National Committee For Quality Assurance (NCQA)

Overview of the Patient Centered Medical Home project piloted by Geisinger Health System in Danville, Pennsylvania

*NCQA-focuses on patient safety, confidentiality, consumer protection, access to services, service quality, and continous improvement.

They say they will help with hospital bills and insurance claims and teach their patients and families how to ensure proper care of the patient after hospitalization” (AHA 2). The AHA defines patient’s rights as:

The purpose of this paper is to identify the type of facility and the resident being served. In addition, this paper will identify the role of the Nurse Practitioner (NP), and the regulatory issues as it supports this role.

Alongside these nursing aids, our organization offers health concierge services to clients in their own comforts at home. Among the services we provide to our clients include Companion Care, which is designed to meet the needs of the elderly, Respite Care for patients recovering from illness, Jet Care geared towards the traveling customers, and Home Care that is focused on home-based care delivery. I have served in Home Care of La Jolla since its creation in 2002. The interest to offer a more customized and a need-based service to special groups in the society is the main reason for concentrating in the long-term care industry.

The medical model, which originated in the 1950's, delivered high‐quality, standardized care to a large number of individuals. The care provided in long-term care facilities has traditionally been based on a medical model. This is characterized by nursing units with centralized nursing stations and long, doubly loaded corridors with shared bedrooms and bathrooms. Often, the finishes and ambiance are institutional and bare, and the setting provides few opportunities for residents to personalize their environments. Residents follow a rigid routine that dictates when they eat and when they sleep. The medical model involves the use of medical jargon, which can be problematic for residents and families. The medical model also focused on the individual’s

Residential Care is when a person leaves their home environment in order to be cared for in a secure and safe place. People who need and use this type of care may not be able to independently care for themselves and keep themselves healthy, but not necessarily need nurse care. A residential care setting will make sure that the person is cared for personally, that their medication is organised and taken at the appropriate times and encourage them to be

The National Quality Measures Clearinghouse (NQMC) is an initiative of the Agency for Healthcare Research and Quality under the U.S. Department of Health and Human Services (U.S. Department of Health & Human Services, 2015). NQMC is a website and database for information on evidence-based health care quality measures and measure sets (U.S. Department of Health & Human Services, 2015). “The NQMC mission is to provide practitioners, health care providers, health plans, integrated delivery systems, purchasers and others an accessible mechanism for obtaining detailed information on quality measures, and to further their dissemination, implementation, and use in order to inform health care decisions” (U.S. Department of Health & Human Services, 2015). There are several measures established in the NQMC that deal with prescribing the correct medications for hospitalized patients.

The patient- centered medical home is designed to improve quality of care through a team-bases coordination of care, which would treat the majority of a patients needs at once by increasing access to care and empowering patients to be a part of their own care (U.S Department of Health and Human Services, 2014). In order for these homes to work, the authors suggest that specialists might be the best candidates to certain conditions, however for these specialist to function in the capacity that is needed in these medical homes, they would have to have interest and proficiency to manage other conditions that fall outside of their

Home environment have to be safe for each service user and we need to make sure that it doesn't pose any harm or danger. Environment and feeling of the home is very important for our service users. Decoration and changes should be consulted with service users and it is their home. Each service user should be able to choose furniture, colour of the walls, carpet and other items for their own bedroom. Service users have their choices and they should be supported to decide for themselves as it improve their independence and boost self esteem. Every service user is different and they should be treated differently according their preferences. This is person centred care. Nor two people with same diagnosis should be treated and cared for exactly same. We all have different routines, preferences, likes and dislikes. We all like different things and we should encourage our service users to voice their needs, wants and desires. Quality of care we provide is very important factor in Health and Social care. Each home should comply with Essential Standards of Quality and Safety set by Care Quality Commission. The Care Quality Commission (CQC) is the independent regulator of all health and adult social care in England. Our aim is to make sure better care is provided for everyone, whether that’s in hospital, in care homes, in people’s own homes, or elsewhere. The aim of CQC is to make sure better care is provided for

LeadingAge Texas is working with policy makers to pass the Nursing Home Quality Rate Enhancement health policy. Some of the issues addressed in the meeting regarding quality care will be addressed in this paper. How the NHQRE policy will impact the advanced nursing practice and the delivery of health care. NHQRE is a needed health policy that will increase our quality care.

Patient-Centered Medical Homes (PCMH) are growing in popularity as the right thing to do improve patient care. PCMH are growing in popularity, as there is early evidence of their effectiveness (Egge, M. 2012). The PCMH concept has been widely promoted as a way to enhance primary care and deliver better care to patients with chronic conditions. This model of care has stimulated the attention of payers, Medicaid policy makers, physicians, and patient advocates, as it has the potential to address several of the limitations of the current healthcare system (Wang, J. et al 2014). Currently, primary care in the United States is focused on acute and episodic illness, it inadvertently limits comprehensive, coordinated, preventive and chronic care (Bleser, W. et al 2014). The PCMH address these limitations through organizing patient care, emphasizing team work, and coordinating data tracking (Bleser, W. et al 2014). A PCMH and HMO have some similarities but are markedly different.

Quality Improvement Organizations (QIOs), work in partnership with the Centers for Medicare and Medicaid Services (CMS) to advocate for safe, efficient, and quality healthcare for Americans. Working at the community level, QIOs collaborate with providers and interact with beneficiaries to improve patient outcomes. Additionally, QIOs support new models of care and promote healthcare goals endorsed by the National Quality Strategy, and CMS Quality Strategy. CMS has strategically placed QIOs in several regions nationwide, and Mississippi is served by Information and Quality Healthcare (IQH). IQH founded in 1971 as a non-profit organization has strived to improve the quality of care received in Mississippi. IQH participates in a tobacco cessation helpline, behavioral health services, and diabetes education for Medicare beneficiaries.

One of the aims of the Patient Protection and Affordable Care Act (ACA) of 2010 is improved integration and coordination of services for primary patient care. The patient-centered medical home (PCMH) is one of the approaches by which improvements can be established. The patient-centered medical home model is particularly well-suited for people who have chronic illness. The design of the patient-centered medical home model departs substantively from traditional reimbursement policies, in that, the ACA provides for incentives and resources to enable care coordinators to be directly recognized and compensated for their care coordination work. Care coordinators are most often registered nurses who through their work that aligns with ACA engage in quality improvement work, cost-effectiveness measures, and patient advocacy. To bring the ACA model to a human scale, the authors present a case study of a care coordinator at a patient-centered medical home in rural Maine. The table provided below provides a basic textual analysis of the study as it is published in the professional nursing journal.

The purpose of this essay is to provide a review of the models which are Chronic Care Model and Patient-Centered Medical Home Model. Also to provide how both achieve quality and safety and add as much information on how both models benefit in providing care to the patients.