GeorgiePorgie
PR Founding Father
Sturd will love this, i'm sure he will dissect my entire piece and prove how I "just don't get it."
I've been up all night. If you politico guys want to see what Nurses go through and hospitals go through read my annotated bibliography on three articles I researched.
It will shed light on the bull manure nurses and hospital financial management deal with everyday, and how government healthcare just adds to the pile of this manure.
here's what I wrote: Read if you want, if you don't no big deal just stay ill informed and think you know exactly what is going on in hospitals. "Nurses got it made, they make great money....blah blah, Hospitals got it made they're revenue sucking vaccuums." Both not the case.
Oh and Thanks Obama!
Clarke, L. (2010). A common flaw in healthcare finance mechanisms that adversely affects service quality and capacity: professional caregiver insurance risk in the trenches. Journal of Psychiatric and Mental Health Nursing, 16(10), 938-940. doi: http://dx.doi.org.proxy.library.ohiou.edu/10.1111/j.1365-2850.2009.01514.x.
The editor is a Registered Nurse that works for the Journal of Psychiatric Mental Health Nursing. The audience is intended for nurses in the field. The article is well researched and has supporting evidence. In my opinion, I feel that the problem explored is not only a problem in psychiatric units but also intensive care units (ICUs). This articles explores how nurses are falling prey to set payment style (capitation) service models as opposed to the insurance model that pays for services. This new style of a set payment system is moving the uncertainty of financial outcomes from the insurers to the providers. At the root of the concept it seems simple to manage as providers can simply adapt treatments to the entitlements of the patient.
Additionally, when looking at this from an ethical standpoint this payment type is problematic. There are patients that do not have any clear indication of their expected outcomes. So, it is difficult for billing to be applied to these patients when it is unclear on the longevity or the number of services needed. According to the article capitation negatively impacts healthcare settings and providers. It also increases inefficiency in every way possible of operations.
I chose this article because in the ICU, we consistently come across patients who cannot be placed into a set payment system. The outcome is unclear at any time during the admission. It is not as easy as a healthy individual coming in for a blood pressure check, lab work, and a consultation by a physician. I feel as though government involvement in healthcare is restricting quality care given to patients on the basis of reimbursements to set payment systems. Their idea is to reduce cost by explicitly determining what it costs per patient to receive any given service. It cannot be modeled this way as there are too many variables, quality will decrease and patients will lose. Additionally, once systems are not reimbursed for services provided hospitals will cut from nurses salary, benefits, and staffing among numerous other things to off set the rising cost from unpaid reimbursements. So now we have patients losing, and nurses losing in an uncertain dawn of new government involved healthcare.
Douglas, K. (2010). Ratios--if it were only that easy. Nursing Economic$, 28(2), 119-125. doi: 2010626743.
Kathy Douglas is the founder and president of the Institute for Staffing Excellence and Innovations. Her knowledge is vast when evaluating today’s issues of reimbursement and staffing with the influx of governmental involvement. The audience is intended for both nurses and management in the field. The article explores how to provide safe, effective and cost-effective care through staffing, but it is not simple. The system is broken on both sides of nursing and finance. It will take close collaboration between nursing and finance to fix what is broken. Variability is a nightmare to control, and it is prevalent in units—changing from minute to minute. Furthermore, in California, and according to the author, there is no clear indication that mandatory staffing ratios increase quality. They can be burdensome for cost-effectiveness as well.
More importantly, to determine staffing ratios it important for nurses to be competent and have valuable experience. Once we give that determination up to mandatory staffing ratios, the expertise and competence of the nurse is given to the government, which has no direct expertise involving the duties of the registered nurse. The author really brings to light the problem with staffing when she goes on to explain that the static numbers of formulas used to measure operational performance do not actually measure the operational performance. Then the plans based on those numbers will never work. This seems to be the problem where I work, the operational performance algorithms that are in place do not work and thus staffing cuts are made when they should not be. The irritation level reaches higher levels, turnover increases and ultimately quality decreases. This type of environment skews the relationship and makes a symptom-level intervention system attractive (pay “a set amount for a set service” only system). But this is a false premise; this is the wrong route to go. To determine a solution, the system must first be fixed.
I chose this article because many valid points are brought up. In the unit, you hear statements from nurses: “we need mandatory minimum staffing numbers.” Staff is upset about cuts and turnover rate increases. On the surface it seems easy—just add more nurses, and there is a clear divide on finance departments and nursing staff. Both parties do anything and everything but work together. It is a constant battle between the two, which has to cost the hospital an insane mount of money. Hiring, and orienting new nurses to a competent state in the unit is not cheap—if nurses and finance could work together then the orientation cost can be reduced by retaining the nurses in the current workforce.
