Value Proposition in Patient Care

1. The meaning of value-added service
Responsible Reform for the Middle Class stated, The Patient Protection and Affordable Care Act will ensure that all Americans have access to quality, affordable health care and will create the transformation within the health care system necessary to contain costs. One part of the transformation is the creation of value proposition. Value proposition is a promise of value to be delivered. Value is defined as “a fair return or equivalent in goods, services, or money for something exchanged; the monetary worth of something; market price; or the relative worth, utility, or importance (Merriam-Webster 2010).” In health care, the Agency for Healthcare Research and Quality states value refers to reducing unnecessary costs (waste) and increasing efficiency while maintaining or improving healthcare quality. In healthcare, value is measured by the outcomes achieved, not the volume of services delivered nor measured by the process of care used.

Value can be seen as a mathematical equation. Outcomes are the numerator of the value equation. The outcomes are perceived as the real measures of quality. Outcome measurement focuses on the immediate results of particular procedures or interventions, rather than the overall full care cycle for medical conditions or primary and preventive care. Cost, is the equation’s denominator. It refers to the total costs of the entire cycle of care for the patient’s medical condition. To, the best approach is often to spend more on some services to decrease the need for others.

An example of why value added services matter is because the value should be about the patients. No longer should it be about how many patients a physician can see, how many tests and procedures the physician can order, or how much the doctor offices or hospitals can charge for these things. Instead, the focus will be about successful patient outcomes that can be measured by quicker recoveries, fewer readmissions to hospitals, lower infection rates, and fewer preventable medical errors.

2. Identifying the functional areas
The way we practice healthcare and healthcare organizations are changing due to the pressure to reduce costs, improve the quality of care and to meet rigorous guidelines. This change has forced health care professionals to examine we evaluate our overall performance. Paradise Hospital, Inc. has not had any service improvements since 1995. A physician named Avedis Donabedian (2005) proposed a model for assessing health care quality based on structures, processes, and outcomes. He defined structure as the environment in which health care is provided. This is known as the organizational characteristics such as the measurement of staffing ratios and the number of hospital beds. The process is described as the method by which health care is provided. This represents the communication and interaction seen between doctor and patient. The necessity for the tests and procedures performed. The outcome is defined as the consequence of the health care provided, was there a desirable or undesirable effect.

In order to identify the functional areas for improvement would require some kind of survey that would be sent to the patients after discharge from the hospital. Yet, another way would be having someone speak directly with the patients admitted or awaiting services to understand how they feel and their perception of care. A survey would be needed all the hospital personnel to encompassing the opinions of the employees. This would include feedback regarding the hospitals process, policy and procedures, management issues, and any human resources issue, financial compensation opinions and the feeling of work-life balance. The third type of survey would evaluate the performance for our outside customers who provide the hospital with service (i.e. outside vendors). By conducting these different types of studies, the hospitals will be able to get a clear idea of its strengths, weaknesses, opportunities and the overall threats that is also called the SWOT analysis. This analysis will specify the objective from the added-value service improvement project and identifying the internal and external factors that are favorable and unfavorable to achieve the overall goal

3. Specific areas
The four specific areas I believe administration can add value in Paradise Hospital includes prioritization of patient safety and satisfaction, transparency in communication with our customers, adherence to professional ethics and confidentiality, and continuous improvement.

Prioritization of patient security and satisfaction: the hospital needs to be able to provide care that is safe and meets or exceeds patient expectations for service quality. Value contributes to safety and satisfaction. If the nurses and staff if feel satisfied and engaged, they will spends appropriate amount of time with the patient at the bedside and will know their patients better which in turn they are able to provide for the patients’ needs. This will ultimately lead to have a positive outcome. The patients and family will have a sense of open engagement and communication. This can be done with patient controlled medical records. This will allow the patient or family to input and manage their health records. They can access their medical records at any time.

Transparency in communication with our customers, the customers want to be able to trust what the hospital is saying. The ability to be transparent and clear is the way to relay on open communication. Transparency builds trust. Transparency gives the information that people need in order to understand what is happening. This can be done with virtual ICU visits; the physician can monitor the patient who is in the ICU from a remote location allowing the best quality of care. The physicians and specialist will be available to provide the best care.

Adherence to professional ethics and confidentiality is a series of principles that govern professional interactions. This includes: Treating patients and staff with the same degree of respect you would wish them to show you. To maintain patient confidentiality of medical information and respecting the patient’s right. Maintain the ability to be truthful in all verbal and written communications. This can be done with integration of electronic documentation, in which medical records are maintained in a data base and access would entail access. All personal would not be allowed access as the confidentiality of the patient would be maintained.

Continuous improvement: This is continuous work that systematically seeks to achieve small, incremental changes in processes in order to improve efficiency and overall quality. This can be done through performance evaluations, continual education, seminars, and quality improvement initiatives.

Both internal and external factors have hospitals in a constant state of transition as there is a higher demand by both providers and consumers for excellence in quality of care, affordable cost and satisfaction. Yet, all healthcare facilities and providers must remember the ultimate focus should be on value for patients, not just lowering costs.

References

Burns, L. R., Bradley, E. H., Weiner, B. J., Shortell, S. M., & Kaluzny, A. D. (2012). Shortell and Kaluzny’s health care management: Organization, design, and behavior (6th ed.). Clifton Park, NY: Delmar Cengage Learning. Casta, K. (1999). Performance Measurement in Health Care. Retrieved from http://www.qualitydigest.com/may99/html/body_health.html Clawson, J., Lawyer, P., Schweizer, C., & Larsaon, S. (2014, January 16). Competing on Outcomes: Winning Strategies for Value-Based Health Care. Retrieved from https://www.bcgperspectives.com/content/articles/health_care_payers_providers_biopharma_competing_on_outcomes_winning_strategies_value_based_health_care/#chapter1 Denning, S. (2011, May 19). Straight Talk On Fixing Health Care: The Innovator’s Prescription – Forbes. Retrieved from http://www.forbes.com/sites/stevedenning/2011/05/19/straight-talk-on-fixing-health-care-the-innovators-prescription/ Donabedian, A. (2005). Evaluating the quality of medical care. The Millbank Quarterly, 83(4), 691–729. Retrieved from 691-729 Porter, PhD, M. E. (2010). What Is Value in Health Care? The New England Journal of Medicine. doi:10.1056/NEJMp1011024 Skok, M. J.