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Competitive market in healthcare
Competition in the healthcare industry
Competition in the healthcare industry
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Hospital Acquired Conditions (HAC) Baptist Memorial Hospital is in a highly competitive healthcare environment. This capitation is not only the result of efforts of the other healthcare organizations but, also driven by patient consumerism. The government sponsored hospital compare website allows potential patients the ability to compare our clinical outcome data. The targeted group is also the group with the greatest healthcare choice, our medicare population. One of the major reporting categories is Hospital acquired condition, the most significant of these is hospital aired infections. The significance of the website data is:
These infections result from the hospital not using proper procedures and precautions
Show a comparison of Baptist Memorial directly to Methodist Healthcare as well as the state and national benchmarks. Indicate there are published guidelines that if followed would reduce infections.
Central Line-Associated Bloodstream Infections (CLABSI) I believe CLABSI represent an area of greatest concern and should be our first focus area. This concert is supported by:
A hospital wide CLABSI rate 4.5 times that of Methodist and twice the state rate.
An ICU CLABSI rate that is 15
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This unit has the highest identified CLASBI rate. Correction of the rate in this unit may have the greatest impact on the total hospital rate. In addition it has a limited number of staff as compared to the total hospital. This unit likely represents the highest number of central line use at any single time interval. By beginning the CPG in this unit, the PDSA cycles can be utilized to optimize the process for Baptist before the attempt is made to move it the rest of the hospital. By beginning the process in the ICU, there will be a group of line care experts and champions to move the process out the rest of the hospital. The use of central lines is ubiquitous through out the hospital and so should the care
According to an article by Timsit, J., et al. an estimated 5 million central venous catheters are inserted in patients each year. CBIs, most of which are associated with central venous catheters, account for more than 11% of all health-care associated infections. Additionally, more than 250,000 central-line associated blood stream infections also occur annually, with an estimated mortality rate of 12-25%. For patients within the intensive care unit, the numbers were even higher. Each episode significantly increases the patient’s hospital stay, as well as increasing costs from $4,000 to $56,000 per episode.
Coastal Medical Center was established a few years after World War II and began as a 100 bed, acute care hospital, serving the population of the tri-county area. Since conception, CMC significantly grew into a larger, more proficient hospital. However, in the past few years, Coastal Medical Center has become a declining 450-bed tertiary care hospital serving the current population of the tri-county area. CMC has a governing board which consists of 27 members and a parent cooperation board which consists of 19 members. The parent cooperation board, Coastal Healthcare Inc., has 24 subsidiary cooperation’s including Coastal Medical Center, three nursing homes, three hospitals, a home health company, and many additional services. Coastal Medical Center also coordinates 53 major new service projects and 66 special programs.
Strengths Long-standing reputation Provision of quality healthcare Highest rank in patient satisfaction Recipient of Joint Commission accreditation Serving a diverse population Weaknesses Smaller than other four hospitals Decrease in net profit Increase in expenses Significant increase in long-term debt Not-for-profit status Opportunities Changes in government regulations Change in lifestyle Influx of patients due to higher patient satisfaction Cost savings Opening of some outpatient clinics and surgery centers Threats Too much competition
The cost of Medical equipment plays a significant role in the delivery of health care. The clinical engineering at Victoria Hospital is an important branch of the hospital team management that are working to strategies ways to improve quality of service and lower cost repairs of equipments. The team members from Biomedical and maintenance engineering’s roles are to ensure utilization of quality equipments such as endoscope and minimize length of repair time. All these issues are a major influence in the hospital’s project cost. For example, Victory hospital, which is located in Canada, is in the process of evaluating different options to decrease cost of its endoscope repair. This equipment is use in the endoscopy department for gastroenterological and surgical procedures. In 1993, 2,500 cases where approximately performed and extensive maintenance of the equipment where needed before and after each of those cases. Despite the appropriate care of the scope, repair requirement where still needed. The total cost of repair that year was $60,000 and the repair services where done by an original equipment manufacturers in Ontario.
It is obvious that there is a large gap between where Coastal Medical Center is and where they need and want to be. When comparing CMC’s competitors, Johnson Medical Center and Lutheran Medical Center, CMC needs to provide more efficient, high quality care and focus on more profitable priorities instead of funding multiple unsuccessful projects such as the fifty-three unfinished developments.
There has been a shortage of physicians, lack of inpatient beds, problems with ambulatory services, as well as not having proper methods of dealing with patient overflow, all in the past 10 years (Cummings & francescutti, 2006, p.101). The area of concern that have been worse...
Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012). There have been numerous studies conducted, with the objective to determine steps to take to decrease CLABSI infection rate, and research continues to be ongoing today. The problem is prevalent on many nursing units, with some patients at great risk than others, but some studies have shown if health care providers follow the current literature, or evidence based guidelines, CLABSIs can be prevented (The Joint Commission, 2012). The purpose of this paper is to summarize current findings related to this topic, and establish a quality assurance (QA) change plan nurses can implement for CL placement and maintenance, leading to decreased risk of nosocomial CLABSIs.
Hospitals recognized the need for the case management model in the mid 1980’s to manage the lengths of stay of hospitalized patients and the treatment plans (Jacob & Cherry, 2007). In 1983, the Medicare prospective payment program was implemented which allowed hospitals to be reimbursed a set payment based on the patient’s diagnosis, or Diagnosis Related Groups (DRG), regardless of what treatment was provided or how long the patient was hospitalized (Jacob & Cherry, 2007). To keep the costs below the diagnosis related payment, hospitals ...
Clinical Infectious Diseases, 49(3), 438-443. Doi:10.1086/600391. See full address and map. Medicare.gov/Hospital Compare - The Official U.S. Government Site for Medicare (n.d).
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
This system provides annual statics on Medicare payment amounts for institutional providers. A nurse leader can use HCRIS to find other similar institutions with whom to compare reimbursement rates and use this information to make necessary adjustments (“Healthcare Cost Report”, 2016). Lastly, nurse leaders can also use cost-to-charge ratios, volume-based measures, per diem rates, and balanced scorecards to gain better insight of unit reimbursement (Liberty University,
The hypotheses in this study indicated that the use of comorbidities along with severity of injury in trauma patients as compared with a severity score alone would help to determine the hospital ranking. The null hypothesis was accepted in this case as there was no difference in the comparison.
Hospital acquired infections are one of the most common complications of care in the hospital setting. Hospital acquired infections are infections that patients acquired during the stay in the hospital. These infections can cause an increase in the number of days the patients stay in the hospital. Hospital acquired infections make the patients worse or even cause death. “In the USA alone, hospital acquired infections cause about 1.7 million infections and 99,000 deaths per year”(secondary).
Then, patients have the choice of paying at POS or paying later (Butcher, 2015). For uninsured patients, the estimation tool automatically raises the discount program. Baptist Health incorporates a 40 percent reduction from the full amount (Butcher, 2015). However, numerous patients cannot bear the high costs of health care services, even at a reduced rate. In this case, patients at Baptist Health are referred to a registrar who uses a four-question study to determine if a patient qualifies for Medicaid (Butcher, 2015). If a patient does not qualify for Medicaid and cannot bear the estimated costs, he or she is referred to a financial counselor to apply for charity care (Butcher,
[1] Selected patient and provider characteristics for ambulatory care visits to physician offices and hospital outpatient and emergency departments: United States, 2009-2010