Sanford, K. (2010). Nurse staffing finding the right number and mix. Healthcare Financial Management, 64(9), 38-39. doi: 2010795168.
Kathleen Sanford is the chief nursing officer (CNO) and is responsible for quality and patient safety. She also recognizes it is important that finance and nursing collaborate to attack the problems in today’s healthcare reimbursement bubble. The audience is geared again towards nurses in the field and financial managers for collaboration. Her article discusses the need for collaboration as well as turnover relating to staffing dissatisfaction. Furthermore, nosocomial infections are higher in facilities with lower registered nurse hours per patient day. Realistically, the problem I see that the author touches upon is that nurses state the route of staffing linking quality patient care and finance leaders are being mandated to reduce costs in anticipation of declining payments under healthcare reform.
When times get hard, hospitals look to nursing expenses for cuts. With nurses being the largest work force in almost all hospitals, cuts to them significantly reduces operating costs but at the expense of quality and satisfaction. The problems lies within accounting for nurse services, which historically has never been done. So likewise, if they have no true understanding of nursing costs, it makes it exceptionally difficult to manage those costs. Cost cutting at the expense of staff levels by reducing nurse workforce is seen immediately, but poses a significant risk later of revenue collection and increase in overall costs through turnover and lack quality.
This article sheds light on the problems with staffing, finance teams and cost cutting. I chose it because nursing is the largest workforce in most hospitals and cuts are being made to nurses that immediately show a reduction of costs; however, then this becomes a revolving door (where we get back to costs being out of control once again) over the long term due to training expense and increased number of adverse events (mistakes on the job—they happen). Adverse events are not going to be reimbursed. There is a clear problem implementing cost cutting techniques in the light of government healthcare. The Affordable Healthcare Act was pushed entirely too fast to gauge the true ramifications it will pose on healthcare. It was built on a lie that services would be cheaper, with no real evidence of how it was going to actually make the services cheaper—except through theory that has not been tested. The disconnect between caregivers and suits needs to be reconnected now more than ever in history of healthcare in the United States.
I've been up all night. If you politico guys want to see what Nurses go through and hospitals go through read my annotated bibliography on three articles I researched.
It will shed light on the bull manure nurses and hospital financial management deal with everyday, and how government healthcare just adds to the pile of this manure.
here's what I wrote: Read if you want, if you don't no big deal just stay ill informed and think you know exactly what is going on in hospitals. "Nurses got it made, they make great money....blah blah, Hospitals got it made they're revenue sucking vaccuums." Both not the case.
Oh and Thanks Obama!
Clarke, L. (2010). A common flaw in healthcare finance mechanisms that adversely affects service quality and capacity: professional caregiver insurance risk in the trenches. Journal of Psychiatric and Mental Health Nursing, 16(10), 938-940. doi: http://dx.doi.org.proxy.library.ohiou.edu/10.1111/j.1365-2850.2009.01514.x.
The editor is a Registered Nurse that works for the Journal of Psychiatric Mental Health Nursing. The audience is intended for nurses in the field. The article is well researched and has supporting evidence. In my opinion, I feel that the problem explored is not only a problem in psychiatric units but also intensive care units (ICUs). This articles explores how nurses are falling prey to set payment style (capitation) service models as opposed to the insurance model that pays for services. This new style of a set payment system is moving the uncertainty of financial outcomes from the insurers to the providers. At the root of the concept it seems simple to manage as providers can simply adapt treatments to the entitlements of the patient.
Additionally, when looking at this from an ethical standpoint this payment type is problematic. There are patients that do not have any clear indication of their expected outcomes. So, it is difficult for billing to be applied to these patients when it is unclear on the longevity or the number of services needed. According to the article capitation negatively impacts healthcare settings and providers. It also increases inefficiency in every way possible of operations.
I chose this article because in the ICU, we consistently come across patients who cannot be placed into a set payment system. The outcome is unclear at any time during the admission. It is not as easy as a healthy individual coming in for a blood pressure check, lab work, and a consultation by a physician. I feel as though government involvement in healthcare is restricting quality care given to patients on the basis of reimbursements to set payment systems. Their idea is to reduce cost by explicitly determining what it costs per patient to receive any given service. It cannot be modeled this way as there are too many variables, quality will decrease and patients will lose. Additionally, once systems are not reimbursed for services provided hospitals will cut from nurses salary, benefits, and staffing among numerous other things to off set the rising cost from unpaid reimbursements. So now we have patients losing, and nurses losing in an uncertain dawn of new government involved healthcare.
