D026 PPT-revised-4
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Western Governors University *
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D026
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Feb 20, 2024
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pptx
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AXM1 Task 1: Achieving Excellence in Patient Care through Value-Based Care Strategies
BRIGITTE M. PHILLIPS
COLLEGE OF HEALTH PROFESSIONS, WESTERN GOVERNORS UNIVERSITY
D026: QUALITY OUTCOMES IN A CULTURE OF VALUE-BASED NURSING CARE
DR. SANDY KANGAS
APRIL 7, 2023
Elements of a Value-Based Healthcare Framework
Understand the shared health needs of patients
Design solutions to improve health outcomes
Integrate learning teams
Measure health outcomes and cost of care
Expand partnerships
(Teisberg et al, 2020)
Benefits of Value-Based Care for Patients and Populations
Improved health outcomes for patients
Delivery of high-quality care
Improved patient experience
Elimination of unnecessary tests and procedures
Reduced cost
(Teisberg et al, 2020)
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Rationale for Implementing Value-Based Care in a Healthcare Organization
Improvement in health outcomes by using best practices
Decrease in readmissions
Decrease in emergency room visits
Improvement in overall health and well being
Reduction of costs
Nursing Role
Nurse as the manager of the healing environment
Creates
Coordinates
Advocates
(Western Governors University, n.d.)
The Advanced Professional Nurse
Nurse as the manager of the healing environment
Creates a therapeutic environment
Coordinates patient care with the multidisciplinary team
Advocates for policy change to better serve patient needs
(Western Governors University, n.d.)
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Summary of Current Evidence: Article #1
Payers are moving away from fee-for-service plans to value-based care to help with the extreme rising cost of health care
Patients need to be identified by risk and have their chronic diseases managed in a successful value-based care model
Diagnosis codes need to be precise
Team members need to huddle daily to discuss patients
(Dom Dera, 2021)
Summary of Current Evidence: Article #2
Need for high-quality healthcare and reduced costs
Healthcare costs continues to rise, passing 3 billion dollars in 2019
United States has lowest life expectancy, highest disease burden and highest number of preventable hospitalizations amongst the industrialized nations
Steps to implement value-based care:
Form a specialized team of healthcare professionals
Identify the needs of the patient population
Design and measure outcomes
Evaluate the programs effectiveness
(Rutherford et al, 2022)
Summary of Current Evidence: Article #3
Measuring and monitoring health outcomes started over 20 years ago
Measuring the value of healthcare is a relatively new concept
Value is the ratio between outcomes in health vs the costs of healthcare
A shared goal of value-based care and quality improvement is leading this initiative
Suggested strategies
Focus on patient needs
Measure outcomes
Bundled payments
Concentrate resources
Expand covered areas
(Salvatore et al, 2021)
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Summary of Current Evidence: Article #4
Value-based care delivery (VBCD) structure ties compensation to clinical outcomes
Leadership must possess certain skills to ensure success of VBCD
The Accountable Leadership Theory of Five P’s: p
romoting p
artnership between p
roviders, p
atients, and p
ayers
(Cornell, 2020)
Summary of Current Evidence: Article #5
Organizations need to evaluate outcomes and value
Evidence-based practices improve outcomes and my reduce costs
A study on the use of incentive spirometry found no evidence to support the use to prevent pulmonary complications after surgery, yet they continue to be widely used
Using a LEAN principles improve value
(Langell, 2019)
Implementation of Strategies
Strategy #1: Complete an impact analysis
Key Stakeholders: Quality improvement team, providers, and nurse management
Stakeholder’s Role: Review the impact that changes will have on patients, finances and team members
Method of Measurement: improved health outcomes with minimal impact to finances
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Implementation of Strategies
Strategy #2: Identify value metrics
Key Stakeholders: Quality improvement team, providers, team members, and nurse management
Stakeholder’s Role: Identify and input patient specific, measurable data into EHR Method of Measurement: Data retrieved from EHR
Readiness Assessment Summary
Defined need
Readiness for change
Leadership & Management support
Time, resources, personnel,
Sustainment of the change
Organizational Strengths
Supportive leadership team
Health information system to support metrics
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Organizational Opportunities for Improvement
Impact Analysis
Insufficient staffing
Level of Readiness
ECU Health-Duplin Hospital
Readiness Assessment Score
9
Readiness Assessment Copy
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References
Cornell, T. (2020). Leadership skills essential in the value-based care era.
Leadership in Health Services, 33
(3), 307-323. https://doi.org/10.1108/LHS-12-2019-0079
Dom Dera, J. (2021). How to succeed in value-based care.
Family Practice Management
,
28
(6), 25–31.
Langell, J. (2019) Evidence-based medicine: A data-driven approach to lean healthcare operations,
International Journal of Healthcare Management
, 14:1, 226-229. https://
doi.org
/10.1080/20479799.2019.1641650 Rutherford, B., Brockman, M., Hunt, S., Helton, J., & Schmidt, R. N. (2022). Transitions from a fee-for-
service (FFS) payment model: Evolutionary triple to quadruple aim transformation, value-based care and decreased provider burnout.
Journal of Business & Educational Leadership
,
12
(1), 97–109.
References
Salvatore, F. P., Fanelli, S., Donelli, C. C., & Milone, M. (2021). Value-based health-care principles in health-care organizations.
International Journal of Organizational Analysis, 29
(6), 1443-1454. https://doi.org/10.1108/IJOA-07-2020-2322
Teisberg, E., Wallace, S., & O'Hara, S. (2020). Defining and implementing value-based health care: A strategic framework.
Academic Medicine: Journal of the Association of American Medical Colleges
,
95
(5), 682–685. https://doi.org/10.1097/ACM.0000000000003122
Western Governors University. (n.d.). Nursing programs conceptual model
. https://cm.wgu.edu/t5/Nursing-Student-Handbook/Nursing-Programs-Conceptual-Model/ta-p/19