How do hospitals ensure they are meeting the needs of vulnerable populations within the communities that they serve?
Learning Materials: Nickitas, D. M., Middaugh, D. J., & Feeg, V. D. (2019). Policy and politics for nurses and other health professions: Advocacy and action. (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers. Read Chapters 13 & 14. Additional Resources: Lin, Y.-L., Du, Y., Gomez, C., & Ortiz, J. (2018). Does patient-centered medical home Recognition Relate to Accountable Care Organization Participation? Population Health Management, 21(3), 188–195. Ryan, A. M., Shortell, S. M., Ramsay, P. P., & Casalino, L. P. (2015). Salary and quality compensation for physician practices participating in accountable care organizations. Annals of Family Medicine, 13(4), 321–324. Weeks, W. B., Gregg, J., Fisher, E. S., & Weinstein, J. N. (2015). Accelerating uptake of new Medicare payment models. Hfm (Healthcare Financial Management), 69(4), 104–105. Discussion Question: How do hospitals ensure they are meeting the needs of vulnerable populations within the communities that they serve? What factors should be considered to ensure that nurses working in acute care settings meet the six Institute of Medicine’s (IOM) Aims for Improving Healthcare Quality? Below I listed my experience with this discussion and provided examples of SAFETY, EFFECTIVE, PATIENT CENTERD, Timely, EFFICIENT, and EQUITABLE. I work in an outpatient chemotherapy unit at a VA hospital. We meet safety, by double verification with chemotherapy done at the patients chairside. Per unit policy, two nurses always verify the five rights at the chair side. The patient will read back their last four of their social security number with first and last name. In return the nurse administering will read out the drug, patients name, route, and dose. Effective: chemotherapy given will is based on body surface area (BSA) height and weight. Also takes into consideration a patient’s kidney and liver functions (CBC and chemistry labs) Patient-centered: Interdisciplinary team meet weekly and discuss cases, e.g., concerns, support system, psychosocial, IV access (does the patient need a mediport or a PICC?) and compliance. Timely: the outpatient unit sees between 20-35 patients per day. We base the time in the chair based on the regimen and this can vary from 15 minutes to seven hours. Reducing waits and sometimes harmful delays for both those who receive and those who give care. Efficient: Although patients are screened prior to the day of treatment some patients present with issues such as fever, open wounds or abnormal labs and therefore unable to administer chemotherapy. Unfortunately, the medication is prepared the morning of treatment and its wasted. Equitable: There are different healthcare enrollment plans at the VA. Some have no out of pocket costs and some pay a small copayments.