Douglas, K. (2010). Ratios--if it were only that easy. Nursing Economic$, 28(2), 119-125. doi: 2010626743.
Kathy Douglas is the founder and president of the Institute for Staffing Excellence and Innovations. Her knowledge is vast when evaluating today’s issues of reimbursement and staffing with the influx of governmental involvement. The audience is intended for both nurses and management in the field. The article explores how to provide safe, effective and cost-effective care through staffing, but it is not simple. The system is broken on both sides of nursing and finance. It will take close collaboration between nursing and finance to fix what is broken. Variability is a nightmare to control, and it is prevalent in units—changing from minute to minute. Furthermore, in California, and according to the author, there is no clear indication that mandatory staffing ratios increase quality. They can be burdensome for cost-effectiveness as well.
More importantly, to determine staffing ratios it important for nurses to be competent and have valuable experience. Once we give that determination up to mandatory staffing ratios, the expertise and competence of the nurse is given to the government, which has no direct expertise involving the duties of the registered nurse. The author really brings to light the problem with staffing when she goes on to explain that the static numbers of formulas used to measure operational performance do not actually measure the operational performance. Then the plans based on those numbers will never work. This seems to be the problem where I work, the operational performance algorithms that are in place do not work and thus staffing cuts are made when they should not be. The irritation level reaches higher levels, turnover increases and ultimately quality decreases. This type of environment skews the relationship and makes a symptom-level intervention system attractive (pay “a set amount for a set service” only system). But this is a false premise; this is the wrong route to go. To determine a solution, the system must first be fixed.
I chose this article because many valid points are brought up. In the unit, you hear statements from nurses: “we need mandatory minimum staffing numbers.” Staff is upset about cuts and turnover rate increases. On the surface it seems easy—just add more nurses, and there is a clear divide on finance departments and nursing staff. Both parties do anything and everything but work together. It is a constant battle between the two, which has to cost the hospital an insane mount of money. Hiring, and orienting new nurses to a competent state in the unit is not cheap—if nurses and finance could work together then the orientation cost can be reduced by retaining the nurses in the current workforce.
Sanford, K. (2010). Nurse staffing finding the right number and mix. Healthcare Financial Management, 64(9), 38-39. doi: 2010795168.
Kathleen Sanford is the chief nursing officer (CNO) and is responsible for quality and patient safety. She also recognizes it is important that finance and nursing collaborate to attack the problems in today’s healthcare reimbursement bubble. The audience is geared again towards nurses in the field and financial managers for collaboration. Her article discusses the need for collaboration as well as turnover relating to staffing dissatisfaction. Furthermore, nosocomial infections are higher in facilities with lower registered nurse hours per patient day. Realistically, the problem I see that the author touches upon is that nurses state the route of staffing linking quality patient care and finance leaders are being mandated to reduce costs in anticipation of declining payments under healthcare reform.
When times get hard, hospitals look to nursing expenses for cuts. With nurses being the largest work force in almost all hospitals, cuts to them significantly reduces operating costs but at the expense of quality and satisfaction. The problems lies within accounting for nurse services, which historically has never been done. So likewise, if they have no true understanding of nursing costs, it makes it exceptionally difficult to manage those costs. Cost cutting at the expense of staff levels by reducing nurse workforce is seen immediately, but poses a significant risk later of revenue collection and increase in overall costs through turnover and lack quality.
This article sheds light on the problems with staffing, finance teams and cost cutting. I chose it because nursing is the largest workforce in most hospitals and cuts are being made to nurses that immediately show a reduction of costs; however, then this becomes a revolving door (where we get back to costs being out of control once again) over the long term due to training expense and increased number of adverse events (mistakes on the job—they happen). Adverse events are not going to be reimbursed. There is a clear problem implementing cost cutting techniques in the light of government healthcare. The Affordable Healthcare Act was pushed entirely too fast to gauge the true ramifications it will pose on healthcare. It was built on a lie that services would be cheaper, with no real evidence of how it was going to actually make the services cheaper—except through theory that has not been tested. The disconnect between caregivers and suits needs to be reconnected now more than ever in history of healthcare in the United States.
