The document provides tips for convincing key decision makers to integrate health literacy into their organizations. It begins by showing data on the importance of health literacy and its impact on health outcomes. Examples of presentation materials are given to underscore the business case, including impact on costs from issues like readmissions, medical errors, and patient satisfaction. Laws and regulations that encourage clear communication are also reviewed. The document concludes by offering actionable steps for implementation, such as creating a patient advisory council, training on techniques like teach back, and developing pilot projects to test and measure outcomes.
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
The system of delivery within health care has always been on the change and rise due
to technology along with self-care, health care, development, education, and creating a healthy society. As the old saying goes, “where there is good health there is also good financial wealth” and this is where the formation of the ACA took place and a new integrated delivery system created.
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
The system of delivery within health care has always been on the change and rise due
to technology along with self-care, health care, development, education, and creating a healthy society. As the old saying goes, “where there is good health there is also good financial wealth” and this is where the formation of the ACA took place and a new integrated delivery system created.
The Paradigm Shift from Healthcare to Population HealthPractical Playbook
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
This presentation from the 2014 ASHRM Conference analyzes the legal, regulatory and clinical risks related to meaningful consent and offers ways to mitigate them.
Medical Informatics Update 2013 Programpaulgoldfarb
Event program for the Medical Informatics Update 2013 held October 16, 2013 and sponsored by the Center for Advanced Information Management at Columbia University and IBM Healthcare.
Partnering with Patients, Families and Communities for Health: A Global Imper...EngagingPatients
Engagement is an essential tool to improving global health. This report introduces a new framework for engagement to help countries assess current programs and think strategically about future engagement opportunities. It spotlights barriers to engagement and offers concrete examples of effective engagement from around the globe.
National Conference on Health and Domestic Violence. Plenary talk Paul Grundy
explaining how the Patient Centered Medical Home (PCMH) platform for healthcare deliver is more likely to support domestic violence prevention and creat a safer environment than the FFS episode of care system we are in now. The medical Home is a home for the data where the all the data goes and is held accountable this idea was first articulated by Dr. Calvin C.J. Sia, a Honolulu-based pediatrician in 1967.
This concept of the medical home was integrated with Ed Wagners Chronic disease Model and Thomas Bodenheimer Kevin Grumbach advanced/proactive primary care at the request of the Patient Centered Primary care Collaborative into a set of principles Know as the Joint principles of the Patient centered medical home.
The patient-centered medical home (PCMH), is a team based health care delivery set of principles led by a physician that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. It is "an approach to providing comprehensive primary care for children, youth and adults" The provision PCMH medical homes allow better access to health care, increase satisfaction with care, and improve health. Joint principles that define a PCMH have been established through the cohesive efforts of the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Physicians (ACP), and American Osteopathic Association (AOA).[10] Care coordination is an essential component of the PCMH. Care coordination requires additional resources such as health information technology, and appropriately trained staff to provide coordinated care through team-based models. Additionally, payment models that compensate PCMHs for their effort devoted to care coordination activities and patient-centered care management that fall outside the face-to-face patient encounter may help encourage coordination.
Engines of Success for U.S. Health Reform?
Eric B. Larson, MD, MPHVice President for Research, Group Health Executive Director, Group Health Research Institute
The Patient-Centered Medical Home in the Transformation From Healthcare to He...Paul Grundy
Surgeon General of the Navy VADM Matthew L. Nathan, MC USN
Fortunately, we have a way to address this crisis—the
Patient-Centered Medical Home (PCMH) model launched at Naval Hospital Pensacola and Walter Reed National Military Medical Center, Bethesda, Maryland (formerly the National Naval Medical Center) in 2008. It is now being implemented throughout the Military Health System (MHS) and carries great promise. It provides the clinical framework we need to meet our strategic objectives in terms of quality of care, impact on costs, population health, and readiness. One of the most significant benefits of the team-based, collaborative approach is that it allows us to embed within a primary care environment the psychologists, nutritionists, tobacco cessation specialists, mind-body medicine therapists, and health educators our patients need in order to develop and maintain mindful, healthy behaviors—along with the “mental armor,” our active duty military personnel need to increase their operational effectiveness and their resiliency in bouncing back from stressful situations. As we move ahead with this more comprehensive approach to health, we can begin to better address so many of our patients for whom we can find no specific reason for pain and discomfort. The PCMH model also provides a positive impact on our costs. Early data reporting from the PCMH clinics at Bethesda show reduced visits to the emergency room, lowered pharmacy costs, and significant per beneficiary per year savings and improved Healthcare Effectiveness Data and Information Set metrics, access, and patient satisfaction and trust. These positive impacts on the bottom line can be applied directly to improved costs or toward the reallocation of resources from reimbursing those who are sick to the population health-based programs that can make and keep our patients healthy.More significant, however, the PCMH environment allows us to go beyond mere collaboration and to a much more proactive approach to managing our patient populations. It is within the context of the medical home that we can begin to surround our patients with the tools and resources they need to move them from health care to health.
