Task 1 Healthcare Organization Analysis

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Apr 3, 2024

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1 D223 – UKM1 – Performance Assessment 1 Brittany de Leon Leavitt School of Health, Western Governors University D223: Healthcare Policy and Economics Susie Perez March 27, 2024

2 A. Examine a healthcare organization that has significance to you, using the American Hospital Directory (AHD) website. A1. Selected Healthcare Organization from the AHD Site Nashville VA Medical Center at 1310 24th Avenue South, Nashville, TN 37212. A2. Significance of Chosen Healthcare Organization I chose the VA Medical Center because I am currently employed by the facility as an RN Care Manager. I am the wife of a Veteran who receives their care at the facility, and I have several Veterans in my family. I am honored to be a part of this healthcare organization that provides the necessary healthcare services for our Veterans each day. I believe in the core values and mission of fulfilling President Lincoln’s promise “to care for those who have served in our nation’s military and for their families, caregivers, and survivors” (va.gov). A3. Type of Facility The Nashville VA Medical Center is a short-term acute care facility. It provides a variety of traditional inpatient services including surgery, critical care, mental health, organ transplants, physical therapy, radiology, and palliative and hospice care. In addition, the facility offers outpatient primary and specialty care services including audiology and speech therapy, geriatric care, Oncology and Hematology, eye care, blind rehabilitation, and dental. A3a. Type of Control The Nashville VA Medical Center is a federal government-controlled facility. A4. Discussion of the Healthcare Organizations Overall Star Rating Centers of Medicare Services calculates the overall star rating based on the following quality measures: mortality, the safety of care, readmission, patient experience, and timely and effective care (medicare.gov). The overall rating reflects the hospital's performance in the quality measures compared to other hospitals within the U.S. The weight of each quality measure is about 22% with the exception of timely and effective care which is only 12% (cms.gov). The Nashville VA Medical Center was awarded a 4-star rating in 2023. According to the VA news release, 67% of VA hospitals included in the CMS overall star rating received either a 4 or 5-star rating, compared to 41% of non-VA hospitals (va.gov). A4a. Additional Source of Quality Data Clinical Outcomes CMS uses additional sources of quality measurement such as patient-reported data and surveys. For example, the VA uses a SHEP survey to randomly ask a portion of discharged patients about important aspects of their recent hospital stay. The SHEP survey includes the same topics used in the national standardized Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) Survey. The topics of the survey include communication with

3 the doctors and nurses, pain management, responsiveness of the staff, communication about medications, discharge education, cleanliness of the facility, hospital environment, and transition of care when discharging home (cms.gov). A5. Organizational Ethics Reflected in Facility and Control Type The VA has five core values that are the foundation for the VA’s mission which are the following: integrity, commitment, advocacy, respect, and excellence. In healthcare, we recognize the importance of providing high-quality care which means that we must be continuously looking for areas of improvement. The Nashville VA Medical Center is adopting high-reliability principles to support the Veteran Health Administration (VHA) High-Reliability Organization journey, which includes encouraging staff to report errors and/or patient safety concerns by utilizing an internal reporting database to report events that could lead to potential errors and/or patient safety events. The data collected through this promotes a Root Cause Analysis (RCA) to allow staff from multiple areas to look at the cause of the event and develop standardization to prevent the event from occurring. The VA also recognizes the importance of accessibility to healthcare. To improve access to care, the Nashville VA Primary Care teams have implemented monthly Saturday clinics for newly enrolled Veterans to establish care with Primary Care. Implementing Saturday clinics for establishing new Veterans has decreased wait times for existing patients to be seen for acute concerns, which has also improved overall patient satisfaction scores. A6. The Nurse’s Role in Value-Based Care (VBC) As a VA outpatient nurse, we have many roles in value-based care. A nurse’s role is to effectively and efficiently manage resources to provide high-quality care while also attempting to limit the cost incurred by the facility. In the last four years, VA nurses have expanded our role by integrating telehealth technology to help manage our Veteran’s chronic conditions such as hypertension. Remote telehealth monitoring allows the nurse to have real-time tracking and monitoring of the patient’s blood pressure readings while completing routine blood pressure follow-ups to assist the provider in monitoring the effectiveness of the medications. This allows the provider the opportunity to make changes to a medication without the patient needing an appointment for a follow-up visit which improves access for other patients to be seen. The outpatient nurse also improves the coordination of care by coordinating with multidisciplinary teams to ensure the patient has follow-up care needs addressed appropriately. Telehealth monitoring is effective not only in improving patients’ knowledge and ability to manage their health but also in reducing ER visits or hospitalizations. A7. Organizational Change Improving VBC Delivery Example(s) The VA recognizes the importance of transparency to gain the trust of the Veterans while helping the Veterans make informed decisions about their healthcare. When COVID spread quickly across our nation, the VA opted to promote the use of telehealth appointments to improve access to healthcare while keeping staff and patient safety a priority. This allowed the

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