organizingpatientcare-130707231102-phpapp01.pptx

8/9/2019 organizingpatientcare-130707231102-phpapp01.pptx

1/79


2/79

Presentation by: Mae Michelle F. Aguilar R.N.NRSG125A-1

ORGAN ! NG

PA" #N" $AR#


3/79

Learning Objectives1. Get reac%uainte& 'ith the "ra&itional Mo&els o(

Organi)ing Patient $are their brie( bac*groun&as 'ell as its a&+antages an& &isa&+antages.

2. ,ist the essential co onents o( caseanage ent an& &isease anage ent.

/. 0no' the &i erent ,ea&ershi an& ManagerialFunctions in Organi)ing Patient $are.


4/79

• FIRST and MIDDLE-LEVELMANAGERS in3uences theorgani)ing hase o( the anage ent

rocess at the unit or &e art entle+el.


5/79

• UNIT LEADER-MANAGER

&eter ines ho' best to lan 'or*acti+ities so that organi)ational goalsare et e ecti+ely an& e4ciently.


6/79

• TOP LEVEL MANAGER in3uenceon the hiloso hy an& resourcesnecessary (or any selecte& care&eli+ery syste to be e ecti+e.


7/79

Leaders i! R"#es andManage$ent F%ncti"ns

Ass"ciated &it Organi'ingPatient (are


8/79

EADERS)IP ROLES

1. Perio&ically e+aluates thee ecti+eness o( the organi)ationalstructure (or the &eli+ery o( atient

care.2. eter ines i( a&e%uate resources

an& su ort e6ist be(ore a*ing any

changes in the organi)ation o(


9/79

/. #6a ines the hu an ele ent in'or* re&esign an& su orts

ersonnel &uring a&7ust ent to

change.

8. ns ires the 'or* grou to'ar& a

tea e ort.


10/79

5. ns ires subor&inates to achie+ehigher le+els o( e&ucation9 clinicale6 ertise9 co etency9 an& e6 eriencein &i erentiate& ractice.

. #nsures that chosen nursing care&eli+ery o&els a&+ance the racticeo( ro(essional nursing.


11/79

1. #6a ines the unit hiloso hy toensure that it su orts any changein the atient care &eli+ery syste .

2. Selects a atient care &eli+erysyste that is ost a ro riate tothe nee&s o( the atients beingser+e&.

NAGEMENT FUN(TIONS


12/79

/.;ses scienti


13/79

5. #nsures that non ro(essional staare a ro riately traine& an&su er+ise& in the ro+ision o( care.

. Organi)es 'or* acti+ities to attainorgani)ational goals.


14/79

=. Grou s acti+ities in a anner that(acilitates co unication an&coor&ination 'ithin an& bet'een&e art ents.

>. Organi)es 'or* so that it is as cost-e ecti+e as ossible.


15/79

?. Ma*e changes in 'or* &esign to(acilitate eeting organi)ational

goals. >. $learly &elineates criteria to be use&

(or &i erentiate& ractice roles.


16/79

"RA " ONA, MO #SOF ORGAN ! NG

PA" #N" $AR#


17/79

TOTAL PATIENT (ARE*(ASE MET)OD NURSING

• Nurses assu e total res onsibility&uring their ti e on &uty (or eetingall the nee&s o( assigne& atients.

• So eti es re(erre& to asCase Method of Assignment .


18/79

$harge Nurse

NursingSta

Patients

NursingSta

Patients

NursingSta

Patients


19/79

• 1? th $entury total atient care 'as ro+i&e&in the ho es.


20/79

• Great e ression o( the1?/@ s eo le can no longera or& ho e care an& beganusing hos itals. Nurses an&stu&ents also beca ecaregi+ers in hos itals an& in

ublic health agencies.

• 1?/@ s an& 1?8@ s hos italsgre' an& ro+i&e& total carecontinue& as the ri ary

eans o( organi)ing atientcare.


21/79

•

Pro+i&es nurses 'ith high autono yan& res onsibility.

• Assigning atients is si le an&

&irect.• ,ines o( res onsibility an&

accountability are clear.•

Patient theoretically recei+es holistican& un(rag ente& care &uring thenurse s ti e on &uty.


22/79

•

"he atient ay recei+e three&i erent a roaches to care9 o(tenresulting in con(usion (or the

atients.• Re%uires highly s*ille& ersonnel an&

thus ay cost ore than so e other(or s o( atient care.

• May result to unsa(e care 'henNurses ha+e a hea+y atient loa&.


23/79

FUN(TIONAL MET)OD• Personnel 'ere assigne& to co lete

certain tas*s rather than care (ors eci


24/79

• B$are trough othersC - Nursesbeca e anagers o( care ratherthan &irect care ro+i&ers.

