Healthcare Improvement:Current Understanding of System/Process (Term Paper Sample)

HOSPITAL CASE STUDY DEVELOPMENT BASED ON EFFICIENCY OF A SUCCESSFUL (LOCAL) HOSPITAL ENHANCEMENT IN A MUCH WIDER SCALE CONTEXT
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A Business Case for the Implementation of a Successful Local Healthcare Improvement on a Smaller Scale
Introduction
The health care sector has changed dramatically in recent years, making it challenging for practitioners to stay up. Organizations are seeking innovative methods to boost their bottom line while keeping expenses down (Braithwaite, 2018). It is common to need business cases to introduce new products or services. Uncover the advantages and costs of a proposed endeavour through a business case. To get hospital leadership on board with healthcare changes, provide a compelling commercial case (Lindsay et al., 2020). There are several reasons for hospitals to explore implementing healthcare innovations, even if they are on a small scale. For starters, hospitals may take smaller-scale triumphs and grow them up (Mahmudova, 2021). Moreover, hospitals may enhance patient care and save money by scaling up successful innovations (Lindsay et al., 2020). Hospitals may enhance healthcare in several ways. Lowering readmissions, boosting patient happiness, staff efficiency, and reducing medical mistakes are examples. This presentation will concentrate on lowering readmissions and, thereby, reducing costs.
Current understanding of system/process
A strong business case includes details on the background of what has already been done, data on current practices and future strategies. Moreover, it includes methods for improvement, expected benefits, required resources, risks involved with the particular healthcare improvement, historical costs for similar improvements in other organizations (if applicable), and estimates of how long it will take to implement (Hoffman et al., 2020). Hospitals must decide for themselves which forms of potential improvements they can apply. There are many ways to create a successful business case; therefore, it is crucial to identify hospital-specific limitations when submitting one. According to Zhang et al. (2020), a financially savvy solution will only do the organization well if the intended audience agrees that it will be beneficial over time.
Hospitals can improve healthcare by reducing readmissions. Readmissions are defined as the number of patients that are readmitted to hospitals after being discharged. The goal is to have no more than 20% of all patients discharged return within 30 days. Hospitals aim for this because readmissions can increase costs and cause patient complications (Montgomery et al., 2019). Readmissions, unfortunately, are a significant issue around the world healthcare system today. According to one study conducted by Dartmouth-Hitchcock Medical Centre, about 15 million adults were readmitted within 30 days of their initial hospital visit. This resulted in an estimated cost of 17 billion dollars annually (Glans et al., 2021). Similar research has shown that nearly 29% of Medicare payments are spent on patients that have been readmitted at least once (Al-Amin, 2016).
Rational and drivers for the improvement
The Hospital Readmissions Reduction Program (HRRP) helped reduce the number of readmissions by penalizing hospitals financially for high readmission rates. In October 2012, the HHS announced that over 2,200 U.S. hospitals would be receiving a penalty on their reimbursements due to excessive patient readmissions (Bingham et al., 2016). On January 1, 2015, the HRRP was replaced with the new Medicare Patient-Cantered Outcomes Research Institute (PCORI). Although PCORI and its board received some criticism from experts in healthcare improvement for not using data more readily available from CMS or other sources to guide its decisions, many experts still consider this shift an overall improvement over HRRP (Bingham et al., 2016).
One-way hospitals can reduce the number of readmissions is by using predictive modelling to identify patients at risk for readmission. Predictive modelling is a data-driven approach to forecasting future events (Khera et al., 2018). Hospitals can use this information to determine which patients are most likely to be readmitted and design interventions specifically for those patients. There are many different methods for predicting patient readmission, but one popular method is using historical data to create a risk score (Gupta and Fonarow, 2018). A risk score is a value assigned to each patient that predicts their likelihood of being readmitted within a specific period. This information can be used to target interventions at high-risk patients and ultimately reduce readmissions.
Stakeholder analysis and engagement plan
A readmission plan is a strategy that hospitals use to reduce the number of readmitted patients within 30 days of being discharged. It may be challenging to develop a business case for transferring a successful small-scale (local) healthcare improvement to a larger large-scale environment in hospitals. However, by engaging stakeholders in the design of the readmission plan, its chances for success can be improved.
Project planners should involve several key stakeholders in designing a readmission plan: hospital leadership, clinicians, care managers, case managers, and patients and their families (Gupta and Fonarow, 2018). Each group has a unique perspective on how to improve patient care and reduce readmissions. By engaging these groups in the planning process, hospitals can ensure that the readmission plan is tailored to their patients and staff (Ravn-Nielsen et al., 2018). Clinicians play a crucial role in providing care to patients and should be consulted on how best to reduce readmissions. Care managers and case managers are responsible for coordinating patient care and should develop strategies to improve communication between clinicians and patients. Patients and their families should also be included in the planning process to know what steps need to be taken to reduce their risk of being readmitted.
Stakeholder participation is vital to every healthcare improvement project. Engaging stakeholders in the readmission plan design ensures that it meets the requirements of patients and employees (Braithwaite, 2018). This will help the readmission strategy succeed and enhance patient care. The involvement of stakeholders in the readmission plan creation is crucial. Involve hospital leadership, physicians, care managers, case managers, patients, and their families to ensure the plan is personalized to their requirements. Engaging these groups should enhance communication and hence patient care. Reducing hospital readmissions requires better patient care (Gupta and Fonarow, 2018). Involve stakeholders in the construction of a readmission strategy to enhance success rates and minimize readmissions.
Risk analysis (including potential for project failure)
Using predictive modelling to identify patients at risk of readmission is one method hospitals may minimize readmissions. Predictive modelling uses data to estimate future occurrences (Glans et al., 2021). Hospitals may utilize this data to identify high-risk patients and tailor therapies to them. One prominent strategy for predicting patient readmission is utilizing past data to generate a risk score. Hospitals may utilize the risk score to predict future outcomes by reducing readmissions. One such strategy is Lean process improvement, which aims to reduce variability in healthcare. It involves identifying waste causes (Muda) and removing them via process simplification and standardization (Bingham et al., 20116). Standardizing care ensures everyone gets the same high-quality care.
While HRRP has been successful in reducing readmissions, there is still room for improvement. Researchers from the University of Michigan found that while overall readmission rates decreased after the HRRP was implemented, disparities still existed among different patient populations (Bingham et al., 2016). The study used data from Medicare beneficiaries discharged from acute care hospitals in 2011 and 2012. The data was disaggregated by race or ethnicity, gender, and age group. The study results showed that Black patients, female patients, and patients aged 65 years or older were more likely to be readmitted than their counterparts (Bingham et al., 2016). In addition, the study found that certain hospitals had higher readmission rates for specific populations than other hospitals (Demiralp, 2019).
These findings highlight the need for interventions that are tailored to specific populations. Standardizing care is one way to help ensure that all patients receive a high-quality treatment, but it is not enough. Hospitals need to employ interventions that are tailored to the specific needs of different patient populations.
Expected benefits/impact/outcome
Healthcare improvement is essential for ensuring that all patients receive high-quality care at all times. Implementing a Lean process improvement methodology can help hospitals reduce readmission rates (Glans et al., 2021). In addition, using a risk score model in conjunction with the Lean process improvement methodology can help hospitals target interventions at high-risk patients. Standardizing care is one way to help ensure that all patients receive a high-quality treatment, but it is not enough. Hospitals need to employ interventions that are tailored to the specific needs of different patient populations. The HRRP provides hospitals with financial incentives to reduce their readmission rates, but these incentives are not enough on thei...