Cost-Effective, Innovative Models of Care Delivery Discussion
Cost-Effective, Innovative Models of Care Delivery Discussion
The Evolution of Nursing Informatics Presentation
Topic 5: Cost-Effective, Innovative Models of Care Delivery
The Cleveland Clinic is one of the top innovative healthcare provider organizations that use an innovative model of care. It began as a single building and has grown into a system of community hospitals, suburban family health and ambulatory surgery centers. Cleveland Clinic is a regional healthcare delivery system that offers a variety of care through numerous providers and facilities linked by multi-modal transport and information technology. Their system is focused on a patient-centered model of care. Cleveland Clinic has organized its system to provide patients with the appropriate level of care at the right time. By integrating healthcare systems and providing access at all points of care, healthcare costs are reduced. Some other ways cost is reduced include reducing wait times for patient visits, reducing length of stay, implementing drug utilization management strategies, using the electronic medical records to make appointments, and eliminating duplication of services. (Cleveland Clinic, 2009)
Christian values are essential to embody in all aspects of life. While GCU utilizes these values as a foundational component for educational standards, these should also be standard for how students are influenced in their academic performance as well. Academic dishonesty, which is the opposite of academic integrity, plagues all academic levels. There are several reasons why I think students are tempted into dishonesty including pressure for success, lack of understanding about what constitutes plagiarism, and not fully understanding the entire process of academia. Integrity is the intrinsic belief to do the right thing even when no one is watching and is an essential value of the Christian doctrine. When students believe and practice integrity, they will be able to apply this outside of the classroom and to other aspects of life. If students are engaging in academic dishonesty, this may be suggestive of a lack of integrity outside of the classroom as well. Lack of integrity is one example of the brokenness seen in society today. It shows a desire for success regardless of the means to get there or if there was any actual self-growth in the achievement of success. Having an educational infrastructure based on Christian values will not only foster academic success but will support students to apply these values beyond the classroom and become a part of their daily lives.
Interprofessional collaboration has strengthened the system’s ability to provide timely, effective, coordinated, and efficient care (Cleveland Clinic, 2009). Collaboration entails the sharing of high-quality data, clinical best practices, and the use of information technology, all of which lead to improved patient health outcomes. Cleveland Clinic emphasizes the importance of creating a culture that encourages and supports high reliability in order to encourage health teams to collaborate in order to advance quality improvement and safety processes and outcomes (Hancock, 2018).
“Cleveland Clinic has established an innovative home-based care model designed to prevent repeated hospitalizations and emergency department visits among high-risk patients and was developed to serve homebound primary care patients with chronic illnesses,” according to the Cleveland Clinic (Cleveland Clinic, 2020, para. 1-2). Patients who call in with a problem are triaged by a nurse. The nurse determines whether the patient requires a paramedic home visit and a virtual visit by a physician. Another function of this home-based model is to follow up on recently discharged high-risk patients with home visits. An advanced practice nurse conducts the initial visit. If the patient is considered high-risk for hospital readmission within 30 days, he or she will receive two to five visits from paramedics, as well as virtual visits from a physician, over a 30- to 45-day period (Cleveland Clinic, 2020).
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Also Read: Emerging Technology Brief Assignment
The health care system in the United States tends to evolve constantly to keep up with the changes that consistently
characterize the health care provision (Stalter & Mota, 2018). For instance, the shift to a value-based healthcare has resulted to quality care instead of attending to the highest number of patients by the providers. Value-based health connotes a reward system that provides incentives to health care providers depending on the quality they deliver to individuals with Medicare. The goals of value-based health care are to lower costs of health care, better health for individuals, and better public health in populations (Lewis, 2019). Value-based health care has impacted the delivery of care by ensuring provision of quality and affordable care services. On the other hand, it has impacted the nursing role by positively affecting the work environment for nurses, with quick patient discharge, reduced readmissions, and assignment of fewer patients to nurses. Consequently, the nurse to patient ratio, burnout, and workload decreases leading to less stress and increasing opportunities to pay more attention to patients, leading to improved health outcomes (Lewis, 2019). Value-based health care also stresses on strong care coordination, which also improves the workplace and environment for nurses.
The projected major evolving trends in the health care delivery system that are likely to affect nursing practice include the impact of the alarming nursing shortage, increased specialization, concerns of privacy and confidentiality, continued growth of telehealth, advancing nursing education online, increasing entrepreneurship opportunities in nursing, and the rise of nurse navigator. According to AONL (2021), the advanced registered nurse can influence the direction of health care by formulating a clear strategic plan and goals to help in leading to desired direction.
