![Page 1: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/1.jpg)
Health Care Delivery System:
Societal Trends and Economics
Unit III
![Page 2: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/2.jpg)
Change & Health Care Delivery Rapid and Constant Nurses must embrace change Nurses must contribute to problem solving
![Page 3: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/3.jpg)
Why Did Health Care Delivery Need to Change?
Rising health care cost Increasing elderly population Expanding technology Emphasis on acute care rather than prevention Insurance reimbursement that rewarded
increased spending
![Page 4: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/4.jpg)
Health Care Delivery Changes:Cause and Effect
Cause: Consumer demands Technological advances Governmental scrutiny
Impact on Nursing: Challenge theoretical viewpoint, practice models,
and patient services
![Page 5: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/5.jpg)
Approaches Introduced to Control Costs
Managed-care strategies HMO’s, PPO’s
Changes in reimbursement methods Change to prospective payment system (DRG’s)
Hospital restructuring Mergers
Corporatization Integrated Health Care Delivery Systems
![Page 6: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/6.jpg)
Do We Need National Health Care?
Improved access to care Competitive free-market
![Page 7: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/7.jpg)
Questions to Ponder How does futile care contribute to
increased costs? How can preventive health care and
wellness education lower costs of later acute care?
Should health care adopt corporate business practices? Telemedicine For-profit organizations
![Page 8: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/8.jpg)
Health Care Trends Graying of America Technological advances Globilization Delivery System changes Social evolution
![Page 9: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/9.jpg)
Globilization and Nursing Spread of a common culture around the world Universal sharing of attitudes, products, industry,
and stocks
Role of Nursing: Learn about health care beliefs and practices of
other cultures International Nursing Forums to share nursing
practice
![Page 10: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/10.jpg)
Social Changes and Nursing Consumer control
Desire to make own choices Conventional vs. Alternative therapies
Question health information Research independently Demand more preventive care
Judge value of health care Service orientation
Aging Majority population Multiple health care needs
New technology Telemedicine
![Page 11: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/11.jpg)
Current Trends affecting the Vision of Nursing
Dominant role in health care delivery systems
Geriatrics a prominent specialty Leadership role in determining/implementing
policy Provide holistic care (integration of multiple
facets) Technology enhanced quality care
![Page 12: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/12.jpg)
Current Trends (continued) Quality care based upon outcome criteria Emphasis on case-management Increased nursing involvement in making
policy and governmental decisions affecting health care
Education more user-friendly Expanding cultural knowledge and practice
![Page 13: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/13.jpg)
Health Maintenance Organizations Staff Model Group Model Network Model Independent Practice Association
![Page 14: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/14.jpg)
Preferred Provider Organization (PPO)
Another type of Health Plan Use of physicians who have agreed to
provide services at a lower price to the insurer
![Page 15: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/15.jpg)
Ethics and Nanotechnology Need new delivery systems which
incorporate demands of advanced technology
Need lower-tech, higher-touch therapeutic interventions to offset technology
Need to combine alternative care approaches with conventional medical treatments
![Page 16: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/16.jpg)
Types of Health Care Organizations
Acute Care Hospitals Psychiatric Hospitals Community Mental Health Centers Long-term Care Facilities Day Care Centers and Homes for Elderly Ambulatory Care Home Health Care
![Page 17: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/17.jpg)
Organizational Structures Centralized Decentralized
![Page 18: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/18.jpg)
Organizational Charts Maps that determine who reports to whom Shape dependent upon size and
governance style Reflect formal communication patterns
![Page 19: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/19.jpg)
Organizational Approaches to Getting Work Done
Committee structure Participative management Shared governance Self-governance Unions
![Page 20: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/20.jpg)
Nursing Care Delivery Patterns Functional Team Primary Patient-focused Case-managed
What are the pro’s and con’s?
![Page 21: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/21.jpg)
Delegation Who can delegate? What can be delegated? When should delegation be used? How can you determine if delegation is
effective?
