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PERFECTING THE PATIENT CARE SERVICES STRATEGIC PLAN 13 Key Nursing Objectives for Health Care's Changing Future Larger Health System Priorities 1 Enhance Performance on Measures Tied to Payment The success of these five health system priorities depends heavily on nursing. Read below to learn about 13 key patient care services objectives that hold the greatest promise for advancing these priorities and safeguarding hospital margins while elevating care quality. Redistribution of VBP' Payments Net Loss! Breakeven? Net Gain %24 Top performers can earn back between approximately MAXIMIZE BEND THE EXPAND MANAGE HARDWIRE REVENUE CAPTURE COST CURVE EFFECTIVE CAPACITY CASE MIX COMMON PURPOSE I 1.25 and 1.75 of total withhold Hospital Payment 2 Prevent Unnecessary Readmissions 3 Pay the Appropriate Dollars per Worked Hour 4 Flex Staffing to Actual Demand Estimated Annual Labor Costs Attributable Key Organizational Pay Practice Audit Questions Estimated Cost of Calling Off One Nurse to Readmissions Within 30 Days3 Could you further reduce incremental overtime pay? 21 Hour $12.2 M Are you paying differentials that reflect the needs of a past market? 2 Hours 10%- Average 300- to 350-bed hospital will spend per year caring for patients who have been readmitted within 30 days Are one-to-one sitters greatly contributing to overall labor spend? Minimum Pay PTO Accrual Dissatisfaction Total Elevate Role of Nurses in Outpatient Setting 7 Achieve Zero-Defect for Preventable Complications Innovate on the Inpatient Staffing Model Impact of Select HACS' on Medicare Patient LOS8 Projected Shortage of Primary Care Providers by 20156 Rising Acuity and Cost Pressures Unsustainable 29.61 MEDICARE CASE MIX INDEX4 TOTAL RN COMPENSATIONS Today 2015 1.60 $48.75 $42.94 14.71 14.85 $36.21 7.09 8.32 6.1 7.47 4.4 5.15 2.4 1.50 SSIP Following SSI Following Bariatric Surgery CAUTI BSI0 DVT" 1.44 CABG13 29,800 2001 2005 2010 2004 2006 2008 2010 Anticipated Physician Shortage LOS Without HAC LOS with HAC 8. 8 Embed Risk Assessment for 9. 10 Redistribute Siloed Patient Care Tasks to a Cross-Continuum Navigator Preempt Unnecessary Hospital Utilization Utilization into Staff Workflow Key Populations at Risk for Avoidable Hospital Utilization National ED Utilization Distilling New Cross-Continuum Nursing Roles 1 Inpatient Care Coordinator Transfer Coordinator Care Admitting Nurse 2 Comorbidity Chronic Care Coordinator DIABETES COACH O Patient Flow Coordinator 27% 3 IT-Based Care Coordinator PATIENT SERVICE COORDINATOR TRANSITION COACH 17% of Medicare discharges ambulatory-sensitive!5 NURSE CASE MANAGER 19% of Medicare patients ED visits that could be 4 Non-Urgent Care Navigator Nurse Navigator Care Coordinator Asthma Health Discharge Planner NURSE LIFE CARE PLANNER are readmitted within treated in retail clinics or urgent care centers16 5 Clinical Patient Guide COACH Clinical Nurse 30 days of dischargel4 Life CHRONIC DISEASE MANAGER 6 Disease-Specific Chronic Care Coach Leader Telehealth Nurse PATIENT CARE FACILITATOR Chronic Care Coordinator 7 Transition Partner 11 Drive Individual Accountability 12 Strengthen Interdisciplinary Collaboration 13 Position Nursing as a Best-in-Class Partner for IT Benefits of IT Integration to Nursing Association Between Nurse-Physician Collaboration and Negative Patient Outcomes in ICU!7 Underlying Components of Peak Performance 3.50 Peak Performance 2.50 ENGAGES PATIENTS Protocol design important but even best designed protocols likely to have limited impact without frontline investment 1.00 0.86 0.77 TRACKS PERFORMANCE 0.47 FOSTERS COMMUNICATION in organizational goals Med-Surg ICU Surgical ICU Medical ICU Innovation Standardization INFORMS REAL-TIME DECISIONS Collaboration Score, 1 (poor) –7 (high) IMPROVES QUALITY AND SAFETY Frontline Accountability for Organizational Goals Negative Outcome to Predicted Mortality Unit 1 Value-based purchasing. Hospital-acquired conditions. 8 MEDPAR 2009. 15 MEDPAR 2009. 16 Weinick R, et al., "Many Emergency Department Visits Could Be Managed at Urgent Care and Retail Clinics," Health Affairs, 2010: 1630-1636. 2 +/- 0.25% of median. 9 Catheter-associated urinary tract infection. 3 Key model assumptions include: total operating expenses of $203.6 million, labor costs account for 60% of total hospital costs, 10% 30-day medical readmission rate; HCRIS Hospital Cost Reports, available at: https//, accessed November 4, 2011. 4 Case mix index in short-stay hospitals participating in Medicare's Inpatient Prospective Payment System; excludes Medicare Advantage patients. 10 Bloodstream infection. The Advisory Board Company 17 Baggs, et al., "Association Between Nurse-Physician Collaboration and Physician Outcomes in Three Intensive Care Units," Critical Care Medicine, 1999, 27(9): 1991–1998. 11 Deep vein thrombosis. 12 Surgical site infection. Nursing Executive Center 13 Coronary artery bypass graft. 14 Jencks SF, et al., "Rehospitalizations Among Patients in the Medicare Fee-for-Service Program," New England Journal of Medicine, 2009, 360: 1418-1428; Krumholz 5 Per hour worked; MEDPAR 2001, 2005, 2010; Bureau of Labor Statistics, "Employer Costs for Employee Compensation Historical Listing March 2004-June 2011," available at:, accessed November 10, 2011; Friedman B, et al., "Hospital Inpatient Costs for Adults with Multiple Chronic Conditions," Medical Care Research and Review, 2006, 63: 327-346. 6 Kliff S, "Success of Health Reform Hinges on Hiring 30,000 Primary Care Doctors by 2015," The Washington Post, February 10, 2012. HM, et al., "Patterns of Hospital Performance in Acute Myocardial Infarction and Heart Failure 30-Day Mortality Quality and Outcomes, 2009, 2: 407-413. LEARN MORE AT Readmission," Circulation Cardiovascular O 2012 The Advisory Board Company • 24253 Unit-Based Clinical Nurse Specialist Total Performance Score


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Learn about the13 patient care services objectives that hold the greatest promise for advancing strategic priorities and safeguarding hospital margins while elevating care quality.


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