Peer response’s # 2Rules Please try not to make the responses s.docxdanhaley45372
Peer response’s # 2
Rules: Please try not to make the responses super lengthy, contribute one fact AND include references
HMGT 420
· Wk#3
Talar posted Jun 4, 2016 11:57 PM
Patients who have complex health needs require not only medical. But also social services and support from a variety of caregivers and providers. Facility managers who are part of care coordination could assist patient in receiving optimal care by addressing the challenges in coordinating care for these patients, and offer programmatic changes and policies that help deliver the best services to all patients.
Facility managers can come up with strategic plans based on prior data and make necessary changes based on preexisting conditions. “Patient- centered, comprehensive, coordinated, and accessible care that continuously improved through a systems-based approach to quality and safety” (AHRQ, 2012) are what’s needed to achieve the highest quality care possible in any health care facility.
Patient centered care can’t be achieved with providers only. It requires team work and collaboration among all stakeholders. To improve the quality and safety of patients, health care facility managers can work hand and hand with the coordinated team to provide a system based approach by drawing on decision-support tools, taking into account patient experience, and using population health management approach. Patient preference and needs on what aspects of care to be improved.
Respond to Talar here:
· Vanscoy, Week 3
Sarah posted Jun 5, 2016 11:07 AM
As a facility manager, and part of the care coordination team, I would look into models of care that would assist our situation. With the Affordable Care Act in place, there are accountable care organizations (ACOs), which provide models of care (“Promise,” 2013). There are many different definitions and perspectives on care coordination, but all lead to the goal of meeting patient needs and providing adequate healthcare (“Care,” 2014).
Care coordination is essential because each patient can interact with a variety of professionals each visit. For example, for a routine physical appointment, the patient could meet with the scheduling staff, medical assistants, nurses, doctors, pharmacists, and the billing staff. If each one of these member fails to coordinate as a whole, the patient could be harmed or neglected. As a care coordinator, I would be responsible for discussing an individualized care plan with each patient and ensuring that they understand their responsibilities. All barriers should be identified, such as financial, social (language), psychological, and anything that would effect the patient from following their correct plan of care and interacting with the staff (“Promise,” 2013). Another key point is to ensure the medical staff has reviewed the patient’s medical records and ensure that everyone is on the same page. These are just a few examples, because each case is different and each patient will have different needs. .
DQ 3-2Integrated health care delivery systems (IDS) was develope.docxelinoraudley582231
DQ 3-2
Integrated health care delivery systems (IDS) was developed to initiate excellence health care access and quality of care to entire populations and community by collaborating and coordinating diverse healthcare professionals. Main driving force of IDS is patient centered care by using resources such as collaborating care from physicians and allied health care professionals to construct continuum of care, to deliver care in the most cost-effective way, utilize trained and competent providers by utilizing evidenced -based practice and combine innovation such as EHR (Electronic Health Records) system and team work to produce improved healthcare system.
Excellence in care is attainable by incorporating allied healthcare professional, as high quality care is possible when coordination is unified and covers all areas of responsibilities. For an example-combining resources and coordination of care by involving physicians, dietitian, physical therapy or occupational therapy to work with patient diagnosed with obesity by promoting teamwork approach and ultimately delivering endurance in care and utilizing various resources.
Barriers to IDS can be a huge block in delivering quality care. Among many one limitation is physicians not participating in integrated healthcare system, which disconnect physicians from team based approached by deterring continuous quality improvement (essentialhospitals.org, n.d). This is because, system such as EHR or new innovative quality assurance programs are time consuming and overwhelming, thus decline in physicians support in IDS programs. By implementing user friendly system approach, enforcing focused based care and accepting the necessity of evidenced based practice can improve these barriers. Hence, increasing clinical expertise to produce better service and quality of care in integrated delivery system.
Essentialhospitls.org (n.d). Retrieved from: http://essentialhospitals.org/wp-content/uploads/2013/12/Integrated-Health-Care-Literature-Review-Webpost-8-22-13-CB.pdf
Dq 3-1
1.
In the US, there is not one type of health care system but rather a subset of systems, some of them catering to specific populations. These subsystems include managed care, military, and vulnerable populations. Managed care is a health care delivery system that seeks to achieve efficiency by integrating the basic functions of health care delivery, employs mechanisms to control utilization of medical services, and determines the price at which the services are purchased and how much the providers get paid, military health care system is available free of charge to active duty military personnel and covers preventative and treatment services that are provided by salaried health care personnel and this system combines public health with medical services, and vulnerable population subsystem offers comprehensive medical and enabling services targeted to the needs of vulnerable populations and government health insurance programs provide.
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, DioneWang844
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS
Page | 1
Quality
Nearly fifteen years ago, the Institute of Medicine published the “To Err Is Human” report, which exposed the substantial impact of medical errors in the US healthcare system and called for a dramatic system change, including an improved understanding of those errors (McCarthy, Tuiskula, Driscoll, & Davis, 2017). Medical errors are considered to be failure to achieve the original goal or plan of action, and these errors may range from a patient falls to a mistake in the operating room. Not only do medical errors cause harm to the patient and jeopardize the patient’s trust, but they also cause a financial strain for the health system (“To Err is Human,” 1999). One of the contributing factors to medical errors is the lack of effective communication between doctors who are treating the same patient. This results in healthcare providers overprescribing medications for patients as well as increases the possibility of a patient having unnecessary tests or procedures performed. The report’s four-tiered approach includes:
· Focusing on creating a stronger foundation of education on patient safety
· Mandating a nationwide reporting system to encourage timely reporting of errors
· Increasing the standards of performance for healthcare providers
· Taking advantage of the security that safety systems offer (“To Err is Human,” 1999)
Creating a strong educational foundation for patient safety is most important. Healthcare personnel are much more likely to actively participate in reporting systems, encourage one another to perform at a higher level, and take advantage of safety systems when they are well educated on patient safety and the implications of medical errors. The reporting system seems to provide the least amount of impact on patient safety as they can result in losing patient trust in certain healthcare systems. The healthcare system as a whole has made progress in establishing a safe environment for patients when they are in need of care.
