Health Care and Business Collaboratives Reduce Costs and Improve Patient Care

January 6, 2012 at 9:45 pm

We’ve all heard that high administrative and medical costs are greatly effecting hospitals causing higher nurse-to-patient ratios, a decline in patient care, and various cutbacks. However, there is a new plan that cuts costs AND can improve patient care. This system may even help nurses with a BSN degree on the job.

Harris Meyer writes in Kaiser Health News that an unusual collaboration has been constructed between a company, a health care system and an insurance provider that reduces the bureaucracy for patients to get access to the aid they need. By reducing time it takes for patients to get seen, their costs have been reduced by approximately $2 million and the cost per patient has greatly reduced between 10 to 30 percent.

“Experts say employers, hospitals, physicians and health plans increasingly are willing to work together because cost and quality problems have reached crisis levels. The goal is to carve out health-care spending that’s wasteful and doesn’t help patients,” explains Meyer. “Collaboratives help physicians and hospital leaders see employers and patients as customers whose expectations, such as rapid access to care, must be met.”

There are some major roadblocks that prevent collaboratives from becoming the norm. Meyer writes that, “It’s often difficult to get traditional competitors and antagonists to collaborate, including sharing proprietary medical and financial data. Some employers are reluctant to get directly involved in how health care is delivered. Critics warn about rationing of care. And some physicians complain about interference with their professional autonomy… Perhaps the biggest roadblock is the predominant fee-for-service system, which pays providers to deliver more services, rather than better, more efficient care. Health-care payers, including private insurers and Medicare, have been slow to change their payment models to reward outcomes rather than volume of care. That sometimes puts providers in the position of losing revenue by doing the right thing for patients.”

It seems that this idea will take time to catch on. Although those who have participated in this health care experiment are pleased with the financial savings and patient approval ratings, the old equation of dollars and cents cannot be applied to this model.

As a nurse in a BSN degree program, it is important to research what trends are being implemented at the hospital that you potentially want to work at. Not only is there the stress of patient care, but also the twisted mass of bureaucracy that influences the attitude of the hospital.

To read the complete article mentioned in this post, please visit
http://www.kaiserhealthnews.org/Stories/2012/January/06/Collaborative-Efforts-Can-Save-Money-And-Improve-Care.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+khn+%28All+Kaiser+Health+News%29

Partnership for Patients Initiative to Improve Patient Care

December 26, 2011 at 4:13 pm

One of the best ways to study is with a fellow nursing student to share experiences, knowledge and accountability. Now the U.S. Department of Health and Human Services (HHS) is doing something similar by having bigger hospitals with high patient care ratings share their methods for success with struggling hospitals. This could create better working environments and safer procedures for nurses getting their online RN to BSN degree.

On NurseZone.com it was reported that, “As a part of the Partnership for Patients initiative, a nationwide public-private collaboration to improve the quality, safety, and affordability of health care for all Americans, $218 million will go to 26 state, regional, national, or hospital system organizations. As Hospital Engagement Networks, these organizations will help identify solutions already working to reduce healthcare acquired conditions, and work to spread them to other hospitals and health care providers.”

Hospitals in these “Engagement Networks” will “be required to conduct intensive training programs to teach and support hospitals in making patient care safer, provide technical assistance to hospitals so that hospitals can achieve quality measurement goals, and establish and implement a system to track and monitor hospital progress in meeting quality improvement goals,” states the website.

I think it’s great for hospitals to collaborate so that each one doesn’t have to spend time or money and risk patient health and nurses’ sanity to find out what works and what doesn’t. However, I didn’t see any comments as to how to the weaker hospitals are chosen or whether or not the hospitals being helped are in low income areas. I bring this up because I think it’s easier for a large, profitable hospital located in an affluent area to have a lower patient readmission rate and greater success due to patient education, safer neighborhoods and healthier personal bank accounts. Will success at one of these hospitals equal success at a hospital serving primarily seniors or low income individuals? (Or maybe I’m just a cynic…)

This program boasts that “Achieving the Partnership for Patients’ objectives would mean approximately 1.8 million fewer injuries to patients in the hospital, saving over 60,000 lives over three years, and would mean more than 1.6 million patients to recover from illness without suffering a preventable complication requiring re-hospitalization.”

Going to an RN to BSN college means that there will always be new procedures to learn, new skills to employ and new strategies to be educated in. It will be interesting to see if this one sticks and reaches it’s goals.

