Wait a second!
More handpicked essays just for you.
More handpicked essays just for you.
The real reason why healthcare costs are on the rise
The real reason why healthcare costs are on the rise
The real reason why healthcare costs are on the rise
Don’t take our word for it - see why 10 million students trust us with their essay needs.
Recommended: The real reason why healthcare costs are on the rise
INTRODUCTION:
In health delivery system, one common goal for all providers, doctors and administrators is to provide high quality health care services at low costs. But in the United States, health care spending has increased drastically, but outcomes are not efficient. In the recent study conducted by common wealth fund shows that United States health care spending is 50 percent more when compared to 13 top nations in the world. [1] This report also shows that despite of having high health care expenditure in the United States, the health care outcomes are worse when compared to other countries whose health expenditure is low. To address these problems and improve outcomes, patient safety and satisfaction, in the field of surgery the American
…show more content…
Later in 2002 American academy of pediatrics extended this model to include 37 specialties and in 2007 different physician associations collaboratively proposed the principles of patient centered medical homes. [2] Based on this model in 2006, American society of anesthesiologist proposed similar model, perioperative surgical home model in the field of surgery for achieving triple aims; improving patient health care and providing quality health care at low costs. [2]However these concepts have evolved two decades earlier their popularity has increased only after the implementation of affordable care act in 2010 as it introduced the concept of Accountable care organizations which requires different healthcare providers to work collaboratively to provide quality healthcare services at low costs. Similar to perioperative surgical homes, enhanced recovery after surgery model (ERAS) is popular outside United States. …show more content…
According to agency of health care research and quality it is estimated that almost one third of health care spending is due to inpatient surgical procedures and it also estimates that average hospital costs has been increased from $ 9,100 in 2003 to $11,000 in 2013. [4] Some major reasons for this increase in costs includes lack of coordination, risk associated with complicated surgical procedures, poor patient engagement in decision making, quality requirements and etc. The perioperative surgical homes are very effective in solving these problems and achieve better surgical outcomes as it is a coordinated care which is led by multi specialty physicians who provides continuum of care to patients from the time of decision to 30 days after discharge of the patient i.e., it is incorporated in to include all three phases of surgery; perioperative, intra-operative and postoperative
Ignatavicius, D. D., & Workman, M. L. (2013). Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier Saunders.
Ignatavicius, D. D., & Workman, M. L. (2013). Care of Intraoperative Patients. Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier.
Sarpel, U., Vladeck, B. C., Divino, C. M., & Klotman, P. E. (2008). Fact and Fiction: Debunking Myths in the US Healthcare System. Annals of Surgery, 247(4), 563-569. doi:10.1097/SLA.0b013e318159d566
Wrong site, wrong procedure, and wrong patient errors are avoidable safety issues. Nearly 1.9 trillion dollars are spent on medical errors each year in the United States (Catalano & Fickenscher, 2008). Between 1995 and 2007, 691 wrong-site surgeries have been reported to The Joint Commission's Sentinel Event data repository (AHC Media LLC, 2008). In 2003 in response to the outcry for better patient safety The Joint Commission published their National Patient Safety Goals. Among the goals was the Universal Protocol. The Universal Protocol is actually drawn from several of the National Patient Safety Goals. It relies on multiple check points and the involvement of the entire surgical team to avoid such errors. Wrong site, wrong procedure, and wrong patient surgeries should never happen. The Universal Protocol is an evolving process which reflects the success and failures of healthcare practice, thus it requires periodic updates and policy revisions.
Elective surgery average waiting times increased from 2011-12 to 2012-13, from 33 days to 36 days respectively. In 2012-13, wait times ranged from an average of 27 Days in Queensland hospitals and 51 days in hospitals located in the ACT (Australian Institute of Health and Welfare, 2013, p. 13-15). With the looming pressure of decreasing tax revenue and heavy reliance on government funding; implementation of activity based funding may result in cost savings for the government, however hospitals will be short-changed if costs cannot be accurately analysed.