Challenges for Patient Safety and Steps for Improvement
Despite continuing evidence of problems in patient safety and gaps between the care that patients receive and the evidence about what they should receive, efforts to improve quality in healthcare show mostly inconsistent and patchy results.
Tap each image to know more.
Data Collection and Monitoring Systems
This always takes much more time and energy than anyone anticipates. It is worth investing heavily in data from the outset. Assess local systems, train people, and have quality assurance.
Tribalism and Lack of Staff Engagement
Overcoming a perceived lack of ownership and professional or disciplinary boundaries can be very difficult. Clarify who owns the problem and solution, agree roles and responsibilities at the outset, work to common goals, and use shared language.
Convince People That There's a Problem
Use hard data to secure emotional e ...
The Paradigm Shift from Healthcare to Population HealthPractical Playbook
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
This presentation from the 2014 ASHRM Conference analyzes the legal, regulatory and clinical risks related to meaningful consent and offers ways to mitigate them.
Medical Informatics Update 2013 Programpaulgoldfarb
Event program for the Medical Informatics Update 2013 held October 16, 2013 and sponsored by the Center for Advanced Information Management at Columbia University and IBM Healthcare.
Partnering with Patients, Families and Communities for Health: A Global Imper...EngagingPatients
Engagement is an essential tool to improving global health. This report introduces a new framework for engagement to help countries assess current programs and think strategically about future engagement opportunities. It spotlights barriers to engagement and offers concrete examples of effective engagement from around the globe.
National Conference on Health and Domestic Violence. Plenary talk Paul Grundy
explaining how the Patient Centered Medical Home (PCMH) platform for healthcare deliver is more likely to support domestic violence prevention and creat a safer environment than the FFS episode of care system we are in now. The medical Home is a home for the data where the all the data goes and is held accountable this idea was first articulated by Dr. Calvin C.J. Sia, a Honolulu-based pediatrician in 1967.
This concept of the medical home was integrated with Ed Wagners Chronic disease Model and Thomas Bodenheimer Kevin Grumbach advanced/proactive primary care at the request of the Patient Centered Primary care Collaborative into a set of principles Know as the Joint principles of the Patient centered medical home.
The patient-centered medical home (PCMH), is a team based health care delivery set of principles led by a physician that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. It is "an approach to providing comprehensive primary care for children, youth and adults" The provision PCMH medical homes allow better access to health care, increase satisfaction with care, and improve health. Joint principles that define a PCMH have been established through the cohesive efforts of the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Physicians (ACP), and American Osteopathic Association (AOA).[10] Care coordination is an essential component of the PCMH. Care coordination requires additional resources such as health information technology, and appropriately trained staff to provide coordinated care through team-based models. Additionally, payment models that compensate PCMHs for their effort devoted to care coordination activities and patient-centered care management that fall outside the face-to-face patient encounter may help encourage coordination.
Engines of Success for U.S. Health Reform?
Eric B. Larson, MD, MPHVice President for Research, Group Health Executive Director, Group Health Research Institute
The Patient-Centered Medical Home in the Transformation From Healthcare to He...Paul Grundy
Surgeon General of the Navy VADM Matthew L. Nathan, MC USN
Fortunately, we have a way to address this crisis—the
Patient-Centered Medical Home (PCMH) model launched at Naval Hospital Pensacola and Walter Reed National Military Medical Center, Bethesda, Maryland (formerly the National Naval Medical Center) in 2008. It is now being implemented throughout the Military Health System (MHS) and carries great promise. It provides the clinical framework we need to meet our strategic objectives in terms of quality of care, impact on costs, population health, and readiness. One of the most significant benefits of the team-based, collaborative approach is that it allows us to embed within a primary care environment the psychologists, nutritionists, tobacco cessation specialists, mind-body medicine therapists, and health educators our patients need in order to develop and maintain mindful, healthy behaviors—along with the “mental armor,” our active duty military personnel need to increase their operational effectiveness and their resiliency in bouncing back from stressful situations. As we move ahead with this more comprehensive approach to health, we can begin to better address so many of our patients for whom we can find no specific reason for pain and discomfort. The PCMH model also provides a positive impact on our costs. Early data reporting from the PCMH clinics at Bethesda show reduced visits to the emergency room, lowered pharmacy costs, and significant per beneficiary per year savings and improved Healthcare Effectiveness Data and Information Set metrics, access, and patient satisfaction and trust. These positive impacts on the bottom line can be applied directly to improved costs or toward the reallocation of resources from reimbursing those who are sick to the population health-based programs that can make and keep our patients healthy.More significant, however, the PCMH environment allows us to go beyond mere collaboration and to a much more proactive approach to managing our patient populations. It is within the context of the medical home that we can begin to surround our patients with the tools and resources they need to move them from health care to health.