To read the complete article mentioned in this post, please visit
http://nursezone.com/Nursing-News-Events/more-news/Partnership-for-Patients-Initiative-to-Improve-Hospital-Care_38726.aspx

Drug Shortages are a Problem Nurses May Face

December 7, 2011 at 8:08 pm

Drug shortages seem to be a growing problem in the medical world. From manufacturers discontinuing less profitable medications to ingredients being difficult to obtain, certain patients are suffering from not being able to acquire the drugs that they need for their ailments. As a nurse with a BSN degree, it can be difficult to know what your patient needs are and not being able to provide the answer.

On NurseZone.com, contributor Debra Wood reported on the increasing problem of drug shortages that is affecting nurses and patients alike. “Often shortages remain off the radar until a nurse goes to give the drug, and it is not available. The nurse may call the pharmacy to track it down and learn about the national shortage. The nurse then notifies the physician to try to obtain a different order. Meanwhile, the patient waits.”

“Every day something different comes up, and it’s hard to predict [what won’t be available],” said AnnMarie Papa, DNP, RN, CEN, NE-BC, FAEN, president of the Emergency Nurses Association, adding that “the biggest thing for nurses is the frustration.”

Wood also explains the dangers of drug errors when a doctor tries to replace a medication for one that isn’t available. “When the morphine shortage began, the 2 mg. strength was not available and pharmacies stocked higher dosages. The nurse expecting a 2 mg vial might not recognize it really is 10 mg and could administer an overdose. Eventually, even higher strengths of morphine became unavailable and hospital pharmacies switched to hydromorphone, which is seven times stronger than morphine. Some physicians inadvertently ordered the same number of milligrams, and nurses administered it, resulting in patient deaths. Likewise, different strength epinephrine led to overdoses of that drug.”

The FDA reported that drug shortages are increasing in current years. There were 61 shortages in 2005 which then jumped to 178 in 2010. Of the 127 in 2011, 80% are administered by sterile injection, primarily for oncology patients. “Injectables present more complex manufacturing processes, and most have only one manufacturer that produces at least 90 percent of the drug, according to facts released by the White House,” writes Wood.

As a student in an online RN to BSN degree program, there are many frustrations that lay ahead. Listening, being knowledgeable and having compassion are the best ways to help your patients when things are out of your control.

To read the complete article mentioned in this post, please visit
http://nursezone.com/nursing-news-events/more-news.aspx?articleid=38484

Should States Step in to Aid Failing Hospitals?

November 30, 2011 at 5:24 pm

I just read a couple of articles about how some states are discussing how to take over floundering hospitals that are in a mass amount of debt. Hmmm… I must say that I am rather conflicted over whether this is the right thing to do: on one hand, if the management is incompetent and patients are at risk due to poor decisions, then something definitely has to change. On the other hand, our country is based on free enterprise and minimal government intervention. If the government steps in now, what will limit it from other industries? How will this impact us as taxpayers and as nurses with a BSN degree?

According to the Wall Street Journal, reporters Joseph De Avila and Jacob Gershman explain, “A New York state panel called Monday for sweeping changes that expand the state’s authority to assume control over troubled hospitals and also recommended the mergers of several troubled Brooklyn medical centers.

“The report was the culmination of a six-month effort by the state Department of Health to assess the finances of Brooklyn hospitals that have taken on staggering amounts of debt to remain open. The hospitals serve mostly the poor who use Medicaid insurance and patients who overly rely on costly emergency services for basic medical care.”

I think state intervention would be beneficial in this situation since most of the funding comes from Medicaid which is government dollars. However, I wonder if changing from a private hospital to a government run one would affect medical staff’s benefits, overtime, work schedules, etc. Also, are taxpayers going to have to foot the bill to get their local hospital out of major debt? These are already in financial strapped areas with people who don’t have extra cash to spare. Where is this additional government money going to come from?

Nina Bernstein reports in the New York Times that, “No hospital would simply be bailed out, the report said, but all would have to apply for support based on new patient-centered delivery models being promoted by the government to reduce Medicaid costs and improve outcomes. Support could include forgiveness of long-term debt, which could be controversial if private investors play a role.”

Now I know that this is happening in New York (and Arizona), but I’m guessing that every state has it’s distressed hospitals in low income neighborhoods. This may be the first state to intervene to save some hospitals, but I doubt it will be the last. RN to BSN bridge program students may have to decide if this is a viable option for employment and watch how this plays out across the nation.

