Comprehensive Literature Review

The biggest distractions as an acute care leader that impacts my work are numerous administrative meetings; they tend to take up most of my daily schedule leaving me with little time to talk to the patients. To alleviate this challenge I have allocated time on my daily calendar to participate in bedside inter-disciplinary and leader rounding on the unit with the team to discuss patient plan of care with other healthcare teams, patient and family. This time allocation enables me to have designated time dedicated to making sure the patient receives my professional presence that supports

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.

Moreover, the office visit length will be shortened due to the high demand of customers making it harder to provide good quality of care to patients as well . On the other hand, from the physician point of view it is predictable that doctors will change practice patterns from private offices to hospital services because the facilities pay salaries with less expectations in the number of patients seen per day. Furthermore, due to the elevated number of patients, time left for clinical documentation and record keeping will be nulle.

A common goal all healthcare providers share, is the desire to provide excellent patient care. The delivery of care is constantly changing in healthcare, however, the patient will continue to remain the focus of care. The success of nursing care thrives off the ability to fulfill patient needs and to maintain patient safety and satisfaction. When patients are admitted to the hospital, their need for an increase in their level of care and attention, due to the decline in their health status, and inability to preform normal daily activities of daily living. The loss of independence places the patient in a vulnerable state of mind, causing the individual to rely on members of the healthcare team to assist with basic self-care needs while in a stable and well-organized environment. A structured environment can be accomplished through the practice of hourly rounding on all patients.

The office would need to establish a goal to accommodate all post-discharge patients. When appointments cannot be made then an escalation process to the office manager needs to occur. In order to foster communication with professional partners, an investigation of the system failures. How can the transition to home be improved? The workflow should include a validation step that would entail hand-off communication between hospital rounders and office schedulers. If missteps occur, then the office staff could catch the near misses and call the patient at home. Care coordination among providers on an outpatient basis could be supported by the electronic medical record and having verbal care conferences. Next strategy could involve the hospital completing a call back within twenty-four hours to all patients discharged. This intervention could potentially catch some of the missed opportunities. Another approach involves face to face reinforcement of the patient-centered partnership with H. H. According to Counsil et al. (2012), “patient-centered care plans for complex patients changed the relationships with the health team” (p. 190). The development of this patient directed plan of care and partnership is

During the second week, I had the opportunity to accompany Mr. Price to meetings that he had with the managers of the nurses and schedulers. During those meetings, the managers discussed the ideal approach of how to accommodate patients who call the schedulers to acquire appointments for urgent medical concerns. There seemed to be a problem with patients taking up appointment slots when they do not have a true need to be assessed by their doctor. It was ultimately concluded that the schedulers would coordinate communication between the patient and the registered nurse. The nurse would then triage the patient’s concerns over the phone and provide medical guidance,

Primary care teams in VM's eight locations used VMPS to realign their work and improve the patient experience. By making key changes, providers were able to see more patients, deliver better quality care, and have shorter work days. Some of the changes included having all exam rooms and supplies set up identically, and having physicians do non-direct patient care, such as reviewing lab results and calling the pharmacy, in between patient visits. Today these clinics consistently achieve positive net margins and see more patients without reducing the time spent with each patient.

It is easy to understand the rushed appointments. Physicians regularly see close to 20 patients per day. Furthermore, the medical model focuses primarily on diagnosing and treating the illness at hand, at the expense of seeing the whole clinical picture. This often leads to frustration and decreased motivation to seek follow-up care.

In Mrs. Lushko's case, even though she underwent expedited inpatient evaluation, she had to consult different specialists and they asked almost the same questions which indicates that there is no seamless sharing of information/records about a patient's medical condition. Also, these specialist teams were not working as single integrated team of specialists to determine her treatment plan which is why her initial evaluation took so much time and she received conflicting opinions about removing her tumor. Mrs. Lushko was not admitted through oncology department instead of primary team. It could have eased her oncology/endocrinology evaluation tests and diagnosis during her initial evaluation. In addition, each doctor had his/her own interpretation of data instead of collaboratively working as a team to decide upon definitive treatment plan. Excellent providers will not only integrate across the value chain within their own organizations, but also with independent entities involved in the care cycle. An ideal CDVC

Rodak, S. (2012) How Cleveland Clinic Reduced Cancer Patients' Wait Times by More Than 80%. Becker's Hospital Review. 26 Sept 2012. Retrieved from: http://www.beckershospitalreview.com/capacity-management/how-cleveland-clinic-reduced-cancer-patients-wait-times-by-more-than-80.html

The additional revenues that were collected due to increase in ICU capacity by 20 beds enhanced the total ED revenues by 10%.4 The efficiency of care delivery is decreased when patients are diverted to other hospitals, they have to wait for long period to receive care or if they are placed on the floors where they do not belong. This is seen often due to delay in discharging patients.3 These delays and inefficiencies are the primary cause of decreased satisfaction among patients, their families, hospital employees, and physicians. They also result in avoidable increases in patient length-of-stay, reduced quality of care, and lost or diminished hospital revenue.3

All staff meets briefly to make everyone aware of how many patients are booked; how many appointments are confirmed; and how many appointments are available. Staff is also informed of who will be out, who will be late, and what things need to be done if time permits, so that priorities for the day may be established.” (Schuman, August 2015)

What literature lacked was the importance of buy-in from the outpatient oncology staff. Change and challenge are intertwining concepts in any health care organization. Change does not come without its challenges as there are always someone or something standing in the way of its acceptance. Royal Perth Hospital and Sir Charles Gairdner Hospital in Western Australia were experiencing capacity constraints that limited their ability to efficiently deliver chemotherapy treatments to their patients, so they performed a study on the benefits of same day appointments vs. next day appointments (same concept as visit de-coupling). While data revealed significant improvements with visit-decoupling within their facilities, some staff and patients seen

Information and communication technology has been adopted and implemented within various sectors of the economy. This is attributed to the benefits of technology in facilitating organizational activities and processes and its use in meeting the changes which characterize the modern society. The health sector is one of the industries which have significantly implemented technology. The health sector’s technological applications have been achieved within health information systems. The implementation of technology in this sector has resulted into both positive and negative implications on health

A key operational challenge in most healthcare organizations is the efficient movement of patients in a hospital or a clinic, which is referred to as the