Peer response’s # 2Rules Please try not to make the responses s.docxdanhaley45372
Peer response’s # 2
Rules: Please try not to make the responses super lengthy, contribute one fact AND include references
HMGT 420
· Wk#3
Talar posted Jun 4, 2016 11:57 PM
Patients who have complex health needs require not only medical. But also social services and support from a variety of caregivers and providers. Facility managers who are part of care coordination could assist patient in receiving optimal care by addressing the challenges in coordinating care for these patients, and offer programmatic changes and policies that help deliver the best services to all patients.
Facility managers can come up with strategic plans based on prior data and make necessary changes based on preexisting conditions. “Patient- centered, comprehensive, coordinated, and accessible care that continuously improved through a systems-based approach to quality and safety” (AHRQ, 2012) are what’s needed to achieve the highest quality care possible in any health care facility.
Patient centered care can’t be achieved with providers only. It requires team work and collaboration among all stakeholders. To improve the quality and safety of patients, health care facility managers can work hand and hand with the coordinated team to provide a system based approach by drawing on decision-support tools, taking into account patient experience, and using population health management approach. Patient preference and needs on what aspects of care to be improved.
Respond to Talar here:
· Vanscoy, Week 3
Sarah posted Jun 5, 2016 11:07 AM
As a facility manager, and part of the care coordination team, I would look into models of care that would assist our situation. With the Affordable Care Act in place, there are accountable care organizations (ACOs), which provide models of care (“Promise,” 2013). There are many different definitions and perspectives on care coordination, but all lead to the goal of meeting patient needs and providing adequate healthcare (“Care,” 2014).
Care coordination is essential because each patient can interact with a variety of professionals each visit. For example, for a routine physical appointment, the patient could meet with the scheduling staff, medical assistants, nurses, doctors, pharmacists, and the billing staff. If each one of these member fails to coordinate as a whole, the patient could be harmed or neglected. As a care coordinator, I would be responsible for discussing an individualized care plan with each patient and ensuring that they understand their responsibilities. All barriers should be identified, such as financial, social (language), psychological, and anything that would effect the patient from following their correct plan of care and interacting with the staff (“Promise,” 2013). Another key point is to ensure the medical staff has reviewed the patient’s medical records and ensure that everyone is on the same page. These are just a few examples, because each case is different and each patient will have different needs. .
DQ 3-2Integrated health care delivery systems (IDS) was develope.docxelinoraudley582231
DQ 3-2
Integrated health care delivery systems (IDS) was developed to initiate excellence health care access and quality of care to entire populations and community by collaborating and coordinating diverse healthcare professionals. Main driving force of IDS is patient centered care by using resources such as collaborating care from physicians and allied health care professionals to construct continuum of care, to deliver care in the most cost-effective way, utilize trained and competent providers by utilizing evidenced -based practice and combine innovation such as EHR (Electronic Health Records) system and team work to produce improved healthcare system.
Excellence in care is attainable by incorporating allied healthcare professional, as high quality care is possible when coordination is unified and covers all areas of responsibilities. For an example-combining resources and coordination of care by involving physicians, dietitian, physical therapy or occupational therapy to work with patient diagnosed with obesity by promoting teamwork approach and ultimately delivering endurance in care and utilizing various resources.
Barriers to IDS can be a huge block in delivering quality care. Among many one limitation is physicians not participating in integrated healthcare system, which disconnect physicians from team based approached by deterring continuous quality improvement (essentialhospitals.org, n.d). This is because, system such as EHR or new innovative quality assurance programs are time consuming and overwhelming, thus decline in physicians support in IDS programs. By implementing user friendly system approach, enforcing focused based care and accepting the necessity of evidenced based practice can improve these barriers. Hence, increasing clinical expertise to produce better service and quality of care in integrated delivery system.
Essentialhospitls.org (n.d). Retrieved from: http://essentialhospitals.org/wp-content/uploads/2013/12/Integrated-Health-Care-Literature-Review-Webpost-8-22-13-CB.pdf
Dq 3-1
1.
In the US, there is not one type of health care system but rather a subset of systems, some of them catering to specific populations. These subsystems include managed care, military, and vulnerable populations. Managed care is a health care delivery system that seeks to achieve efficiency by integrating the basic functions of health care delivery, employs mechanisms to control utilization of medical services, and determines the price at which the services are purchased and how much the providers get paid, military health care system is available free of charge to active duty military personnel and covers preventative and treatment services that are provided by salaried health care personnel and this system combines public health with medical services, and vulnerable population subsystem offers comprehensive medical and enabling services targeted to the needs of vulnerable populations and government health insurance programs provide.
