organizational leadership and interprofessional team development c158 western governors university
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LEADERSHIP C158
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Running head: LEADERSHIP C158 1
ORGANIZATIONAL Leadership and Interprofessional Team Development
C158 Western Governors University
Organizational Leadership and Interprofessional Team Development
C158 Western 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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