• ;AP ;nlicense& Assisti+e Personnel


25/79

Patients

Me&icationNurse

"reat entNurse

NursingAssistantsDEygienic

$are

$lericalDEouse*ee ing

$harge&Nurse


26/79

• #+ol+e& as a result o( orl& ar an& theEill urton Act.

• $ontinue& &ue to the B aby oo C a(terthe ar.


27/79

• #cono ical eans o( ro+i&ing care.• "as* are co lete& %uic*ly 'ith little

con(usion regar&ing res onsibilities.• Allo's care to be ro+i&e& 'ith

ini al nu ber o( nurses.• Functions 'ell in areas such as the

o erating roo .


28/79


29/79

TEAM and MODULARNURSING

• Ancillary ersonnel collaborate inro+i&ing care to a grou o( atients

un&er the &irection o( a ro(essionalnurse.


30/79

$harge& Nurse

"ea,ea&er

NursingSta

Patients

"ea,ea&er

NursingSta

Patients

"ea,ea&er

NursingSta

Patients


31/79

• e+elo e& in the1?5@ s to &ecrease

roble sassociate& 'ith(unctionalorgani)ation o(

atient care.


32/79

• Nurse acts as a "ea ,ea&erres onsible (or *no'ing the con&itionan& nee&s o( all the atients assigne&to the tea an& (or lanning

in&i+i&ual care.

• uties ay inclu&e: assisting tea

e bers9 gi+ing &irect ersonal careto atients9 teaching an&coor&inating atient acti+ities.


33/79

• A tea shoul& consist o( not orethan 5 eo le.

• Most tea nursing 'as ne+erractice& in its urest (or but 'as in

co bination o( tea an& (unctionalstructure.


34/79

MO ;,AR N;RS NGMO ;,AR N;RS NG a ini-tea H2-/

e bers a roachI• Me bers are so eti es calle& Bcare

airsC.• A s all tea re%uires less

co unication9 allo'ing e bersbetter use o( their ti e (or &irect

atient care acti+ities.


35/79

• Allo's e bers to contribute theiro'n s ecial e6 ertise or s*ill.

• $o rehensi+e care can be ro+i&e&(or atient &es ite a relati+ely high

ro ortion o( ancillary sta .


36/79

•

isa&+antages are associate& 'ithi ro er i le entation rather than'ith the hiloso hy itsel(.

e.g. insu4cient ti e (or tea carelanning an& co unication canlea& to blurre& lines o( res onsibility9errors an& (rag ente& atient care.


37/79

PRIMAR+ NURSING• Pri ary Nurse assu es 28-hour

res onsibility (or lanning the care o(one or ore atients (ro a& issionor the start o( treat ent to &ischargeor the treat ent s en&.


38/79

• A.0.A Relationshi -base& Nursing.

•

Pro+i&es total &irect care (or atients.

• Re%uires a nursing sta a&e u o(

only Nurses.


39/79

• e+elo e& in the1?=@ s an& usesso e conce ts o(

total atient carean& brings nursesbac* to thebe&si&e to ro+i&e

clinical care.


40/79

Pri$ar,

N%rse

Patient

( arge

N%rse)ea#t(are

Organi'ati"ns

Res"%rces

Ass"ciat

e N%rseDa,s.

Ass"ciate N%rseNig ts.

Ass"ciate N%rse

Evenings.

P ,sician


41/79

• Associate Nurses (ollo's the carelan establishe& by the ri ary

nurse 'hen the ri ary nurse is noton &uty.

• "his structure len&s itsel( 'ell toho e health nursing9 hos ice nursingan& other health care &eli+eryenter rises.


42/79

• $lear inter&isci linary grouco unication an& consistent9 &irect

atient care by relati+ely (e' nursing

sta s allo's (or holistic9 high-%ualityatient care.

•

Eigh 7ob satis(action.


43/79

• isa&+antages in this etho& lie ini ro er i le entation.

• Many nurses ay be unco (ortablein this role &ue to lac* o( e6 eriencean& s*ills necessary (or the role.


44/79

(ASE MANAGEMENT


45/79

• ntro&uce& in the 1?=@ s by insurance

co anies as a etho& to onitor an&control e6 ensi+e health insurance clai s.

•

"o&ay +irtually e+ery a7or healthinsurance co any has a caseanage ent rogra to &irect an&anage the use o( health care ser+ices (or

their clients.

• 0no'n as e6ternal case anage ent.


46/79

• Mi& 1?>@ s hos itals ha& recogni)e&the nee& (or a case anage ent

o&el to anage treat ent lansan& length o( stay o( hos itali)e&

atients.

