Business Case For Quality And Inadequate Nursing Care

The interviewee claimed that, the quality improvement and star rating is a driving force in the care delivered. The nurses are much more motivated when they know they are recognized and valued for their effort. Teamwork and collaboration between all interdisciplinary teams and management improves the way the care is delivered. Through training and innovation with new technology,

Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).

By measuring nursing sensitive indicators hospital wide and collecting this information, quality patient care in hospitals can be advanced due to the administrators knowing which areas of practice nurses need to improve. All organizations, including hospitals have institutional cultures, these cultures can potentially have a positive or negative effect on desired outcomes. In the case of hospitals this would be the quality of patient care. If the institutional culture of nurses in the hospital promotes negligence in care, lack of respect for patient autonomy, or poor prioritization, the nursing sensitive indicators should reveal it as for example: negligent care would lead to higher rates of falls and complications acquired during the patient stay.

This paper will describe current quality outcome measures and the significance for improving medical care. Organizational accountability and transparency has improved with the emergence of Hospital Inpatient Quality Reporting (IQR) programs and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPs). This article will review the role of the nurse manager in creating a culture for quality care as well as the nurse for meeting organizational and patient expectations. Organizations like The Joint Commission (JC), Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare and Medicaid Services (CMS), and The American Nurses Association (ANA) have been critical in establishing standards for quality. This paper will also report on the most recent hospital statistics and steps taken to improve HCAHP scores and reduce readmission rates at the University of Tennessee Medical Center in Knoxville (UTMCK). Statistics at UTMCK will also be compared to the Tennessee and National averages found on the Medicare website Hospital Compare. The aim of this paper is to explore if healthcare system initiatives are improving quality and enhancing patient outcomes.

In this era of healthcare reform, with the increasing complexity of care, declining reimbursement for services and increased accountability for patient outcomes, attention is focused on quality outcomes that yield a financial return on investment for the patient and the healthcare organization. While hospital leadership may embrace evidence-based practice, a mission critical environment requires making the business case for implementing evidence-based interventions by justifying the potential for cost savings. In order to demonstrate a return on investment for clinical interventions, Clinical Nurse Specialists’ (CNSs’) must learn business skills that allow them to justify a need for change in practice. Business skills include intervention planning that considers the resources involved in planning, implementing and evaluating interventions and the associated costs, known as the “business case.” The purpose of this paper is to describe the process of making a business case for developing CNS-led interventions. The business case framework was developed by CNS faculty to help CNS students develop these skills in making the business case for intervention development. This framework can be used as a tool for educating CNS students as well as for practicing CNSs.

In 1994 the American Nurses Association (ANA) started the Patient Safety and Quality Initiative. It was a pilot program designed to evaluate the links between nurse staffing and quality care (Montalvo, 2007). The program outcome was a set of nursing-sensitive indicators used to evaluate quality care for patients in the acute setting and the start of the National Database of Nursing Quality Indicators (NDNQI). The NDNQI is a

Patients want and expect to receive high quality care. Nurses want to provide the best care possible to their patients and like everybody else; want a pleasing job environment. Hospitals, on the other hand, are expected to provide a safe environment to patients, have enough nursing staff and remain profitable (Keller, Dulle, Kwiecinski, Altimier & Owens, 2013). The ultimate goal is to improve quality of care and patient safety across the United States; therefore, all the different interests of these major stakeholders should be taken into

Over the past decades, various studies world-wide have been conducted on the connection of nursing quality indicators and their outcomes. The

Nursing shortages have been an issue in the health care field for a few years now. This shortage is seriously impacting nursing homes and the elderly in our society today. With a shortage of 8.1% of nurses in 2008, it is important to understand what is happening to nurses (Addressing the Nursing Shortage, 2010). To help one understand the nurse shortage more, this paper will discuss resource scarcity, stakeholders, economic flows, changes in supply and demand, pricing decisions, along with a business proposal. The business proposal will discuss where the market has a shortage of providers, list of services the firm will provide, explanations of set prices, and who will be hired and how much one will be

The delivery of healthcare has evolved and changed over the years and with the advances in science and technology, the ability to provide safe, quality care to all patients has been impacted by the changes. With the rising healthcare costs and decrease in reimbursement for care provided, organizations must look for ways of cost containment to maintain viability for the future. Fabre (2005) noted that administrators are struggling to maintain financial stability and retain competent nurses during these difficult

Dr. Avedis Donabedian developed a model for categorizing and measuring the quality of healthcare providing a framework that conceptualized quality in broad terms and classification to measure and assess different aspects of quality in nursing care (Sollecito & Johnson, 2013). In the footsteps of Donabedian’s framework, Dr. Beatrice Kalisch developed a model conceptualizing missed nursing care otherwise known as “unfinished nursing care” or “care left undone”. Missed nursing care as defined in the Missed Nursing Care Model is any aspect of required patient care that is omitted, either in part or whole, or delayed (Kalisch, Landstrom, & Hinshaw, 2009). The structural aspects Kalisch’s model include labor resources, nursing staff, competency level of staff, education and experience, material resources, teamwork and communication. Kalisch model indicates that nurses with recent restricted resources in the nursing process determining clinical priorities is costly making decisions either to delay or omit certain care and is heavily influenced by team perception, nurse judgment, ("Missed Nursing Care AHRQ," 2015).

Improving the quality of health care system is the main goal of this organization. In this case study we will be talking about the strategic plans being made by the organization for the next decade to deal with the problems of resource management, network growth, patient satisfaction as well as nurse staffing. The readiness of the organization towards catering the citizens' needs for health care will also be discussed in this case study (Goetsch and Davis, 2010).

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting

According to the IOM report, the nursing profession is undergoing fundamental changes within the underlying operations of the field. A new regulatory environment coupled with increased scrutiny of the profession will dramatically impact the nursing profession. As the report indicates nurses, in the near future, will have job requirements that are business oriented. Nurses will need to have a better understanding of quality management methods in addition to overall concepts of management. As the health care system continues its rapid reform nurses must also be cognizant of the effects these changes will have on their overall roles and responsibilities. This involves a transformation of the roles and responsibilities of nurses as they enter the profession. As the health care landscape continues to change, so too must the nurses of the future. A dedication to continual learning is therefore needed to help diminish the influence of antiquated and obsolete knowledge regarding the profession.

Weston, M. & Roberts, D., 2013, September. The Influence of Quality Improvement Efforts on Patient Outcomes And Nursing Work: A Perspective from Chief Nursing Officers at Three Large Health Systems. The Online Journal of Issues in Nursing. Retrieved on January 23, 2015 from http://www.nursingworld.org/Quality-Improvement-on-Patient-Outcomes.html