NUR-621 Delivery Models Essay

Health care in the US is a complex system which is characterized by fragmented care where there is no single entity that is accountable for the overall coordination and quality of patient care. As a result, patients tend to get the services they pay for and the fee-for-service system that is mostly used has led to a situation where massive resources are spent on acute care, tests, and procedure. Therefore, the health care industry players are increasingly under pressure to deliver better, effective care with minimal resources. As a result, incentives for inclusive care delivery models and payment for quality and care were created to rebalance the resource allocation and incentive value of care rather than volume of care in the health care system.

The care delivery model operates through a dyad model, which consists of nurses and physicians functioning as a team with operational role and accountability for patient quality of care, proficient service, efficiency in health care delivery. Importantly, the patient population is infused in delivery models that represent range of critical, acute, and progressive care (UK HealthCare, 2020). Therefore, the aim of this paper is delve into the health care delivery models by exploring specific areas such as addressing the triple aim in relation to population health management and delivery models, describe current trends in health care delivery models, and describe how quality and safety influence delivery models in health care.

The Triple Aim as it Relates to Population Health Management and Delivery Models

Over the recent past, there has been effort to enhance health care quality by minimizing defects in patient health care in different categories proposed by the Institute of Medicine (IOM) such as safety, timeliness, patient-centeredness, effectiveness, efficiency, and equity. However, there has been slow progress in realizing these objectives, making it difficult to improve individual patient care. Besides, considerably few improvement efforts tend tackle the flaws in care across the continuum of health care. Therefore, there is need for more effort to thrive, expand, and enhance site-specific care for every patient. However, these objectives aimed at realizing high-value health care may not be achieved unless the initiatives for improvement seek a wider system of related goals. Overall, these goals are the “Triple Aim” which entails enhancing the individual patient experience of care, enhancing health of populations, and lowering of the per capita cost of care for populations.

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Essentially, the Triple Aim connotes a model created by the Institute for Healthcare Improvement (IHI) which illustrates a strategy to maximize the performance of health care system. The three dimensions, which are referred to as the “Triple Aim” include enhancement of patient experience of care through quality of care and satisfaction, improving the health of populations, and reducing the per capita cost of health care. The Triple Aim is crucial in the current health care system in the US to reduce health care cost (Institute for Healthcare Improvement, 2017). Moreover, Triple Aim will address issues such as aging populations and increased longevity and challenges associated with chronic health that put more pressure on medical and social services.

In population health, it is critical to simultaneously address the dimensions of Triple Aim due to its ambitious improvement at all levels of health care system to improve the health of communities and all patients. Organizations that implement Triple Aim are likely to have healthy population because of new designs that identifies problems and solutions to such problems. Patients will expect less intricate and more coordinated care and the load of illness will reduce. Moreover, the reduction of per capita cost of health care for populations will enable health care organizations opportunity to enhance competitiveness, eradicate pressure on the public funds on health care, and ensure flexibility for communities to focus on activities that increases vigor and economic security for their populations (Institute for Healthcare Improvement, 2020). To succeed in this, it is critical to bind range of community determinants of health, empower populations, ensure sophisticated journey across the entire health care system in the entire life of a person, and significantly increase the role and influence of primary care and community services.

Regarding the delivery models, Triple Aim thinking can be used to advance and strengthen many areas of reform in the US health care system. According to Institute for Healthcare Improvement (2020), the Triple Aim thinking may encompass innovative financing approaches such as Accountable Care Organizations (ACOs) and bundled payments; sanctions for preventable occurrences such as hospital acquire infections and readmission rates; new approaches for primary care including patient-centered medical homes; and the adoption of information technology.

The Current Trends in Health Care Delivery Models

Health care systems in US and the globally encounter hurdles in delivering accessible, high-quality, and affordable care. As such, health care providers need to be empowered to address these challenges by assuming evolving health care delivery models. Essentially, there are several health care delivery models that are essential in making positive contribution in patient care and health care system. Currently, there are many different trends in health care delivery models. They include;

Accountable Care Organizations (ACOs)

ACOs connote providers who work collaboratively to provide cost-effective and quality café for their clients. It ensures delivery of greater degree of care integration, quality-based care delivery, and sophisticated communication throughout the spectrum of patient care. The providers enjoy financial incentives designed to meet quality targets and cost effectiveness.

