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HCA320 Assignment Mod 6:

Assignment:

Accountability in Healthcare

This assignment will be at least 1500 words. Address each bulleted item (topic) in detail including the questions that follow each bullet. There should be three (3) sections in your paper; one for each bullet below. Separate each section in your paper with a clear brief heading that allows your professor to know which bullet you are addressing in that section of your paper. Include a “Conclusion” section that summarizes all topics.

This week you will reflect upon accountability in healthcare and address the following questions:

· Briefly define an Accountability Care Organization (ACO) and how it impacts health care providers:

How do ACOs differ from the health maintenance organizations (HMOs) of earlier years

What role does health information technology (HIT) play in the newer models of care?

· What is the benefit of hospitals partnering with primary care providers?

How does bundling payments contain healthcare costs?

How does pay for performance (P4P) improve quality care?

· Briefly discuss the value-based purchasing program?

How do value-based purchasing (VBP) programs affect reimbursement to hospitals?

Who benefits the most from value-based reimbursement and why?

How does the VBP program measure hospital performance?

Assignment Expectations

Length: 1500-2000 words in length

Structure: Include a title page and reference page in APA format. These do not count towards the minimal word amount for this assignment. Your essay must include an introduction and a conclusion.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment.

A conditions/medication template will be provided. Conditions will be given for each system. You will identify one drug/medication to treat each condition and give full details for that medication on the template provided here

Conditions:

• Hayfever (Allergies)
• Crohn’s Disease
• Influenza
• Latent tuberculosis 

2.  In your opinion what, if anything, can be done to prevent the spread of this polio-like illness which appears to be spreading across the nation? Should we be overly concerned or do you feel it will pass in time and no longer be an issue? 

1 Discussion

1 Journal

1 Reflective Paper

Case Study 1 & 2 Lyme Disease

The answers must be in your own words with reference to journal or book where you found the evidence to your answer. Do not copy paste or use a past students work as all files submited in this course are registered and saved in turn it in program.

Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

All answers to case studies must have reference cited in text for each answer and minimum of 2 Scholarly References (Journals, books) (No websites)  per case Study

APA STYLE AT LEAST 2 REFERENCES

Read Chapter on Davis Plus:Finance

1-Mention the types of budgets that you know and give examples of then?

2- What is budgeting?

3- What is directed and indirect cost?

4- Give examples of productive and non-productive hours?

5- What does HMO, PPO, POS means?

A) Mention one example of each of then in your city, or state?

6- What is DRGs.?

7- Give some examples of strategies for Cost-conscious nursing practice that your Nursing unit use to lower medical care cost? 

Respond to at least two of your colleagues in one or more of the following ways:

• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• 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.

POST 1

According to Cleary and Hunt, (2011), recent studies have shown the majority of nursing doctoral candidates are female, clinically experienced, and in their 40s or 50s at the time of starting their PhD. Based on that criteria, this writer fits exactly into that criteria. It is noted that other disciplines tend to start doctoral training much earlier (Cleary & Hunt, 2011).  As a practicing nurse of 30 years, most of it as an Associate Degree nurse the recognition of the PhD nurse was seen as a profession in a nursing league of their own. According to Michael and Clochesy, (2016), the PhD in nursing was predominant throughout the 20th century with members of the academic nursing community recognizing the need for the development of knowledge to inform practice and to promote the credibility of the profession.  Nursing theorists such as Jean Watson and Patricia Benner were game changers in the industry of theoretical nursing. The ability in achieving higher levels of education and in conducting research are hallmarks of professionalism (Houser, 2018).

This writer has a passion for teaching students and wants to be the best instructor she can be. She chose to go down the path of the PhD in Nursing education to increase skills and knowledge to improve what is delivered to students every day. The PhD is being pursued to separate myself from the growing amount of DNP faculty that she works with daily.  Being an alumni with Walden University for the MSN, it was an easy choice to pick Walden University for the terminal degree. Michael and Clochesy, (2016), states the PhD and DNP represent complementary and alternative approaches to the highest level of educational preparation in nursing. PhD programs prepare nurse scientists to conduct original research and to generate knowledge that may be broadly applicable or generalizable using advanced research designs and statistical evaluative methods. Conversely, DNP programs prepare students for advanced specialty practice at a high level of complexity with a concurrent focus on the development of knowledge and skills required for translation of evidence to improve health outcomes and health care delivery (Michael & Clochesy, 2016). 

