Nursing Economics最新文献

As we move toward a value-based health care system and payment models based on individual performance of providers, nurses are faced with a dilemma. Should we as a profession actively pursue the development of individual nurse performance metrics, analysis, benchmarks, and practice standards, similar to those being implemented for physicians? Or should we wait until these metrics are imposed by payers and policymakers with little or no input from nurses?

Mentoring programs can enhance nursing satisfaction, improve retention, ensure optimal patient outcomes, and may have a positive organizational effect in developing leadership skills in nursing. In this study, the effects of a formal mentoring program were explored on a sample of 18 professional nurse leaders (nine mentors and nine proteges) at a university hospital in Turkey. After receiving a formal mentoring training program, mentors and proteges were paired with each other for a 6-month monitoring period. An overall assessment revealed both mentors and proteges perceived benefits from the mentoring program. The formal mentoring program created positive change in leadership behaviors for both mentors and proteges and contributed toward relational job learning for mentors and personal skill development for proteges. Suggestions are provided for the integration of formal mentoring programs into the organizational culture.

As this election campaign, like many, has been more about personality than policy, it is important to remember that positions on policy are the real substance of election outcomes. Although health care is ranking lower than other national issues in the minds of voters, it remains a vital topic. Nurses need to stay informed on this important issue, especially regarding the policy proposals from both parties and candidates

Evidence supporting a relationship between costs and quality in nursing homes has been inconsistent. The Minnesota Performance-based Incentive Payment Program (PIPP) is an innovative public policy that promotes quality improvement (QI) in the state's nursing facilities. The objective of this study was to investigate the economic or business perspective surrounding QI participation by exploring nursing home leader perceptions regarding market-based motivations for improvements, or a business case for engaging in a quality improvement project. There appeared to be a perception that without the increased rates provided by PIPP, needed changes to improve quality would not have occurred.

Accountable Care Organizations (ACOs) are a promising new model for payment reform in the complex and fragmented health care system in the United States. Nursing vision and leadership are essential for the success of an organization participating in an ACO. By understanding the political, financial, and cultural facilitators and barriers to change, as well as models for helping organizations transition toward change (e.g., Kotter Model of Change Management), nurses have the potential to be leaders in health care change.

Interest in care transitions has intensified in light of emphasis placed on hospital readmissions. This study provides a comparative analysis of the costs of providing transitional care through a program for cardiac patients against hospital readmission costs. The advanced practice registered nurse-managed BRIDGE model reduced health care costs associated with readmissions that were in excess of program costs. On average, there was a per-patient savings of $4,944 in avoided readmissions within 30 days of hospital discharge. Over the duration of the program, this equates to a $306,537 savings in patients with acute coronary syndrome. Nurse practitioners have a unique, holistic, and supportive approach to providing care that may make them ideal for the transitional care setting.

Staffing solutions are evolving at remarkable speed. It no longer takes large, complicated, technical teams to create powerful, reliable, high-quality solutions. Today's cloud-based solutions can be implemented in hours and configured as fast as an organization can tolerate. These new, well-designed systems are highly intuitive and adopted rapidly. Data can be displayed in different ways for different users with different responsibilities. Upgrades are no longer big, costly events; they are done automatically. Large outlays for licensing fees and big start-up costs are also things of the past.

The Centers for Medicare & Medicaid Services (CMS) reimbursement policy identified 11preventable adverse outcomes. Of these 11 patient outcomes, four (severe pressure ulcers, falls and trauma, catheter-associatedurinary tract infections, and vascular catheter-associated infections) are considered nursing-sensitive quality outcomes thatcan be decreased with greater and better nursing care. A cross-sectional study examined the CMS reimbursement policyfocusing on nursing-sensitive adverse patient outcomes. The percentage of Medicare patients served as a proxy for ameasure of the CMS changes in reimbursement. The CMS reimbursement policy measured by the proxy variablewas not related to a reduction of the four adverse outcomes.

With increasing acuity and simultaneous pressures for optimal productivity, reducing unnecessary patient companions has been a focus for many health care organizations. At the same time, nursing leaders are seeking to accelerate improvement in patient safety, specifically the prevention of falls. This study suggests the use of remote video monitoring is a safe tool for fall prevention. While there was a decrease in 1:1 sitter usage, there was no corollary increase in falls. In fact, falls decreased 35%. Not only was video monitoring a safe intervention, it was more effective than patient companions alone in decreasing falls by expanding the number of patients who are directly observed 24/7.