Case Study: Transforming Care At The Bedside

Nevertheless, many organizations continue to struggle with what “it” is. This ambiguity ultimately leaves many with vague or muddled expectations for what constitutes patient-centered care. Is it a surprise, then, that many leaders report feeling bewildered at how to go about becoming more patient-centered? Or that others, convinced that their approach is indeed a patient-centered one, are surprised to find data reflecting patient and/or staff discontent? In the broadest terms, patient-centered care is care organized around the patient. It is a model in which providers partner with patients and families to identify and satisfy the full range of patient needs and preferences. Not to be overlooked in defining patient-centered care is its concurrent focus on staff. To succeed, a patient-centered approach must also address the staff experience, as staff’s ability and inclination to effectively care for patients is unquestionably compromised if they do not feel cared for themselves. Although patients may not always be able to accurately assess the clinical quality of their care, or whether safety processes are in place, patient safety and high clinical quality are fundamental to a patient-centered approach. Patient-centered care does not replace excellent medicine―it both complements clinical excellence and contributes to it through effective partnerships and communication. A wealth of resources exists to guide organizations in addressing clinical

To reduce clinical errors and promote positive outcomes, IOM implemented five core competencies to be include in the education of each health care professional. Patient centered care could be understood, as providing the highest level of care possible while encompassing every aspect of caring though respecting differences of cultural diversity, income, race, religion, and allowing the patient to actively participate in their care while being educated on disease processes, treatments, prevention, and wellness

Upgrading our documentation to information and informatics comes with many advantages for the health care team to improve quality and safe ty improvement. Also, the use of technology such as telehealth, telenursing and videoconferencing are on the rise, and will be embedded into our communities and nursing organizations so that we can reach people around the country who do not have accessibility quality health care. Using technology to educate patients and families about credible websites, and how to search for pertinent information that is relevant to his or her health is a priority. The goal is to eliminate unnecessary emergency rooms visits. These actions foster communication and minimize anxiety

The Quality and Safety Education for Nurses (QSEN) Institute developed six core competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics (Quality and Safety Education for Nurses Institute, 2017). At my facility, it is clearly evident that they have adopted these six core competencies to improve patient quality and safety. My facility created the Office of Patient Experience which supports care that is safe, of high quality and high value. Patient satisfaction is a top priority which is why our guiding principle is known as “Patients First”. Through teamwork and collaboration, we deliver care that is patient-centered by working together in multidisciplinary rounds on the inpatient units. Also, the nursing education department supports quality, safety and consistent nursing care through a database of policies and procedures developed using evidence-based research. Lastly, the nursing informatics department is working towards making our EPIC system more patient-centered. They are doing this by decreasing the redundancy in charting for the nursing staff and finding ways to improve processes which automate tasks. This in turn will reduce the time that the nursing staff spends with their computer and increase the time that the nursing staff can spend with their patients.

Advances in modern technology surrounds us in our day to day lives, allowing conveniences and efficiency at our fingertips. Great strides have been made over the years with technology, and the healthcare industry along with many other industries have adopted this new way of functioning; electronically. The effects of technology have come to the forefront in where our government has acknowledged the benefits and opportunities. “The promise of Health Information Technology for improving quality and safety of health care while reducing costs has caught the eye of policy makers and other leaders in health care” (Hersh, 2006). It deeply affects how we connect, interact, and communicate internally and externally, but also gives us a sense of control on how we engage ourselves to the innovative software and systems.

Quality patient centered care is vital to a hospital or clinic’s ability to treat whole patients. Dabney and Tzeng (2013) address the necessity to implement patient-centered care into clinic and hospital settings. The article clarifies what patient-centered care and service quality is by consolidating many works and sighting benefits medical professionals can observe in their practice.

"Health information technology can be used to study or improve care coordination and its patient-centeredness. More pointedly, HIT provides an opportunity to organize disparate data sources into one cohesive, patient-centered record" (Steichen & Gregg, 2015, p. 34). With its ability to rapidly share health care information such as care plans and discharge summaries, clinical staff can make more timely decisions. Families will also be prompted to be more involved in the patient care due to the availability of current information and resources. There is no doubt that health care is evolving, and technology is creating new ways for us to stay connected, which is essential for successful care coordination.

The author has been employed in the healthcare field for over fifteen years that has allowed the time to observe the transformation of the primary care practice. This paper will examine the industry using Aspirus, Inc. as the reference point; however encompassing an examination of other healthcare institutions. Evidence suggests the Patient Centered Medical Home (PCHM) model, also known as the medical come, of care can offer many benefits, including improved quality in the patient experience and disease management and lower costs to the patient and system because of reduced emergency room visits or hospital admissions. The main objective of this paper is to highlight the challenges and explore what the PCMH model will be like in five years within the primary care setting of a healthcare organization.