Patient Centered Medical Homes (PCMH)

The PCMH model is developed to give primary care physician (PCP) support in leadership role patient care coordination. The model emphasizes on developing a strong relationships and trust between patients, practice staff, and providers. Moreover, it is patient oriented as it seeks improve clinical outcomes and reduce cost through coordinated care. The model also relies on IT and evidence-based medicine that is crucial in health care cost reduction.

Community-Based Hospitals

These establishments provide specific health care services such as quick availability of treatment, emergency services, and ensuring shorter wait time.

Proactive and Intensive Care for Intricate Health Conditions

Currently, many people are diagnosed with complex and long term health conditions. Many of these conditions are attributed to unhealthy lifestyle and aging population. Therefore, this model identifies proactive mechanisms to control complex health conditions in the community.

Telemedicine

Telemedicine is a health care delivery model to reach out remote areas. The model applies IT and telecommunications to deliver health care from a distance. The model is critical in eradicating distance barriers and has the potential to enhance availability of medical services that are rarely found in rural areas.

However, despite the advancement in health care delivery model, the review by the Health People 2020 indicates that there are considerable disparities in care accessibility by sex, age, ethnicity, race, education, and family income in all levels of care. Moreover, geographical disparities also exist with millions of people living in rural settings lack access to primary care services as a result of poor staffing. Therefore, there is need to effectively distribute primary care workforce and provide them with sufficient training for cultural competent care to diverse population (Healthy People 2020, 2020).

How Quality and Safety Impact Delivery Models in Health Care

The health care delivery organization is often determined by various factors including leadership beliefs, staff retention, and economic issues. Similarly, the impact of health care delivery models on quality and safety is also a key consideration in decision making. As stated earlier, health care delivery models emerge to address the current challenges facing the health care industry and they keep changing to accommodate the ever-evolving and dynamic health care system. Essentially, it is vital for the individuals and populations to be given quality health care services that are seamlessly coordinated in the health system to enjoy optimal health. Consequently, health care delivery models ensure quality health services that utilize the right care and responding to the needs and inclinations of the service users. The quality health care provided under the appropriate care delivery model enhances the chances of obtaining the desired health outcomes which is consisted with IoM’s recommendations of safety, timeliness, patient-centered, equitable, effectiveness, care integration, and efficiency (Havaei, MacPhee & Dahinten, 2019). On the other hand, health care delivery model is associated with safety since it utilizes various levels and sites of care in the health care system to manage the provision of safe health care services to enable people to receive a range of disease prevention, health promotion, disease management, diagnosis, treatment, and palliative care services based on the needs of the people.

Conclusion

Health care in the US is increasingly becoming complex and evolving making patients to get the services they pay for and the fee-for-service system that is mostly used has led to a situation where massive resources are spent on acute care, tests, and procedure. Therefore, there is need for provision of quality and cost effective care. As such, incentives such as inclusive care delivery models and payment for quality and care were created to rebalance the resource allocation and incentive value of care.

References

Havaei, F., MacPhee, M., & Dahinten, V. S. (2019). The effect of nursing care delivery models on quality and safety outcomes of care: A cross‐sectional survey study of medical‐surgical nurses. Journal of advanced nursing, 75(10), 2144-2155.

Healthy People 2020. (2020). Access to Health Services. Healthypeople.gov. Retrieved 21 July 2020, from https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services.

Institute for Healthcare Improvement. (2017). IHI triple aim initiative.

Institute for Healthcare Improvement. (2020). The IHI Triple Aim | IHI – Institute for Healthcare Improvement. Ihi.org. Retrieved 20 July 2020, from http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx

UK HealthCare. (2020). Care Delivery Model. Ukhealthcare.uky.edu. Retrieved 20 July 2020, from https://ukhealthcare.uky.edu/medical-professionals/nursing/care-delivery-model

NUR-621 Delivery Models Essay