Discussion Week5
Purpose
The purpose of this discussion is for you to explore your healthcare setting culture and the shifting paradigm from volume-based care to value-based care within the context of patient safety.
Instructions
A paradigm shift is occurring across the United States from volume-based to value-based care. Reflect upon your organizational culture to address the following:
- Analyze and assess the culture of your healthcare setting as it relates to patient safety.
- Examine one opportunity to improve patient safety outcomes. Include in your strategy current technology being used to support safety and explain the importance of interprofessional collaboration to help promote a safer environment.
Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:
Course Outcomes
This discussion enables the student to meet the following course outcomes:
- Assess the impact of informatics and information technology on organizational systems, change, and improvement. (PO 6)
- Evaluate the types of healthcare information systems, knowledge-based systems, and patient care technology and the impact on patient safety, quality of care, and outcome measurement. (PO 7)
Due Dates
- Initial Post:
Welcome to week 5!
Remember: you may begin posting for credit on Week 5. Please do not post before then.
When you make your initial response, click on the “Reply” arrow above this post. In Canvas this will set your post apart from all others. When you reply to another’s post, you will click the “Reply” arrow under that post.
Please read the question carefully to understand all the components. Then respond in a scholarly manner following the Graduate Discussion Grading Guidelines and Rubric. Our interactive discussion addresses the following course outcomes:
CO 1: Assess the impact of informatics and information technology on organizational systems, change, and improvement. (PO 6)
CO 4: Evaluate the types of healthcare information systems, knowledge-based systems, and patient care technology and the impact on patient safety, quality of care and outcome measurement. (PO7)
Consider your own experiences as well as the literature.
I am looking forward to your discussions.
Rubric
| Professionalism in Communication | Presents information using clear, concise language in organized manner (0-1 error patterns in English grammar, spelling, syntax, and punctuation). | Presents information using clear, concise language in organized manner (2-3 error patterns in English grammar, spelling, syntax, and punctuation). | Presents information using understandable language; information is not organized 4-5 error patterns in English grammar, spelling, syntax, and punctuation). | Presents information that is not clear, logical, professional, or organized; reader has difficulty understanding the post; 6 or more error patterns in English grammar, spelling, syntax, punctuation). |
Participation
| Left blank | 5 points | 0 points |
| Participation Wednesday Response: Responds to initial discussion question(s) by Monday 11:59 p.m. MT. | Posts substantive response to initial discussion question(s) by Monday, 11:59 p.m. MT. | Does not post substantive response to initial discussion question(s) by Monday , 11:59 p.m. MT. |
| Total Participation Responses: Participates in discussion thread at least three times on at least 2 different days. | Posts in discussion at least three times AND on two different days during discussion week. | Posts fewer than three times OR does not participate on at least two different days during discussion week. |
Week 5Lesson 1
From Volume to Value: Transforming Healthcare through Information Technology
Shifting Paradigms: From Volume to Value
Across the United States, there is a widespread belief that the nation’s healthcare system must transform from volume to value (Abraham & McGann, 2019). Until recently, volume-based or fee-for-service care has been the standard. A shift towards value-based or fee-for-value reimbursement challenges healthcare organizations and healthcare providers to offer the best quality care possible. Value-based reimbursement incentivizes healthcare providers to provide safe, quality care at lower costs. These reimbursement structures are transforming the nature of care delivery by removing payment for the number of services provided and providing payment incentives for reducing costs and improving quality. Information technology can improve the quality of care a patient receives by reducing errors and costs while improving communication and efficiency.
View the following video to explore how the move from volume-based care to value-based care is transforming healthcare.
Technology-Driven Quality of Care and Patient Safety (2:50)
National Quality Strategy for Quality Improvement
In 2011, the National Quality Strategy (NQS) for Quality Improvement in Health Care was established by the Agency for Healthcare Research and Quality as a representative of the U.S. Department of Health and Human Services. Today, the NQS provides guidance for quality improvement efforts, including the evaluation of the success of healthcare stakeholders in the federal, state, public, and private sectors (National Quality Strategy, 2017). The goal is to improve the quality of healthcare while maintaining affordable costs. To ensure alignment with the NQS guidelines, nine levers have been identified to drive quality improvement initiatives.
Review below the NQS fact sheet for the nine levers:
View the following video to investigate nationwide efforts of the NQS to improve health and healthcare through value-based purchasing.
