Tuesday, July 19, 2011

Future Patient Care Delivery Committee: Innovation and Future Trends

Do you publish most everything electronically instead of on paper, have a Facebook presence within your practice setting, know the latest apps for enabling efficient workflow at the bedside or communicate real time via SharePoint and twitter with your nurses? Despite the protests, barriers and challenges to each of those innovations in practice, they are rapidly moving from innovative ideas to assumed practices by our millennial nursing workforce.

How can you discover what is needed to cope, plan and deal effectively with the rapid changes in care delivery models, reimbursement value engineering, the volume and speed of leadership transitions and the need to completely reinvent how we provide care? To start, every nurse executive must have critical knowledge of emerging trends and learn to navigate changes real-time. Moving from dealing with the rapid changes that are faced regularly to incorporating complex and fast changing trends into strategy is quickly becoming a core competency.

In April, Dr. James Canton, CEO, Institute for Global Futures posted the four futures that will shape medicine: prediction, personalization, prevention and promotion. These futures are already influencing the practice of nurse executives, requiring infrastructure creation in the practice environment to produce innovations and rapid change. Several references in the AONE Future Care Delivery Toolkit describe the context in which Chief Nurse Executives must create innovation in practice to support the futures of healthcare.

The toolkit provides a thorough and efficient framework for gaining critical knowledge of important TRENDS:
T – Technology-enabled innovations are driving the game changing disruption that is producing the solutions to reinventing healthcare delivery.
R – Re-inventing health care will require rapid dissemination of successful exemplars and, in turn, rapid cycle change in all practice areas.
E – Ensuring quality and safety are at the core of care delivery is imperative.
N – Nurse executives must be transformational leaders to produce organizational innovation.
D – Disruptive innovation will produce new products of medical care at much lower cost.
S – Skills are required for managing innovation and ensuring the presence of high-level innovation within all practice areas.

Stay closely tuned to this blog, the Future Care Delivery Toolkit and AONE, because it won’t be long that the answer to your question about innovation and future trends for the nurse executive will come with one simple answer: There’s an app for that!

Lamont M. Yoder, MSN, RN, MBA, NEA-BC, FACHE

Wednesday, July 6, 2011

Future Patient Care Delivery Committee: Patient and Family-Centered Care

In its recent landmark report, the Institute of Medicine (IOM, 2010) envisioned the future of care delivery as patient-centered. They also indicated that healthcare should be “seamless, affordable, quality care that is accessible to all and leads to improved health.” This certainly seems to be in direct agreement with AONE’s Guiding Principles for Future Care Delivery.

Not only are healthcare providers to base care on a safe environment, but also we must individualize that care to the needs and circumstances of the patient and family (AONE, 2010). The Guidelines call upon us to recognize ourselves as “guests” in that environment, whether this is in the hospital or in the home. One might wonder how care givers will shift their views from that of “hosts” to that of “guests”. This idea calls to mind the image of a bow in those cultures where it is customary to bow when greeting. The late philosopher, Joseph Campbell, indicated that the bow is to acknowledge the deity within the greeted individual.

Inherent in care based on a patient and/or family focus, one might immediately think of the concept of Relationship-Based Care. Delivery of this type of care is obtainable only when we are able to understand what patients and families see as the most important aspects of their care (Person, 2004). Indeed we see that the development of a therapeutic and trusting relationship with the professional caregiver results in better patient satisfaction. Furthermore, nurse satisfaction and quality outcomes have shown improvement in this model.

As we look to the future (and does it not seem like the future is now?), we must consider the transition from acute care to home as not only seamless but also coordinated. Even more importantly our primary care model must shift to one of integrated from home and throughout the system (Birk, 2011). Birk points out that having fewer patients per PCP allows more time on the front end for care management. Think about our trends on the nursing floors. Are not many of our institutions trying to move to an increased patient assignment for the nurses? Does an increase in the number of patients for whom a professional nurse must develop a plan of care not reduce the amount of time that nurse has to provide for the management of care and to develop those trusting relationships? What IS that magic number? How will we support and institute changes to our care delivery models in this challenging financial climate?

Please consider using the resources and exemplars in the Future Care Delivery Toolkit as you navigate in the coming months. While the questions above are meant to be rhetorical, it does seem pertinent for leaders who have the opportunity to move towards effective, integrated, and coordinated care that keeps the patient and family at the center of all decisions.

Annelle Beall, MSN, RN, CNN, NE-BC