Application of Healthcare Business and Financial Management Principles

Application of Healthcare Business and Financial Management Principles

The current trend in the United States’ healthcare system is payment for Value or performances and not solely on service quantity. Chee et al. (2016) illustrate that the centre of Medicare and Medicaid Services (CMS) has introduced a new system for rewarding hospitals, which reward acute care hospitals for quality care for Medicare beneficiaries. It is an initiative that either negatively or positively rewards hospitals based on their performance. CMS has adopted Hospital Value-Based-Purchasing (HVBP) to promote healthcare and meet the 2010 patient protection act (Chee et al., 2016). HVBP reward hospital based on the following factors, observance of best clinical practices, quality care and facilitating excellent patient experience, Value-Based purchasing likewise reward hospitals based on measures of patient safety,

clinical care, patient care experience,

HAI, process, mortality, efficiency, and mortality and complications. Hospitals are rewarded if there is an improvement in those mentioned above, which is compared to the baseline period. All acute care hospitals are paid based on Value and performance, and thus John Hopkins Hospital is taking initiatives to improve the VBP program in the hospital.

Section A1:

John Hopkins Hospital is among the best hospitals in the United States. Johns Hopkins (n.d) asserts that the hospital has been ranked number three out of 4500 hospitals reviewed for the U. S. News and World Report’s 2020-21 Best Hospital Lists. It was recognized for offering specialized care with the hospital leading in 15 speciality areas. The hospital top position is also attributed to its quality care, positive patient experience, and evidence-based practices. Thus, John Hopkins Hospital has completely embraced the value-based purchasing program. Additionally, the hospital prioritizes and delivers in numerous value metrics of HVBP. It is known for being the best at speciality services, like gynaecological services, because it adopts the best clinical practices (Pronovost et al., 2016). Secondly, patients and their families report receiving excellent service and experience, where the hospital communicate effectively and show concern over consumers’ needs. Johns Hopkins (n.d) points out that compared to the national average rating of patient care quality, which is 3.5, the overall hospital quality of care rating is higher, 4. It indicates better performance by the hospital on various measures, particularly patient experience.

The hospital has likewise demonstrated great performance in the other HVBP measures, patient safety, mortality and complication, process, efficiency, and cost reductions. Its pediatric department has made a tremendous effort in increasing the survival rate of children. The pediatric unit is dedicated to offering high-quality care to children to promote good health and prevent avoidable deaths. Martinez et al. (2018) elaborate that the hospital pays close attention to three VBP domains, clinical care, mortality and complication and safety to be the best in the country. The hospital management is highly interested in financially gaining from the value-based purchasing program; it aims to gain maximum rewards and increase hospital finances. The management has spearheaded hospital projects and programs such as tech advancement to improve the organization’s performance and meet the HVBP measures. Martinez et al. (2018) agree that the hospital’s programs consider HVBP 2018-2025 criteria developed by CMS. They are focused on surpassing or at least meeting the requirements of CMS.

B1- B1a. Hospital IT Department

The IT department is one of the key hospital departments that will help the organization further adopt VBP. John Hopkins Hospital’s IT department is in charge of the patients’ health records and managing the whole hospital’s data. It facilitates communication and access to crucial information about patients among the medical practitioners of various units. The IT team will install and run a health information system (HIS) software that allows input, processing, and storing of data. The system will also protect patient sensitive information’s confidentiality and security. Therefore, the department will initiate patient safety as it will ensure the third party does not access that patient’s data. The IT department will also facilitate the availability and access of patient data promptly. This will, in turn, promote informed decision making and inter-disciplinary cooperation to offer the best medical treatment. The IT department will also processes and issues the management with information about hospital performance. It will provide a report on hospital performance compared to other hospitals, HVBP measures, and the national benchmark. This will allows strategizing on how to strengthen the hospital to meet HVBP. IT department also greatly influences patient safety, quality care, medical cost, and efficiency through patient data provision.

 

 

 

 

B2. Goal

Develop and maintain a strong and advanced ICT system for the hospital capable of accommodating an extensive database of health information in 9 months. The HIS will provide all the useful patients’ information needed with the medical team to offer treatment. The system will allow easy and timely access to information to provide quality care. The ICT system will also foster collaboration between the clinical staff, patient, and family by harmonizing information that can be understood by different users.

B3. Attaining Quality Outcomes inpatient care over the next three years.

An advanced HIS will allow the patients to access information to manage their health.

• A large database containing all health information will provide medical practitioners with useful information to provide quality care.
• Timely medical data will facilitate great medical interventions.
• The data in the HIS will help the health ministry promote public health.

