Feb 23, 2024 NR 506 Week 5: Drivers of High Performance Healthcare Systems
NR 506 Week 5: Drivers of High Performance Healthcare Systems
NR 506 Week 5: Drivers of High Performance Healthcare Systems
Two drivers of high performance for healthcare systems are quality and cost. In my current work situation, I am a nurse in the operating room. Cost data and information is usually inadequate in a hospital, but most often occurs in operating rooms (Farmer, 2015). In order to obtain high performance standards for our patients, we work together as a team and that is a top priority for us as members of the hospital. Maintaining high standards of care and giving patients a good experience at our hospital is what we strive for and hope to achieve. The patient experience is sometimes known as the driving force that patients look for in receiving care at a facility; their experience keeps them coming back. Cost is always a main driver in any business. Healthcare is no exception to the rule. Balancing competitive costs and still making profit for the company is sometimes a challenge with issues from Medicare reimbursements and public aid programs. In the operating room. We are very frugal with supplies, limiting the patient’s charges and saving the facility money is always a goal. If there are two options, the surgeon will usually ask to compare the prices to see which is cheaper in order to save the patient money. The facility also limits the number of nurses in each operating room. This saves the company money because resources are usually limited, and the hospital is usually low on nursing staff. It also saves the patient money. Studies show that surgical interventions account for over forty percent of total expenses of a hospital (Winkle, Champagne, Mays, & Aucoin, 2016). A hospital’s operating rooms are the most costly to run making them targets for cost saving innovations (Winkle, Champagne, Mays, & Aucoin, 2016). Operating room delays are a prime example of cost saving measures that are a driving force to high performance in an organization. The facility where I work places strict measures to reduce operating room delays that cost the facility money and also reduce the patient’s quality of care. When room times are delayed the patients become anxious and their experience with the facility is not at an optimal level.
Farmer, A. (2015). Cost Accounting in the operating room. Retrieved from
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Winkle, R., Champagne, M., Mays, M., & Aucoin, J. (2016). Operating room delays.
Retrieved from https://www.nursing.duke.edu (Links to an external site.)
Quality and access to care is essential to the well-being of our community. More often than not the two do not go together. Patients may have to drive miles for better quality of care. As an advance practice nurse, it is our duty to provide the best quality of care to help patients reach optimal health. Members of rural communities are often overlooked when it comes to access to quality of care. In July 2016, the Georgia Budget and Policy Institute reported Charlton County as being one of the worst counties with provider shortage. Charlton ranks 75 percent below the state average for providers in the state of Georgia (Harker, 2016). They are 65 percent below the average in regard to nurses the deficit leads to patients traveling 35 to 50 miles away for the nearest hospital. Georgia hospitals in rural areas are closing due to financial difficulties, leaving patients without access to quality healthcare.
Georgia is one of many states that do not allow advanced practice nurses autonomy. Family nurse practitioners and physician assistants have to practice under the supervision of a medical doctor. The shortage in patient provider ratio could be decreased if autonomy to practice independently were granted to advanced practice nurse and physician assistants. Not only would this increase access to care but it would also increase quality of care. Nurses are taught to have impeccable bedside manners and listen to the patients. We wear many hats from nurse, case manager, social worker, friend and confidant. Patients feel comfortable speaking to nurse’s vs the medical doctor. These characteristics are enhanced when becoming an advanced practice nurse. Taking the skills learned in graduate courses can benefit the quality and access to care for many patients Legislators have to chance to change the law and allow for better care to patients.
Harker, L. (2016, July 1). Charlton Ranks Among Georgia Counties With Dire Health Provider Shortages. Retrieved from Georgia Budget and Poicy Institute: https://gbpi.org/2016/charlton-ranks-among-georgia-counties-with-dire-health-provider-shortages/
I have noticed that in our area ,access has been something many hospitals have focused on. As I mentioned, our clinics now have later office hours where they are open until after 7pm. Our CEO is a firm believer that if we do not offer the services for our patients they will go elsewhere. Obviously that is a loss of potential revenue and can lead to dissatisfied patients if they must go elsewhere to be seen. One of the big things our clinics are now promoting are “same day appointments.” Our CEO would like to guarantee that all acute patients are seen within 24 hours of calling their provider. Each provider has to keep open a certain number of acute visits to ensure that no patient is turned away in that 24 hour window.
Another thing I have noticed is that several of the Emergency Departments within an hour or hour and half of my home have signs located next to the interstate with updated wait times. One town that is about 50 minutes from my house has two hospitals. Each of those hospitals have live billboards that show their wait time. If no other factors came into play (i.e. insurance) and one ER had a shorter wait time than the other, the patient would likely choose that facility simply because of access or availability.
That is frustrating that you had to see a specialist in order to be seen quicker. That is the opposite here. My urologist, along with most specialists, are an hour and a half from where we live. When I try to schedule with him, he is always several months out. I tried to schedule an appointment in January and they gave me an appointment date of April 2nd. This is unreasonable in my opinion. In my opinion there needs to be something done in order to accommodate for patients who need to be seen. I was able to get into his APN much sooner, but my wait time was still a month.
That is also frustrating about being unable to find a pediatrician. That is an issue we do not have here currently. Our issue is that we have limited options available, so if a family is not satisfied with their provider, they have limited options. One of our pediatricians does not take Medicaid, which leaves the other pediatricians to care for all of the Medicaid patients.
As far as the drivers are concerned, I definitely think that they should be standardized across the US. While I understand access may be limited in rural areas or lower populated areas, those people still deserve to have access to a provider. I wish there was some kind of rule/law that a patient had to be seen within a certain amount of time of calling. I think two weeks seems reasonable. I do not know how that could be enforced though.
As far as quality and cost, those should be standardized regardless of where you live as well. There should be set prices for every procedure or test. It is not fair for patients to have to search around or “price hunt” for their healthcare. The quality needs to be high regardless of where you live as well, as every patient deserves to have high quality healthcare.
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