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, DioneWang844
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS
Page | 1
Quality
Nearly fifteen years ago, the Institute of Medicine published the “To Err Is Human” report, which exposed the substantial impact of medical errors in the US healthcare system and called for a dramatic system change, including an improved understanding of those errors (McCarthy, Tuiskula, Driscoll, & Davis, 2017). Medical errors are considered to be failure to achieve the original goal or plan of action, and these errors may range from a patient falls to a mistake in the operating room. Not only do medical errors cause harm to the patient and jeopardize the patient’s trust, but they also cause a financial strain for the health system (“To Err is Human,” 1999). One of the contributing factors to medical errors is the lack of effective communication between doctors who are treating the same patient. This results in healthcare providers overprescribing medications for patients as well as increases the possibility of a patient having unnecessary tests or procedures performed. The report’s four-tiered approach includes:
· Focusing on creating a stronger foundation of education on patient safety
· Mandating a nationwide reporting system to encourage timely reporting of errors
· Increasing the standards of performance for healthcare providers
· Taking advantage of the security that safety systems offer (“To Err is Human,” 1999)
Creating a strong educational foundation for patient safety is most important. Healthcare personnel are much more likely to actively participate in reporting systems, encourage one another to perform at a higher level, and take advantage of safety systems when they are well educated on patient safety and the implications of medical errors. The reporting system seems to provide the least amount of impact on patient safety as they can result in losing patient trust in certain healthcare systems. The healthcare system as a whole has made progress in establishing a safe environment for patients when they are in need of care.
Challenges for Patient Safety and Steps for Improvement
Despite continuing evidence of problems in patient safety and gaps between the care that patients receive and the evidence about what they should receive, efforts to improve quality in healthcare show mostly inconsistent and patchy results.
Tap each image to know more.
Data Collection and Monitoring Systems
This always takes much more time and energy than anyone anticipates. It is worth investing heavily in data from the outset. Assess local systems, train people, and have quality assurance.
Tribalism and Lack of Staff Engagement
Overcoming a perceived lack of ownership and professional or disciplinary boundaries can be very difficult. Clarify who owns the problem and solution, agree roles and responsibilities at the outset, work to common goals, and use shared language.
Convince People That There's a Problem
Use hard data to secure emotional e ...
Working with Regulators: A Focus on CMS | Took Kit: A Guide for Patient AdocatesCancerSupportComm
The Affordable Care Act (ACA) is the tip of a very large, multi-faceted iceberg, one that is moving inexorably forward and will result in broad, deep changes in the way that health care in this country is understood and delivered. These changes are already exerting a significant impact on cancer research and care, and will continue to do so for the foreseeable future. This is also an era in which the patient voice and genuine, active patient participation have become integral to the process of developing and implementing biomedical research and health care policy.
That process is complex and multidimensional—but also well defined and transparent. The ability to influence the outcomes requires that an organization have a working knowledge of how the process works, which agencies are responsible and who makes the decisions. It is also critical to understand the ways in which electoral politics at both the national and state level impact health care policy. While that sounds straightforward, the regulatory process often can appear impenetrable to the organizations who seek to make their voices heard and influence the outcomes.
This Tool Kit is intended as a practical guide for patient advocacy organizations in their efforts to educate themselves about the regulatory process, develop appropriate staff expertise and responsibility for this area, and ultimately make a difference.
The Future of Personalizing Care Management & the Patient ExperienceRaphael Louis Vitón
Actionable segmentation model findings - by Raphael Louis Vitón & Dream team of industry experts, physicians and leaders from Blue Cross, GEHealthCare, RingLeaderVentures, Maddock Douglas, Dr.Daniel Friedland, etc working on improving health outcomes by Personalizing the Care Management business model for Better Outcomes & Better Economics (through patient empowerment)
Jim Warren
National Institute for Health Innovation (NIHI)
The University of Auckland
The presentation was accompanied by this video:
http://www.youtube.com/watch?v=jbvmGqmIxXY
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4Seeking an Effective Care ContinuumLearning Objective.docxblondellchancy
4
Seeking an Effective Care Continuum
Learning Objectives
After reading this chapter, you should be able to:
• Identify programs that address the health issues surrounding workplace accidents.
• Assess the need for a continuum of care that comprises a comprehensive approach to
health care for vulnerable populations.
• Identify the preventive care services available to vulnerable populations.
• Examine the treatment services available to vulnerable populations.
• Explain the options that vulnerable populations have for accessing long-term care.
Courtesy of Kurhan/Fotolia
bur25613_04_c04_111-148.indd 111 11/26/12 10:30 AM
CHAPTER 4
Critical Thinking
OSHA provides many programs to ensure workers’ health and safety. Is there a similar program for
health care elsewhere? If not, could OSHA be used as a model to create or redesign existing programs?
Introduction
Introduction
Workplace injuries, deaths, and work-related illnesses cost the United States approximately $693.5 billion a year (National Safety Council, 2009). The Occu-pational Safety and Health Administration (OSHA), established in 1970,
ensures safe and healthy working conditions for men and women by setting standards
and providing training, outreach, and education. In other words, OSHA focuses on the
prevention of injuries by regulating the workplace.
