NHS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue
Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Professor Name Date Identifying a Local Health Care Economic Issue Hospital readmission rates are a perilous healthcare economic issue that has a considerable impact on the elderly population in Texas, United States. This concern is centered around the fact that a higher number of older adults are readmitted to healthcare facilities after their discharge, impacting patients’ health as well as incurring financial implications. Therefore, this assessment explores more about the particular economic concern, its impact on the population and the working groups, and identifies the gap contributing to rising readmission rates. Issue Description and its Impact on Elderly Population Hospital readmission is described as the number of patients returning to the hospital within a specific interval from discharge, usually 30 days, for further treatment. It is an important measure that indicates adverse outcomes which are preventable by improving the quality of care. According to the Centers for Medicare & Medicaid Services (CMS), hospital readmissions are frequent, where 20 percent of Medicare receivers are readmitted within 30 days of discharge (Gupta et al., 2019). Our observations reveal that repeated readmissions can result in poor health outcomes for older adults. Each hospital stay transmits the risk of acquiring hospital-related infections, medical errors, and adverse events, which can further complicate their existing health conditions. Furthermore, hospital readmissions can impose a substantial monetary burden on the patients and their families, especially for those without insurance coverage (Lau et al., 2021). Other potential impacts include reduced quality of life and experiences of anxiety, stress, and vulnerability due to recurring health problems and the need for hospitalizations. The Rationale for Choosing Particular Healthcare Economic Issue The reasons for choosing the particular healthcare economic issue are my personal and professional experiences related to this matter. One of the reasons is that recurrent admissions within my workplace have led to several monetary penalties under the act of the Hospital Readmissions Reduction Program (HRRP). The focus of the program is to improve healthcare services, enhance communication, and optimize care coordination to prevent avoidable readmissions, eventually improving patient outcomes and quality of care (Centers for Medicare & Medicaid Services, 2023). Hospitals showing contrary observations may receive minimal reimbursements and pay additional penalties in this regard, consequently imposing a financial burden on the organizations. Another reason for choosing this problem is a personal connection where I witnessed the struggles and difficulties that my parents and grandparents have encountered due to repeated hospitalizations. The values that I hold as a registered nurse to provide empathetic and compassionate care for the well-being of patients have led me to choose this critical healthcare economic issue, requiring immediate interventions by the stakeholders. Impact of Increasing Hospital Readmission Rates As healthcare workers, the mounting concern of hospital readmission rates has had an overwhelming impact on our work and our organization. As we strive to provide adequate care to returning patients to improve their health and well-being, aggregated workload and resource scarcity are two major challenges that my colleagues and I have confronted. My colleagues and I have had to adapt to more complex patient needs, improve our care coordination process, augment discharge planning, and expand follow-up protocols, all of which demand for additional work and resources. While the organization had to pay penalties for the recurrent admissions, it also handled the detrimental challenge of additional expenses used on the surplus resources. A study presents that these additional costs may lead to decreased profitability for the organization, eventually impacting financial viability (Upadhyay et al., 2019). Simultaneously, the increasing hospital readmission rates are particularly challenging for the low socio-economic population within the community. Since the population has limited access to preventive care services and post-discharge support, they are at high risk for acute health issues, increasing the probability of hospitalization and readmission. NHS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue Moreover, social factors like insecure housing, lack of proper food, and insignificant income impact their overall well-being, contributing to higher hospitalization rates (Murray et al., 2021). Lastly, frequent readmissions can lead to extensive out-of-pocket costs for medications and other healthcare expenses, which may aggravate the existing financial burden for these diverse and low socioeconomic groups. Therefore, it is crucial to focus on healthcare equity and accessibility while devising interventions to address readmission rates within the community. The Contributing Gap and its Evidence The gap significantly increasing the readmission rates exists in the quality of healthcare due to inadequate post-discharge care planning and ineffective care coordination. A systematic review by Hunt‐O’Connor et al. (2021) corroborated a reduced risk of readmission rates for those patients who had received comprehensive post-discharge care. Discharge planning is essential to prevent post-hospital complications and reduce errors, ultimately minimizing the readmission rates. Another important factor is fragmented healthcare. Ineffective care coordination and disintegrated care are associated with higher risks of readmissions in chronically ill patients (Joo, 2023). Elderly patients often experience fragmented care due to the complex nature of their diseases; thus, healthcare professionals must ensure care coordination while dealing with chronic illnesses and older adults. Addressing these gaps is fundamental to improving the transition from hospital to patients’ residences and reducing hospital readmission rates. References Centers for Medicare & Medicaid Services. (2023, June). Hospital readmissions reduction program (HRRP). CMS.gov. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/hospital-readmissions-reduction-program-hrrp Gupta, S., Zengul, F. D., Davlyatov, G. K., & Weech-Maldonado, R. (2019). Reduction in hospitals’ readmission rates: Role of hospital-based skilled nursing facilities. Inquiry: A Journal of Medical Care Organization, Provision and Financing, 56, 0046958018817994. https://doi.org/10.1177/0046958018817994 Hunt‐O’Connor, C., Moore, Z., Patton, D., Nugent, L., Avsar, P., & O’Connor, T. (2021). The effect of discharge planning on length of stay and readmission rates of older adults in acute hospitals: A systematic review and meta‐analysis of systematic reviews. Journal of Nursing Management, 29(8), 2697–2706. https://doi.org/10.1111/jonm.13409 NHS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue Joo, J. Y. (2023). Fragmented care and chronic illness patient outcomes: A systematic review. Nursing Open, 10(6), 3460–3473. https://doi.org/10.1002/nop2.1607 Lau, H. L., Patel, S. D., & Garg, N.