Patient Safety and Quality (3:36)
Week 5Lesson 2
Patient Safety and Quality: Value-Based Care
Health Information Technology for Economic and Clinical Health Act: Ensuring Quality and Privacy
As part of the American Recovery and Reinvestment Act of 2009 (ARRA), the Health Information Technology for Economic and Clinical Health (HITECH) Act promoted meaningful use of health information technology. Under this act, all healthcare organizations were required to have electronic health records by 2015 to avoid financial penalties. HITECH reinforces the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in relation to the privacy and security of electronic health information sharing. The goal of HITECH is to promote information technology (IT) within healthcare settings to improve the quality, safety, and efficiency of healthcare while reducing costs and ensuring patient privacy during the exchange of information.
View the following video to discover more about HITECH improves outcomes and reinforces HIPAA.
What Is HITECH? (1:44)
Creating an Informatics Culture Supporting Outcome, Data-Driven Care: Electronic Clinical Quality Measures
You have learned over the last few weeks about the impact of technology on the nurse’s decision-making, workflow processes, communication, and interprofessional collaboration, which influences the patient care continuum. With the shift from volume-based to value-based care and the implementation of clinical quality measures by the Centers for Medicare and Medicaid Services, coupled with the Promoting Interoperability Program, formerly known as Meaningful Use, the drive towards outcome-based care continues.
Proposed future strategies demonstrate a stronger shift to outcome, data-driven care. You will experience increased data sharing and information exchange to develop predictive models for future improvement of population health and patient care programs. Initially, clinical quality measures from the Centers for Medicare and Medicaid Services were manually extracted from the electronic medical record. Now, with enhanced interoperability, the data is being reported electronically.
Electronic clinical quality measures (eCMS) or digital quality measures (dQMs) do require some standardization of terms or data fields. However, this strategic emphasis on information exchange and interoperability will be supported by artificial intelligence to assist clinical practice and promote a safer healthcare environment for patients and staff.
The implementation of eCMS or dQMs is completed in a stepwise fashion with annual guidelines from the Centers for Medicare and Medicaid Services. The guiding focus is the Institute of Medicine’s six domains for healthcare quality, which have been transformational in guiding process improvement and creating a safer environment (Centers for Medicare & Medicaid Services, 2020).
Institute of Medicine Six Domains for Healthcare Quality
| Safe | Evaluate processes to ensure patient care does not create harm. |
| Effective | Direct research-based services to those who need it, avoiding overuse or misuse of resources to maximize resources. |
| Patient-Centered | Develop patient care process reflective of patients’ needs, values, and culture in a respectful manner to engage the patient in decision making. |
| Timely | Decrease delays in care for the patient and for the staff. |
| Efficient | Decrease waste of both physical and human resources. |
| Equitable | Demonstrate the same quality of care to everyone regardless of culture, gender, ethnicity, or socioeconomic status. |
(Agency for Healthcare Research and Quality [AHRQ], 2020)
Eligible hospitals and critical access hospitals along with healthcare providers will report electronic clinical quality measures. Standardized terminology must be used to achieve the electronic transfer of the required measures. This outcome, data-driven healthcare environment will accelerate innovative technologies and further research. The DNP-prepared nurse leader is at the forefront of healthcare delivery, assuring health data is effectively and efficiently shared with providers and patients. As a DNP-prepared nurse you may assist in transforming traditional interprofessional communication modalities and healthcare delivery systems.
Learn More!
If you want to delve deeper into the topic of electronic clinical quality measures, consider investigating the following webpages:
- Link (webpage): Eligible Hospital/Critical Access Hospital eCQMs (Links to an external site.)
- Link (webpage): Electronic Clinical Quality Measure Basics (Links to an external site.)
- Link (webpage): Digital Quality Measures (Links to an external site.)
Week 5References
Abraham, M., & McGann, P. (2019). Contribution of the transforming clinical practice initiative in advancing the movement to value-based care. Annals of Family Medicine, 17(1), s6-s8. https://doi.org/10.1370/afm.2425
Agency for Healthcare Research and Quality. (2016). National quality strategy stakeholder’s toolkit. https://www.ahrq.gov/sites/default/files/wysiwyg/nqsleverfactsheet.pdf
Agency for Healthcare Research and Quality. (2020). Six domains of healthcare quality. https://www.ahrq.gov/talkingquality/measures/six-domains.html
Centers for Medicare & Medicaid Services. (2020). Electronic clinical quality measure basics. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/ClinicalQualityMeasures
National Quality Strategy. (2017). Agency for healthcare research and quality. https://www.ahrq.gov/workingforquality/about/index.html