In contrast, workers’ compensation programs, which are administered through the
Department of Labor, help workers who have already sustained a work-related injury or
an occupational disease. These programs focus on wage replacement, medical treatment,
and rehabilitation services coverage. Employers pay into the workers’ compensation
programs through companies that work to mitigate costs to insurance companies, called
insurance underwriters, or government programs to help cover these expenses. Although
paying into the national workers’ compensation program represents a significant expense
for employers, lost employee productivity is more costly. To minimize workers’ compen-
sation and lost productivity expenses, many employers have preventive workplace safety
programs that include educational sessions on safety and even posters with images and
safety messages to remind workers of best practices for safety. These preventive programs
aim to minimize risks both to the workers and the employers. Some of these programs
are available through OSHA, the national programs for workers’ compensation, or their
company insurance or liability underwriter.
Workplace safety programs and workers’ compensation programs provide a continuum
to address the health issues surrounding workplace accidents. From prevention to treat-
ment to rehabilitation to return-to-work, workplace safety and workers’ compensation
programs address the specific health care needs of America’s working population. This is
one example of the way a continuum of care works and how programs can work together
to create a continuum of care. E ...
3.1 INTRODUCTION
When the health community makes reference to patients having access to care, the reference is
generally limited. The concept of access is too often described as individuals getting to and from
health services and having the ability to pay for the services either by virtue of a third party or
out-of-pocket. We believe access to be much more than this and suggest that a redefinition of
access is long overdue. True access means being able to get to and from health services, having the
ability to pay for the services needed, and getting your needs met once you enter the health system.
This text introduces a framework for assessing the strengths and weaknesses of selective healthcare
systems, and determining if the system is providing true access to health care. The framework is
called “The Eight Factor Model.”
The comparison of health systems is made by utilizing The Eight Factor Model, which was
developed by the authors, and has “true access” as the driving value. As illustrated in Figure 3-1 ,
the model has true access at its core, and eight surrounding factors that are important for health
systems to demonstrate in order to provide that true access. A solid directional arrow from the
factor to the core depicts a system that has demonstrated evidence to support that it is providing
true access. A broken directional arrow from the core to the factor suggests the system is not
providing true access, and much work must be done to achieve it. Table 3-1 (a format for assessing
true access) provides a template for learners to formulate their own opinions about the extent to
which countries discussed in this text provide true access. Table 7 in Chapter 16 , The Eight Factor
Model for True Access, summarizes author observations regarding the extent to which each of the
11 countries discussed in the “Health Care in Industrialized (Developed) Countries and “Health
Care in Developing Countries” sections of this text have addressed true access. This will hopefully
enable the learner to briefly review it against the Eight Factor Model illustrated in Figure 3-1 . Table
7, The Eight Factor Model for True Access, which appears at the end of Chapter 16 (Comparative
health perspectives) should be fully reviewed as the l ...
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How to convince key decisionmakers to integrate health literacy
1. Convincing Key Decisionmakers to
Integrate Health Literacy
Professor Chris Trudeau, JD
Professor of Law, Western Michigan University -
Thomas M. Cooley Law School
Swimming with
the Sharks:
2. Start by showing the
importance of health literacy
(even if you think they already know
it)
3. An example of a session agenda I’ve used
To underscore the
importance of HL
To provide some
actionable steps
To make the business &
regulatory case for
integrating HL
4. Which of the following is the best
predictor of an individual’s health status?
a. Age
b. Income
c. Race/ethnicity
d. Education Level
e. Literacy Skills
75% of patients who reported being in
poor health also tested in the below-basic
HL category
Source:Weiss BD. Health Literacy: A Manual for Clinicians.American Medical Association /
American MedicalAssociation Foundation, 2003. p. 7.
5.
6.
7. Source: U.S. Department of Education, Institute of Education Sciences
2003 National Assessment of Adult Literacy
8. Scary data we all need to know
In one of the largest studies conducted on health literacy,
researchers using patients from two public hospitals found
that:
Source: http://www.ncbi.nlm.nih.gov/pubmed/7474271
9. Show them videos – they act like a
hammer to drive in your points
Source: AMA Health LiteracyVideo (ShortVersion)
https://www.youtube.com/watch?v=ubPkdpGHWAQ
AMA Health Literacy Video (short version):
This is bad enough Youtube video:
https://www.youtube.com/watch?v=R3tJ-MXqPmk
11. Think of some avoidable problems in health settings
Hospital readmissions
Insurance issues
Low adherence rates
Medical errors Patient dissatisfaction
Low health literacy & poor organizational
communication are key factors in all of these.
Source: National Action Plan for the Improvement of Health Literacy:
https://health.gov/communication/initiatives/health-literacy-action-plan.asp
12. Use the Org’s Strategic Goals to Make Your Case
(Here are some I’ve used)
1. Optimal Health
Reduce unnecessary variation in care through the
development of patient-centered, value-based
pathways.
2. Exceptional Experience
Provide consumer-centric and patient-centric access to
services and care.
Deliver personalized, integrated, and equitable health
care that meets and anticipates the needs of individual
members of our diverse community.
3. Organizational Vitality – integrating health literacy
will help you save money and meet your financial
goals.
13. Integrating health literacy will help with your care-
improvement goals
Patient Safety: Research has shown that using health-literate practices
“during medication reconciliation with patients helps reduce
medication errors and increase adherence.”
Patient-centered care: “Making sure patients understand their
options and involving them in decision-making helps ensure they get
the care they need and want. Understanding patients’ lifestyles is
important to making self-care information usable and helping them set
personal action plans.”
