Asante-Centered Care Model

Describe the factors that help or hinder person-centred care and interprofessional working in relation to a chosen incident. (Word Count 2,993)

Many entities outside of nursing are making initiatives to measure the quality and safety of the patient experience such as the Agency for Healthcare Research and Quality (AHRQ) and Centers for Medicare & Medicaid Services (CMS). The CMS Partnership for Patients Program (PPP) is a group of over 8000 hospitals, representative of health care organizations, state governments, employers, and unions. Partnership for patients is focused on providing safer, more reliable and less costly hospital care. Other organizations such as not- for-profit groups focus on improving relationship between patients, families and health care professionals. The goal of enhancing this relationship is to ensure the provision of high quality care, delivery of safe care, reduction of the cost of care, and enhancement in the transition of care from provider to the next level of care. Even though nurses strive to provide safe and high quality care, they often lost their hope in patient satisfaction scores, performance improvement and quality measurement. Nurse are willing to provide the best care to their patients and committed to the process of improvement, if their efforts are resulted in better patient outcomes. According to the 2014, issue of the New England journal of medicine, a CMS report of 2013 confirmed that the partnership for patients at an estimated cost of $1 billion, showed early elective deliveries in the CMS hospital engagement networks were down by 48% and nationally, readmissions were

Hospitals implement HCAHPS with the support of the Hospital Quality Alliance (HQA), a public or private partnership that includes key hospital and medical associations, consumer groups, measurement and accrediting bodies and government agencies that have the same interest in improving the quality of hospitals. The Hospital Quality Alliance (HQA) program that is overseen by and public and private entities, that include the Centers for Medicare and Medicaid Services (CMS) as well as the Joint Commission, is dominating this effort in the hospital district, generating reports quarterly on the delivery of effective services for mutual conditions. Even though the Hospital Quality Alliance has made this data more available to the public, there has not been enough information on the quality of hospital care from a patients ' point of view. As the Institute of Medicine shows, the foundation of patient centered care is a key factor to having a premium health care system. The HQA backs HCAHPS.

Person –centred care refers to the care delivered in accordance with the individual needs and preferences, but also considering all aspects including physical and mental health issues. Furthermore, family and carers are being provided information in order to understand and to support the patient through their care with the aim for the best care under the given circumstances (National Institute for Health and Care Excellence 2011). In addition, the care planning needs to consider all aspects of care, including the individual 's wishes and preferences in accordance with their rights to accept or to refuse the treatment. Buka (2015) argues that before the Human Rights Act 1998 patients ' rights were not recognised and the decision making process belonged entirely to the doctors due to paternalism which now was substituted by the Person-centred care.

Patient-centered care is a philosophy of care delivery in which services are arranged around the needs of the patient. It defines healthcare delivery from the patient’s perspective and organizes the building blocks of work around the patient and her care. It consists of sequences of activities by all involved staff members who care for the patients. It is consistent with cooperative work in clinical settings. According to Schmidt and Simone, “cooperative work is constituted by the interdependence of multiple actors who, in their individual activities, in changing the state of their individual field of work, also change the state of the field of work of others and who thus interact through changing the state of a common field of work.” A patient constitutes the common field of work for clinical and non-clinical healthcare delivery workers. The patient-oriented workflow also captures the temporal order of various roles’ contributions to care delivery (Ozkaynak et al., 2013). Example: We used a patient-oriented workflow approach to evaluate a health information exchange technology intervention in terms of how the intervention affects patient care in three emergency departments. We conducted a systematic investigation of patient care, captured in a temporal sequential context. Using a patient-oriented workflow approach was valuable because we were able to monitor the overall organization of care delivery individual patient episodes, capturing the engagement of multiple staff

Middlefield Hospital is in an urban area where patients should have access to the best quality healthcare possible. Middlefield needs to offer their patients a triad of care, which includes access, cost and quality of care. There are many factors why a patient may not be able to access care, such as lack of health insurance or financial resources, therefore Middlefield needs to ensure the population that we are affordable and the patient will receive the best possible care regardless of their financial situation. Cost refers to the total expenditures related directly and indirectly to the provision of healthcare. It is imperative that the hospital manages these costs as effectively and efficiently as possible so that these costs do not reflect to our patients and their care. Quality of care can be conceptualized by two measures, process and outcome. Process measures look at the specific components of providing care and assesses whether these concepts are effective in achieving the desired outcomes, i.e., did the patient receive the appropriate care for the diagnosis in the ER? Outcome measures evaluate the end result of care and assess whether treatment has produced the desired outcomes, i.e., did the patient have a heart attack

