Long Term Acute Care Hospital
With today’s technology and the specialized skills of doctors, nurses, and therapists, patients who need long term care of acute problems can obtain these services at institutions known as postacute care providers. One type of facility that falls under this title is the Long Term Acute Care Hospital (LTACH) (Munoz-Price, 2009, p. 438). This paper will discuss services provided by LTACHs, the role of the Chief Nursing Officer (CNO) in these facilities, and Medicare reimbursement effected by patient satisfaction surveys.
For patients requiring longer acute care than what is generally given at an inpatient acute care hospital, The Long Term Acute Care Hospital is an option. To be admitted to an LTACH, patients are required to have “medically complex situations with a mean length of stay > 25 days” (Munoz-Price, 2009, p. 438 ). Examples of patients with complex acute care needs are those with multiple comorbidities who need mechanical ventilator weaning, administration of intravenous antibiotics, and those with complex wound care (Munoz-Price, 2009, p. 438). According to Landon Horton, CNO of Select Specialty Hospital in Fort Smith, Arkansas, “The services provided by LTACH facilities allow the patients to get home who would not otherwise, have a higher level of functioning at discharge, and increase their quality of life” (personal communication, March 7, 2014).
The role of the Chief Nursing Officer is a complex position. Educational preparation for the CNO role range from a Master’s in Nursing to a degree outside of the profession such as an MBA or a degree in a related area of study (Kerfoot, 2012, p. 38-39). As L. Horton’s role of the CNO for Select Specialty Hospital, the duties required by h...
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...essionals are giving quality care to patients by allowing them the opportunity to voice their opinion of the care they feel was given to them. By reviewing this data, health care facilities can encourage their employees to address areas of concern and strive for success in satisfying their customers.
References
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Munoz-Price, L. S. (2009). Long-Term Acute Care Hospitals. Clinical Infectious Diseases, 49(3), 438-443. Doi:10.1086/600391.
Medicare.gov/Hospital Compare The Official U.S. Government Site for Medicare (n.d). Linking Quality to Payment. Retrieved from http://www.medicare.gov/hospitalcompare/linking-quality-to-payment.html.
Generally, in a LTC setting there is a director, assistant director, physician, pharmacist, nurses, medication aides, certified nursing assistants, case managers, social workers, and clergy. These individuals are tasked with providing a daily health plan for long-term care residents 24 hours a day, seven days a week. This group could consist of less or more healthcare associates which is conditional and determined by the goal plan; moreover, the intended outcome not solely geared towards physical rehabilitation. In modern society, rehabilitation is targeted to restore mind, body and soul thereby promoting the overall health of the patient, or
Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2010). Essentials of nursing leadership and
The HCAHPS/Press Ganey survey greatly impacts the nursing population. Nurses directly provide care to patients. They are those who care for, work with, and make the most contact with patients. Therefore, it is the face of the nurse that usually comes to mind when patients think back to their care at the hospital. It is the nurse whom the patient will remember when filling out the HCAHPS/Press Ganey survey. The survey creates an additional check of accountability as it is another tool that monitors and holds nurses responsible for their care (Thompson, 2014). This in turn promotes nurses to perform better quality of care as it increases the transparency to their care. Repetitively reported poor care
In her paper emerging model of quality, June Larrabee discusses quality as a construct that includes beneficence, value, prudence and justice (Larrabee, 1996). She speaks of quality and value as integral issues that are intertwined with mutually beneficial outcomes. Her model investigates how the well-being of individuals are affected by perceptions of how services are delivered, along with the distribution of resources based on the decisions that are made (Larrabee, 1996). She speaks of the industrial model of quality and how the cornerstone ideas of that model (that the customer always knows what is best for themselves) does not fit the healthcare model (Larrabee, 1996). Larrabee introduces the concept that the patient va provider goal incongruence affects the provide (in this case the nurse) from being able to positively affect healthcare outcomes (Larrabee, 1996). The recent introduction of healthcare measures such as HCAHPS: Patients' Perspectives of Care Survey has encouraged the healthcare community to firmly espouse an industrial model of quality. HCAHPS is a survey where patients are asked questions related to their recent hospitalization that identifies satisfaction with case based solely on the individuals’ perception of the care given. This can lead to divergent goals among the healthcare team or which the patient is a member. Larrabee’s model of quality of care model
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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 ...