Attaining Quality Outcomes in reimbursement over the next three years

• HIS will minimize errors and improve patient safety
• A well structured IT system promotes interdisciplinary sharing of information to process patients faster.

The

• ICT system will minimize waste of time and resources and increase efficiency and cut the cost.

HIS will improve patient and doctors communication promoting

• patient experience measure

B4. key Points

• The use of technology, such as computers and tablets, to access patient health records instead of paper records is easier and efficient.
• Learning and upgrading technology skills is necessary for medical staff to deliver service.
• Proper use of the health information system will promote the quality of care provided to patients.

 

B4 a. Marketing Techniques for those Key Points

• Demonstrate the thrill of learning and using technology

Identify the benefits of using ICT when treating patients like efficiency,

• accuracy, and time-saving.
• Address any concern and fears associated with using advanced HIS
• Demonstrate the financial benefits of an advanced HIS for the hospital and health provider

B6 Coordinating Informational Events

Setup the hospital’s app where staff can access information about

• the HIS
• Create an information help centre in the IT department to answers any question concerning tech
• Issue a manual on how to use the organization’s HIS
• Staff meeting to communicate about the HIS of the hospital

Coordinating Educational Events

On the job training on how to operate the

• HIS
• A short course training on ICT and technology
• Books and pamphlets on how to use HIS

 

 

 

B1- B1a. Inpatient Department

The other department that is linked with hospitals implementing more VBP is the inpatient department. Okeke et al. (2020) explain that it is the hospital unit concerned with patients hospitalized for overnight treatment or longer-term acute care. It consists of the hospital’s wards and medical team that work there. The inpatients are at the highest risk of acquiring HAI and injuries since they spend a lot of time at the hospital. As a result, inpatient department can help with meeting VBP outcome measures of patient safety and preventing HAI. If the inpatient department is dedicated to the needs of patients and providing quality care, it will deter HAI that is associated with negligence and, at the same promotes patient safety (Okeke et al., 2020). Besides, the inpatient department is the unit related to the patient’s stay and thus has a significant impact on the patient experience. Many patients judge good or bad experience depending on comfort, relationship, and service offered when admitted to the hospital. Hence, the inpatient department has massive power in promoting patient experience. This department also provides medical treatment to the patients. Thus, it can influence other HVBP measures, mortality, and complication, efficiency, and cost.

 

 

B2. Goal

The hospital to empower the inpatient department by hiring and maintaining well-trained medical staff in the next three year. It will ensure there is adequate staff that can meet patients’ clinical care needs and provides patient-centred care, where all the needs of the patients are met. The hospital will continuously train the medical staff for eight months to increase their skills in promoting patient experience, patient safety, evidence-based practices, and quality care.

B3. Attaining Quality Outcomes inpatient care over the next three years.

• Nurses will promote patient safety through measures like bedside alarm and responding to patients’ calls on time.
• Patient-centred care will promote patient satisfaction.

.

• The patient will receive evidence-based care that promotes positive health outcomes.

 

Attaining Quality Outcomes in reimbursement over the next three years

• Adequate staff in the inpatient unit will minimize HAI meeting HVBP measure.
• The patient experience will increase, promoting more value-based purchasing rewards.
• Patient safety and mortality rate reduction will improve further, resulting in more Medicare pay.

B4. key Points

• The medical staff should invest in advancing their education and practicing their skills.

Medical practitioners should develop a good relationship with patients and demonstrate empathy to gain their trust.

• Nurses working in the inpatient department are the medical staff that can promote patients’ safety and HAI reduction since they spend the most time with patients.

 

B4 a. Marketing Techniques for those Key Points

• Advancing one’s education, benefit the person the more; higher salary, increased competence, and promotions.
• Giving the best at work can be job satisfying.
• Increasing competence and providing quality care saves the patients’ lives as minor mistakes can result in loss of life.
• The hospital will offer scholarships and give promotions to medical staff that advances their education.

