Question

consider You are a registered nurse (RN) in the intensive care unit (ICU) at your facility. The ICU has 24 beds, 1 nurse manager, 4 clinical nurse specialists (on a rotating schedule), and 6 charge nurses (on a rotating schedule). Typically, your unit has anywhere from 18-24 patients per shift. In order to climb the clinical ladder, you have been asked to create a new policy for your unit that will improve patient outcomes related to Readmissions.

1. Research best practices for improving Readmissions healthcare outcome.
2. Identify the best methods for implementing the best practices for Readmissions healthcare outcome
3. discuss the need for policy creation
4. elaborate on the role of the nurse manager, nurse leader and patient in the implementation process of this policy

Answer 1

1- In recent years, hospital leaders have intensified efforts to reduce rehospitalization. These efforts have been increased by aligning payments with patient outcomes through the Hospital Readmissions Reduction Program (HRRP), established as part of the Affordable Care Act (ACA). The ACA also expands eligibility for Medicaid coverage and assumes federal responsibility for much of the cost of this expansion. Many states began expanding Medicaid eligibility on January 1, 2011. While the Medicaid expansion was intended to be national, a Supreme Court ruling in June 2012 made it optional for states.As of December 2018, 14 states, including Missouri, had not expanded their Medicaid programs.

Hospital readmissions are costly to our national healthcare system. The annual cost of readmissions to the US healthcare system is approximately $17.4 billion per year.hospital team members readmit approximately 20 percent of patients who have Medicare as their primary payer within 30 days of initial discharge and readmit 34 percent of these patients within 90 days., the HRRP was enacted to help reduce the high rates of readmission by preventing avoidable hospital readmissions.

Excess costs for the delivery of healthcare can cause a financial strain on both the federal government and hospitals. Unnecessary healthcare costs total about $765 billion annually.Avoidable readmissions cost Medicare approximately $17 billion per year.Under the current payment structure, the fee-for-service model, providers have an incentive to overtreat their patients because their payments are based on services rendered, not on the quality or appropriateness of services.The fee-for-service model does not include adjustments for medical necessity or tie any quality measures or patient satisfaction elements to a provider's reimbursement.The federal government is attempting to recoup some of these costs by using quality programs such as the HRRP.

The HRRP creates accountability for hospital leaders and clinicians to provide better care for patients after their initial hospital discharge.Holding hospital leaders and clinicians accountable for patients after discharge promotes communication and integration with healthcare providers across the continuum of care.Poor communication from hospital team members to post-acute care providers is a common reason for hospital readmissions; improving communication among stakeholders increases the quality of the care that hospital team members provide to patients.Effective communication is instrumental in helping patients understand their diagnoses and the importance of taking their medications and properly caring for themselves. The prevalence of excessive readmissions has intensified administrators’ and clinicians’ efforts, as these initiatives are based on the notion that readmissions reflect poor quality of care.

The objective of this multiple case study was to explore the strategies and initiatives that hospital leaders use to reduce readmission rates at their facilities. By implementing successful strategies to prevent or minimize readmissions, hospital leaders can mitigate the hospital's financial exposure from unnecessary rehospitalization.

2-Today nurses continue to make an important contribution to planning and decision-making, and to the development of appropriate and effective public, health and nursing policy on all levels.”The work nurses do in influencing policy affects decisions that impact quality of life and universal access to care.

Nurses achieve leadership positions throughout the healthcare system (e.g., organizational, local, state, and federal levels) to design and implement innovative changes to health policy. Nursing organizations monitor health policy regulations to ensure they are supportive of patient care and nursing practice.

Nurse managers and leader's role in reengineering health care is by being advocates for patients and staff, as well as making sure the hospital's environment is calm and functioning smoothly. ... Leaders must help people work through the grieving process and conflicts experienced during time of change.

The primary role of community health nurses is to provide treatment to patients. ... They plan educational assemblies, hand -out fliers, conduct health screenings, dispense medications and administer immunizations. Nurses also may distribute health-related items like condoms and pregnancy tests.

Nurse leaders maintain the rigorous standards of care that patients and their families come to expect from exemplary healthcare facilities. Nurse leaders bridge the gap between policy and practice by ensuring that all members of a team are obeying safety protocols.

Nursing leadership and management is most successful when the entire team is also successful. ... This style of nursing leadership has been linked to improved patient outcomes, reduced medical errors, and improved staff retention, benefiting the healthcare workplace as whole.