Feb 23, 2024 DNP 835 Topic 2 DQ 1 Describe the role of the DNP-prepared nurse in managing costs
DNP 835 Topic 2 DQ 1 Describe the role of the DNP-prepared nurse in managing costs
DNP 835 Topic 2 DQ 1 Describe the role of the DNP-prepared nurse in managing costs
Topic 2 DQ 1
Reflecting on the “IHI Module TA 103: Increasing Value and Reducing Waste at the Point of Care,” describe the role of the DNP-prepared nurse in managing costs. Identify one common barrier to cost management and inappropriate resource use. Discuss a change theory and how it can be applied in nursing practice to integrate sustainable care delivery. Provide supporting evidence.
DNP-prepared nurses play a critical role in managing costs in healthcare by using their advanced education and training to improve patient outcomes and reduce healthcare spending. They can do this through various means, including implementing evidence-based practices, utilizing technology to improve efficiency and communication, and developing innovative care delivery models. Additionally, DNP-prepared nurses may be involved in research to identify cost-saving opportunities and implement financial management strategies.
One common barrier to cost management and inappropriate resource use in healthcare is a need for more transparency in pricing and cost information. With clear and accurate information about the costs of different treatments, procedures, and medications, it can be easier for healthcare providers, patients, and payers to make informed decisions about care. Additionally, the lack of transparency can lead to the overuse of resources, as providers may need to be made aware of more cost-effective alternatives. Furthermore, patients may need help to make informed decisions about their care, leading to higher out-of-pocket costs and financial burdens.
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One change theory that can be applied in nursing practice to integrate sustainable care delivery is Lewin’s Change Management Theory. This theory posits that change occurs in three stages: unfreezing, changing, and refreezing (Henry et al., 2021). In the unfreezing stage, individuals or groups are made aware of the need for change and their current attitudes and behaviors are questioned. In the changing stage, individuals or groups are provided with new information and skills needed to adapt to the change. In the refreezing stage, the new attitudes and behaviors are consolidated and become the new norm. In nursing practice, Lewin’s Change Management Theory can be applied to integrate sustainable care delivery by first unfreezing current attitudes and behaviors related to resource consumption and waste. This can be done through education and awareness campaigns about the environmental impact of healthcare and the benefits of sustainable care delivery.
In the changing stage, new sustainable care delivery practices and technologies can be introduced and
DNP 835 Topic 2 DQ 1 Describe the role of the DNP-prepared nurse in managing costs
implemented, such as the use of electronic medical records, telehealth, and green cleaning products. In the refreezing stage, the new sustainable practices and technologies are consolidated and become the new norm in the healthcare setting. Supporting evidence can be found in various studies that have applied Lewin’s Change Management Theory in healthcare settings. A study by Cone and Unni (2020) found that Lewin’s Change Management Theory was effective in improving faculty satisfaction in a pharmacy school. Another study by Harrison et al., (2021) found that Lewin’s Change Management Theory was effective in implementing a new guideline for the prevention of surgical site infections in a hospital setting.
DNP 835 Topic 2 DQ 1 Describe the role of the DNP-prepared nurse in managing costs References
Cone, C., & Unni, E. (2020). Achieving consensus using a modified Delphi Technique embedded in Lewin’s change management model designed to improve faculty satisfaction in a pharmacy school. Research in Social and Administrative Pharmacy, 16(12), 1711-1717. https://www.sciencedirect.com/science/article/abs/pii/S1551741119310484
Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of healthcare leadership, 13, 85. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7966357/
Henry, E. S., Robertshaw, S., & Stephenson, J. (2021). Improving accessibility to outpatient clinics for adults with suspected seizures from the emergency department: a quality improvement project. Seizure, 93, 160-168. https://www.sciencedirect.com/science/article/pii/S1059131121003514
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I think your change model is spot on. Change is crucial for organizations in growing, highly competitive business environments. The world changes very fast, so the organizations must have to be changed quickly for the development and surviving of the organization. Organizational change is a kind of chaos, so number of variables are changing, the environment changing, frequent change and resistant to change create confluence of change process at the same time, that not only stimulates difficulties in prediction but also make control impossible. In the change process when employees contribute, the knowledge sharing stage identifies the kind of knowledge that generates the value of organization after that generating the mechanism for that knowledge. The required knowledge is identified for organizational need which is getting from two sources of external as renting or consultancy from other companies or share knowledge by internal source in informal networks among employees who have expertise.
Hussain, S.T., Lei, S., Akram, T., Haider, M.J., Hussain, S.H. and Ali, M. (2018) Kurt Lewin’s Process Model for Organizational Change: The Role of Leadership and Employee Involvement: A Critical Review. Journal of Innovation and Knowledge, 3, 123-127.