To read the complete articles mentioned in this post, please visit
http://online.wsj.com/article/SB10001424052970203935604577066853179976904.html?mod=googlenews_wsj
and
http://www.nytimes.com/2011/11/29/nyregion/panel-urges-sharp-change-for-hospitals-in-brooklyn.html?_r=1

Hospital Develops Program to Greatly Reduce Infections

November 18, 2011 at 4:50 pm

We’ve had to go to the emergency room a couple of times for my daughter over the years and I always think “Are we going to be exposed to a virus worse than the condition we already have?” Honestly, ERs terrify me because of the variety of illnesses contained in one small room, the lack of sanitary precautions most patients take and the amount of people sick people constantly in one room. However, infections are not just a problem in the ER. Due to this risk factor, several hospitals in Ohio have developed a program to protect their patients from bloodstream infections which could help RN to BSN bridge program nurses throughout the country.

A press release was posted by the Ohio Hospital Association describing their new strategy for decreasing bloodstream infections by half. “By working together, 53 Ohio hospitals have drastically reduced central line-associated bloodstream infections (CLABSI) in intensive care units by 48 percent over a 22-month period, saving lives and health care costs.

“Through collaboration with the Ohio Hospital Association, the 53 participating hospitals worked with 80 patient care units in Ohio on the CUSP: Stop BSI as part of a voluntary national effort to eliminate CLABSI using the Comprehensive Unit-Based Safety Program (CUSP). A central line is a catheter that ends in large vessels going into the heart so clinicians can more closely monitor patients and administer medication.”

With this new development, hospitals in Ohio and two other states were able to save more than $4,558,000, they prevented 86 bloodstream infections, saved 17 lives, and saved 688 excess hospital days. This makes me think that Benjamin Franklin was right: “An ounce of prevention is worth a pound of cure.”

Granted, I know these studies are costly and grant money is hard to come by, but these results are quite impressive. The press release stated that their bloodstream infection rate dropped by half. I’m just thinking about what studies could be done in different areas. The financial costs, lives saved, nurses wouldn’t be overextended, and an increase inpatient health and morale could be incredible outcomes.

The purpose of getting an online BSN degree is to help people get and stay well. With these new studies on the horizon, more nurses will be able to do just that!

To read the complete article mentioned in this post, please visit
http://www.ohanet.org/Press-Release/Ohio_Hospitals_Reduce_Bloodstream_Infections_by_Half

Are You Ready For Flu Season?

October 31, 2011 at 3:51 pm

I love Fall. I adore the fire reds and vibrant yellows that paint the leaves on the trees. I love to snuggle up on the couch with a steaming mug of hot chocolate while listening to the soft tap of rain on my windows. I love to pull out my cozy sweaters that have been neglected all winter and I can’t wait to slip my feet into my Uggs that pillow my toes. Ah, Fall. Is there any better time of year?

Okay, so a dreamer thinks all of those above thoughts while a nurse thinks this: Where is my Purell? I think I’ve seen enough mucus to fill a pool. If one more person sneezes and doesn’t cover their mouth, I’m going to scream!

Being a nurse with an RN to BSN degree, flu season is one of the busiest times of the year. But fear not! It seems like we have the perfect vaccine for the strains that are most common this year.

On Nursezone.com, Megan M. Krischke quotes that, “’The good news about this year’s flu season is that the vaccine seems to be perfectly formulated for the strains of flu–the pandemic influenza A [H1N1], seasonal [H3N2] and influenza B–that have been most commonly seen in the Southern Hemisphere. And, what happens in the Southern Hemisphere is typically a good predictor of what will happen in the Northern,’ noted Paul J. Poduska, CIC, M(ASCP), infection control preventionist for Poudre Valley Health System (PVHS) in Fort Collins, Colo.” While we can’t always be sure what the flu season will be like, the prospects are looking up.

“’Nurses and all medical staff should be getting a flu vaccination, not only for their own protection but also for the safety of their patients,’ emphasized Samuel B. Graitcer, M.D., medical epidemiologist for the immunization services division of the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC).”

In years past there was a terrible shortage of the flu shot. Now, that is not the case. Currently there is an overflow, so it is vital that everyone get one to prevent illness. Now is the perfect time before the flu season really takes off.

As a nurse in an online RN to BSN nursing program, it is so important to take care of yourself so you can take care of others. Get your flu shot today!