Health equity: “Clear communication is key to efforts to eliminate
health disparities and build cultural and linguistic competence. This
includes understanding and responding to cultural and language
differences through interpretation and translation services.”
Source: Building Health-Literate Organizations (Unity Health):
https://www.unitypoint.org/filesimages/Literacy/Health%20Literacy%20Guidebook.pdf
14. Happy Patients, Healthy Margins (Accenture study)
https://www.accenture.com/t20151003T033201__w__/us-en/_acnmedia/Accenture/Conversion-
Assets/DotCom/Documents/Global/PDF/Industries_17/Accenture-Happy-Patients-Healthy-Margins.pdf
“A superior customer experience
doesn’t just strengthen patient
engagement — it also correlates to 50
percent higher hospital margins.”
“[A] hospital system earning $2B in revenue would have to
cut 460 jobs (assuming a loaded salary of $100K) to
achieve the same 2.3 percent margin benefit that
improving the consumer experience might bring through
revenue growth.”
15. The SCAN Foundation Report on Patient-
Centered Care (June 2016)
http://www.thescanfoundation.org/person-centered-care-todays-health-care-
environment-business-case-stronger-ever-issue-brief
“For the person receiving care, PCC results in a greater sense of
empowerment, a focus on wellness and quality of life, and a better
care experience. There is also evidence that it improves the job
satisfaction of health care providers, who enjoy connecting
meaningfully with patients and working as a team.”
“[For older adults], Medicare pays the hospital a certain amount for
a hospitalization based on the person’s diagnosis, regardless of
length of stay. . . . [W]hen the PCC program shortens stays, the
hospital receives the same compensation but has lower costs and it
realizes a return on its investment in PCC.”
16. Los Angeles County – revised documents & phone messages;
conducted training on clear communication
o 30% reduction in customer assistance calls
Cleveland Clinic – revised billing statements back in the 90s
o 80% increase in patient payments because they knew where
to pay, how to pay, when to pay, etc.
Veteran’s Benefits Administration – revised beneficiary letter
o Saved $4,430,000 by improving response rate from 43% to
65%.
Health-literate communications will also help
you save money in other ways
Joe Kimble, Writing for Dollars; Writing to Please
17. Laws, regulations, & accrediting
standards encourage integrating
health literacy
18. HHS, CDC, and FDA care about improving
health literacy:
“Engage individuals and families as
partners in their care by incorporating
patient and caregiver preferences;
using clear and productive
communication strategies; improving
the experience of care for patients,
caregivers, and families; integrating
health literacy principles; and
promoting patient self-
management.”
Strategic Goal #1 from HHS’s
2011-2015 Strategic Plan:
19. The MACRA Final Rule Provides Incentive Payments for…
“Improvement activities . . . that support broad aims
within healthcare delivery, including care
coordination, beneficiary engagement, population
management, and health equity.”
https://qpp.cms.gov/docs/QPP_Executive_Summary_of_Final_Rule.pdf
One of the specific initial improvement goals in the final
rule is to “[e]ngage patients, family and caregivers in
developing a plan of care and prioritizing their goals for
action, documented in the CEHRT.”
See Table 8, p 786 of the Final Rule for MACRA https://qpp.cms.gov/docs/CMS-5517-FC.pdf
20. CMS’s Conditions of Participation (tag C-0320) says
this about patient understanding of consent:
“Informed consent requires
that a patient have a full
understanding of that to
which he or she has
consented. An authorization
from a patient who does not
understand what he/she is
consenting to is not
informed consent.”
Ctr. for Medicare & Medicaid Serv., State Operations
Manual, Appendix W, at C-0320 (2015).
21. 4 of the top 10 reasons
for malpractice:
o No informed consent
o No informed refusal
o Communication problems
o Weak patient education
The liability risk of poor health communication
“The Top 10 Reasons Physicians are Sued for Malpractice” ProAssurance Corp
22. “Informed consent forms that
are written by lawyers for
lawyers do not increase the
knowledge of those who, with
their signature, are committing
to allow the performance of
treatments and procedures
that may be associated with
significant risks. The typical
informed consent form is
unreadable for any level of
reader.”
The Joint Commission cares about clear communication
THE JOINT COMM’N, WHAT DID THE DOCTOR SAY? IMPROVING HEALTH LITERACY
TO PROTECT PATIENT SAFETY, p. 34 (2007).
23. • The Final Rule on Section 1557 of the ACA (discussing non-
discrimination) requires health providers to provide language
assistance for those with low English proficiency, nearly all of
whom have low health literacy.
81 F.R. 31375, 31390-91 (May 18, 2016).
• The CARE Act, which the AARP has been helping to pass in
numerous states, requires that caregivers be explained
options in “non-technical language.” For example, Michigan’s
CARE Act specifically states that
“training or instructions provided to a designated caregiver shall
be provided in nontechnical language, [and] in a culturally
competent manner . . . .”
Mich. Comp. Laws Ann § 333.26289 (2016).