References
AONL. (2021). AONL Nurse Leader Competencies. https://www.aonl.org/resources/nurse-leader-competencies
Lewis, S. (2019). Value-based healthcare–meeting the evolving needs of our population. Australian Health Review, 43(5), 485-485. https://doi.org/10.1071/AHv43n5_ED
Stalter, A. M., & Mota, A. (2018). Using systems thinking to envision quality and safety in healthcare. Nursing management, 49(2), 32-39. doi: 10.1097/01.NUMA.0000529925.66375.d0
Re: Topic 5 DQ 2
Accountable Care Organizations (ACOs) are made up of physician groups, hospitals, and other health-care providers who work together to provide high-quality, systematic care to Medicare beneficiaries. ACOs typically reduce health-care costs by coordinating care to avoid overlapping or duplicative treatment methods. To maximize reimbursement, all members must collaborate to ensure a smooth transition in care. ACO members are motivated to develop innovations that improve care while lowering costs in order to receive full Medicare reimbursement. Numerous initiatives have been developed within this concept to ensure the best possible patient outcomes. The total joint replacement program aims to optimize patients, improve recovery time, reduce problems, and lower health-care costs. Nutrition, wound healing, deep vein thrombosis prevention, pain management, nausea medications, early ambulation, and physical and occupational therapy are all available at the joint replacement center. These areas are being targeted in order to reduce problems and hospital readmissions. The perioperative program at my hospital has developed clinical pathways that incorporate evidence-based practices for optimal care. This is a win-win situation for patients. The nation’s health-care workforce must work together to develop novel solutions that improve patient outcomes while reducing costs. D’Aunno et al. (2018) identify a number of high-performing ACO characteristics. D’Aunno and colleagues (2018) Physician engagement with hospitals, optimal physician group practice prior to ACO adoption, effective physician leaders focused on high-quality care, proficient use of information systems, constructive feedback to physicians, and care coordinators are examples of these components. Addressing these issues within an ACO will help to ensure optimal care and reimbursement.
References
D’Aunno, T., Broffman, L., Sparer, M., & Kumar, S. R. (2018). Factors that distinguish high-performing accountable care organizations in the medicare shared savings program. Health Services Research, 53(1), 120–137. https://doi.org/10.1111/1475-6773.12642
References
Cleveland Clinic. (2009). Bending the Cost Curve. https://my.clevelandclinic.org/-/scassets/files/org/about/model-healthcare/bending-the-cost.ashx?la=en
Cleveland Clinic. (2020, May 14). Patients Out of the Hospital:
Multispecialty teams address patients’ needs to prevent health crises. Consult QD. https://consultqd.clevelandclinic.org/innovative-home-based-care-model-keeps-high-risk-patients-out-of-the-hospital/
Hancock, K. (2018, January 22). Nursing and the journey to high reliability: Nurses are key to interprofessional collaborative practice. Consult QD.https://consultqd.clevelandclinic.org/nursing-and-the-journey-to-high-reliability
RESPOND HERE (150 W0RDS, 2 REFERENCES)
Hello Elizabeth,
I agree with you that the Cleveland clinic is one of the highly innovative and well-developed collaborative system of healthcare. The institution has an advanced multi-modal system of transport and integrated information technology system. This facilitates access to care even for families living in the suburban areas (Alotaibi & Federico, 2017). The emergence of Covid-19 posed a major challenge to hospitals capacity to cope up with the large number of patients in need of critical care services. However, with the advanced system of home-based care at Cleveland clinics, it was easier to manage the situation. The organization has well established transport routes and telecommunication networks that allows the primary healthcare providers to attend to patients at the comfort of their homes and reduce the cost of hospitalization and readmission. The use of telemedicine has enhanced strong collaborative networks among healthcare workers and the families that have patients with chronic illness that require long-term primary care especially in the recent times of Covid-19 pandemic (Monaghesh & Hajizadeh, 2020). NUR 514 The Evolution of Nursing Informatics Presentation
References
Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09301-4
Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631
Nursing informatics is among the nursing specialties characterized by remarkable growth. As health care providers continue to use electronic health records and information systems, the relevance and application of nursing informatics will be more dominant. The purpose of this presentation is to explore nursing informatics from multiple dimensions to understand its importance and influence. Focus areas include defining nursing informatics, history, and its effects on critical areas such as nursing education, leadership, and clinical practice. It further explores the effects of government regulation on organizational policy on health information systems, nurse-led innovation, and an example of the nurse’s role in transforming health care data into knowledge.