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DNP-prepared nurses play a critical role in managing costs in healthcare by using their advanced education and training to improve patient outcomes and reduce healthcare spending. They can do this through various means, including implementing evidence-based practices, utilizing technology to improve efficiency and communication, and developing innovative care delivery models. Additionally, DNP-prepared nurses may be involved in research to identify cost-saving opportunities and implement financial management strategies.
One common barrier to cost management and inappropriate resource use in healthcare is a need for more transparency in pricing and cost information. With clear and accurate information about the costs of different treatments, procedures, and medications, it can be easier for healthcare providers, patients, and payers to make informed decisions about care. Additionally, the lack of transparency can lead to the overuse of resources, as providers may need to be made aware of more cost-effective alternatives. Furthermore, patients may need help to make informed decisions about their care, leading to higher out-of-pocket costs and financial burdens.
One change theory that can be applied in nursing practice to integrate sustainable care delivery is Lewin’s Change Management Theory. This theory posits that change occurs in three stages: unfreezing, changing, and refreezing (Henry et al., 2021). In the unfreezing stage, individuals or groups are made aware of the need for change and their current attitudes and behaviors are questioned. In the changing stage, individuals or groups are provided with new information and skills needed to adapt to the change. In the refreezing stage, the new attitudes and behaviors are consolidated and become the new norm. In nursing practice, Lewin’s Change Management Theory can be applied to integrate sustainable care delivery by first unfreezing current attitudes and behaviors related to resource consumption and waste. This can be done through education and awareness campaigns about the environmental impact of healthcare and the benefits of sustainable care delivery.
In the changing stage, new sustainable care delivery practices and technologies can be introduced and implemented, such as the use of electronic medical records, telehealth, and green cleaning products. In the refreezing stage, the new sustainable practices and technologies are consolidated and become the new norm in the healthcare setting. Supporting evidence can be found in various studies that have applied Lewin’s Change Management Theory in healthcare settings. A study by Cone and Unni (2020) found that Lewin’s Change Management Theory was effective in improving faculty satisfaction in a pharmacy school. Another study by Harrison et al., (2021) found that Lewin’s Change Management Theory was effective in implementing a new guideline for the prevention of surgical site infections in a hospital setting.
DNP 835 Topic 2 DQ 1 Describe the role of the DNP-prepared nurse in managing costs References
Cone, C., & Unni, E. (2020). Achieving consensus using a modified Delphi Technique embedded in Lewin’s change management model designed to improve faculty satisfaction in a pharmacy school. Research in Social and Administrative Pharmacy, 16(12), 1711-1717. https://www.sciencedirect.com/science/article/abs/pii/S1551741119310484
Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of healthcare leadership, 13, 85. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7966357/
Henry, E. S., Robertshaw, S., & Stephenson, J. (2021). Improving accessibility to outpatient clinics for adults with suspected seizures from the emergency department: a quality improvement project. Seizure, 93, 160-168. https://www.sciencedirect.com/science/article/pii/S1059131121003514
The “IHI Module TA 103: Increasing Value and Reducing Waste at the Point of Care” has assisted me to recognize, as a nursing leader, areas of opportunity in my facility throughout the organization. It is imperative to take the time to assess or reassess these areas to ensure that we are practicing good resource stewardship. Perez et al. (2018) noted that approaches for reducing overuse often reduce access to certain medical services, which may be alarming to those who equate more care with better care or are concerned about interference with doctor-patient decisions. The authors also stated that potential strategies to reduce overuse might threaten aspects of healthcare delivery that the public highly values, such as physician autonomy or patient choice.
The role of the DNP-prepared nurse in managing costs for both the patient and the organization is utilizing the latest in evidence-based practice to implement interventions that will help improve the current practice. The DNP-prepared nurse must educate the patient on their treatment plan, which includes the doctor’s orders and diagnostic procedures. Hueth et al. (2022) noted that diagnostic stewardship aims to deliver the proper test to the right patient at the right time and is optimally combined with antimicrobial stewardship to allow for the correct interpretation to translate into the proper antimicrobial at the right time.
One identified barrier in cost management and inappropriate resource use is the clinical practices of healthcare professionals who place the same orders for all their patients, thus not providing individualized treatment plans. Hueth et al. (2022) discussed that an important activity for the diagnostic stewardship team is understanding their institution’s utilization trends and practices, mainly when a new test is being offered. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, is a systematic evaluation method that helps us to understand a broad array of issues that an effective program must address (Yuan et al., 2021). Healthcare professionals may use this framework when implementing change to ensure the successful adoption and maintenance of the new intervention. As a healthcare leader, I have witnessed new interventions that are not sustained after moving on to the following quality improvement project.