Michael and Clochesy, (2016), also states two of the main reasons for not completing a doctoral program are financial and family stresses. Strategic plans must include financial considerations (e.g., research costs), support systems and a systemic approach to the dissertation to balance the demands successfully and complete a doctoral degree. Support from family and significant others, faculty, or fellow students is likely to result in greater positive feelings and outcomes (Michael & Clochesy, 2016). This student was fortunate enough to be able to personally finance the PhD program without creating student loans or an overwhelming financial burden on the family. She has a strong support network of family members including her husband and daughter. This writer plans to elevate her workplace position from a team leader of a fundamentals course to an associate degree program coordinator, associate degree of nursing director or dean of health sciences with the completion of her PhD in Nursing Education. 

References

Cleary, M., & Hunt, G. E. (2011). Demystifying PhDs: A review of doctorate programs designed to fulfil the needs of the next generation of nursing professionals. Contemporary Nurse: A Journal for the Australian Nursing Profession, 39(2), 273-80. Retrieved from https://ezp.waldenulibrary.org/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fdocview%2F1022984001%3Faccountid%3D14872

Houser, J. (2018). Nursing research; Reading, using, and creating evidence (4th ed.). Jones & Bartlett Learning

Michael, M. J., & Clochesy, J. M. (2016). From scientific discovery to health outcomes: A synergistic model of doctoral nursing education. Nurse Education Today, 40, 84–86. https://doi.org/10.1016/j.nedt.2016.02.011

POST 2

What does it Mean to be a Nurse with a Practice or Research Doctorate

Over the past decade, the doctoral prepared nurse role continues to evolve as healthcare organizations continue to seek qualified nurses who are geared and prepared in providing evidence-based patient-centered care. The doctorate role in nursing practice is emerging in numerous practices setting, especially hospitals, outpatient settings, and academic institutions, using guidelines to evaluate and enact new standards of care in education and practice to enhance best patient outcomes (Beeber et al., 2019).

What are the Expectations Associated with this Degree

Being a Doctor of Nurse Practice (DNP) means individuals are prepared to apply research in promoting evidence-based practice while advocating for patients. The DNP-prepared nurse provides leadership with the highest clinical expertise, which evaluates provider practices, clinical education design, and implementation translating research into practice (Greco, 2019). The Ph.D. nurse and DNP nurse work together in collaboration with the Ph.D. nurse focusing on research methodologies and ways to implement research (Hartjes et al., 2019). In other words, the Ph.D. nurse is a nurse scientist. The Ph.D. nurse research methodologies, develop theory, generalizes and replicate findings from an analysis of results to enhance quality improvement projects, and implement regulatory compliance (Hartjes et al., 2019).

How Might this be Different for a Nurse who Holds a Different Degree

The nurse who are considering a doctoral degree may choose from various education-focused degrees, such as the Doctor of Education (EdD), or a research-focused degree, such as a Ph.D. Others chose the Doctor of Nursing Practice (DNP). The doctoral options increase the skillset and knowledge with the ability to create policy reforms applying research into evidence-based practice. Historically, the Ph.D. degree is research-intensive and prepares the nurse for a career in academia or conducting independent research (Malloch, 2017).

How Considerations Relate to my Motivation to Pursue a Doctoral Degree now

The decision that influence my career choice in obtaining a DNP is my fellow peers. I have several colleagues who are doctorate-prepared nurses. During my clinical rotation during my MSN program, I was enormously impressed by these DNP prepared nurses. These DNP nurses were able to translate current practice guidelines and evidence-based practice into the way they care for patients, which, in my opinion, were beneficial for optimal patient care. I knew I wanted to also implement quality improvement methodologies in my practice, along with translating research into practice. The DNP degree will prepare me to become a clinical expert and a leader in health care with innovation, which will help to influence policy and practice changes at the highest organizational level (Udlis, & Mancuso, 2015).

