussion of Mrs. Zwick's coverage under Medicare Parts A, B and C

Medicare Part A (often called "hospital insurance") (U.S. Department of Health and Human Services, 2011, p. 15) assists in covering inpatient hospitalization and skilled nursing facilities, hospice and home health care (U.S. Department of Health and Human Services, 2011, p. 14). There is usually no monthly premium if you and/or your spouse paid Medicare taxes while employed (U.S. Department of Health and Human Services, 2011, p. 28). However,…...

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Ethical implications of Mrs. Zwick's incurring costs related to her hospital-acquired condition are applicable despite the rehabilitation facility's exemption from POA/HAC Medicare laws. Having no first-hand knowledge of the cause of the urinary tract infection, no clear indication that I work at the rehabilitation facility and neither the privilege nor the duty of diagnosis, it would be unethical for me to tell Mrs. Zwick about my suspicions. Rather, a nurse is required to maintain his/her professional boundaries (American Nurses Association, 2001, p. 6). Simultaneously, a nurse is supposed to assure "responsible disclosure of errors" to patients and act to stop bad practices and promote best practices (American Nurses Association, 2001, p. 6). Consequently, a nurse in my position faces a dilemma: lack of personal knowledge and authority vs. my concern for the patient's well-being and constant improvement of the profession. In the face of this dilemma, I would: contact the rehabilitation facility's newly-hired nurse and advise/remind him/her of the duty to report to the appropriate supervisor and responsible disclosure to Mrs. Zwick; contact Mrs. Zwick's personal physician and explain the entire situation; direct Mrs. Zwick to discuss her health issues with her personal physician, who can review, diagnose and discuss the ramifications of her medical records, including but not limited to the urinary tract infection (American Nurses Association, 2001, p. 7). The desired outcomes would be: the rehabilitation center's absorption of Mrs. Zwick's costs related to her hospital-acquired infection through pressure exerted by its own nursing staff and Mrs. Zwick's personal physician; Mrs. Zwick's awareness of the true cause of her infection by health care providers who are directly responsible and capable.

Explain how the COBRA will allow Mr. Davis to continue his insurance coverage while he is out of work.

Due to Mr. Davis' termination from an employer of more than 20 employees, he can obtain coverage for himself, his spouse and his dependent children for up to 18 months (U.S. Department of Labor, 2012). In addition, due to his chronic cycle cell anemia, he may be entitled to an additional 11 months' extension for disability (U.S. Department of Labor, 2012). His employer is required to give a qualifying event notice to COBRA; then, COBRA sends a notice of the right to elect to continue coverage and an explanation of the steps that must be taken to continue coverage; Mr. Davis, his spouse and either or both of them in behalf of dependent children may elect for continuation of coverage

The idea with this part of the strategy is to be able to form some kind of a partnership with these individuals. This will help to push for a transformation inside the organization. As, these people will help to provide everyone with: a reason for adapting and pushing others to do so (indirectly). (Turner, 1999, pp. 162 -- 163)
Once this occurs, you could then have these individuals become a part of a committee. They will have the responsibility for making specific recommendations about how this can be implemented. This is important, because this will help everyone to realize that some kind of change is occurring inside the facility. Over the course of time, this will lead to shifts in the operating environment by giving people reason for embracing these changes. (Turner, 1999, pp. 162 -- 163)

The Effectiveness of the Plan

To determine the effectiveness of the plan the Human Resources…...

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Bibliography

Nationwide Medical Errors Cost $19.5 Billion. (2010). The Society of Actuaries. Retrieved from:  http://www.qualitydigest.com/inside/health-care-news/study-nationwide-medical-errors-cost-195-billion-annually.html 

Kovnar, A. (2008). Jonas and Kovnar's Health Care Delivery in the United States. New York, NY: Springer Publishing.

Turner, S. (1999). Essential Readings in Managed Nursing Care. Gaithersburg, MD: Aspen Publishing.

The expectations for these kinds of changes will be to see gradual shifts at first. Where, it may not seem like anything is changing at the facility. However, over the course of time, these kinds of changes will be obvious in the quality of treatment that is being provided will improve. As a result, the strategy will take approximately one year to fully implement a change in the atmosphere of the operating environment.

To ensure that these improvements can continue to be built upon a new system will be introduced of monitoring for shifts that are occurring. In this case, the committee that was established to implement these changes will become way of: monitoring the kinds of treatment that is being provided and the challenges that are facing the facility. This will be accomplished by having outside consultants conduct anonymous surveys of patients, staff members and within the community. They would…...

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Bibliography

Online Customer Surveys. (2011). Key Survey. Retrieved from:  http://www.keysurvey.com/solutions/healthcare-surveys.jsp 

SWOT Analysis. (2010). Quick MBA. Retrieved from: http://www.quickmba.com/strategy/SWOT/

Badrick, T. (2002). Role of External Management. Clinical Leadership, 16 (5), 281 -- 286.

Bennis, W. (1969). Organizational Development. New York, NY: Addison Wesley.

Healthcare Inequalities
Are healthcare inequalities UK

Defining Health Inequality

The term healthcare disparity or healthcare differences have been defined in a number of ways. Healthcare inequality can be defined as the difference of the health levels of any tow comparable demographic groups within a certain country or a region even when proper healthcare facilities are available. The inclusive incidences include higher rates of mortality as well as morbidity within the people who belong to lower occupational classes and are poorer. These rates are higher as compared to the mortality rates in the people who belong to better occupational classes being richer and more privileged. Second important aspect that has been highlighted in the definitions of healthcare inequality includes increased rates of occurrence of mental healthcare-based issues in people from poor classes.

A number of countries have been highlighted with healthcare inequalities including Canada and UK. Since 1980, the documentation of healthcare inequality in UK…...

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References

Asthana, S, and Dr. Halliday, J 2006, What works in tackling health inequalities?: pathways, policies and practice through the life course, Studies in poverty, inequality, and social exclusion, The Policy Press.

Barron K. 2009, Health inequalities: written evidence; Volume 422 of HC SeriesPaper (Great Britain. Parliament. (Session 2007-08). House of Commons)) Written evidence, The Stationery Office.

Davies P. 2007, The NHS in the UK 2007/08, 9th edn, The NHS Confederation.

Dowler E. 2007, Challenging health inequalities: from Acheson to choosing health, Health and Society Series, The Policy Press.

Achieving the Triple Aim in Healthcare

Introduction

The triple aim, introduced by the Institute for Healthcare Improvement (IHI) in 2007, has become a guiding principle for healthcare systems worldwide. It encompasses the three key objectives of improving population health, enhancing patient experiences, and reducing costs. While seemingly straightforward, achieving these goals simultaneously presents numerous challenges for healthcare organizations. This paper explores effective strategies and approaches to successfully navigate the complexities of the triple aim.

1. Focus on Population Health

Utilize Data Analytics: Gather and analyze data on health outcomes, risk factors, and demographics to identify population health needs and develop targeted interventions.
Promote....