Explain What is the relationship between financial reimbursement and quality of care?

In order to promote safe, caring, patient-centered environments, nurse leaders must both conceptually understand and be proficient at performing a wide variety of leadership skills. Effective nursing leaders develop and maintain awareness of issues that emerge at many levels within and outside of their organizations. In addition to developing self-assessing competencies necessary for their roles, nurse leaders must also acquire organizational and systems leadership skill sets.

In this program, you have examined the role, concepts, and principles of health care policy and how legal and regulatory agencies interact with professional nursing practice. You have also looked closely at the factors that impact disparities in health care access. This understanding of health care policy, as well as the multicultural, socioeconomic, political, legal, and regulatory elements that affect individuals, communities, and vulnerable populations, positions nurses to bring about change through effective communication with colleagues, consumers, and officials. Added to this is your demonstrated knowledge of financial management and cost containment, as well as how they affect quality of care.

 

  • What is the relationship between financial reimbursement and quality of care?
  • How can nurses and health care organizations influence health policy?
  • What is the process in your organization to initiate, implement, and support improvement changes?

For this assessment, write an executive summary analyzing the financial and regulatory impact of organizational compliance with a specific core measure of your choice. The summary must include recommendations for improving performance on the measure.

You must be able to explain the financial implications associated with the measure, as well as its importance in terms of policy, regulation, and finance. This is another good opportunity to consult with a key stakeholder within the organization. Talking to someone who works closely with the organization’s finances can help you develop a deeper understanding of the financial aspects of compliance. You also need to suggest ways your organization can improve compliance and how you would implement changes and overcome obstacles.

 

Directions

Select a core measure and investigate your organization’s compliance rate with the measure. In your executive summary, address the following:

  1. Compare the compliance rates of your organization with those of other organizations.
  2. Identify the financial implications associated with the measure.
  3. Explain why the measure is important in terms of policy, regulation, and finance.
  4. Describe changes that could be made that would improve compliance with the measure.
  5. Identify the people who would be affected by the changes.
  6. Outline a plan to implement the changes within the organization.
  7. Identify obstacles you would expect to encounter.
  8. Explain your strategies for overcoming obstacles.

Identify a major patient-safety issue within your own organization and use evidence-based best practices and technology to develop a plan to improve the safety issue.

identify a major patient-safety issue within your own organization and use evidence-based best practices and technology to develop a plan to improve the safety issue.

Quality improvement and patient safety are central to the nursing leadership role.

Central to the nursing leadership role, quality improvement and patient safety are analyzed from many perspectives. Types of quality improvement and patient safety programs may range from internal, organization-based quality improvement team reports to external benchmarks from The Joint Commission, the Agency for Healthcare Research and Quality (AHRQ), MAGNET, and numerous other organizations.

Preparation

As you prepare for this assessment, complete the following:

  1. Before you begin, examine your organization’s history of safety in a specific area and how your organization addresses patient safety issues. If possible, consult with a key stakeholder in the organization (such as an administrator) to better understand specific patient-safety concerns and how the organization is working to resolve the concerns. This person should also be able to discuss some of the organizational barriers impacting the patient safety issue.
  2. Next, look at the basic concepts, principles, and practices that contribute to organizational quality improvement and patient safety. Review the literature for best practices and how technology might be used to improve the issue.
  3. Finally, be sure to consider the legal and ethical implications associated with the safety issue, as well as possible organizational barriers to change.

Directions

As you construct this assessment, address each point as completely as possible:

  • Describe a patient-safety issue within your organization.
  • Compare the way your organization addresses patient-safety issues with the concepts, principles, and practices that contribute to quality improvement and patient safety.
  • Analyze the legal and ethical consequences of not addressing the issue.
  • Recommend evidence-based interventions to address the patient-safety issue.
  • Explain how technology can be used to improve the issue.
  • Identify possible organizational barriers to change (budget, vision, technology, et cetera).
  • Describe strategies to overcome organizational barriers to change, based on your knowledge of the organization.

Analyze a key issue facing a population segment in order to propose an area for additional research. Your research will: Part I: Background Describe your chosen population segment. Explain one major social issue facing your selected population segment.

analyze a key issue facing a population segment in order to propose an area for additional research. Your research will: Part I: Background Describe your chosen population segment. Explain one major social issue facing your selected population segment. Provide statistics and background data to document the social issues facing your selected population segment. Analyze the social and cultural factors contributing to the social issue. What are the political, economic, legal, practical, and ethical aspects of the issue? What are the multiple levels contributing to and/or perpetuating the issues (i.e., individual, group, and societal levels)? What are the personal, professional, and ethical implications on the society? Relate two sociological perspectives to provide context for your selected population in order to explain their most significant challenges faced by that population. Apply data from your research to support your claims about the challenges. Part II: Research Proposal Propose a statistical research project that directly relates to the social issue you identified for your selected population. Create a plan to conduct your research study, describing in detail what you want to measure and why. Below are a few points to include: Who would be involved? What would be a realistic timeline for completing your proposed project? How many people would be needed to conduct the research project from a staffing perspective? Which statistical analysis method (e.g., statistical tests/measurements) would be most appropriate for your application? How many subjects would you require for your study? Evaluate the importance of your proposed research study, and describe how the resulting data could best be used and which organizations or agencies will benefit best from it