Hospital Consumer Assessment Of Healthcare Providers And Systems ( Cms ) Value Based Purchasing Program

A change I would recommend for this department is for the staff to become more aware of how rounding and pain management affects the patient experience. Another suggestion based on the objective of improving patient experience would be to continue educating staff on how patient experience plays a crucial role in the reimbursement and how it impacts not only the hospital but them as well. I also recommend that the staff should continue performing rounding and pain management as if they were still being measured so that eventually these two areas will occur automatically without even having to think about it. By doing so, it will turn into a habit and will hopefully lead to a more consistent score in these two areas. New staff should also be trained that both monitoring for pain management and rounding is standard practice for the unit. As it is a lot easier to train someone new to get into this habit earlier than it is to try and implement it later after he/she has already established a routine. Staff members that have a higher role in the department must also continue to lead by example as well, in order to instill the importance of these two areas. Lastly, I recommend that the department needs to find a way to motivate and encourage staff to do rounding and pain management effectively with more internal rewards such as staff members seeing the positive impact focusing on these two areas have on patient lives.

Healthcare is in a constant state of change with movements that impact rates, access and quality of care. Hospitals have become more competitive due to the rising cost of care delivery and the reduction in reimbursement from payers. This causes difficulty in delivering quality care to all patients, which is being measured by mandated patient perception surveys, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS scores are part of value

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.

Prior to the hourly rounding implementation, all the clinical staff (staff involved in patient care) will attend an hour workshop, which will cover the advantages and significance of hourly rounding to patient safety, reduction of falls, increase patient satisfaction, improved health outcomes, and financial impact to the organization. A video on how to do the hourly rounding properly and what behavior to avoid will be shown. After the workshop, the staff will do return demonstration, playing the role of the staff, while being checked off to ensure that the expectations during hourly rounding are met. This includes how to properly introduce oneself to the patients, informing the patients that the staff will be rounding every hour till 2200 then every two hours till 0600, to address their pain, possession, position, and potty needs. By performing return demonstrations, the validators (nurse managers, educators) will be able to ascertain that the staff understood and will

The results of the study showed that significant increase in patient satisfaction scores, decreased call light usage, and reduction in patients fall rates. One-hour rounding shows higher satisfaction than two hour- rounding. Hypothesis supported the study because the research shows rounding can reduce patient call light usage (Meade, Bursell, Ketelsen , 2006). The theoretical framework that forms the basis of the research is that consistent nursing rounds can meet the basic needs of patient and ultimately reduce call light use and [pic]improve management of patient care while also[pic] increasing [pic]patient satisfaction and[pic] safety.

Hourly rounding, also known as “intentional” or “comfort” rounding is essentially when the nurse or tech routinely checks on a patient at scheduled times to anticipate individual needs prior to the activation of the call bell alarm (Harrington et al., 2012). In a recent study, authors imply that hourly rounding is an effective process for improving patient satisfaction and clinical outcomes (Brosey and March, 2015). I feel that the implementation of hourly rounding will improve multiple aspects of care, including patient and nurse

Rounding allows nurses to gather information in a structured way. It’s proactive, not reactive like call light responses. It’s a great way to get a handle on patient problems before they occur. It’s all about providing the best patient-driven health care… The great thing about hourly rounding is that it doesn’t benefit only the patients. (¶ 4).

When a patient becomes hospitalized, it is important to ensure patient safety and satisfaction. A process known as hourly rounding has been implemented in many hospitals as a way to achieve this increase in patient satisfaction. The hourly rounding process consists of four concepts that are covered with each hourly round. When these concepts are implemented, the nurse will anticipate the needs of the patient and prevent unnecessary and untimely call lights. Hospital implementation of this process may receive some resistance but with the proper training and education this process can increase patient safety and patient

Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.

Hourly rounding also known as intentional rounding or comfort rounding is an initiative that hospitals nationwide are beginning to implement. Hourly rounding should be purposeful. “Hourly rounding is a systematic proactive nurse-driven evidence based intervention to anticipate and address needs in hospitalized patients” (Deitrick, Baker, Paxton, Flores, & Swavely, 2012, p.13). “Purposeful nurse rounds encompass a practice where nurses attend to and document scheduled patient reviews at pre-determined and regular intervals (hourly or second hourly)” (Lyons, Biunero, & Lamont, 2015, p.31).

The purpose of the study was to identify the effect of regular nurse rounding on patient fall rate, call light usage and patient satisfaction in a medical surgical unit. A literature review using three studies from Medline and

The Johns Hopkins Hospital, located in Baltimore, MD, is one of the greatest institutions in modern medicine. Established in 1889 from the donation of philanthropist Johns Hopkins, the hospital and university serve millions of patients annually for emergency, inpatient, and outpatient visits. Patient care is the focus of Johns Hopkins vision. The hospital uses quality care and innovation to enhance patient care. It is the hospital’s goal to have great precision, safety, comfort, coordination, and improved workflow to achieve an outstanding customer experience. An added feature to the customer experience are the design elements that can be found flowing throughout their newest facilities which helps foster healing and stress free environments. From the dramatic art collections that fill the walls and windows of patients rooms, to its 20-year reign as U.S. News and World Report’s “Best Hospital”, Johns Hopkins has made its mark on society. At some point, however, every great dynasty loses its ranks. Unfortunately, Johns Hopkins is no different. With the creation of a federally-mandated patient satisfaction survey for Medicare and Medicaid reimbursement, the stakes for high ratings is of fiscal importance. In an effort to increase its patient satisfaction ratings, the hospital created performance measurements to highlight strengths and areas of improvement with patient outcomes. The implementation of this new initiative, the Patient Toolbox, considers the fundamental reasons

Hospitals nationwide are experiencing nurse shortage and increased workloads because of shorter hospital stays, fewer support resources and higher acuity in patients (Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D., 2004). Higher nurse workloads are directly associated with job burnout and job dissatisfaction which in turn causes more voluntary nurse turnover and relates to the increased nursing shortage. According to the Missouri Hospital Association the turnover rate of nurses has increased by fourteen percent in the last five years (Browning M., 2012). Nursing shortage is a real threat to the patient population. According to the Quality Health Outcomes Model by the American Academy of Nursing by Donabedian, effects of the healthcare interventions are characterized by the environment the staff works in (Vahey et al., 2004). Donabedian describes that quality metrics can be divided into three broad categories, structural, process, and clinical.

Hourly rounding contributes in several key areas to achievement of high levels of patient satisfaction, including quality of care and patient safety. This puts patients at the center of care by building on the fundamental aspects of care, which are so important. Thus by checking in on patients in wards regularly to see whether they are comfortable and have everything they need can produce a number of positive results. Nurses