Essay Sample on Value-Based Nursing Care

Introduction

Value-based healthcare is a nursing care delivery model in which hospitals and healthcare providers' payment depends on patient health outcomes. It is different from a capitated or fee-for-service approach, where providers rely on the number of healthcare services they offer. It is a model that focuses on quality rather than the volume of the services provided (Jain, 2019). This essay will discuss value-based healthcare delivery and also develop a strategic action plan for its implementation.

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Elements of a Value-Based Healthcare

The elements of a value-based healthcare framework include the creation of integrated practice units. Such involves planning the healthcare system to address the patients' medical conditions .g. knee and hip complications (Jain, 2019). The idea is that if healthcare givers looked at the patients' health over the full care pathway and not at isolated remedies, they would be able to deal with the complexity of the patients' needs. They would also develop models, improve the quality of care, use multi-disciplinary services, and have a more integrated focus (Martin et al., 2018). In Canada, for example, this concept is already in place, with Strategic Clinical Networks (SCNs) addressing such medical conditions.

Another element is the measuring of the cost. Costs are usually involved and go beyond the acquisition price. This method's departure from the standard one is its emphasis on value representing patient care expenses. It should also mean the full life cycle of the condition, and all the initial and ongoing resources should go beyond just the price tag on a solution or technology. There is, therefore, a need to focus more on value than price when selecting solutions and technology for healthcare (Martin et al., 2018).

Outcome measurement is another element in healthcare that looks ate the quality care and patient outcomes. It is not easy today to gauge the effect of the medical care on a patient, whether in the short or long term, or even an outcome to a specific intervention. It is also not common to fully consider related morbidities, inter-related conditions, or a patient's view of a particular situation. According to Harvard theory, medical issues reflect how patients think about their medical condition (Martin et al., 2018). A patient with diabetes, for example, has a medical condition that includes co-existing renal, retinal, and hypertensive illnesses. Hence if diabetes is treated, all the other medical needs get cared for as well. There is also the element of full patient care.

Given that value is looked at in terms of improved patient results at a lower cost, the health system should adopt such a method when compensating healthcare providers (Martin et al., 2018). Most healthcare systems pay clinicians on a fee for service, carry out reimbursements depending on specific codes and schedules for particular treatments. The value-based healthcare model requires that alternate payment models should need an amendment to allocate funds according to a total cycle of care needed by a medical condition. Such an arrangement would see the HCPs more incentivized to offer quality healthcare and increased value for the patients (Martin et al., 2018).

System integration is a concept suggesting that to focus more on the patients' needs, the volume of treatment based on medical conditions should be enhanced, and on-acute care moved out of heavily resourced health centers. The result would be an improved outcome of the hospital facilities, and costs reduced. Developing centers of excellence to handle acute illnesses and giving more funding to community resources would see an improved value for all parties concerned like service providers, taxpayers, government, and patients (Martin et al., 2018).

Geographic expansion stipulates that the top clinicians' expertise and skills should leverage across broader geographic areas. The centers of excellence and integration of the health care systems and the expertise's reach ought to expand. Such is possible if affiliations and better pathways exist to aid in the sharing and to improve the patient experience (Martin et al., 2018). Lastly, the use of IT should be robust and consistent to help measure and report the outcomes. The initiative is vital to ensure better delivery of healthcare. There is currently inconsistency in collecting data, expense tracking, and case costing, making benchmarking complication improvements and outcome measurement (Martin et al., 2018).

The value-based care benefits the patient by replacing the usually fractured system that subjects patients to a plethora of unnecessary and costly procedures and tests. Reimbursements in value-based care are determined by data that shows best practices for increasing the possibility of patients' recovery from or living with their conditions. The other benefit is that healthcare givers get compensated for conducting coordinated services that are comprehensive and beneficial. Generally, value-based care is all about cost-cutting and the provision of first-rate care (Martin et al., 2018).

This model would benefit health organizations where it is implemented. The value obtained from health care is measured by the improvement in a patient's health compared to the cost involved in achieving the same. The objective of transforming a healthcare system's values is to see patients get more value for the money they spend. Usually, money value is visible when a patient's health improves, but a description of value-based health care should not only focus solely on cost reduction. The latter is essential but not exclusively enough (Teisberg et al., 2020). According to Whitten (2020), if cost reduction were the only element of value-based health care, compassion, and pain killers would suffice

Value-based health care is usually conflated with quality, a vague concept meaning a myriad of virtues. In healthcare, it does include inputs and process compliance (Teisberg et al., 2020). Even among healthcare providers, efforts to improve quality may not yield appropriate patients' health outcomes even under similar processes; various teams may produce varying results. Besides, the need to track and report on the process compliance may distract the health organizations and caregivers from the primary goal of improving health outcomes. The care for diabetes in Italy is a perfect example of process compliance that has not yielded better results. Health care providers should offer services that are consistent with the scientific method and follow evidenced-based care procedures. They should not just go for products but better health results, which is purely patient-based (Teisberg et al., 2020).

