Value-based Care; An Organizational Shift from Volume to Value-based Care

2803 words (11 pages) Nursing Essay

28th May 2020 Nursing Essay Reference this

Tags: healthcare

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Introduction

To provide general information that would support why the shift from volume to value-based care is more effective and efficient. It will also reflect on how value-based care can be cost-effective as well as improve the quality services provided.

Proposal/thesis statement

There is a need for healthcare institutions to shift operational basis to other modules that translate to better patient care and disease management outcomes. The standards of operation should agree with the Healthcare Act and put more emphasis on the value of patient care and not the number of patients seen at any given point in time. There is a need to have healthcare institutions shift from volume to value-based care.

Healthcare Administrative, Overview of the Problem

Most healthcare organizations public or privately owned operate on a business module that translates to the need to incur profits in order to sustain operations. The need to make profits by extension forces the healthcare organizations to adopt a module of service delivery that is volume based and not value based (Cleven et al., 2016). The more patients a given doctor or hospital institution sees, the more profits made. Research studies have shown that increased emphasis on patient numbers instead of the quality of care results in sub-optimal service delivery and with prolonged hospital stay (Hata et al., 2016). An increased number of patients compared to the number of physician’s available results in physician burn out with an eventual result of reduced productivity and medical errors (West et al., 2016). The lack of quality care as a result of increased emphasis on the patient number as opposed to the quality of care can be addressed from a managerial or administrative standpoint through the formulation of regulatory policies that will focus on the quality of care.

The project is mainly aimed at trying to find out the advantages that will be realized in the vent that healthcare institution shifts from volume to value-based care. This project seeks to establish new information about this shift and suggest possible reasons why it should be adopted as a common practice.

Personal /Professional Research

It is expected that this project will bring out the negative impact of volume-based care to value-based care. The results from the project should be able to influence policy makers and hospital administrators to consider the shift to a value-based care model given the various advantages it promises to both the patients and the human resource.

Project Research

The actual study will be carried out through a literature search in various online databases. The study will only take into account credible and reliable articles and peer-reviewed journals. The study will make use of search engines and keywords to find relevant research work that can be used for the study.

HCA Topics- Healthcare Quality

Personnel

Healthcare quality is determined by the number and competence of the personnel. A highly trained and competent healthcare worker that meets the demand of the population is effective in promoting quality in the provision of healthcare services. Further, they should be enough for a given catchment area; hence the reason for WHO recommendation a physician population ratio (Prakash, 2019).

Equipment and Materials

Healthcare thrives on medical technology seen in the type of equipment used in patient management. Good quality of healthcare is brought by the adoption of the best equipment and technology in the treatment of patients. However, such equipment is often significantly costly to acquire and maintain.

HCA Topic -Strategic Planning

Human Resource Planning

Human resource planning, in this case, entails the determination of population that forms the catchment area and using the WHO doctor-population ration to find out the required number of healthcare workers needed. Planning in this case, therefore, heavily relies on demographic findings of an area.

Planning for Equipment and Materials

The process of strategic planning for this case requires the determination of the desired equipment and materials for the healthcare sector. The materials herein include drugs as well as supplies such as syringes, cotton, gloves, and other accessories. The strategy of achieving the equipment and materials would involve soliciting for funds from the relevant sources such as the government, private developers as well as donors. The expected period of acquiring the desired equipment and materials is documented.

Leadership Traits- Skill

There are certain important leadership skills important in resolving evidence-based solutions considered herein. The first one is communication skills in which the leader portrays the ability to promote top-down, bottom-up, and horizontal communication (Hudak, Russell, Fung & Rosenkrans, 2015). Communication skills will enhance employee leadership. Another skill which of utmost importance, in this case, is listening and learning because effective leaders need to listen to the problem and learn from others as well as the environment to understand the best ways for resolution (Hudak, Russell, Fung & Rosenkrans, 2015). Flexibility is another skill required because research has shown that healthcare is one of the most dynamic fields because of the ever-changing information that is derived from research as well as technological advancement (Hudak, Russell, Fung & Rosenkrans, 2015). There are several cases whereby a solution becomes obsolete hence requires an individual who is flexible to adapt to the new changes. Flexibility, in this case, is characterized by the ability to embrace new information and to adopt evidence-based outcome in real practice.

