A Strong Patient Advocacy Team

The business operation I am going to discuss is patient advocacy. Patient advocacy is an effort to protect and/or defend patients; taken on by individuals, organizations, or groups. Therefore, advocacy is standing for or with a patient that have particular challenges or health concerns. Patient advocacy may include educating the patient and family, affecting public policies, and joining associations. Professional patient advocates heave often worked as social workers, case managers, nurses, or other professions that now focus on helping patient in their decisions making. Patient advocates works in partnership with patient educators, dietitians, psychologists, pharmacist, and community health workers.

The Patient Protection and Affordable Care Act (ACA) has created new forms of care organizations in order to provide better healthcare to Medicare and Medicaid patients at a greater value. The two types of organizations that this paper will focus on are Accountable Care Organizations (ACO’s) and Coordinated Care Organizations (CCO’s). There has been much information gathered regarding the similarities and differences between these organizations. This research has been conducted to better understand the way that ACO’s and CCO’s effect the hospitals, physicians, insurance providers, and patients involved in their implementation.

The health care system must change to improve our nation’s health and takes strong steps to address the unsustainable growth of health care costs in America. We still have a long way to go before our health system become effective. We still have population that do not have insurance, have difficulties accessing their health care, or their needs are not met within the healthcare system. It is an investment in prevention and wellness and increasing access to primary care physician.

The fact that there are broad spectrums of services available within the Kaiser Permanente network makes it easier to coordinate patient care. For example the Northern California site has implemented programs that focus on five “imperatives of personal care”, which are: patients have to have a primary care doctor, they need to be able to see that physician, patients that call have a short telephone wait, patients should receive timely appointments and have a great care experience (Commonwealth fund June 2009). Care management definitely plays a crucial role in health care. When the patients needs are met and quality care is received the result is patient satisfaction and potentially cost saving for the organization. Patients not only have to deal with health issues, many experience challenges within their environment and certain limitations depending on socioeconomic status. Therefore , coordination of patient care is key to the success of any health care delivery system.

Patient-Centered Medical Homes (PCMH) are growing in popularity as the right thing to do improve patient care. PCMH are growing in popularity, as there is early evidence of their effectiveness (Egge, M. 2012). The PCMH concept has been widely promoted as a way to enhance primary care and deliver better care to patients with chronic conditions. This model of care has stimulated the attention of payers, Medicaid policy makers, physicians, and patient advocates, as it has the potential to address several of the limitations of the current healthcare system (Wang, J. et al 2014). Currently, primary care in the United States is focused on acute and episodic illness, it inadvertently limits comprehensive, coordinated, preventive and chronic care (Bleser, W. et al 2014). The PCMH address these limitations through organizing patient care, emphasizing team work, and coordinating data tracking (Bleser, W. et al 2014). A PCMH and HMO have some similarities but are markedly different.

Using the Patients Rights listed above the American Hospital Association identified what expectations patients have that should be met under the Patient’s Bill of Rights in the Patient Care Partnership. Patients should expect high

Health care spending grew 3.7 percent in 2012 and the traditional way medicine was practiced had to change (Edlin, Goldman & Leive, 2014). The Affordable Care Act and Population Health was designed based on the concept of “The Triple Aim” to foster change in patient care by providing better care for individuals, better health for populations and decrease the cost of health through improved care (Perez, 2014). As a result, population management has moved to the front by linking services, reducing hospital admission, risk stratification, pursing preventive medicine, ensuring medication review and lowering health care cost. Several organizations have follow in the pursuit of population management by forming Accountable Care Organizations

One of the aims of the Patient Protection and Affordable Care Act (ACA) of 2010 is improved integration and coordination of services for primary patient care. The patient-centered medical home (PCMH) is one of the approaches by which improvements can be established. The patient-centered medical home model is particularly well-suited for people who have chronic illness. The design of the patient-centered medical home model departs substantively from traditional reimbursement policies, in that, the ACA provides for incentives and resources to enable care coordinators to be directly recognized and compensated for their care coordination work. Care coordinators are most often registered nurses who through their work that aligns with ACA engage in quality improvement work, cost-effectiveness measures, and patient advocacy. To bring the ACA model to a human scale, the authors present a case study of a care coordinator at a patient-centered medical home in rural Maine. The table provided below provides a basic textual analysis of the study as it is published in the professional nursing journal.