Nursing informatics is among the increasingly growing nursing specialties as the nursing field evolves. According to the American Nurses Association, nursing informatics is a specialty that combines nursing with information and analytical sciences to develop and maintain medical data and systems that support the nursing practice (Hussey & Kennedy, 2021). Blending nursing, computer, and analytical sciences is critical to improving patient outcomes. Different technologies have evolved as a result of nursing informatics. The most dominant is electronic health records (EHRs) that contain digitized patients’ data that can be shared across health care settings. The other technology is computerized provider order entry (CPOE) which primarily involves entering and sending treatment instructions using computer applications.
Understanding the roles of nurse informaticists can help to explore further what nursing informatics involves. As health systems continue accessing and using data, nurse informaticists continue to be more pivotal in health care transformation as they serve three primary responsibilities. The first responsibility is communicating the reasons behind new processes. Generally, nursing informatics is associated with process changes that the nursing workforce needs to understand. For instance, data must be collected accurately without estimations. Nurse informaticists ensure that such process changes are understood in detail. Nurse informaticists are also centrally involved in implementing new technologies and processes. Data validation includes promoting data-driven decision-making through effective data adoption. The roles demonstrate how nursing informatics is associated with significant transformations as health care processes become more data-centered.
Nursing informatics has a rich history as the specialty evolves from one phase to another. Conceptually, nursing informatics dates back to Florence Nightingale as she complied and processed data to improve medical protocols. As a field centered on information technology, specific engagement with technologies in nursing can be traced to the 1960s, before the first conference on nursing and computers (Frenn & Whitehead, 2020). Other crucial dates in the history of nursing informatics include defining nursing informatics as a specialty in 1992 and outlining practice’s scope and standards in 1994-1995. As Frenn and Whitehead (2020) further explained, the first set of competencies was introduced in 2001 before revision in 2015. More transformation is expected as technology evolves.
Nursing informatics has evolved gradually, and the evolution can be grouped into distinct phases with unique features. The first phase is introducing the concept into the health care arena in the 1960s and 1970s (Frenn & Whitehead, 2020). The introduction laid the foundation of data application and computer use in health care before advancing into a more complex and independent field. The second phase is data collection through machines as data started becoming an essential component of health care delivery. Such machines include mechanical ventilators that collect patients’ vitals in intensive care units. Later, nursing informatics advanced to be primarily about applying computer-based information systems [computers playing a major role in health care delivery] before becoming an independent specialty.
The influence of nursing informatics on nursing leadership cannot be underestimated. Through informatics, nurse leaders can communicate more effectively with other health care personnel. To benefit from such opportunities, nurse leaders must be more tech-savvy and increasingly committed to adopting new health care technologies and systems. Due to its increased relevance in health care delivery, nursing informatics also changes the role landscape of nurse leaders. It makes nursing leadership acquire new roles, including adopting health care processes that promote evidence-based practice, interprofessional collaboration through health care technologies, and leveraging health information technology in health care organizations. Nursing leadership must also focus on fostering progressive improvement in clinical systems as new technologies emerge.
This presentation includes a definition of nursing informatics and discusses the history of nursing informatics and how it has evolved. I will also discuss how nursing informatics impacts nursing leadership, clinical practice, administration, education, and research. In addition, I will explain how government regulation can impact organizational policy on health information systems. I will also explain nurse-led innovation relating to the advances in informatics and how informatics innovation can improve the quality of patient care.
Nursing informatics is a specialty that integrates nursing science with information and analytical sciences. It seeks to identify, define, manage, and communicate information and knowledge in nursing practice. A nurse informaticist uses their clinical skills with knowledge of technology, computers, and data (Asiri, 2018). Nurse informaticists take on complex tasks like utilizing health data to analyze patient care outcomes and training other nursing staff on new patient care technology. Nursing informatics is committed to delivering high-quality patient care through efficient management of data and technology systems. Nurse informaticists use data to analyze trends, monitor for errors, and implement new, more efficient information systems (Asiri, 2018). Nursing informatics focuses on patient care, particularly by optimizing the technology used by nurses.
The term nursing informatics was first proposed by Scholes and Barber in 1976. The first computer applications in nursing practice appeared in the literature in the early 1970s. In the 70s, nursing informatics was supported by the development of some of the early health information systems (HIS) by multiple agencies in the US (Blažun Vošner et al., 2020). The HIS included nursing care planning and documentation. Besides, nurses were involved in interdisciplinary efforts that sought to develop and implement applications that support health care. Through the ’80s, NI practice, education, and scholarship thrived and grew in the US (Blažun Vošner et al., 2020). In the 1990s, large integrated healthcare delivery systems evolved, which further created the need for information across healthcare organizations within the large systems to regulate processes, control costs, and assure the quality of care.