To read the complete article mentioned in this post, please visit

http://nursezone.com/Nursing-News-Events/more-news/Flu-Season-News-Vaccinations-and-Virus-Tracking_38160.aspx

Safer Needles Verses Hospital Costs

October 24, 2011 at 4:48 pm

There are countless precautions that nurses need to take on a daily basis. From contagious illnesses to infected needles, nursing can be a dangerous profession. Learning safety procedures in an online BSN degree program is some of the most important information you can use in your occupation.

On FoxNews.com, there was an interesting article on unsafe needles that are being used in thousands of hospitals. “Every year, nurses, physicians and other health care workers suffer an estimated 800,000 needlestick injuries in U.S. hospitals, according to the National Center for Biotechnology Information… More than 1,000 of these hospital workers become infected with HIV/AIDS, hepatitis B and C and other bloodborne diseases as a result.”

I had no idea that there was a safer alternative to the tradition syringe. “The problem might be preventable with a potentially life-saving safety syringe, which has a retractable needle, developed in the early 1990s. In trials, nurses and doctors loved the syringe, and the National Institutes of Health awarded the manufacturer a grant to refine it… However, due to a million-dollar agreement between hospital group purchasing organizations (GPOs) and a big needle maker, GPOs blocked the introduction of the new safety syringes to the market – as well as other medical innovations – in favor of unsafe standard needles.”

There is a new movie called Puncture that addresses this very issue. Based on a true story, it reenacts the tragedy of a Houston ER nurse who died from HIV as the result of a needle prick. The Fox News article states, “Puncture filmmakers said the movie highlights a ‘massive problem’ in America, where the best and most affordable medical devices aren’t always accessible, costing taxpayers more than $37 billion dollars per year… Some progress has been made thanks to the Needle Safety and Prevention Act signed in 2000, which set requirements for employers to identify, evaluate and implement safer medical devices, as well as maintain injury logs for employees… However, unsafe needles are still used throughout the country. The filmmakers said this is because the act did not fix the underlying problem, which is that GPOs continue to control the purchasing of medical supplies in the U.S.”

On this rare occasion, I feel the need to applaud Hollywood for highlighting this issue in the health care industry. Movies can be a great platform to bring attention to societal problems (such as Erin Brockovich), but most of the resources go into just making more money regardless of moral costs. Bravo filmmakers for taking a stand. You have a bunch of RN to BSN bridge program students behind you!

To read the complete article mentioned in this post, please visit
http://www.foxnews.com/health/2011/10/20/unsafe-needles-pose-major-health-risk-to-doctors-nurses/

Healthcare Jobs Continue to Rise

October 21, 2011 at 1:31 pm

Is there anything better than reading a recent news story that says that nursing jobs are still on the rise? As student in an RN to BSN bridge program, probably not.

On PRWeb.com, there is an article which reports on the incredible increase in healthcare jobs being offered. “Leading travel nurse agency, American Traveler, announced in October a year-over-year increase of 56 percent in nurse job employment, a number that includes both staff RN positions and travel nurse jobs. The uptick, said Clinical Resource Manager, Deborah Bacurin, RN, is due to larger healthcare employers rebounding from recession and hiring travel nurses again, along with a sprouting up of ambulatory outpatient centers across all 50 states,” explains the article.

The article also states that “Though nurse pay flattened during the recession, recruitment VP, Mary Kay Hull said she’s starting to see wages bounce back to pre-recession levels and better. Her firm is experiencing a significant demand for nurse job specialties such as Operating Room and Labor and Delivery, and continues to fulfill requests for nurses and therapists well-versed in computerized patient care systems and modern therapies.”

The BLS also supports these numbers and reports that by the end of the year there will be approximately 344,000 health care jobs available which is the highest level in four years and higher than any other industry. The increase is jobs is often attributed to new technology positions, a higher need for preventative care and the aging population.

If you are not currently getting your online BSN degree, now is the time to do so. Many employers are looking for nurses with a higher degree and specialized skills. With the job market continuing to grow, what do you have to lose?

To read the complete articles mentioned in this post, please visit
http://www.prweb.com/releases/healthcare-jobs-demand/2011/prweb8892488.htm
and
http://www.bls.gov/oco/cg/cgs035.htm

Would You Report a Medical Error?

October 5, 2011 at 8:37 pm

As someone in the medical field, the last thing a patient wants to hear from you is “oops!” (Trust me, I’ve been on the receiving end of the “oops” and it was not fun. I even changed doctors over it, but I digress…) If you saw a fellow nurse making a mistake or even if you yourself made a mistake, how likely are you to report it?