Planning skill is essential for a healthcare leader in the resolution or implementation of any solution (Shaw, Wong, Griffin, Robertson & Bhatia, 2017). Planning skills enables the leadership to consider all the possible factors, both seeable and unforeseen before taking action (Shaw, Wong, Griffin, Robertson & Bhatia, 2017). In this case, there is a need to know the consequences of the proposed evidence-based solution and sorting them first before finalizing the resolution process. This skill also requires the leader to be visionary so that effective and productive planning is conducted to ensure the vision of the organization is attained. Creativity skills are highly critical for this case because it should be borne in mind that resources are often limited in any setting (Sözbilir, 2018). Such a situation requires leadership that is greatly resourceful to help achieve the desired goals. Creative leadership in this scenario will strive to look for alternative ways of resolving an issue with the most beneficial outcome out of the many possible options.

Decision-making skills cannot be underestimated as essential leadership skills in any situation or problem. Important steps for an organization or at an individual level are carried out after good decision making (Szymaniec-Mlicka, 2017). A good choice to pursue comes from good decision-making skills, which has certain critical components. They include careful consideration of circumstances, the definition of the question and the objective, brainstorming, organizing ideas, seeking opinions and feedback, evaluating the options, and making a choice (Szymaniec-Mlicka, 2017). The final components are taking action and evaluating the decision made.

Healthcare is a high-risk industry, and for that reason, there is a need for composure. It should be noted that an action that a healthcare worker takes directly affects a patients’ wellbeing and subsequently their lives. Further, the environment is often a stressful one, coupled with the problem of employee burnout. It for this reason that a good leader should have composure and avoid causing additional stress to members of the healthcare team as well as to patients.

Skills in participative management are also required in the resolution of evidence-based solution regarded in this paper. It requires that leaders employ more than one style of management and that there is a need to include every stakeholder concerned in the running of the healthcare organization (Okpala, 2018). Leaders with these skills will encourage employees to share ideas and perspectives regarding the action that is to be taken. They might have crucial information that may change the course of events for the better.

Knowledge

Knowledge in leadership is also essential for this resolution of the evidence-based solutions. There are seven elements of knowledge leadership that are considered herein, such as the context in the sense that it incorporates the performance metrics. Knowledge leadership is a matter of context because organizations are composed of self-managing knowledge workers. The second element that is necessary as regards to knowledge is competence in which leadership needs to portray the highest level of competence in the application of the solutions obtained from the evidence-based process.

Knowledge in leadership also needs to incorporate culture. Both the organizational culture, as well as the cultural background of every member should be paid attention to ensure that the best approach is employed in the resolution process (Ghasabeh & Provitera, 2018). It is related to the fourth element, which stipulates that knowledge in leadership should be a matter of communities. In this case, convergence is advisable if certain disciplines have common goals. Other aspects of knowledge that are useful for leadership include conversation, communication, and coaching (Ghasabeh & Provitera, 2018).

Leadership needs to have an in-depth and vast knowledge regarding healthcare systems because it puts it at a better place in making resolutions affecting the sector. It is also important that the leadership acquires good knowledge on the management of resources since it is critical in implementing almost all evidence-based solutions (Ghasabeh & Provitera, 2018). The reason for such is because the resolution, in this case, is a management issue; hence, leaders involved in the exercise need to have experience in managing healthcare system. The knowledge that is necessary for this case also includes human resource and technology. Moreover, good background and knowledge in research are essential for healthcare leaders.

Organizational Excellence: Resolve

The organizational excellence in resolving the solution considered herein takes into consideration six effective steps. First, as regards to information, there is well-developed decision support. Such a phase enhances the decision-process in all the levels of management. The second step is that of the organizational structure that is characterized by the effective distribution of roles and responsibilities to all the parties involved. This step of organizational excellence will ensure that the highest productivity is attained in each functional area. The third phase concerns the people whereby all the required human capital needs to be obtained to implement the proposed solution. It should be noted that the actual work of resolution or implementation of any solution is carried out by people who should, therefore, possess the required skills and knowledge for the job.