Since the introduction of computer applications in nursing, nursing informatics has evolved to become one of the foundation stones of the health informatics field. Nursing informatics has evolved not only in practice but also in education and research. In 1988, the first graduate program in Nursing Informatics was launched at the University of Maryland School of Nursing focusing on understanding nursing informatics systems and science (Asiri, 2018). In 1990, the University of Utah launched a graduate program for Nursing Informatics targeting the transformation of data into clinical decision-making. In 1992, Nursing Informatics was formally recognized as a nursing specialty by the American Nurses Association. In 1995 Nursing Informatics certification was introduced through the American Nurses Credentialing Center (ANCC). In 2003, the first doctorate in nursing with a healthcare informatics option was introduced at the University of Arizona College of Nursing (Asiri, 2018). Today, with the advancement in technology, more institutions are offering varied Nursing Informatics degrees as a part of their nursing programs.
Nursing informatics helps nurse leaders to combine their analytical and clinical skills to provide their patients with the highest quality care. Nurse leaders must demonstrate abilities and develop specific informatics competencies to provide meaningful leadership and support the continuing transformation of the healthcare system (Kennedy & Moen, 2018). They are required to leverage healthcare technology to improve healthcare goals. Research shows that nurse leaders who have adopted healthcare technology have significantly improved outcomes for all stakeholders, including patients, nurses, and healthcare teams (Kennedy & Moen, 2018). Nurse leaders are positioned to adopt informatics research to improve patient care. Furthermore, nurse leaders are now using informatics to analyze trends in patient care and identify potential errors in delivering care.
Nursing informatics plays a key role in the nursing process. Nurses obtain patient information and use the data to develop nursing care plans, execute the plan, and communicate findings with other providers. Advances in nursing informatics have enabled nurses to access vital patient data with the click of a button. In hospitals and clinic offices, providers have access to electronic health records, which enable them to access private and confidential patient health information in a secure environment (Al Najjar & Shafie, 2022). In addition, informatics has impacted clinical practice through services such as telehealth, which provide a channel for client education and medical and healthcare services like health monitoring and clinical diagnosis (Al Najjar & Shafie, 2022). Currently, health providers can communicate and plan care more effectively, in collaboration with patients and other providers, owing to technological advances.
Nursing informatics is revolutionizing how health care is delivered. Healthcare systems are integrating wireless solutions, high-speed data networks, handheld devices, automated exchanges between organizations/providers and patients, and various social media platforms into their daily interactions (Al Najjar & Shafie, 2022). Informatics has helped healthcare administrators and managers to communicate more efficiently with the medical personnel in their organizations. Furthermore, informatics helps healthcare administrators to customize incentive plans for patients. Health informaticists help managers in the healthcare industry access pertinent information to produce actionable insights that enhance both therapeutic and organizational efficiency (Kennedy & Moen, 2018). Informatics enables health administrators to access patient data that enables them to provide administrative services, like appropriately billing patients.
The evolvement of nursing informatics has led to the establishment of degree programs in informatics to equip nurses with knowledge and skills in this field. Graduate programs at Master’s and Doctorate levels continue to grow. They provide education, certification, and credentialing to expand the knowledge, skills, and vision required for the nursing informatician of today and tomorrow (Singh & Masango, 2020). In addition, nursing informatics has led to the introduction of informatics in the nursing curricula to teach nursing students to use technology and informatics. This ensures that nursing students acquire the necessary psychomotor skills related to the use of technology hardware and software important in healthcare settings.
Informatics literacy is considered a vital issue in improving nursing evidence-based practice (EBP). Informatics and computer skills are crucial components that support and reinforce the EBP framework. Nurses and other health providers are expected to have high-level information literacy to improve their science-based performance (Abdekhoda & Khezri, 2021). The clinical team particularly nurses who have a crucial role in caring for patients, use informatics to obtain information on the latest changes related to clinical care. They also use informatics to update themselves on the latest clinical information to better patient care. Health providers use online databases to stay up-to-date on current research and make decisions based on that research, thus increasing the chances of improved health care. To effectively search databases, nurses must have information literacy skills like how to organize information in databases, create and arrange search terms, and create search strategies to obtain high-quality literature in research (Abdekhoda & Khezri, 2021).
Government regulations lay the foundation for the documenting, storing, and use of electronic health information (EHI). Government laws play a key role in enabling health departments to use HIT to optimize systems that use patient information to monitor population health trends and interface with similar HIT systems used by healthcare providers and hospitals (Ramanathan et al., 2018). The Office of the National Coordinator for Health Information Technology (ONC) creates regulations that outline the standards and certification criteria that EHRs must meet to assure health providers and hospitals that the systems they take on can perform various functions (Ramanathan et al., 2018). Thus, this regulation can affect organizational policies on EHR systems since hospitals must comply with and adopt EHR systems that meet the ONC’s regulations. Government regulations like the HITECH Act drive health organizations to adopt security that promotes secure electronic health information exchange.