![Page 22: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/22.jpg)
Nursing Assignments JCAHO
Require that staffing be based on organized system
Patient Classification or Acuity System ANA
Identified principles of staffing Patient care-related Staff-related Institution/organization-related
![Page 23: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/23.jpg)
Nursing Shortages and Staffing What constitutes a staffing crisis? What can be done when there is a staffing
crisis? What are your responsibilities when staffing
is short?
![Page 24: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/24.jpg)
Nurse’s Role in Decreasing Health Care Costs
Challenge: provide excellent care with fewer dollars Knowledge about equipment/service costs
Resource utilization Promote preventive health care
Consumer education
![Page 25: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/25.jpg)
Computers and Health Care Telemedicine
Use of computer technology and telecommunications to provide contact between the provider and the consumer.
Primary goal: provide access to rural and underserved communities.
![Page 26: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/26.jpg)
Computers in Healthcare Information Superhighway
“term used to describe the explosion of electronic information retrieval and communication taking place through computers and modems.”
What is important to remember when using electronic data?
![Page 27: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/27.jpg)
Role of Nursing in Telehealth/Telemedicine
Active involvement Practice issues when care transcends state
lines Triage from emergency care facilities Home care services Hospice care Video assessments and vitals through
telemonitoring
![Page 28: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/28.jpg)
Realities of Health Care Financing Expenditures are continuing to increase Managed care has not reduced the growth
of Medicare beneficiaries and overall spending
Reasons for continued increases Inflation Increased demand for services Expensive technological advances
![Page 29: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/29.jpg)
How is Health Care Financed? Self-payment Third-party payment Health care assistance
![Page 30: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/30.jpg)
Health Care Financing and the Role of the Nursing
Nurses are involved in the decision-making process
Patient/consumer advocacy Need to understand budget process
![Page 31: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/31.jpg)
Questions to Ponder Why must nurses be involved in fiscal
management? What does the budget have to do with
nursing practice?
![Page 32: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/32.jpg)
Terms to Know Budget
Operating budget Capital budget Personnel budget
![Page 33: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/33.jpg)
Budgets and Cost Control Unit cost Standard costs Target or budget costs Cost variance report
![Page 34: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/34.jpg)
Reasons for Cost Problems Poor quality Theft Carelessness
![Page 35: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/35.jpg)
“Costing Out” Nursing Services Used to understand the cost of treating a
patient relative to the revenue received from treating that patient.
![Page 36: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/36.jpg)
Quality and Patient Care Why must quality be controlled? What is the best way to control quality?
(prospective vs. retrospective) Who is responsible for quality? How is quality measured? What is the bottom line?
![Page 37: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/37.jpg)
Quality JCAHO
Mission: “enhance the quality of health care provided to the public”
Quality Assurance Method of monitoring and improving consumer-oriented
services Unique to each institution Unit based and requires individual involvement
Definition: What does quality mean to you?, to consumers?
Evaluation perspectives: Structure Process outcome
![Page 38: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/38.jpg)
Computerization Mainframe PC PDA
We must balance the use of this technology with increased personal contact (touch) to maintain the human element of nursing.
![Page 39: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/39.jpg)
Nursing Informatics 1994 ANA Recognition A specialty that “integrates nursing science,
computer science, and information science in identifying, collecting, processing, and managing data and information to support nursing practice, administration, education, research, and the expansion of nursing knowledge” (ANA, 1994)
![Page 40: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/40.jpg)
Theories Associated with Nursing Informatics
Nomenclature, Classification and Taxonomy
General Systems Theory Change Theory
![Page 41: Health Care Delivery System: Societal Trends and Economics Unit III](https://reader030.vdocuments.site/reader030/viewer/2022032709/56649eaa5503460f94bb0078/html5/thumbnails/41.jpg)
Buzzwords for the Future Preventive medicine Preventive care