Resolution of the solutions from the evidence-based process also requires compensation and incentives. The leadership has the mandate of ensuring that there is a proper and functional reward system that allows for action plans to be executed. The next step of attaining organizational excellence, in this case, is through learning systems characterized by knowledge acquisition and training. Proper training of the personnel is undertaken so that they can carry out the healthcare tasks that require high levels of skills, knowledge, and competence. The final phase of realizing organizational excellence regards work processes whereby the leadership considers the interaction and linkage of workflows to ensure that the solution is carried to completion.

Proposed Evidence-Based Solutions

The proposed evidence-based solutions considered herein are the adoption of evidence-based practice in the healthcare system, utilization of recommended technology for optimal outcome and instituting an appropriate size of the workforce. The other solutions for improving healthcare quality are increasing resource allocation and ensuring that wastefulness is minimized since there is a scarcity of resources and healthcare sector is an expensive one to run effectively to achieve the desired goals.

Potential obstacles and challenges

As with any research, there are potential challenges and barriers that are unforeseen and always present during the project. Such kind of obstacles ends up threatening the credibility and validity of the research findings, thus making this an important point to note prior to the start of the research project. Among the potential challenges include the lack of relevant data on the research question. This will make it very difficult to do a detailed literature review and consequently, by extension, impact on the discussion of the study findings. The resources that will be explored in order to find relevant data on the topic include the use of online scientific databases such as NIH, AMA and google scholars.

Strategic Analysis/Risk Management

Reputation damage: Given that the research will be focusing on various organizations and their modes of operations, there is a possibility of publication of negative information that would taint the image of the respective organizations. This will be mitigated by ensuring that the research adheres to the objectives and not any other information.

Conclusion/Objectives

The project is aimed at establishing the advantages of a shift from volume to value-based care in the delivery of healthcare services. This project seeks to establish new information about this shift and suggest possible reasons why it should be adopted/implemented as a common practice.

References

  • Cleven, A., Mettler, T., Rohner, P., & Winter, R. (2016). Healthcare quality innovation and performance through process orientation: Evidence from general hospitals in Switzerland. Technological Forecasting and Social Change, 113, 386-395.
  • Ghasabeh, M., & Provitera, M. (2018). Transformational Leadership and Knowledge Management: Analysing Knowledge Management Models. Journal Of Values-Based Leadership, 11(1), 8.
  • Hata, T., Motoi, F., Ishida, M., Naitoh, T., Katayose, Y., Egawa, S., &Unno, M. (2016). Effect of hospital volume on surgical outcomes after pancreaticoduodenectomy. Annals of surgery, 263(4), 664-672.
  • Hudak, R., Russell, R., Fung, M., & Rosenkrans, W. (2015). Federal Health Care Leadership Skills Required in the 21st Century. Journal Of Leadership Studies, 9(3), 8-22.
  • Okpala, P. (2018). Innovative Leadership Initiatives to Reduce the Cost of Healthcare. Journal Of Healthcare Management, 63(5), 313-321.
  • Prakash, S. (2019). Medical education in India: Looking beyond doctor: Population ratio. Journal Of Family Medicine And Primary Care, 8(3), 1290.
  • Shaw, J., Wong, I., Griffin, B., Robertson, M., & Bhatia, R. (2017). Principles for Health System Capacity Planning: Insights for Healthcare Leaders. Healthcare Quarterly, 19(4), 17-22.
  • Sözbilir, F. (2018). The interaction between social capital, creativity, and efficiency in organizations. Thinking Skills And Creativity, 27(1), 92-100.
  • Szymaniec-Mlicka, K. (2017). The decision-making process in public healthcare entities – identification of the decision-making process type. Management, 21(1), 191-204.
  • West, C. P., Dyrbye, L. N., Erwin, P. J., &Shanafelt, T. D. (2016). Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet, 388(10057), 2272-2281.

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