Just because you have your online BSN degree doesn’t mean that you are mistake free. Can you imagine any other job outside of the medical field where you have to be perfect all of the time? Maybe airplane pilots and lion tamers, but rarely do other occupations carry such a high risk on a daily basis. Johns Hopkins Medicine recently released a report about why so many doctors and nurses do not report mistakes that they see or have committed.

“Investigators e-mailed an anonymous survey to physicians, nurses, radiation physicists and other radiation specialists at Johns Hopkins, North Shore- Long Island Jewish Health System in New York, Washington University in St. Louis, Missouri, and the University of Miami, with questions about their reporting near-misses and errors in delivering radiotherapy. Each of the four centers tracks near-misses and errors through online, intradepartmental systems. Some 274 providers returned completed surveys.

“According to the survey, few nurses and physicians reported routinely submitting online reports, in contrast to physicists, dosimetrists and radiation therapists who reported the most use of error and near-miss reporting systems. Nearly all respondents agreed that error reporting is their responsibility. Getting colleagues into trouble, liability and embarrassment in front of colleagues were reported most often by physicians and residents,” explains the report.

I was surprised to read that 90% of the people surveyed saw “near misses” and didn’t report them because no patient harm was done. Of those surveyed, they mentioned that time management or a complicated online report system were not to blame for not recording the incidences.

“‘A national system that collects pooled data about near-misses and errors, which are thankfully rare, may help us identify common trends and implement safety interventions to improve care,’”commented Johns Hopkins radiation oncology resident Kendra Harris, M.D., who presented an abstract of the data on Oct. 2 at the 53rd Annual Meeting of the American Society for Radiation Oncology (ASTRO).

Honestly, this seems like yet another moral dilemma that those in a RN to BSN bridge program have to face. When you were a kid, you hated being called a “tattle tale.” As an adult, does this stigma still apply?

To read the complete article mentioned in this post, please visit:
http://www.hopkinsmedicine.org/news/media/releases/survey_reveals_reasons_doctors_avoid_online_error_reporting_tools

Nurses Play Important Role in Reducing Patient Readmissions

September 28, 2011 at 8:27 pm

As much as you may like some patients, you certainly don’t want to see them readmitted to the hospital. Many changes have been made to try to reduce readmissions over the past five years with little progress. Nurses who have graduated from a BSN degree program are a big part of helping patients to take care of themselves.

On Fiercehealth.com, Alicia Caramenico writes about the dilemma that many hospitals are facing pertaining to patients who are returning because they never fully recovered from their original hospital stay. “About one in six Medicare patients ended up back in the hospital within a month of being discharged, and more than half of discharged Medicare patients failed to visit a primary care doctor within two weeks of leaving the hospital. These statistics should sound the alarm to hospitals as financial penalties for excessive readmission rates begin next year…

“The findings suggest hospitals need to do a better job of coordinating care for patients across all care settings, especially after they leave the hospital. They also bolster research from the New York State Health Foundation earlier this month that indicated improved discharge processes and post-discharge support can reduce readmission rates by a third.”

“’Everyone–patients, doctors, nurses, caregivers–has a role to play in ensuring quality care and avoiding another hospital stay,’ said Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, a longtime funder of the Dartmouth Atlas Project. ‘This should include a clear understanding of the patient’s medical problems, a schedule for follow-up appointments, a list of medications and instructions for taking them.’”

I can’t help but wonder if these high numbers are due to hospitals releasing patients before they are ready to go home, if patients want to go home and decline the chance to stay longer, if the proper care is lacking, or if patients just don’t listen to the advice of the doctors and nurses upon returning home. I’m sure on some level these are all contributing factors.

One good thing is that “hospitals with high readmission rates will soon face a 1 percent penalty from Medicare beginning in fiscal year 2013. The penalty bumps up to 2 percent in 2014 and 3 percent in 2015. With such payment penalties at risk, hospitals should consider revamping their discharge planning processes and coordination efforts with primary care physicians,” explains Caramenico.

As a nurse with an online BSN degree, you have one of the most important roles in patient recovery. You’re the bridge between the doctor and the patient, you are the one who can see if the patient really understands the procedures they need to take on the path to healing and you are the one who may have to help them if they get readmitted.

To read the complete story featured in this post, please visit:
http://www.fiercehealthcare.com/story/hospital-readmission-rates-stagnant/2011-09-28?utm_medium=nl&utm_source=internal