Today’s healthcare system requires that healthcare professionals across the globe change their focus towards evidence-based practice to meet the needs of the complex clinical setting and constantly strive to improve patient care and outcomes. The United States Institute of Medicine (IOM) has created five core competencies to be utilized by all health care providers in order to enhance patient outcomes (Inter-professional Education Collaborative Expert Panel, 2011). The competencies are employing evidence-based practice, working in interdisciplinary teams, applying quality improvement, utilizing informatics, and providing patient-centered care (Institute of Medicine, 2010).

There are five core competencies needed for health care professionals and they are provide patient centered care, work in interdisciplinary teams, employ evidence based practice, apply quality improvement, and utilizing informatics. In this paper, I will go into further detail how providing patient centered care is challenging, how to overcome the challenges, how it relates to my chosen profession, and how this competency can impact delivery of care to patients.

The transformation of health care through the use of Health Information Technology continued with the passing of the Patient Protection and Affordable Care Act of 2010, which mandated the integration of physician quality reporting and Electronic Health Record reporting. This Act required the creation of measures and reporting of the “meaningful use of the electronic health record” and “quality of care furnished to an individual.” In doing so, the law directly links the adoption of the electronic health record with quality of care to the patient. This entails coordination which the Act requires the use of electronic health

Teamwork is vital in healthcare.  When all participants are engaged in a program, goals are successfully achieved. Being able to communicate and work collectively as a team requires an appreciation for each other’s area of practice.  Every team member has an important role and being acknowledged provides a sense of responsibility and accountability. Essentially, inter-professional collaboration helps ensure that the patient is getting care that is not only accessible but also comprehensive.  The plan of a patients’ care includes active participation by all health care professionals working interdependently in accordance to the patient’s preferences, values and beliefs. The health care team accomplishes the goal of meeting the patient’s medical needs by delivering evidence-based practice.   To deliver quality care, the patient should always be involved.

In health care, patients’ lives are in the hands of the health care practitioners, health care organizations, insurance companies, and to some degree, even health care technology. The growth and future implications of evidence-based medicine (EBM) through improvement of technology in health care are important today, because health care practitioners and organizations want to ultimately decrease cost, improve quality of care, and increase access to health care (Glandon, Smaltz, & Slovensky, 2014, p. 28). One way to achieve these goals is through the implementation and improvement of EBM and interoperability which will enhance the efficiency of work production resulting in these positive outcomes. According to Glandon, Smaltz, and Slovensky (2014), EBM is an “information management and learning strategy that seeks to integrate clinical expertise with the best evidence available to make effective clinical decisions that will ultimately improve patient care,” (p. 6). “Interoperability is the ability of different information and communications technology systems and software applications to communicate, to exchange data accurately, effectively, and consistently, and to use information that has been exchanged,” (Iroju, Soriyan, Gambo, & Olaleke, 2013, para. 1). Without interoperability and EBM, fundamental data and information such as patient records cannot be easily shared across and within enterprises having a direct impact on the quality of care. It

Nursing involves greater purpose beside the objective of treating patients’ ailments in an efficient and effective manner. Nurses, physicians, and health care providers across the board uphold the duty to treat patients with the utmost value of care. As a universal definition of care does not exist, Anita Finkelman and Carole Kenner explain care is drawn from four perspectives: a sense of care involving compassion, knowledge and expertise that allows nurses to advocate for the patient in addition to treating the medial complication, and “…competence in carrying out all the required procedures, personal and technical, with true concern for providing the proper care at the proper time in the proper way (Finkelman & Kenner, 2013) . Combining the foundation of every perspective leads to the Institute of Medicine’s (IOM) first core competency of patient-centered care. Sans the image of patient-centered care the practice of nursing and medicine alike will lack the passion the American Nursing Association envisions for “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and care of individuals, families, communities, and populations” (Finkelman & Kenner, 2013). Therefore, the author of this paper explores the IOM’s definition of patient-centered care, implementation of the concept, and its pivotal relationship to the nursing profession.

The future trends in health care are limitless. From using applications that perform EKG’s to robot-assisted surgery, the rapid expansion of technology applications in health care is astounding. Advancing technology also pushes the boundaries of health care in its ability to integrate health care information. The integration of health care information is critical to the effective, efficient delivery of quality care in a now fragmented health care system. This paper will assess how the internet or any new forms of electronic communication can be used as an external delivery source of communicating patient-specific information, address the impact of distance delivery on health care, how these communication issues impact health care today and