Section A1
VBP is essential for improving health care services and staff performance. Abbott Northwestern Hospital in Minneapolis has already experienced its advantages. As an acute care hospital, Abbott Northwestern Hospital is eligible for the Hospital VBP Program. So far, the hospital has sufficiently embraced VBP in the domains of patient safety and patient and caregiver-centered experience of care. Particularly, such a significant patient outcomes factor as communication with the hospital’s medical professionals was considerably improved. The organization has consistently high staff responsiveness, doctor communication, and nurse communication indicators. Nonetheless, some other VBP aspects seem to lack. Overall, Abbott Northwestern Hospital seems to rely on the VBP standards of hospital performance to an adequate extent.
Department A
Department B
Department C
Section B5
Clinical practice is abundant with complex ethical dilemmas. One such possible dilemma is the necessity to respect a patient’s health care decisions in contrast to the need to act to their benefit. Particularly, this is evident in cross-cultural care when a patient’s cultural background impacts the health care provision (Pereda & Montoya, 2018).
Nevertheless, without the cultural component in care, the principle of benefice cannot be respected since acting in a patient’s best interests requires considering their views on death, life, and health (Pereda & Montoya, 2018). For instance, in ICU, a patient’s family may ask for comfort care and pain relief instead of aggressive interventions that a health care provider believes to be indispensable. The connection between cross-cultural and ethical care becomes particularly considerable in such a highly diversified country as the United States. Therefore, the strategic plan will contain a component of cultural competence.
Clinical practice is not invulnerable to unethical business, possibly to a higher degree in for-profit hospitals. For example, prescribing redundant or unrequited medical procedures and medicines can be considered an unethical business practice. Firstly, redundant prescribing indicates the unsatisfactory quality of a medical professional’s prescribing practices. Secondly, such a situation compromises the principles of honesty, integrity, and respect for others found in ethical business (Tracy, 2016).
It contradicts the principle of fidelity used in medical ethics, potentially diminishing the community’s trust. Additionally, the prescription of redundant drugs can result in adverse outcomes following polypharmacy (Payne, 2020). To avoid similar situations, in the strategic plan, the principles of business ethics and the principle of fidelity will be emphasized to limit redundant prescribing. The strategic plan will incorporate the requirement to prescribe only essential procedures and medicines.
Section B7
Abbott Northwestern Hospital: Executive Summary
VBP can be a considerable source of reimbursement for Abbott Northwestern Hospital. Therefore, it is important for the organization to develop and improve according to the program’s standards. The three areas for improvement are ED patient flow, SSI after abdominal hysterectomy, and the quality of prescription practices. Firstly, improving ED is essential for HCAHPS: crowding in this department can worsen patient experience and their satisfaction from a visit. Moreover, crowding delays the treatment, which can have detrimental consequences for health. In many cases, ED is the first department that a patient sees and therefore bases their judgment about the whole organization on their experience in it. An optimized patient flow could help minimize crowding and increase patient satisfaction.
Secondly, high SSI incidence after abdominal hysterectomy signals the low quality of work performed in a surgical department. Reducing its occurrence in Abbott Northwestern Hospital would show a higher quality of care. In VBP, SSI is associated with the domain of patient safety. Lowering SSI incidence could also positively correlate with decreased length of stay, readmissions, and overall morbidity. Thirdly, the doctor-patient communication and communication about medicines in OPT influences HCAHPS. Refined communication helps patients adhere to treatment, and administer their medicines correctly, positively influencing their safety. High-quality physician-patient communication about newly prescribed drugs is essential for gaining community trust.
ER improvement primarily involves forming and perfecting a patient flow team. In order to promote effective communication, the team’s members will undergo intradepartmental training. Nevertheless, other clinicians of the department should also participate to maximize the results. In the course of the program, with the help of consultants, ED staff will refine their existing communication skill set that will allow them to operate more efficiently in a stressful medical setting. Some ED health professionals will also participate in the Point-Of-Care-Testing Certificate Course to ensure the appropriate use of technology. Constant performance evaluation will be performed through the later phases to validate the training’s effectiveness in improving patient flow.
For the surgical department initiative, nurses will play a significant role due to their function in preoperative patient preparation. The head nurse will be contacted and asked to supervise the deployment of the initiative. Surgical nurses headed by the head nurse will complete training designed to re-educate the medical specialists regarding preoperative patient preparation for abdominal hysterectomy according to CDC guidelines. Once coaching is finished, the surgical nurses will create a post-operative care information sheet to finalize their training. Also, a specialist will be employed to adapt it for ESL patients. Post-operative patient education is the initiative’s other element.
For the OPD, Outpatient Services Manager will head the initiative and oversee the staff’s adherence to the plan. They will notify the OPD physicians and facilitate estimating their performance. The OPD physicians will participate in seminars and training sessions about redundant prescribing, doctor-patient communication about medicines, managing polypharmacy, and use of the teach-back mnemonic method. Some of the activities will be effectuated online, while others will necessitate face-to-face learning, for instance, role-playing exercises. By the end of the training, the medical professionals are supposed to increase the quality of their prescribing practices. The initiative’s success will be evaluated based on changes in HCAHPS.
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