Question

Using a specific example, discuss factors that led to the need for health care transformation.

Identify one health care quality initiative and state your opinion, with rationale, of whether the initiative has or will improve health care.

Answer 1

Healthcare Transformation coverage includes: Delivery: Disruption, innovation andtransformation in the delivery of health care, as well as funding mechanisms. ... Population and Public Health: Greater understanding that the future of healthcaremust focus on creating value for the health of populations.

There are many different factors that can affect your health. These includes

1. Costs

With the Affordable Care Act in place, more than half of the 40 million previously uninsured Americans have affordable access to healthcare — resulting in greater demands for healthcare providers. The rising cost of U.S. healthcare is a significant factor driving change, with Americans projected to spend $3 trillion on healthcare this year. The United States spends more than any other developed country in the world on healthcare. “We are the only developed country in the world that does not have some flavor of a single-payer model, and we have a fairly strong lack of transparency of pricing in this country,” said Peter.

2. An Aging Population

According to the Pew Research Center, there are 79 million baby boomers, which is estimated to account for 26 percent of the population of the United States. These 79 million people are expected to live longer than any previous generation, with many of them needing continuing medical care for the rest of their lives. A report published by the University of Albany’s Center for Health Workforce Studies shows that as people age, they use a disproportionately large share of healthcare services. A larger population of all ages also translates into a greater demand for healthcare providers.

In 2010, the population of people age 65 or older was 39.4 million; fast forward 10 years to 2020, and that number could rise to 53.2 million. It’s been forecasted that by 2020, there will be 3 million jobs in nursing and senior care alone, compared to only 2.4 million today. So, what does this all mean? Well, healthcare talent management professionals will continue to battle head-to-head with their peers in the “war for talent.” “As a result, the biggest growth areas for employment will be home health aides, geriatric nurses, physical therapists and similar jobs,” said Peter.

3. Changing Relationships

Consumerism in the healthcare industry is an inescapable growing trend. In fact, a study from Wolters Kluwer Health shows that a whopping 86% of consumers believe proactivity on their part is critical in ensuring high quality care and outcomes. Patients are increasingly taking an active role in their care experience and are evermore empowered to choose their own care alternatives. “Patients are becoming more like consumers due to the decreasing levels of direct contact with medical professionals,” Peter said. Patients can order refills, schedule appointments, consult with their primary care physicians, and more, all through online patient portals.” This growing connection to technology will likely increase demand for medical assistants, medical secretaries, and IT staff.

4. Drugstore Clinics

The United States currently has about 1,600 small clinics in drugstores, such as CVS and Walgreens, and that number is projected to increase to 3,000 in the next five years. These clinics provide a growing number of services, treating sprains and shingles, administering pregnancy tests, doing diabetes monitoring, and much more. “I was talking to a VP of HR about a month ago, and she was telling me that she is directly competing for nurse practitioners against CVS and Walgreens in her community,” said Peter. “It’s a direct competitive threat for the labor pool, and it’s only going to increase over time.”

5. Technology

Growing advances in medical technology (i.e. brain implants controlling epileptic seizures, colonoscopies done with a pill camera, and medical staff remotely monitoring a patients’ vital signs) will significantly impact healthcare recruitment and employee education and training due to the specific skill-sets needed to carryout these advanced methods of care delivery. And technology us only going to continue to evolve.

6. Opposing Models

The current fee-for-service model is in direct conflict with the growing patient-centered, or population wellness, model. “With one, you get more money for more tests, more procedures, more admissions; the other, you get more money for keeping people out of the hospital, getting tests, procedures, and so forth,” Segall said. “They are in direct opposition to each other, and the CFOs are trying to create this balancing act.” But the general consensus, he said, is that in five to 10 years, the balance will reverse dramatically, across the board.

The Quality Initiative for Assisted Living. ​The Quality Initiative is a national effort that builds upon the existing work of the long term and post-acute care profession by setting specific, measurable targets to further improve quality of care in America's skilled nursing centers and assisted living communities.

The New Health Partnerships initiative seeks to use behavior change and health care system models to develop and test the most effective and efficient approaches for providing support to patients of a sort which enables and encourages greater patient self-management, while at the same time stimulating greater patient

example, A Patient-Centered Primary Care Practice Approach Using Evidence-Based Quality Improvement

Healthcare systems and their primary care practices are redesigning to achieve goals identified in Patient-Centered Medical Home (PCMH) models such as Veterans Affairs (VA)’s Patient Aligned Care Teams (PACT). Implementation of these models, however, requires major transformation. Evidence-Based Quality Improvement (EBQI) is a multi-level approach for supporting organizational change and innovation spread.

OBJECTIVE

To describe EBQI as an approach for promoting VA’s PACT and to assess initial implementation of planned EBQI elements.

DESIGN

Descriptive.

PARTICIPANTS

Regional and local interdisciplinary clinical leaders, patient representatives, Quality Council Coordinators, practicing primary care clinicians and staff, and researchers from six demonstration site practices in three local healthcare systems in one VA region.

INTERVENTION

EBQI promotes bottom-up local innovation and spread within top-down organizational priorities. EBQI innovations are supported by a research-clinical partnership, use continuous quality improvement methods, and are developed in regional demonstration sites.

APPROACH

We developed a logic model for EBQI for PACT (EBQI-PACT) with inputs, outputs, and expected outcomes. We describe implementation of logic model outputs over 18 months, using qualitative data from 84 key stakeholders (104 interviews from two waves) and review of study documents.

RESULTS

Nearly all implementation elements of the EBQI-PACT logic model were fully or partially implemented. Elements not fully achieved included patient engagement in Quality Councils (4/6) and consistent local primary care practice interdisciplinary leadership (4/6). Fourteen of 15 regionally approved innovation projects have been completed, three have undergone initial spread, five are prepared to spread, and two have completed toolkits that have been pretested in two to three sites and are now ready for external spread.

DISCUSSION

EBQI-PACT has been feasible to implement in three participating healthcare systems in one VA region. Further development of methods for engaging patients in care design and for promoting interdisciplinary leadership is needed.