Quality and safety initiatives are driving important changes in the U.S. health care delivery system. Quality in health care is defined as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes are consistent with current professional knowledge (Nash & Goldfarb, 2006, p. 6). The Institute of Medicine (IOM) report, To Err is Human, states that most of the medical errors are resulted from system error and processes. Medical Errors account for 98,000 deaths per year in the US. They increase disability, costs, and decrease confidence in the US health care system (Pham, Aswani, Rosen, Lee, Huddle, Weeks, & Pronovost, 2012). And because of this, the IOM established six aims for improvement. These are safety (care should be as safe for patients in health care facilities as in their homes); effectiveness (the science and evidence behind health care should be applied and serve as the standard in the delivery of care); efficiency (care and service should be cost effective, and waste should be removed from the system); timeliness (patients should experience no waits or delays in receiving care and service); patient-centeredness (the system of care should revolve around the patient, respect patient preferences, and put the patient in control); and equity (unequal treatment should be a fact of the past; disparities in care should be eradicated). These six aims should be measured in order to assess whether the health care

Along with physicians receiving training on different methods to treat patients, a solution that would greatly reduce the U.S.’s healthcare expenditure is switching from a FFS payment model, to a P4P model . P4P has been proven to reduce costs, improve the quality of healthcare, and improve patients’ health whenever this model is implemented within an institution. One example of many is the success of the Cleveland Clinic, a non-profit academic hospital located in Cleveland, Ohio. This clinic utilizes a Value-Based Care Team composed of nurses, physicians, and other experts to care for its patients. This clinic reached the Top 20 of the University HealthSystem Consortium’s (UHC) quality index, earning UHC’s Rising Star award by improving in all six measurements: patient centeredness, mortality, equity, efficiency,

The new required competencies for leaders and health care organization boards to move from fee-for-service to value-based care are a broad and deep understanding of:

The Accountable Care Organization and Patient Centered Medical Home case studies both did best to implement pilot programs, models and experiments that will essentially coordinate at the same time integrate healthcare goals with the healthcare system aimed at improving patient outcome and lowering costs for quality service. PCMH also did best in making sure patients had constant access to their providers at the same time provide care that was team based by coordinating care with various providers at the same time assure the quality and safety of each patient. As for ACO they did best in their improvement of care and lowering cost by coordinating with physicians and institution that are providing care to Medicare beneficiaries. Their ultimate goal is improving the quality and value of health care services at the same time control costs while improving the delivery of healthcare by measuring quality and satisfaction as defined in Shi and Singh (2015) Donabedian Model which can be achieved by establishing structure, process and outcome (p. 494). In the end ACO and PCMH focused their attention in preserving wellness, disease prevention, and treating illness by assuring that each patient received the best care possible from their health care providers.

A comprehensive caring science would aim to achieve holism in ways of knowing, the person in their lifeworld context, the kind of holistic care that is led by the lifeworld and that can integrate ‘head, hand and heart’. (Galvin, 2010, p. 174) Caring science is so much more than just taking care of a patient. I feel like this week’s assigned article really delved deep and taught us that. I liked that you talked about the head, hand, and heart model as a holistic approach because I completely agree with you. By using this model, a nurse is going to ensure that the patient is taken care of as a whole. I am glad to see that you are learning a lot from our clinical site as well. The nurses at KU Rehab are great and they really do approach their

According to Nursing Standard (2011), it is suggested that Person centred care is the principles that mainly focuses the care given to the individual and not just taking into account their health care needs. This implies that a person centred care gives high value and priority to the service user/patient decisions based on informed choices that has been made available to them. This type of approach promotes independence and

The U.S. health care system faces multiple challenges. There is an urgent need for reforms and the U.S. government has centered its attention on uninsured individuals and the implementation of new quality assurance policies to reconstruct the current dysfunctional system. Quality assurance policies, initiatives and measures aim to accomplish better, well-coordinated patient care by assessing the following properties; efficiency, effectiveness, safety, equity and timeliness.

Patient and family centered care is a model of care where the patients’ needs and preferences are taken into consideration when developing a plan of care. The patient, and frequently the family, are included in the decision making process. Education is the key. Well informed patients make better choices about the delivery of their care. In larger markets consumers have more choices about where they go to receive healthcare. “Patients can request that health care facilities provide an institutional report card that describes such indices as outcomes of patient care for medical conditions and surgical interventions, medical error rates, nosocomial infection rates, RN to patient staffing ratios, availability of support personnel, morbidity

The concept of patient and family-centered care has been catapulted to the forefront of the health care system due to the demand of high-quality medical care (Schwarzkopf et al, 2013). Family-centered care identifies that patients exist within a wider social networking of family members and friends (Huffiness et al., 2013). In 2001, the Institute of Medicine published its seminal report, Crossing the Quality Chasm, which depicted the involvement and support of family and friends as a dimension of patient-centeredness (Institute of Medicine, 2001).