NHS FPX 4000 Assessment 4 Analyzing a Current Health Care Problem or Issue
Name Capella university NHS FPX4000 Developing a Health Care Perspective Prof. Name Date Analyzing a Current Health Care Problem or Issue Medication errors can be described as a failure in the medication management process. It can be due to improper prescription, administration, or inaccurate medication records that can potentially damage the patient, resulting in poor health outcomes (Mosisa et al., 2022). This academic paper addresses a significant healthcare concern: medication errors within the healthcare system. The growing incidences of medication errors have developed my interest in this topic. As a healthcare provider, I must prioritize initiatives to prevent these errors in my nursing practice. In the professional context, I have observed various medication errors in my organization where healthcare providers administered incorrect medication doses, misread prescriptions, and neglected possible drug interactions, leading to severe patient complications. Thus, it is essential to tackle the underlying causes and put strong protections in place to reduce medication errors and ensure patient safety. Medication Errors as a Healthcare Issue Globally, medication errors cause morbidity, mortality, and adverse economic effects. The prevalence of medication errors may be correlated with the involvement of healthcare professionals such as medical experts, unit assistants, physicians, pharmacists, and nurses. In USA Intensive Care Units (ICUs), it has been observed that 42% of medication errors are crucial to continuing treatment, while 19% are life-threatening (Alrabadi et al., 2021). One-quarter of all healthcare errors are related to medication errors, including prescribing, transcribing, dispensing, administering, and monitoring. The World Health Organization (WHO) estimates that drug errors cost the global economy $42 billion yearly, or 0.7% of all health spending (Manias et al., 2020). According to the study by Alqenae et al. (2020), Medication errors (MEs) and adverse drug events (ADEs) are common and create severe risks to patients’ safety after discharge from the hospital. According to the review, over half of adult and senior patients have at least one medication error after discharge, with one in every five having one or more ADEs. Antibiotics, antidiabetics, analgesics, and cardiovascular medicines are the most typically related medication classes with ADEs. This highlights the significance of addressing medication safety during care transitions, and further research is required to find effective strategies to lessen these risks. These articles are valuable because they analyze the global significance of medication errors, their impact on patient safety, and the economic consequences. They provide specific statistics and insights into the prevalence and severity of medication errors. They highlight the need for interventions and research to mitigate these risks and improve healthcare outcomes. Analyze the Problem or Issue in Medication Error Medication errors are preventable mistakes that can result in incorrect medication use or harm to the patient. It can occur at any stage of the healthcare process, from prescribing to administration, and involves professionals, patients, and consumers. Medication errors in the healthcare system involve several groups. Prescription, preparation, and administration of pharmaceuticals are the responsibility of doctors, nurses, pharmacists, and other healthcare professionals. Patients also have an essential role in misinterpreting drug instructions, insufficient medical history disclosure, or difficulty adhering to complex prescription schedules. Various contributory human factors cause medication errors (MEs) in hospital pharmacies. These factors include individual elements like fatigue and emotional stress, organizational aspects such as support systems and communication, task-related challenges like high workload during specific shifts, and team dynamics, including interprofessional communication. It is crucial to deal with these human factors for enhancing patient safety within the framework of hospital pharmacy settings. (Faraj et al., 2020). Another study by Kuitunen et al. (2020) describes avoiding safety procedures for high-alert drugs, drug knowledge gaps, calculation errors, double-checking lapses, and LASA medication confusion as systemic causes of medication errors. Addressing these flaws and standardizing processes are critical for improving medicine safety during administration, prescribing, and preparation. Discusses Potential Solutions for Medication Errors Medication errors require a wide range of approaches addressing their underlying causes. Potential solutions to ensure positive outcomes include integrated computerized pharmacy systems. Additionally, staff management and a process improvement approach are crucial. These solutions collectively aim to improve patient safety and reduce the risks associated with medication errors. Integrated Computerized Systems at Pharmacies Look-alike or sound-alike (LASA) errors constitute a significant part of total medication errors. These types of errors can create severe harm to patient health and safety. The approaches and solutions to reduce LASA include. To reduce medication-related errors, minimize interruptions, use ‘Tall Man lettering,’ and leverage barcode technology. One potential solution is using the technology of barcode medication delivery to ensure that the given medicine is correct. Healthcare providers should be informed about LASA medication combinations and computerized physician order entry systems with notifications should also be used to minimize errors (Baryan et al., 2020). The pros and cons of this solution are that proactive measures such as technology integration and healthcare provider education enhance patient safety while neglecting LASA errors, which can lead to patient harm, legal issues, and increased healthcare costs. Management of Staff Potential solutions for reducing hospital medication errors include training junior staff in medication prescribing and administration. Training should focus on being vigilant during duty hours to mitigate these errors. In these trainings, hospital management should also address environmental issues and workload management for new and old nurses. Furthermore, interdisciplinary collaboration and curriculum evaluations on pharmaceutical safety can help avoid these errors (Isaacs et al., 2020). The pros and cons are that training junior staff can improve medication safety through increased vigilance, addressing environmental challenges, and fostering interdisciplinary collaboration. Ignoring this solution can create stress and anxiety within nursing professionals, which can enhance the chance of mistakes being made by nurses. Process Improvement Approach The implementation of Lean Six Sigma (LSS) in a =Thai hospital’s inpatient pharmacy was investigated by Trakulsunti et al. (2022) for the dispensing process. Some of the LSS tools used were cause-and-effect diagrams and brainstorming control charts. The study yielded significant improvements in the medication process. It streamlined the medication process, reduced dispensing errors, and improved overall patient safety. Middle management’s active involvement, leadership, and problem-solving skills can