Response To Peer 10

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Question Description

***** please comments to each peers answer with a paragraph add citations and references ***** Thanks !

Response one: I think we all agree that an increase in cooperation, no matter who the participants are, leads to better business outcomes, increased employee satisfaction, and in the case of medicine a decrease in morbidity and mortality. One way in which I have seen this interprofessional collaboration work is with the inception of a team rounding approach. Due to the nature of the psychiatric unit I worked on we could not all physically round on each individual patient at the facility but would instead sit down in a conference room and as a group review a SBAR format on each patient. The meetings included the physician, the charge nurse, therapist, discharge planner, pharmacist and utilization reviewer. This format allowed the charge nurse to give the background on the patient as well as the status of the patient over the last 24 hours. It allowed the therapist and discharge planner to review all therapeutic needs and the resources required to continue those interventions after discharge. The pharmacist could review the medication reconciliation and advise the nurse and physician about concerns and medication reactions. All of this was done in the presence of the physician who could then interview the patient and have a much greater understanding of the things that may need to be ordered or assessed.

In regard to a current issue that will require more interprofessional collaboration, it would appear more work is needed to standardize the interdisciplinary team approach of care by nursing leaders and physicians (Lynch, n.d.). Two years after the 2010 IOM on the future of nursing and the identification of a greater need of interprofessional collaboration the Robert Wood Johnson Foundation (RWJF) awarded a grant to tackle the difficulties of interprofessional collaboration (Lynch, n.d.). Under the Program Results Report on How to Foster Interprofessional Collaboration Between Physicians and Nurses? A group of 12 “physicians and nurse leaders met throughout summer and fall 2011 to produce a document on interprofessional collaboration” (Jablow, 2012). Unfortunately, the attempt to foster interprofessional collaboration was a failure due to “the leak of a confidential draft consensus document and objections from physicians’ groups, primarily about scope of practice” (Jablow, 2012). One quote stood out to this writer in regard to the groups failure, “We agree that the patient should be at the center, but we have different perspectives on how you honor that focus” (Jablow, 2012).

What do you guys think? If those who are supposed to represent us can’t get along, how can we a direct patient care provider get along?

Jablow, P. (2012). How to foster interprofessional collaboration between physicians and nurses? Retrieved from https://www.rwjf.org/en/library/research/2013/01/how-to-foster-interprofessional-collaboration-between-physicians.html

Lynch, J. (n.d.). National nurse leader talks about the campaign’s progress, future plans. Retrieved from https://www.nurse.com/blog/2015/12/10/iom-releases-progress-report-on-future-of-nursing-2020-goals/

Response two: “Interprofessional collaboration is defined as “when multiple health workers from different professional backgrounds work together with patients, families, carers (caregivers), and communities to deliver the highest quality of care” (Vega & Bernard, 2016).

Traditionally health care professionals have acted in ‘silos.’ In other words, the physician did his job, the nurse did her job, the pharmacist did their job, and the other ancillary services did their jobs. Health care teams need to be developed to better support the physician. These teams may include not only the physician, but nurse practitioners, nurses, pharmacists, dietitians, PT/OT/RT and social workers. All of these people working together can improve the patient outcomes, and the patient experience. Both of which are linked to Medicare/Medicaid and private insurance reimbursement.

Many hospitals perform daily bedside rounds with the patient and the multi-disciplinary teams involved in the patients care as well as discharge rounds in planning for the patient discharge. For example, this can help increase patient safety/reduce errors by recognizing medication interactions or fall risks. Discussing ongoing need for IV’s, central lines, and Foley catheters can help prevent health care acquired infections if these can be removed.

The Patient Protection and Affordable Care Act (PPACA) focuses on health promotion and prevention. It is expected that the PPACA will decrease the cost of health care over the next 10 years. There are two different delivery models of care featured in the PPACA, one is the Patient Centered Medical Home (PCMH), and the other is the Accountable Care Organization (ACO) (Haas, 2011). ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients. The goal of coordinated care is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.

In the ambulatory setting the registered nurse is highly involved in the coordination of care of patients. I work in an outpatient oncology clinic that provides radiation and chemotherapy treatments. Our patients have large amounts of imaging, lab work, and other diagnostic testing that needs to happen in order for them to receive their chemotherapy treatments. We are often times in communication with other providers making sure the correct testing is being completed or not duplicated. The patients do not even realize how much we do behind the scenes to make sure their office visits are as meaningful and productive as possible. It is very frustrating for them to come in for their appointment only to realize a lab exam is missing or an ekg not done and that delays care. We work very closely with pharmacists in a checks and balance system before treatment can happen. This is all for patient safety as chemotherapy medications if not monitored correctly can cause permanent damage to the patients heart, lungs, kidneys or liver.

Reference

Haas, S. A. (2011, March 1). Health Reform Act: New Models of Care and Delivery Systems. AACN Viewpoint, 33(2), 11-12. Retrieved from https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds…

Vega, C. P., & Bernard, A. (2016, February 11). Interprofessional Collaboration to Improve Health Care: An Introduction. Medscape. Retrieved from https://www.medscape.org/viewarticle/857823

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