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
Grellner, L. (2012). Put Your Money Where Your Scores are HCAHPS and VBP. The Oklahoma Nurse, 57(3), 4.
Kerfoot, K. M. (2012). On Leadership. Is Nurse Executive/Nurse Management Practice a Profession?. Nursing Economic$, 30(1), 38-39.
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.
Long-term care (LTC) covers a wide range of clinical and social services for those who need assistance due to functional limitations. These limitations usually result from complications associated with age related chronic conditions, from disabilities related to birth defects, brain damage, or mental retardation in children; or from major illnesses or injuries suffered by adults (Shi L. & Singh D.A., 2011). LTC encompasses a variety of services including traditional clinical services, social services and housing. Unlike acute care, long-term care is much more complicated and has objectives that are much harder to measure. Acute care mainly focuses on returning patients to their previous functional level and is primarily provided by specialty providers. However, LTC mainly focuses on preventing the physical and mental deterioration of an individual and promoting social adjustments to suit the different stages of decline. In addition the providers of LTC are more diverse than those in acute care and is offered in both formal and informal settings, which include: hospitals, physicians, home care, adult day care, nursing home care, assisted living and even informal caregivers such as friends and family members. Long-term care services have been dominated by community based services, which include informal care (86%, about 10 to 11 million) and formal institutional care delivered in nursing facilities (14%, 1.6 million) (McCall, 2001). Of more than the 10 million Americans estimated to require LTC services, 58% are elderly and 42% are under the age of 65 (Shi L. & Singh D.A., 2011). The users of LTC are either frail elderly or disabled and because of the specific care needs of this population, the care varies based on an indiv...
Roussel, L., & Swansburg, R.C. (2009). Management and leadership for nurse administrators. Sudbury, MA: Jones & Bartlett Publishers.
Subacute units offer a transition point between a hospital stay and their journey home or a nursing facility. Emerging to fill the gap between intensive hospital care and the care that can be given in the home or a nursing facility, and provide a more cost-effective form of care than hospital care (Pratt, 2017, p. 113). Subacute care’s focus on the quality of care given at the cheapest price possible allows subacute care to stay relevant in our ever-changing healthcare system. While also ensuring the patient’s care and overall quality of life are the best it can be. Say you have a stroke, after your stay in the hospital you may need physical therapy, this therapy is received in a subacute care facility (can be a part of hospital or nursing facility). When you enter the subacute care facility you enter with a projected check out date, with a set structured plan of action. I believe subacute care should be offered in hospitals and nursing facilities so that no matter what the finical situation of the patient they can receive quality regulated care at a cheaper price than acute
K. Lynn Wieck, RN, PhD, FAAN, is the Jacqueline M. Braithwaite Professor, College of Nursing, The University of Texas at Tyler, Tyler, TX, and CEO, Management Solutions for Healthcare, Houston, TX; Jean Dois, RN, PhD, NEA-BC, FACHE, is the System Director for Quality and Nursing, CHRISTUS Health System, Houston, TX; and Peggy Landrum, RN, PhD, is Clinical Professor, College of Nursing, Texas Woman 's University, Houston,
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...
Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2010). Essentials of nursing leadership and
Jencks, S., Williams, M., & Coleman, E. (2009). Rehospitalizations among Patients in the Medicare Fee-for-Service Program. New England Journal of Medicine, 1418-1428. Retrieved November 12, 2014.
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
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
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
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...
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
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
Azaare, J., & Gross, J. (2011). The nature of leadership in nursing management. British Journal of Nursing, 20(11), 672-680. Retrieved from EBSCO host