References

Beeber, A. S., Palmer, C., Waldrop, J., Lynn, M. R., & Jones, C. B. (2019). The role of Doctor of Nursing Practice-prepared nurses in practice settings. Nursing Outlook, 67, 354-364. https://doi.org/10.1016/j.outlook.2019.02.006

Greco, M. (2019). The lived experience of Doctor of Nursing practice in pursuit of a Doctor of Philosophy degree in nursing. International Journal of Nursing Education, 11(4), 195-199. https://doi.org/10.5958/0974-9357.2019.00118.1

Hartjes, T. M., Lester, D. D, Arasi-Ruddock, L. D, McFadden, B. S.., Munro, S. P, Cowan, L. P, & Goolsby, M. J. (2019). Answering the question: Is the Doctor of Philosophy or Doctor of Nursing Practice right for me? Journal of the American Association of Nurse Practitioners, 31, 439-442. https://doi.org/10.1097/JXX.000000 0000000273

Malloch, K. (2017). Leading DNP professionals. Nursing Administration Quarterly, 41(1), 29-38. https://doi.org/10.1097/NAQ.0000000000000200

Udlis, K. A., & Mancuso, J. M. (2015). Perceptions of the role of the Doctor of Nursing Practice-prepared nurse: Clarity or confusion. Journal of Professional Nursing, 31, 274-283. https://doi.org/10.1016/j.profnurs.2015.01.004

EXAMPLE OF HOW REPLY FOR POST 1 AND POST 2 LOOKS LIKE.

The doctoral education is on a slow but gradual rise between the doctor of philosophy and doctor of nursing practice (Hartjes et al., 2019). The Ph.D. programs prepare nurse scientists intending to generate new knowledge to advance nursing science. The DNP programs prepare nurses to lead interprofessional teams to improve health care quality and systems (Ketefian & Redman, 2015). It is very interesting that most nurses and clinicians seek advancement with a doctoral degree into their 40s and 50s. Can you imagine what the research and practice ladder would be like if there were more doctoral prepared nurses before age 40. Educating the future is essential. You are quite fortunate to be able to go back to school where finances or not an issue. Having family support is critical in one’s success as the demands of the programs can be overwhelming. On a positive note, being a doctorally prepared nurse will provide new and compelling future opportunities.

References

Hartjes, T. M., Lester, D. D, Arasi-Ruddock, L. D, McFadden, B. S.., Munro, S. P, Cowan, L. P, & Goolsby, M. J. (2019). Answering the question: Is the Doctor of Philosophy or Doctor of Nursing Practice right for me? Journal of the American Association of Nurse Practitioners, 31, 439-442. https://doi.org/10.1097/JXX.000000 0000000273

Ketefian, S., & Redman, R. W. (2015). A critical examination of developments in nursing doctoral education in the United States. Revista Latino-Americana de Enfermagem (RLAE), 23, 363-371. https://doi.org/10.1590/0104-1169.0797.2566

This week you have learned about common cardiovascular disorders in the Adult and Geriatric patient. For the purpose of this discussion select one of the following cardiovascular disorders and provide the following in your initial post:

• Common Signs and symptoms seen
• Screening assessment tools
• Recommended diagnostic tests (if any)
• Treatment plans both pharmacologic and non-pharmacologic based on current clinical practice guidelines

Cardiovascular disorders:

• CHF
• Valve disorders
• Angina
• PVD

reply 1

The term “negotiate” implies conferring with another to reach a compromise. Conflict exists if health professionals blindly advise patients, expecting them to follow the recommendations without understanding patients’ feelings or identifying barriers to patient adherence. Negotiation identifies areas of agreement and disagreement and provides a forum for discussion of solutions. (Falvo, 2011). Patient education is one of the important roles of nursing. Patient teaching can be effective only if patient understand and agrees to follow the instruction. Negotiation is a way to work collaboratively with the patient to establish mutually acceptable goals and problem solve to assist patients’ ability to reach them. Negotiation helps to create effective teaching learning environment. Back in the day, the doctor was considered the last word when it came to a patient’s decision making. Today, physicians share the decision-making with their patients because patients have other things going on in their life that they must include in their healthcare decisions such as careers, families, time constraints and other realities. They need to work with physicians to establish effective, individualized treatments that works for the patient and the provider. The term negotiation, when applied to health care, indicates that a back and forth discussion is occurring where proposed treatment options are presented by the health care professional, considered by the patient, and either accepted, rejected, or altered to fit the patient’s needs (Falvo, 2011). By negotiating with patients, physicians and patients can reach a healthy decision for both parties.