Ignatavicius, D.D. & Workman, M.L.(2010). Medical-Surgical Nursing: Patient-Centered Collaborative Care. (6th ed.). St. Philadelphia PA: Saunders Elsevier
The balance between quality patient care and medical necessity is a top priority and the main concern of many of the healthcare organizations today. Due to the rising cost of healthcare, there has been a change in the focus of reimbursement strategies that are affecting the delivery of patient care. This shift from a fee-for-service towards a value-based system creates a challenge that has shifted many providers’ focus more directly on their revenue. As a result, organizations are forced to take a hard look at the cost of services they are providing patients and then determining if the services and level of care are appropriate for the prescribed patient care.
Ignatavicius, D. D. & Workman, M.L. (2010). Medical-surgical nursing: Patient-centered collaborative care. St. Louis, Missouri: Saunders Elsevier.
Perioperative registered nurses- provide surgical patient care by assessing, planning, and implementing the nursing care patients receive before, during and after surgery. These activities include patient assessment, creating and maintaining a sterile and safe surgical environment, pre- and post-operative patient education, monitoring the patient’s physical and emotional well-being, and integrating and coordinating patient care throughout the surgical care continuum
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
...d procedures are now being monitored to improve clinical processes. Ensuring that these processes are implemented in a timely, effective manner can also improve the quality of care given to patients. Management of the processes ensures accountability of the effectiveness of care, which, as mentioned earlier, improves outcomes. Lastly, providing reimbursements based on the quality of care and not the quantity also decreases the “wasting” and overuse of supplies. Providers previously felt the need to do more than necessary to meet a certain quota based on a quantity of supplies or other interventions used. Changing this goal can significantly decrease the cost of care due to using on the supplies necessary to provide effective, high-quality care. I look forward to this implementation of change and hope to see others encouraging an increase in high-quality healthcare.
phase of perioperative care beginning with the decision to perform surgery and continuing until the client reaches the operating area. Starts off whether the patient wants to perform the surgery then continues until the patient reaches the operating area. When a patient is admitted into ambulatory surgery or short before surgery the time for preoperative assessment, nursing diagnoses, and evaluation of the nursing management may be limited. It’s important to recognize the patient’s immediate preoperative needs. Although, the preparation for the surgery is still required by the nursing process. Assessment: in preoperative care it requires a complete assessment of the patient. The assessments differ based on the importance of the surgery and whether the patient is admitted the day of the surgery or earlier. Even in emergencies the nurses are required to take every effort to gather as must information about the patient as possible. During a preoperative assessment the nurses assesses: a review preoperative laboratory and diagnostic studies, Complete blood count, Chest x-ray, Serum electrolytes, Urinalysis, Electrocardiogram, Blood type and crossmatch, and other tests that are relative to the procedure or to the patient’s medical conditions (examples: prothrombin time, partial thromboplastin time, blood urea nitrogen (BUN), creatinine, or other radiographic studies). If the patient isn’t following the instructions (such as portion size/food restrictions) as the nurse advised then the nurse immediately informs the surgeon. The surgeon then determines whether the patient is at risk for any complications that can happen during/after the surgery. When the surgery is considered non-urgent the nurse performs a complete history and physical ...
With the United States government spending 3.3 trillion dollars, or approximately $10,000 per person, this far exceeds any other controls budget for healthcare. One would assume that the overall quality of health care in the United States would be excellent. That assumption would often be incorrect. Even with the CMS enacting many hopeful protocols and programs for quality assurance the US is still falling short. One of the easiest ways to analyze the United States shortcomings and accolades would be to examine the CMS’s clinical quality measures and how the U.S. is meeting or not meeting measures.
When the patient has followed the instructions, things at the surgery center go much smoother. There are decreased incidents of high pressure, pain issues, and/or low/high blood sugar. Escorts and transportation home is readily available to the patient. Post surgery medications are handled. The whole experience is pleasant for the patient. Patient’s that have good encounters are happier patients. Content patients tell their friends, family, and co-workers, which in turn may influence that person at the end of the year to change health insurance plans.
I went to the operating room on March 23, 2016 for the Wilkes Community College Nursing Class of 2017 for observation. Another student and I were assigned to this unit from 7:30am-2:00pm. When we got their we changed into the operating room scrubs, placed a bonnet on our heads and placed booties over our shoes. I got to observe three different surgeries, two laparoscopic shoulder surgeries and one ankle surgery. While cleaning the surgical room for the next surgery, I got to communicate with the nurses and surgical team they explained the flow and equipment that was used in the operating room.