Inter-professional Collaboration
Improving Quality
Improving the quality of health care delivery and patient safety continues to be a political concern and has been at the heart of reform issues for many years. The American Nurses Association (ANA) and the Institute of Medicine (IOM) have increased awareness of health care quality and safety issues, as well as advocated for health care reform. The documents featured at the ANA and IOM websites listed in this week’s Learning Resources focus on many of the current issues surrounding quality and safety in the health care industry.
To prepare:
- Review this week’s Learning Resources, focusing on the Six Aims for Improvement presented in the landmark report “Crossing the Quality Chasm: The IOM Health Care Quality Initiative.”
- Consider these six aims with regard to your current organization, or one with which you are familiar. In what areas have you seen improvement? What areas still present challenges? As a nurse leader, how can you contribute to improving the organization’s achievement of these aims?
- Select one specific quality or safety issue that is presenting a challenge in the organization. Consider at least one quality improvement strategy that could be used to address the issue, as well as which of the six aims for improvement would then be addressed.
- Reflect on your professional practice and your experiences with inter-professional collaboration to improve quality and safety. How has inter-professional collaboration contributed to your organization’s efforts to realize the IOM’s six aims for improving health care? Where has inter-professional collaboration been lacking?
Post a description of the quality or safety issue you selected and a brief summary of the impact that this issue has on health care delivery. Describe at least one quality improvement strategy used to address this issue. Then explain which of the six “aims for improvement” are addressed by the strategy. Finally, explain how inter-professional collaboration helps improve quality in this area.
Read a selection of your colleagues’ responses.
Respond in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Discussion 1
Improving Quality: Patient Center Care
Patient-centered care (PCC) is increasingly being highlighted as an important model to improve quality of health care having been linked to improved patient satisfaction, better health outcomes, and cost-effective care (Bauchat, Seropian & Jeffries, 2016). Lack of communication with patients and providers can affect patient compliance, hospital stays, and overall patient outcomes. Poor communication has been well documented as one of the top three contributors to sentinel events by the Joint Commission (Bauchat, Seropian & Jeffries, 2016). The Institute of Medicine (2012), states that if a health care system can achieve major gains in the six areas of safe, effective, patient-centered, timely, efficient, and equitable care, it would be far better at meeting patient needs. The challenge is to find an effective means of training non-technical skills, such as empathy, to promote a patient-centric model of care; empathy is arguably an important cornerstone to effective PCC (Bauchat, Seropian & Jeffries, 2016).
Impact on Healthcare Delivery
According to Reuben and Tinetti (2012), major efforts have been launched to make care more patient-centered, defined as respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. Attention to patient-centered measures and outcomes will be particularly important as the Centers for Medicare and Medicaid Services (CMS) moves increasingly to link health care providers’ reimbursement to their performance on selected measures (Reuben & Tinetti, 2012). Assessments of quality of care and health outcomes have not incorporated patient-centeredness. Measurement of quality has addressed preventive care while outcomes focuses on condition-specific processes. An alternative approach to providing better care would be to focus on a patient’s individual health goals within or across a variety of dimensions (Reuben & Tinetti, 2012).
Quality Improvement Strategy
The VA looked at developing a better relationship between patients, families and health care teams. Beginning in 2010, the VA adopted the Patient Aligned Care Team (PACT) model of care, which is adapted from the patient-centered medical home (Burkhart & et al., 2016). At the same time, the VA also established the Office of Patient-Centered Care and Cultural Transformation to guide transformation toward patient-centered care (PCC) (Burkhart & et al., 2016). This transformation to care for patients involved health coaching, decision-making initiatives, alternative medicine and pet therapy. Access to care improvements included same-day appointments, after hours availability, expanded visitor policy for inpatients, and valet parking (Burkhart & et al., 2016). The aim for improvement was focused directly on patient-centered care.
Aim for Improvement: Patient-Centered Care
Providing patient-centered care means giving patients the information they need to participate actively in decision making about their care with goals of obtaining the most desirable outcome (Knickman & Kovner, 2015). The individual’s culture, social context and specific needs should be addressed and the patient should have input in their own care. The achievement of a truly patient-centered health system will require the participation of patients, family members, physicians, nurses, and other health care providers involved in the provision of care (Knickman & Kovner, 2015). It is this team collaboration that makes the process more effective in patient care. Families should be more involved in the care process and goals should be discussed with the patient to obtain a more realistic approach.
Inter-professional Collaboration
Collaboration in health care has been shown to improve patient outcomes such as reducing preventable adverse drug reactions, decreasing morbidity and mortality rates and optimizing medication dosages (Bosch, Mansell, 2015). Trust must be established to build health care team. One way is consistency in care. Developing trust takes time and a lot of personal contact (Bosch, Mansell, 2015). This may be a challenge in some health care settings due to things such as rotating staff schedules, which contributes to constantly changing teams. Developing a personal relationship with a patient take time and adds to the patient centered approach to individual care.
Conclusion
In conclusion, the Institute of Medicine of the National Academies (2012) defines patient-centered as providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. Patient care should reflect individual and safe care as part of achieving quality health care.
References
Bauchat, J. R., Seropian, M., & Jeffries, P. R. (2016). Communication and Empathy in the Patient-Centered Care Model—Why Simulation-Based Training Is Not Optional. Clinical Simulation in Nursing, 12(8), 356-359. doi:10.1016/j.ecns.2016.04.003
Bosch, B., & Mansell, H. (2015). Interprofessional collaboration in health care. Canadian Pharmacists Journal (Sage Publications Inc.),148(4), 176-179. doi:10.1177/1715163515588106
Burkhart, L., Min-Woong, S., Jordan, N., Tarlov, E., Gampetro, P., & LaVela, S. L. (2016). Impact of Patient-Centered Care Innovations on Access to Providers, Ambulatory Care Utilization, and Patient Clinical Indicators in the Veterans Health Administration. Quality Management in Health Care, 25(2), 102-110. doi:10.1097/QMH.0000000000000093
Institute of Medicine of the National Academies. (2012). Crossing the quality chasm: The IOM Health Care Quality Initiative. Retrieved from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf
Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.
Reuben, D. B., & Tinetti, M. E. (2012). Goal-oriented patient care—an alternative health outcomes paradigm. New England Journal of Medicine, 366(9), 777-779.
Discussion 2
Quality of care issue: Electronic Health Records.
Today Electronic Health Records (EHRs) are at the center of health care uniting health care professionals, working as one team to improve the quality of care to all patients (Center for Medicare & Medicaid Services, 2012). However, quality of health care throughout the US varies among states, individual providers and even inter-departmental within hospitals (Knickman & Kovner, 2016). Additionally, even with advances in science and technology, 40% of the population is made up of chronic diseases; we need to bridge this gap between acute and chronic care, to ensure patients are receiving what they deserve in a more consistent way (Institute of Medicine, 2001). Providing safe and quality health care is paramount, and the Institute of Medicine (IOM) identified six issues, improving the overall health of the nation: Health care should be safe, effective, patient-centered, timely, efficient,…