The rapid development of healthcare technology gives opportunities for innovations to transform healthcare practices. Nurse-led innovation is vital for enhancing workflow. It should be encouraged and backed up by health systems, and academic settings. Nurse informatics brings added value to the innovation space by consistently focusing on patient quality and safety while promoting a high standard of care (Kelley, 2019). With the widespread use of EHR and clinical information system, nurses have been introduced to the change-making process that involves diffusing innovation in healthcare. Nursing informatics innovations are anticipated to enhance the effectiveness, efficiency, safety, timeliness, and patient-centeredness in patient care and improve patients’ access to healthcare services (Kelley, 2019). However, adopting nursing informatics innovations should be guided by evidence and there should be careful deliberation of anticipated and possibly unintended outcomes.
Informatics innovations can be used to develop healthcare systems that help providers to identify potentially harmful treatment or prescription errors, refine retrieval of patient records, and increase the safety of patient information. Informatics innovation can be used to improve documentation, which is a vital part of the nursing profession (Kelley, 2019). Innovations that enable nurses to document a patient’s condition and share the information electronically can enable nurses more effectively manage patent care, and improve the quality of care.
Health informatics innovation can also help to obtain important patient data that can prevent medical errors. For example, innovations in electronic records can provide information about a potential medication interaction or allergy that may not otherwise be immediately evident. Furthermore, informatics innovation can improve the coordination of patient care (Kelley, 2019). This is by enabling providers to incorporate data into their workflow, making them more productive and improving their ability to provide better care.
The nurse informatician has the role of using data to generate knowledge that improves patient care and administrative functioning. The nurse can access information databases and link the information with patient records to make data-driven decisions about patient care. The information from the databases and patient records can be used to generate knowledge that helps to predict patients at high risk for certain diseases or medical events (Kennedy & Moen, 2018). This can result in precautionary actions and increased screening in the patient population.
For instance, the nurse can use EHRs to access patient data and transform it into knowledge that helps to identify patient disease patterns. This can help identify approaches to increase preventative care and reduce ER visits by directing attention to patients at risk of specific chronic conditions and providing appropriate disease-prevention plans.
Nursing informatics is a specialty that integrates nursing science with information and analytical sciences. The term nursing informatics was first proposed by Scholes and Barber in 1976. In 1992, Nursing Informatics was formally recognized as a nursing specialty by the American Nurses Association. Nurse leaders are required to leverage healthcare technology to improve healthcare goals. Nursing informatics helps administrators to access pertinent patient information to produce actionable insights. Informatics innovations can be used to identify medical errors and improve documentation. Information from databases and patient records can be used to generate knowledge that helps to predict patients at high risk for certain diseases or medical events.
References
}Abdekhoda, M. & Khezri, H. (2021). Investigating the impact of health informatics literacy on the evidence-based practice of nursing. Online Journal of Nursing Informatics (OJNI), 25(2). https://www.himss.org/resources/online-journal-nursing-informatics
}Al Najjar, R. I., & Shafie, Z. M. (2022). Impact of Nursing Informatics on the Quality of Patient Care. International Journal Of Medical Science And Clinical Research Studies, 2(5), 418-421. https://doi.org/10.47191/ijmscrs/v2-i5-19
}Asiri, H. (2018, February). An overview of nursing informatics (NI) as a profession: how we evolved over the years. In International Conference on Health Informatics (Vol. 6, pp. 200-212). SCITEPRESS.
Blažun Vošner, H., Carter-Templeton, H., Završnik, J., & Kokol, P. (2020). Nursing Informatics. CIN: Computers, Informatics, Nursing, Publish Ahead of
}Kelley, T. (2019). The emergence of Nursing Innovation Influenced by Advances in Informatics and Health IT. Nurse Leader. doi:10.1016/j.mnl.2019.09.012
}Kennedy, M. A., & Moen, A. (2018). Nurse Leadership and Informatics Competencies: Shaping Transformation of Professional Practice. Studies in health technology and informatics, 232, 197–206.
}Ramanathan, T., Schmit, C., Menon, A., Sunshine, G., & Pepin, D. (2018). Federal public health laws supporting data use and sharing.
}Singh, F., & Masango, T. (2020). Information technology in nursing education: perspectives of student nurses. The Open Nursing Journal, 14(1). DOI: 10.2174/1874434602014010018