Provisions mandating clear patient communication are
increasingly becoming a feature of healthcare regulations
24. The Delaware CARE Act has some great language for HL
purposes – check to see if your state has passed it.
http://legis.delaware.gov/LIS/lis148.nsf/48224c9dab6a374a852568f70050ed2c/26a56bc4813cebb78
5257f9d00530eb3?OpenDocument
26. Be sure to bring up this resource to raise awareness
27. But how does this relate to my
specific division?
(Be sure to answer this question
before they ask it. They are thinking
it.)
28. Trudeau’s Three Stages of Integration
System-based
changes
Implementation
Outcome
measurement
These stages apply to integration with pilot projects,
within divisions, and at an organizational level.
29. Give them some key tips
(action steps) to get them
started on the path
30. Use clear communication strategies with everyone.
Treat everyone as though they have low health
literacy. You can’t tell by looking.
Action #1: Universal precautions for health communication
31. Action step #2: Create (or use) a Patient Advisory
Council to help integrate health literacy
Use the PAC to conduct a HL/Clear Communication
Assessment of your existing practices – the PAC is your
home-grown focus group, so use them.
A sub-group of this task force should review all widely
used patient-facing material – they can be used to user
test and as independent reviewers.
Members will need to be trained on HL & PCC, but it will
allow you a chance to design an organizational process to
vet all material and gain input for patient-centered
decisions.
32. Action Step #3: Integrate health literacy into the
CANDOR System
• A patient-centered
approach to handling
adverse events.
• Also reduces litigation
costs for adverse
events
• Developed at the Univ
of Mich, who helped
develop AHRQ toolkit
Communication and Optimal Resolution
(CANDOR) process
http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-
resources/resources/candor/introduction.html
33. Redesign your consent processes to facilitate
patient understanding – outline and predict all
interactions patients will have.
Design the consent forms (and all written material)
to be easily understood by those with low HL –
shoot for the 5th or 6th grade reading level.
Design the complaint resolution process to be easy
to follow – it shouldn’t be a procedural nightmare
for patients.
But to implement CANDOR effectively, HL is a must
34. Anyone who has any patient contact whatsoever
should be trained to use teachback (and, generally,
to be empathetic).
Integrate measurement and feedback regarding
teachback into evaluations – for those who routinely
see patients.
Action Step #4: Train EVERYONE to use teachback
http://www.teachbacktraining.org/
35. Action step # 5: Consider HL when working with any
process or vendor that is “patient facing”
36. Still skeptical? Then develop & measure
pilot projects that relate to your goals
System-wide integration should be the goal. But using
AHRQ’s Project Red Toolkit (Re-Engineered Discharge) to
help develop and measure a pilot project in the acute
service line would be a good start.
Want to reducing hospital readmissions?
Want to improve adherence rates?
Design a pilot project that targets a specialty or patient pop.
(1) Train providers & staff to use teach back when dealing
with patients.
(2) Include a patient-education program to increase HL
levels for patients using these specialty services.
(3) Measure the outcomes along the way.
37. Then sum it up for them
so they can remember
some of the key points
38. The case for health lit:
Better health outcomes
Better patient satisfaction
& higher “ratings”
Lower risk of litigation
Better compliance with
laws and regulations
Steps to implement:
System-based changes
Effective implementation
Outcome measurement
39. What
questions do
you have?
s
Bailey E. 86511132566. [Creative Commons]. Startup Stock Photos. http://startupstockphotos.com/post/86511132566/download
39
Editor's Notes
Thank you for having me. This could be the first of these type of talks ever given to such a varied, diverse group of decisionmakers. It’s a testament to your vision and commitment to patient-centered care.
You can vary how much time you take on this section based on the audience’s suspected knowledge of HL. Maybe even show the video.
The key here is to do all three of these things. Remember, this is an advocacy session. You need to lay the foundation and give some calls to action.
Onto the next section…
For optimal health: Health literacy research demonstrates that improved understanding leads to improved outcomes for chronic diseases.
For Exceptional Experience: Patient-centered care isn’t really patient centered if patients can’t act on the information we give to them to improve their health.
For organizational vitality: Creating a HL organization will not only improve health outcomes, but it will help streamline your organizational processes, which will reduce waste and increase value-based payments and improve margins.
Onto the next section…
[Click 4x]
Onto the next section…
Self-Reflection Question: How does my division relate to the patient experience at my health system?
Answer: Anything from the way we speak patients, to the signs they read, to access tools we provide is related to health literacy. So if you influence that process, then HL relates to your department and you should consider how to integrate HL into those processes.
Onto the next section…
So how do you tell if someone you’re treating has low health literacy? The beauty of it is you don’t have to. One of the hallmarks of health literacy best practices is applying universal precautions in your health communications.
Why? We know that everyone is at risk for misunderstanding. How many of you know about Universal Precautions for Clinical Care?
Universal Precautions for clinical care were implemented when medical professionals realized they couldn’t look at someone and tell whether they had an infectious disease. They started using certain safety precautions with everyone with the goal to reduce risk and control infection rates, such as:
Hand washing
Using gowns, gloves, and masks
Handling needles safely
Cleaning the environment and tools
Similarly, health literacy professionals have realized that they can’t look at someone and tell whether they are at risk for misunderstanding the information they receive, so the goal is to communicate in ways everyone can understand. Studies show that even those who can read at higher levels, or have more knowledge of health, still prefer simple health information.