A major change is occurring in the healthcare system as the United States continues to move toward enhancing patient care quality and access while also decreasing cost. This significant transformation is driven by a variety of forces, including changes in managed care, a shift from pay for service to pay for quality, and ever-evolving client characteristics. This paper aims to discuss each of these factors and the ways in which they make this major transformation a difficult one for the nation to undergo.

The healthcare industry has intensely advanced throughout the world, in turn changing the principles that incorporate the practice and culture of nursing practice. Altering the model of care to a patient-centered mode signifies an organizational culture shift and requires the participation of executives at the senior level (Cliff, 2012). To practice this care to provide the best care possible, it goes beyond the nurse to all healthcare professionals and senior leadership. The days of patients and nurses following a physician’s order without favor to care has now loaned themselves to more of an interdisciplinary approach to practice. Though, it is encouraged that the patient makes decisions for themselves, after receiving the proper education and information on their condition. Part of the patient-centered care is to be the patients’ advocate, by letting them know you are there for them when they are unable to speak and advocate for themselves and what is in their best interest. That goes in hand with educating them on “self-management of care, health literacy, patient, and family education through nurse-patient communication and interaction (Finkelman & Kenner, 2016, p. 271).”

Our healthcare system needs major restructuring. Major improvements needs to begin with "all health care organizations, professional groups, and private and public purchasers should adopt as their explicit purpose to continually reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people of the United States", (Crossing the ……, 2001).

The presence of nurse practitioners (NP) in health care has been necessary for more than five decades. The American Association of Nurse Practitioners (AANP) indicates that there are over 205,000 NPs in the United States being utilized by Americans for their health care needs (AANP, 2015). NPs are a vital part of the modern health care system and are accepted by both health care consumers and other health care providers (Fairman, 2015). A study performed by Hart and Mirabella (2015), of emergency department patients determined that patients were satisfied with treatment by a NP in the past and were willing to receive treatment from the NP during their current visit. A study conducted in emergency departments in Canada indicated that NPs demonstrate attentiveness, comprehensive care, and role clarity (Thrasher 2008). These positive characteristics are critical components of patient satisfaction. Additionally, NPs have been utilized more especially with more American developing insurance coverage through health care reform. According to the Department of Health and Human Services (2013), those seeking services in primary care is expected to continually rise through 2020. This increased demand is largely due to the growth of an aging population and from the Affordable Care Act increase in insurance benefits. The Affordable Care Act, along with the shortage of primary care physicians, has expanded the role of the nurse

The American Nurses Association is leading the way by implementing countless initiatives to bring attention to the nurses’ essential role in care coordination. It is up to the nurse to step up and draw attention to the integral part they play in improving patient satisfaction, patient care quality, and the effective and efficient use of health care resources (American Nurses Association, 2012).

In a profession where others' health and well-being are priority, there leaves room for neglect of those who are delegated to care for these people. As a professional nurse, there are many obstacles that arise and affect the care provided to a patient, as well as the livelihood of the nurse. The current deteriorating and unsafe staffing conditions in hospitals and other institutions prompts workplace advocacy as the universally appropriate concept for maintaining professional nursing practice. The Arkansas Nurses Association and the Louisiana State Nurses Association define workplace advocacy as a planned, organized system of services and resources designed to support the professional nurse in the workplace (White Paper on

Fixing problems that face health care in many health facilities demand a system wide set of solutions. The systems used in these facilities must be assessed and redesigned to identify factors that will aid in the achievement of the set goals. The enormous task of achieving the goals should be undertaken collaboratively by all the key stakeholders, who include, health care professionals, planners and policy makers, administrators, payers, and patients and their families. These partnerships must begin with a common understanding of the problems together with a shared commitment to cooperate and work together to eliminate the problems. With this knowledge, therefore, an action plan for redesigning the health care system can be developed and later implemented. For a successful health care service to be realized, there are various factors which should be employed and which are not found in the traditional business setting. These include unique economic processes, proper regulatory requirements and the perfect quality indicators. This creates a need for every leader within the healthcare industry to create or develop unique skill sets that will harmonize both organizational leadership and the inter-professional team development. It is, therefore, important to understand the comprehensive approach to the management of patient care and also how the concepts of team development and organizational leadership support healthcare leaders in creation of a patient-centric