Quality Improvement and Patient Safety Select any two of the Ten…

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Question Answered step-by-step Quality Improvement and Patient Safety Select any two of the Ten… Quality Improvement and Patient SafetySelect any two of the Ten Rules to Guide Improvement. Share a specific example to show how these can be applied in the clinical setting.In the clinical setting, look for evidence of care that incorporates the STEEEP principles, which include safe, timely, effective, efficient, equitable, and patient-centered. How can each improve patient outcomes?What one change that can be made in the health care system to improve quality, and why make the change?What is one clinical indicator that would be used to assess care and how to do it?What barriers to quality improvement may be encountered in the workplace?  How would a nurse manager, address these obstacles? Health Science Science Nursing NURS 307 Share QuestionEmailCopy link Comments (0)

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Question Answered step-by-step Please read chapter 5 case study and answer the questions at the end. Chapter 5 Representative Policy Options  IndUShealth IndUShealth provides a complete package to its U.S. and Canadian clients, including access to Indian superspecialty hospitals that are Joint Commission International accredited and to specialists and supporting physicians with U.S. or U.K. board certification. It arranges for postoperative care in India and for travel, lodging, and meals for the patient and an accompanying family member—all for a single package price. For example, it represents the Wockhardt hospitals in India, which are Joint Commission International accredited and affiliated with Harvard Medical International. Other Indian hospitals boast affiliations with the Johns Hopkins Medical Center and the Cleveland Clinic. Mitral Valve Replacement One of the first cases considered was a mitral valve replacement. IndUShealth and BRPP sought package quotes from a number of domestic medical centers and could get only one estimate. That quote, from the University of Iowa academic medical center, was in the $68,000 to $98,000 range. The quote from India was for $18,000 and included travel, food, and lodging for the patient and one companion. Testifying before the U.S. Senate Special Committee on Aging, Mr. Rajesh Rao, IndUShealth's CEO (2006), cited the following costs: Procedure Typical U.S. Cost India Cost Heart bypass surgery $55,000-$86,000 $6,000 Angioplasty $33,000-$49,000 $6,000 Hip replacement $31,000-$44,000 $5,000 Spinal fusion $42,000-$76,000 $8,000 Employee Participation To encourage employee participation, BRPP prepared a DVD on its medical tourism initiative, which it called Global Health Coverage. It outlined the opportunities and described the Indian facilities and credentials. The next step was to be a trip by an employee "due diligence" committee to India to inspect facilities and talk with doctors. Then they would discuss how to handle the option in the next set of union negotiations. Senate Hearings On June 27, 2006, the U.S. Senate Special Committee on Aging held hearings titled "The Globalization of Health Care: Can Medical Tourism Reduce Health Care Costs?" Both BRPP and IndUShealth testified for the committee. When testifying to the Senate subcommittee, Bonnie Grissom Blackley, benefits director for BRPP, concluded: Should I need a surgical procedure, provide me and my spouse with an all expense-paid trip to a Joint Commission International-approved hospital, that compares to a 5-star hotel, a surgeon educated and credentialed in the U.S., no hospital staph infections, a registered nurse around the clock, no one pushing me out of the hospital after 2 or 3 days, a several-day recovery period (continues) Conclusion 95 at a beach resort, email access, cell phone, great food, touring, etc., etc. for 25% of the savings up to $10,000 and I won't be able to get out my passport fast enough. Blue Ridge Paper Product's Test Case The test case under the new arrangement was a volunteer, Carl Garrett, a 60-yearold BRPP paper-making technician who needed a gallbladder removal and a shoulder repair. He reportedly was looking forward to the trip in September 2006, accompanied by his fiancée. A 40-year employee approaching retirement, he would be the first company-sponsored U.S. worker to receive health care in India. The two operations would have cost $100,000 in the United States, but would cost only $20,000 in India. The arrangement was that the company would pay for the entire thing, waive the 20% co-payment, give Garrett about a $10,000 incentive, and still save $50,000. However, the United Steel Workers Union (USW) national office objected strongly to the whole idea and threatened to file for an injunction. The local district representative commented, "We made it clear that if healthcare was going to be resolved, it would be resolved by modifying the system in the U.S., not by offshoring or exporting our own people." USW President Leo Gerard said, "No U.S. citizen should be exposed to the risk involved in travel internationally for health care services." The USW sent a letter to members of Congress that included the following (Parks, 2006): Our members, along with thousands of unrepresented workers, are now being confronted with proposals to literally export themselves to have certain "expensive" medical procedures provided in India. With companies now proposing to send their own American employees abroad for less expensive health care services, there can be no doubt that the U.S. health care system is in immediate need of massive reform. The right to safe, secure, and dependable health care in one's own country should not be surrendered for any reason, certainly not to fatten the profit margins of corporate investors. Parks (2006) The union also cited the lack of comparable malpractice coverage in other countries. The company agreed to find a domestic source of care for Mr. Garrett, but considered continuing the experiment with its salaried, non-union employees. Carl Garrett responded unhappily. "The company dropped the ball ... people have given me so much encouragement," he said, "so much positive response, and they're devastated. A lot of people were waiting for me to report back on how it went and perhaps go themselves. This leaves them in limbo too" (Jonsson, 2006, p. 2). In 2007, Rank Group, a New Zealand-based company, purchased the company by buying out the ESOP, paying the former employee-owners, on average, approximately $20,000 each. Rank renamed the company Evergreen Packaging Group. ▸ Discussion Questions 1. What difference did it probably make that BRPP is an ESOP owned by the union members or that the national union is busy recruiting healthcare workers as members? 96 Chapter 5 Representative Policy Options 2. What are the ethical implications of a reward of up to $10,000 for the employee to go to India for a major procedure? 3. If you were a hospital administrator, how would you react when a number of patients and companies began to ask to bargain about prices, including presenting price quotes from companies like IndUShealth? 4. What would be the difference in the bargaining position of an academic medical center and a large tertiary community hospital system? 5. How might state and national governments respond to this increasingly popular phenomenon? Health Science Science Nursing NURSING 225 Share QuestionEmailCopy link Comments (0)
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