B6 Coordinating Informational Events

• Daily short meeting before the shift to discuss the duties of staff
• Bi-weekly and monthly meeting of the inpatient department staff on areas that need improvement
• Annual department team building events to discusses issues in the department and how to address them

Coordinating Educational Events

• On the job training on new changes and best practices
• Colleges and University partnered courses.
• Compulsory short –courses training of 3 months
• Optional online courses sponsored by the hospital

 

B1- B1a. Emergency Department

The emergency department is the other hospital unit that will further help in implementing VBP. The hospital’s emergency department receives many patients since John Hopkins Hospital is a big referral hospital that attends to serious accident injuries and emergency medical cases. Okeke et al. (2020) reveal that it is overcrowded when there is an infection outbreak, such as the current pandemic, COVID-19. It offers administration services and immediate care to patients. Therefore, most hospital patients pass through the emergency department. It is the department that has a bit of a long wait period due to high patient numbers. Therefore, it has the opportunity to improve hospital performance and meet the process measure. It also influences patient experience, patient safety, efficiency, and cost. If the emergency department can reorganize and manage the patient crowding, it can promote most HVBP measures.

 

 

B2. Goal

Mitigate the emergency department crowding by managing patients’ flow in the ED and throughout the hospital in three years. The patient flow will be regulated through improving communication and collaboration between the hospital departments and streamlining the cycle-time measurement. The ED will also invest more in medical staff, ensuring ED has adequate staff to address hospital crowding. The hospital will, too, train the ED staff on time management and efficiency at work for two years.

B3. Attaining Quality Outcomes inpatient care over the next three years.

• Reduced crowding in the ED will promote the patient experience.
• Reduced crowding will ensure the timely provision of medical care for critical conditions.
• It will minimize errors and promote quality care for patients.

Attaining Quality Outcomes in reimbursement over the next three years

• The positive patient outcome will promote patient safety needed with VBP.
• Timely provision of treatment will reduce mortality and complication.
• Efficiency in the ED will save the hospital money.
• Reduced number of patients leaving without treatment will increase Medicare payout.

B4. key Points

• The timeliness of medical interventions determines quality care and saving patients lives.
• It is essential to upgrade education to promote efficiency at work.
• All departments should collaborate to streamline flow activities and information.

 

B4 a. Marketing Techniques for those Key Points

• Compensation for staff that perform their work efficiently
• Reward for the emergency department if they reduce patient waiting time
• Demonstrate how efficiency reduce the workload
• Training on efficiency and productivity will be offered to willing employees.

B6 Coordinating Informational Events

• The monthly meeting between departments on improving collaboration
• Daily briefing for ED
• A social network for the hospital staff to share knowledge

 

Coordinating Educational Events

• Routine classes to improve skills
• On the job training
• Online classes available to all the department staff

 

Section B5:

The hospital will incorporate ethical clinical and business practices when implementing the strategic plan to promote VBP in the hospital. It will focus and observe the ethical principles of nonmaleficence and beneficence while implementing its plan. According to Gillon (2015), nonmaleficence is the nursing ethical principle that dedicates actions and decisions that cause no harm or result in the least possible harm while contributing to great outcomes. The hospital staff will be required to provide patients in the inpatient department and ED with the best evidence-based treatment and quality care that will result in the best health outcome and patient safety. They will be empowered to access timely information and collaborate with other departments to provide quality care and avoid errors that put patients’ lives at risk.

The other ethical principle that will be included in VBP strategic plan is beneficence, the act of showing kindness, care, and doing well for others. It expects medical professionals to demonstrate kindness and always do the right thing for the patients (Gillon, 2015). The hospital will train medical staff to show compassion and kindness to all patients while offering care. John Hopkins hospital will also sensitize due diligence at work to ensure they offer patients the best care that will result in good health outcomes. During nurses’ training on various skills, the medical team will also educate on the importance of benevolence. They will inform them on how to apply beneficence when striving to achieve its VBP targets, like patient safety and efficiency.

 

 

Section B7. Timeline:

Duration

Department 1

Department 2

Department 3

0 -9 months

Identify ways to

• develop the hospital HIS
• Hire tech and software experts

Assess

• medical staff gap

Evaluate

• skills and knowledge deficit in the inpatient department
• Investigate the cause of ED crowding
• Research on the strategies to address ED

10-18months

• Inform the staff of the changes in HIS

Conduct a meeting

• to discuss any concern
• Inquire from the supervisors on staffing challenges

Consult with HR on

• staffing needs
• Organize team-building event
• Call a meeting for all the involved staff
• Discuss the incentives of efficiency in the ED

19-27months

• Train various department on using technology
• Develop a manual on operating HIS
• Offer the inpatient department staff training
• Hire more staff and offer them training

Officially launch

• the online classes
• Introduce on the job training

Issue scholarship

• for advanced education

28-36moths

• Run the hospital database using the new software
• Examine the ease of access to information
• Assess the level of competence applied when treating the patient
• Examine the relationship between patients and nurses
• Evaluate efficiency among the staff

Measure the waiting time for the patient and length of the process