Impact of Business Practices, Regulations, and Reimbursement on Patient-Centered Care
Instructions: A. Analyze how business practices, regulatory requirements, and reimbursement impact patientTaskstream
B. Complete the attached “Patient-and Family-Centered Care Organizational Self-Assessment Tool” (PFCC) for a healthcare organization. Note: The PFCC tool is a subjective tool used to assess the organization you have chosen.
1. Describe the healthcare setting you used in the PFCC.
2. Using the completed PFCC tool, describe the strengths and/or weaknesses of the organization for each domain.
C. Identify one area of improvement from the weaknesses identified in part B2.
1. Create a strategy to increase patient-centeredness in the organization by addressing the weakness from part C.
a. Discuss how you would apply either system theory or change theory in the development of your strategy to address the chosen weakness.
2. Discuss the financial implications of implementing this strategy.
3. Discuss the methods you will use to evaluate the effectiveness of your strategy.
D. Create a multidisciplinary team by identifying the following: • potential members that will assist you in implementing the identified strategy • The role of each team member
1. Discuss how cultural diversity within the team supports patient-centered, culturally competent care.
2. Using one of the leadership theories below, discuss the leadership style you would utilize in developing your team: • transactional leadership • transformational leadership • emotional leadership • traditional leadership 3. Discuss how the team will work together to implement the strategy to address the weakness identified in part C1.
4. Describe how the team will communicate the identified strategy and intended outcomes to the healthcare organization.
5. Describe a specific tool you could use to develop the team’s self-assessment skills.
E. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
Impact of Business Practices, Regulations, and Reimbursement on Patient-Centered Care
A patient-centered can best be defined as a setting within healthcare in which patients are actively involved in their care, physical environment, and a dedicated staff that encouraging and promoting patient comfort that meets the patient’s foundations spiritually, physically and emotional necessities. As an organization, it is entitled to have a business plan to follow that has mission and vision statements (Forehand, 2000, p. 267). A mission statement refers to what an organization intends to do and a concrete reason for its existence. A vision statement for a hospital must be clear for Providence on how the future looks like and aid in directions the hospital should take. Contrast to the vision and mission statements there must be meaningful objectives that are evidently well-defined, time-based, quantifiable and fundamental to the success of the hospital. As such, there should be operations that are significant to the financial status, efficient objectives that are necessary for the wellbeing of the day-to-day running of the healthcare center. This paper will focus on how such business practices, regulations, and reimbursement can impact the patient-centered care.
First, business practices can either affect the patients and families negatively or positively (Rathert & May 2007). One of the primary indicators that shows how business practices affecting hospitals today is the cost of sustaining acquiescence concerning regulations. Medicare and Medicaid came up with payment services to quality of care patients received in the year 1999. Therefore, if any facility could commit a medical error, they would cease covering the charges incurred by the error. Sullivan, Monette, and DeJong, 2013 suggest that quality of performance is the standard measurement of rewarding performance. Hospitals need to meet certain indications which are highly considered to be a proactive move to progress the quality of care that patients receive in the healthcare setting. Therefore, poor quality services to customers lead to little or no pay to the hospital. Major hospitals must have astonishing grades concerning hospital safety when compared on Leapfrog. Comparison tools like Leapfrog are essential for organizations so that they can get a chance to improve their quality of service (Sullivan, Monette, & DeJong, 2013).
Secondly, hospitals have to abide by the privacy act the stipulates the fair information practices. The organization, case in point, a hospital must have to maintain records of patients and keep it confidential. The state requires that that nurses and any physician in a care healthcare setting must possess the knowledge for making patients’ credentials private and not to reveal them without consent (Sullivan, Monette, & DeJong, 2013). On the other hand, some regulations affect the patient-centered care positively. Regulations aim at active patient’s safety and improving their well-being. Recently, there have been reports that patients’ records have been breached, which includes patients’ history, social security numbers, insurance data and so on. Managers, leaders, and staff in healthcare setting must be held accountable regarding fortification of patients and their families as well (Vaismoradi, Jordan, & Kangasniemi, 2015, p. 630). Therefore, a rationale stands, if the hospitals or patient-centered care facilities do not abide by the strict regulations in place, they can be fined or imprison the staff responsible (Dearmon & NEA, 2013).
Hospital nowadays has difficulties to train and develop its employees due to the decrease in reimbursement and costly state’s obligated accreditations (Manary, Staelin, Schulman, & Glickman, 2015). Nursing staff and other employees in the healthcare setting have to be trained to improve healthcare quality. Such training is essential for the general outcome of patient’s health. Also, through such practices and training, nurses will have to buy in and be dedicated to the facility as such programs boost their career profile. With the rising population of different dialects in the country, nurses need training programs in learning styles, especially in dialects. Also, training is required in computer-based platforms to ease communication and avoid long ques in patient’s care clinics. Training has always covered clinical competency and compliance. Recently, hospitals have come up with training concerning customer service and patient-centered care to improve care delivery. Business practices in healthcare setting must focus on value-based care and patient experience harmonizing it with cost and quality (Chatterjee, Joynt, Orav, & Jha, 2012). Also, customer service can be covered through best business practices. As the patient experience plays a role in reimbursement, there is a need for healthcare professionals to be trained and educated more in the respective fields that will foster the experience.
Conclusively, business practices, regulations, and reimbursements are critical to the terminal patient-centered care delivery. If the business practices are formulated well and have concrete and elaborate objectives, the patients will not be dismissed in any facility unattended. Therefore, hospitals should major focus on the patient’s end so as to boost the quality of their services. Also, regulations by the state and the federal government should be adhered to in order to meet the reasonable standards to offer the best care for patients. Regulations are meant for the good of the staff and the patients at large. Nurses and healthcare professional must comply with these rules and minimize the rate of medication errors to avoid malpractice suits. With the launch of programs like VBP (Value-Based Programs) for the first time, hospitals will be able to provide quality clinical outcomes and exceptional patient experience that is directly linked to reimbursement (Charmel & Frampton, 2008). Also, hospitals should be able to retain the staff though advantageous training focused on customer service delivery.
Charmel, P., & Frampton, S. (2008, March). Building the Business Case for Patient-Centered Care. Healthcare Financial Management, 62(3), 80-85.
Chatterjee, P., Joynt, K. E., Orav, E. J., & Jha, A. K. (2012). Patient Experience in Safety-Net Hospitals: Implications for Improving Care and Value-Based Purchasing. Archives of Internal Medicine, 172(16), 1204-1210.
Dearmon, V., & NEA, B. (2013). Risk Management and Legal Issues. Management and Leadership for Nurse Administrators.
Forehand, A. (2000). Mission and Organizational Performance in the Healthcare Industry. Journal of Healthcare Management, 45(4), 267.
Manary, M., Staelin, R., K. K., Schulman, K. A., & Glickman, S. W. (2015). Organizational Characteristics and Patient Experiences With Hospital Care A Survey Study of Hospital Chief Patient Experience Officers. American Journal of Medical Quality, 30(5), 432-440.
Rathert, C., & May, D. R. (2007). Health Care Work Environments, Employee Satisfaction, and Patient Safety: Care Provider Perspectives. Health Care Management Review, 32(1), 2-11.
Sullivan, T., Monette, D., & DeJong, C. (2013). Applied Social Research: A Tool for the Human Services. New York: Cengage Learning.
Vaismoradi, M., Jordan, S., & Kangasniemi, M. (2015). Patient Participation in Patient Safety and Nursing Input– A Systematic Review. Journal of Clinical Nursing, 24(5-6), 627-639.