In my practice with the increase of social media on the public’s decisions on healthcare matters, it is important to talk to the patient about their fears and reasons why they want or do not want. By educating them and providing them with evidence-based practice but still letting them make the decision will make them feel more included in the decision process.

Falvo, D. R. (2011). Effective patient education: A guide to increased adherence. (4th ed.). Jones & Bartlett Publishers. Retrieved from: https://viewer.gcu.edu/RQBKXW

reply2

According to the reading “negotiate implies conferring with another to reach compromise” (Falvo, 2011). The reading also points out there are different levels of negotiation by providers. Some (providers) may feel that negotiation interferes with what they consider to be the major goal of patient teaching: to offer information that will help patients improve or maintain health (Falvo, 2011).

Negotiation is part of building a partnership between the provider and patient. Negotiation is a way to work collaboratively with the patient to establish mutual goals and identify problems. Identifying the problems will allow patient’s the ability to reach the goals (Falvo, 2011). Providers also can find areas in the treatment plan the patient may not agree with, this important because this correlates with compliance as well as expectations of outcomes.

I would say that negotiation is a tool that can better or assist in relationships/partnerships between providers and patients. When providers are willing to accept that patients as partners, listen to their side of things and negotiate or meet somewhere in between there is responsibility on both parties. Patients must be honest with providers however and providers must be more flexible. Although the provider is expected to communicate and educate the patient is also responsible for their actions such as following the treatment plan.

An example would be a patient sees a physician the physician says the patient has high cholesterol. Educates on what this finding means, the risks, and suggests medication to correct the problem. The patient voices that she doesn’t want to take medication for the high cholesterol. The physician than explains alternatives to decrease the cholesterol. The patient chooses a non-medication route, the physician then based off this tells the patient they have one month to decrease their cholesterol. The patient and provider agree on the number expected for cholesterol in one month. The physician suggests that the patient decreases trans fats in their diet, adds fiber, adds exercise, and completes smoking cessation (Thorpe, 2017). If the patient goes back and there is not a change the physician tells the patient the medication will need to be started. The patient agrees. The key is now that the patient must be honest whether or not they held them self-accountable and made changes or not when following up. The patient also must express any concerns or difficulties they face with the provider. If the cholesterol is not lower the patient must also follow through on their part of the negotiation.

Critical thinking: Negotiation works in healthcare like it would in any type of relationship. If you tell someone everything is my way and I don’t care about what you think. Most likely that person isn’t going to do what you ask compared to if you said ok, I could see your point can we find a common ground to a solution we agree on. This type of relationship is beneficial for the provider and patient to increase better patient outcomes. Another benefit is the responsibility on the patient as well as the provider. The roles of patient and provider have changed and allows many different levels of acceptance as well as ways to in cooperate better health and patient centered care.

References:

Falvo, D.R. (2011) Effective patient education: A guide to increased adherence. Retrieved from http://gcumedia.com/digital-resources/jonesandbartlett/2010/effective-patient-education_-a-guide-to-increased-adherence_ebook_4e.php

Thorpe, M. (2017). 10 ways to naturally lower cholesterol. Retrieved from https://www.healthline.com/nutrition/how-to-lower-cholesterol

Term Paper 

o Topic: Interviewing a Professional Nurse 

o Interview a nurse professional with years of experience. 

o Provide examples for: 

o Teamwork 

o Patient-care 

o Adaptability 

o Time management 

o Communication style 

o Motivation and core values o 3-5 pages (excluding title page and   reference page) APA style paper with at least 3 references within 5   years. 

Discuss how pay-for-quality performance initiatives are influencing home health care delivery.

Your initial posting should be 250 to 350 words in length and utilize at least one scholarly source other than the textbook.