To provide appropriate care, long-term care admissions must be well thought-out and explicit tasks fulfilled prior to the patient’s arrival. There should be a smooth transition between facilities to promote continuity of care (LaMantia, Scheunemann, Viera, Busby-Whitehead & Hanson, 2010). If discharge planning is inadequate, patient safety and health can be compromised. For example, scheduled drug regimens, such as antibiotics and controlled medications, must be available within a timely manner. Most long-term care facilities do not support an in-house pharmacy. In addition, many pharmacies require original hard scripts before filling controlled medications. If admitting orders are inadequate or cannot be carried out within the appropriate time span, the admitting facility may be unable to meet critical needs. I have experienced this first hand on more than one occasion. The most recent o...
Nursing assistants work in many types of settings including nursing homes, hospice, mental health centers, assisted living residences, home care agencies, hospitals, rehabilitation and restorative care facilities (Sorrentuino & Remmert, 2012). There are many types of Long-term care centers. For this paper, I will focus on the long-term care centers often referred to as nursing homes. These LTCs are "licensed facilities that provide extended care for individuals who do not require the acute care provided in a hospital but who need more care than can be given at home" (U.S Department of Health And Human...
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Clinical Nurse Leaders’ responsibility scope includes all nurse and patient management details except for administrative duties. They are important resources in United States medical intuitions. CNL candidates must have a master’s degree to fulfill this position. This knowledge gives them the needed skill set to manage the daily operation of the hospital’s entire nursing pool. They also observe and regulate the patient care setting. Ultimately, the Clinical Nurse Leaders’ role will continue to gain importance as healthcare caseloads increase in
Confounding variables: Multiple confounding factors exist including the number of “float” RN staff available to supply the unit and the division of patient care between licensed staff and unlicensed assistive personnel (UAP). In addition, the skill set and educational background of the RN’s providing care on the unit are confounding variable that have the possibility to effect the study’s outcome. Patient’s consent is needed to access their medical record, and track outcomes
Spinks, N., & Moore, C. (2007). Nursing Leadership. The Changing Workforce, Workplace and Nature of Work: Implications for Health Human Resource Management, 20(3), 26-41.
Now I believe that transitional care interventions are very important, yet undervalued in the healthcare system. There are not enough protocols in place to ensure the implementation and the quality of the transitional care interventions. As future nurses, I should advocate for the importance of the transitional care interventions and promote the utilization of those interventions. Besides, I feel that a significant cause of preventable readmission is poor communication and coordination of care during transitions. Transitions between care settings are vulnerable periods for all patients, but especially older adults and those with multiply comorbidities. We need to develop an effective system to identify the patients who are at high risk for readmission, and make plans accordingly to ensure optimal communication and coordination of services to provide continuity of safe, timely, high-quality care during transitions. In order to achieve this goal, we need to improve the quality of patient and family education, coordination and arrangement of care in the post-acute care setting, and the communication among healthcare professionals involved in the patient’s care
In today’s society, leadership is a common yet useful trait used in every aspect of life and how we use this trait depends on our role. What defines leadership is when someone has the capability to lead an organization or a group of people. There are many examples that display a great sense of leadership such being an educator in health, a parent to their child, or even a nurse. In the medical field, leadership is highly used among nurses, doctors, nurse managers, director of nursing, and even the vice president of patient care services. Among the many positions in the nursing field, one who is a nurse manager shows great leadership. The reason why nurse manager plays an important role in patient care is because it is known to be the most difficult position. As a nurse manager, one must deal with many patient care issues, relationships with medical staff, staff concerns, supplies, as well as maintaining work-life balance. Also, a nurse manager represents leadership by being accountable for the many responsibilities he or she holds. Furthermore, this position is a collaborative yet vital role because they provide the connection between nursing staff and higher level superiors, as well as giving direction and organization to accomplish tasks and goals. In addition, nurse managers provide nurse-patient ratios and the amount of workload nursing staff has. It is their responsibility to make sure that nursing staff is productive and well balanced between their work and personal lives.