Nurse as Manager of the Healing Environment

Healthcare environments can either create negative feelings or induce positive feelings among patients. A nurse as a manager understands how the various environmental designs can reduce staff and patient stress and anxiety. The patient care unit supports both staff and patients to provide an environment of healing and care (Englebright & Jackson, 2017). With the transitioning of healthcare to a value-based system, the Electronic Health Record (EHR) and other health IT platforms will be essential in demonstrating the contribution nurses have made in achieving that value (Whitten, 2020).

It will also be essential in highlighting nurses' contribution to improving patients and population health outcomes, client safety, efficiency in operation, and clinical effectiveness. Unfortunately, today one may not establish the contributions nurses have made in ensuring an environment conducive to healing patients in the healthcare facilities or even under home care (Englebright & Jackson, 2017). For many years, leaders have agitated for a unique nurse identifier to help identify and improve nursing practice. Nurses and their employers, such as hospitals, physicians, and health systems, require a mechanism for tracking nursing licensure in terms of the job description and geographical location throughout a nurse's career (Englebright & Jackson, 2017).

The same is needed for coding and billing reasons. There is a need to for health systems and hospitals to identify nurses in the Electronic Health Record (HER) and the Enterprise Resource Planning (ERP) systems, among other health IT systems, to ensure education, documentation, training, and research purposes (Mello et al., 2018). The standardization of individual nurses' data has not materialized, a fact attributed to concerns about economic, political, and competitive risks to organizations (Mello et al., 2018). Without this sharing mechanism to reveal the care and caregiver's recipient, care coordination and quality measurement remain unattainable among all organizations. Being the healthcare's most trusted staff, nurses can lead to information sharing by adopting a unique nurse identifier system to document specific individual health and care processes (Englebright & Jackson, 2017).

Strategies to Implement Value-Based Healthcare

Most strategies link value-based care to patient satisfaction, quality improvement, and cost reduction. These, however, are not the same as a value whose role is to improve a patient's health outcomes. A good strategy should identify and understand a section of patients with related health issues with a consistent set of needs (Teisberg et al., 2020). The critical stakeholder here should be an interdisciplinary team of care providers who come together to create and deliver appropriate solutions to address those needs. Such a unit measures health results and costs per patient and employs the same to advance the necessary improvements (Teisberg et al., 2020).

The second strategy is integrating learning teams, derived from an array of many professionals that not necessarily medical disciplines. Such team integrates services while reducing or altogether eliminating the work of coordinators. The team is well engaged to ensure efficient and effective healthcare service provision (Teisberg et al., 2020). The main agenda in this strategy is to personalize and improve healthcare. Also, the joint learning initiative to ensure health care results improve with experience. The team should go beyond traditional geographical boundaries to reach remote clinicians to allow world-class care to get to the patients in their locations, rather than traveling to get the essential services (Teisberg et al., 2020).

References

Englebright, J., & Jackson, E. (2017). Wrestling with Big Data: How Nurse Leaders Can Engage. In Big Data-Enabled Nursing (pp. 115-137). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-319-53300-1_7

Jain, S., Thorpe, K. E., Hockenberry, J. M., & Saltman, R. B. (2019). Strategies for Delivering Value-Based Care: Do Care Management Practices Improve Hospital Performance? Journal of Healthcare Management, 64(6), 430-444. https://journals.lww.com/jhmonline/Abstract/2019/12000/Strategies_for_Delivering_Value_Based_Care__Do.13.aspx

Martin, D., Miller, A. P., Quesnel-Vallée, A., Caron, N. R., Vissandjée, B., & Marchildon, G. P. (2018). Canada's universal health-care system: achieving its potential. The Lancet, 391(10131), 1718-1735. https://cdn.ymaws.com/medec.site-ym.com/resource/resmgr/Value_Based_Healthcare__-_Qu.pdf

Mello, M. M., ADLERMILSTEIN, J. U. L. I. A., Ding, K. L., & Savage, L. (2018). Legal barriers to the growth of health information exchange—boulders or pebbles? The Milbank Quarterly, 96(1), 110-143. https://onlinelibrary.wiley.com/doi/pdf/10.1111/1468-0009.12313?casa_token=h5cfdlriZBkAAAAA:-KEEjrVd2Im_MZGR69j5nru06eRpsOPoF_-YOy3xnHfb0H9O1EplWT-3LATrE2f9ZlR1yzcQjNjdLx1Ck