DNP 835 Topic 2 DQ 1 Describe the role of the DNP-prepared nurse in managing costs References
Hueth, K. D., Prinzi, A. M., & Timbrook, T. T. (2022). Diagnostic Stewardship as a Team Sport: Interdisciplinary Perspectives on Improved Implementation of Interventions and Effect Measurement. Antibiotics, 11(2), 250. https://doiorg.lopes.idm.oclc.org/10.3390/antibiotics11020250
Perez, S. L., Backman, D., & Ginsburg, M. (2018). Assessing social values for California’s efforts to reduce the overuse of unnecessary medical care. Health Expectations, 21(2), 501–507. https://doi-org.lopes.idm.oclc.org/10.1111/hex.12644
Yuan, M., Xiao, X., Wang, Y., Han, Y., Zhang, R., Fu, H., & Fang, Y. (2021). Design and evaluation of a cognitive health education pilot program according to the RE-AIM framework. PLoS ONE, 16(12), 1–12. https://doiorg.lopes.idm.oclc.org/10.1371/journal.pone.0260934
Thank you for your post, Lydia. This week’s assignment was enlightening with the added value of the IHI assignment. The “IHI Module TA 103: Increasing Value and Reducing Waste at the Point of Care” helped me to recognize, as a nursing leader, areas of opportunity in our departments throughout the organization. It is imperative to take the time to assess or reassess these areas to ensure that we are practicing good resource stewardship. Perez et al. (2018) noted that approaches for reducing overuse often reduce access to certain medical services, which may be alarming to those who equate more care with better care or are concerned about interference with doctor-patient decisions. The authors also stated that potential strategies to reduce overuse might threaten aspects of healthcare delivery that the public highly values, such as physician autonomy or patient choice. The role of the DNP-prepared nurse in managing costs for both the patient and the organization is utilizing the latest evidence-based practice to implement interventions that will help improve the current approach. The DNP-prepared nurse must educate patients on their treatment plan, including doctor’s orders and diagnostic procedures. Hueth et al. (2022) noted that diagnostic stewardship aims to deliver the proper test to the right patient at the right time and is optimally combined with antimicrobial stewardship to allow for the correct interpretation to translate into the appropriate antimicrobial at the right time. One identified barrier in cost management and inappropriate resource use is the clinical practices of healthcare professionals who place the same orders for all their patients, thus not providing individualized treatment plans. Hueth et al. (2022) discussed that an essential activity for the diagnostic stewardship team is understanding their institution’s utilization trends and practices, mainly when a new test is being offered.
Hueth, K. D., Prinzi, A. M., & Timbrook, T. T. (2022). Diagnostic Stewardship as a Team Sport: Interdisciplinary Perspectives on Improved Implementation of Interventions and Effect Measurement. Antibiotics, 11(2), 250. https://doi-org.lopes.idm.oclc.org/10.3390/antibiotics11020250
Perez, S. L., Backman, D., & Ginsburg, M. (2018). Assessing social values for California’s efforts to reduce the overuse of unnecessary medical care. Health Expectations, 21(2), 501–507. https://doi-org.lopes.idm.oclc.org/10.1111/hex.12644
Upon reflection on the IHI model, it is evident that the role of a DNP-prepared nurse in managing costs is full of opportunities. As future leaders it is essential to understand existing barriers and current guidelines or laws that could help the problem. A doctoral-prepared nurse leads with presentation of that information to improve care and or outcomes. At an organizational level, a doctoral-prepared nurse should also be able to show management how changes may financially benefit the practice area. The sad truth is that, in most cases, money is key in making “things” feasible.
A common barrier to cost is continuation of life-sustaining treatments. Treatment can vary based on a patient’s diagnosis, age, and culture. In 1992 the U.S. Congress passed the Patient Self- Determination Act, which mandates Medicate-certified institutions to provide written information regarding the right to formulate an advanced directive (Yen et al., 2018). Yen et al. (2018) proved that the elderly, without advanced directives, are most likely to receive life–sustaining measures versus those with a documented wish.
The study was conducted with 1307 deceased elderly patients with a mean age of 84.1. The patient’s sociodemographic and medical history were adjusted. It found that those with an advanced directive were less likely to receive life-sustaining measures, cardiopulmonary resuscitation, and intubation or mechanical support. A total of 31 patients received life-sustaining treatments during their last month of life. A total of 17 patients, which was a 1.7% of patients with advanced directives received services. On the other hand, 14, which was 5% of patients without an advanced directive received care.
A theory that can be used to integrate sustainable care delivery is the theory of change. Gilissen et al. (2018) effectively demonstrated this in a nursing home. A total of nine interventions with specific rationales were identified at different levels to target preconditions. The levels included residents, their families, and staff. The comprehensive plan highlights organizational factors. With the contribution of all details discussed, the map created illustrates how to expect to use the theory of change to unfreeze, change, and refreeze to achieve desired long-term outcomes in facilitating the implementation and sustainable process.
DNP 835 Topic 2 DQ 1 Describe the role of the DNP-prepared nurse in managing costs References:
Gilissen, J., Pivodic, L., Gastmans, C., Vander Stichele, R., Deliens, L., Breuer, E., & Van den Block, L. (2018). How to achieve the desired outcomes of advance care planning in nursing homes: a theor
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