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Summary ORGANISATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT C158 WEST GOVERNORS UNIVERSITY
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ORGANISATIONAL LEADERSHIP AND INTERPROFESSIONAL TEAM DEVELOPMENT C158 WEST GOVERNORS UNIVERSITY
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Running head: LEADERSHIP C158 1ORGANISATIONAL
LEADERSHIP AND
INTERPROFESSIONAL
TEAM DEVELOPMENT
C158 WEST GOVERNORS
UNIVERSITY
,LEADERSHIP C158 2
A.
Healthcare is a business. It has customers, suppliers, government
regulators and reviews on Yelp. Healthcare differs from many
businesses in that customers, or patients, do not often have a choice
where the do business, or seek care. Insurance plans provide their
members with a list of providers they must see in order to be covered.
Providers are held accountable no only to the patient/customer but
also to the regulators, some of whom are also those who pay the
customers bills.
The government, through Medicare and Medicaid, is in the position of
making the rules for the same people it does business with. It can tie
compliance with its rules to reimbursement. If a certain provider fails
to meet a certain regulation, Medicare can limit or deny
reimbursement for that provider’s claim (Sullivan, 2013). An example
of this can be seen in how reimbursement is done for a certain
procedure, Aortic Valve replacement surgery for example. By
analyzing best practices and outcomes over time, reimbursement
agencies have decided on an average amount and length of stay for
this particular surgery. If a hospital can safely do the same surgery for
less or have a shorter length of stay, they can keep the remaining
funds. If they spend more, or take longer, the hospital makes up the
difference. Financial motivation like this can help healthcare facilities
promote best practices and improve patient outcomes not just for
improved patient- centered care but for financial benefit as well.
While many ideas to improve patient safety are regulated by
government agencies, JCAHO calling for the use of computerized
prescriber order entry for example, they are also backed up by
financial incentives (Sullivan, 2013). Research has shown that medical
mistakes are a frequent event in healthcare and the cost of these is
now passed back to the facility.
Medicare and Medicaid have worked to make limiting mistakes a
financial necessity for facilities
, LEADERSHIP C158 3
by not reimbursing costs tied to mistakes (Sullivan, 2013). By tying
the regulation directly to the reimbursement the facility is motivated
to change its practices and eliminate mistakes.
Patient mistakes can be costly, due to lack of reimbursement or
liability of the facility for damages caused. An additional incentive for
hospitals to improve care is by directly linking reimbursement to
“value and quality measures” including clinical outcomes and the
patient experience of care (CMS, 2018). The reimbursement rate for
hospitals is directly tied to their rating, and improvement over time,
by patients regarding their experience of care. By following the
patient-centered care measures set forth by JCAHO (2014), and
improving the patient experience, hospitals can improve their
reimbursement rate.
After a hospital stay, patients are sent a survey asking questions
about communication with doctors and staff, cleanliness, pain
management and other measures of patient-centered care. This
Hospital Consumer Assessment of Healthcare Providers and Systems
(HCAHPS) survey is required by CMS for all hospitals and its results
are made public as well as tied to reimbursement (CMS, 2018). By
directly surveying patients about their experience, and tying
reimbursement to it, patient-centered care has become directly
connected to good business practice as well as being required by
regulation.
An example of this can be seen in the dissemination of information to
patients. JCAHO requires that hospitals “effectively communicate with
patients when providing care” (JCAHO, 2014). Having access to a
trained translator, or translation service, has become standard in
many hospitals. While this used to be necessary only for legal
documents like consents, it is now mandated by JCAHO that patients
understand their care and have the opportunity to ask questions in a
language they understand. This requirement allows for better care,
and better understanding and satisfaction by patients and families,
improving the sense of patient centered
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