• "his 'as calle& internal caseanage ent or case anage ent

B'ithin the 'allsC o( the health care

(acility.


47/79

hat isJ• A collaborati+e rocess that

assesses9 lans9 i le ents9

coor&inates9 onitors9 an& e+aluateso tions an& ser+ices to eet anin&i+i&ual s health nee&s through

co unication an& a+ailableresources to ro ote %uality9 cost-e ecti+e outco es H$MSA9 2@@ I


48/79

• Focus is on in&i+i&ual atients9 noto ulations o( atient.

• $ase anagers han&le each casein&i+i&ually9 i&enti(ying the ost cost-e ecti+e ro+i&ers9 treat ents an&care setting.


49/79

•

$ase Manage ent Nurses canchoose to s eciali)e in treatingeo le 'ith &iseases li*e E KDA S or

cancer9 or you can 'or* 'ith atientso( certain age grou s li*e geriatricsor e&iatrics.


50/79

• A$;"#-$AR# $AS# MANAG#M#N"integrates utili)ation anage entan& &ischarge lanning (unctions an&

ay be unit base&9 assigne& byatient9 &isease base&9 or ri ary

nurse case anage&.


51/79

• A&&itional 'or* e4ciency &ue togeogra hic ro6i ity9 but orei ortantly9 the bene


52/79

• ;se $ritical Path'ays an& Multi&isci linaryaction lans HMAPsI to lan atient care.

•

$are MAP co bination o( $ritical Path'ayan& Nursing $are Plans. – "his in&icates the ti e 'hen nursing

inter+entions shoul& occur an& this ust be

(ollo'e& by health care ro+i&ers. – Kariance anything that occurs to alter theatient s rogress through the nor al criticalath.


53/79

• $ycle "i e Re&uction in+ol+esre+ie'ing the e6isting rocess that

ro+i&es a ro&uct or ser+iceL&eter ining 'aste& ti e or e ortLan& &e+elo ing an i ro+e&9strea line& 'ay to achie+e the sa e

results ore e4ciently. HFurlo' 2@@/I


54/79

#$OM# AJ

(ASE MANAGEMENT NURSE

G E T + O U R /(ase Manage$ent n%rse certi0cati"n 1r"$ t e A$erican N%rses

(redentia#ing (enter

P A S S + O U R /Nati"na# ("%nci# Licens%re E2a$inati"n

N(LE3-RN.

G E T + O U R 4 4Ass"ciate Science "1 N%rsing

ASN.5ac e#"rs "1 Science in N%rsing

5SN.


55/79

• # ecti+e case anagers shoul& ha+e/-5 years o( &irect care e6 erience9

re(erably 'ithin the s ecialty areain 'hich they case anage. HS ith2@@/I

• Role shoul& be reser+e& (or thea&+ance ractice nurse or registere&nurse 'ith a&+ance training HEuston

2@@2I


56/79

6%a#ities "1 a (ase Manager• #6tre ely right• ell-&e+elo e& inter ersonal s*ills• Able to ultitas*• Strong (oun&ation in utili)ation

re+ie'• ;n&erstan&s ayer- atient s eci


57/79

DISEASE MANAGEMENT• One role increasing assu e& by $ase

Managers is coor&inating &iseaseanage ent rogra s.


58/79

• DISEASE MANAGEMENT DM. also *no'n as o ulation-base&

health care an& continuous healthcare i ro+e ent9 is aco rehensi+e9 integrate& a roachto the health care rei burse ent o(

high-cost9 chronic illnesses.


59/79

•

nclu&es early &etection an& earlyinter+ention as 'ell asco rehensi+e trac*ing o( atientoutco es.

• "he &i erence o( M in $ase

Manage ent is that the (ocus is onBco+ere& li+esC or o ulations o(atients9 rather than on the

in&i+i&ual atient.


60/79

• GOA,: Ser+e the o ti al nu ber o(co+ere& li+es re%uire& to reacho erational an& econo ic e4ciency.


61/79

• National $o ittee (or ualityAssurance HN$ AI began anaccre&itation rocess in anuary 2@@2(or organi)ations that o erco rehensi+e M rogra s.


62/79

("$$"n Feat%res1. Focus is on re+ention as 'ell as

early &isease &etection an&

inter+ention.2. Po ulation-base&./. # loys ulti-&isci linary health

care tea 9 inclu&ing s ecialists8. ;se stan&ar&i)e& clinical gui&elines clinical ath'ays re3ecting bestractice research to gui&e ro+i&ers.


63/79

5. ;se integrate& &ata anage entsyste s.

. Fre%uently e loys ro(essionalnurses in the role o( case anager or

rogra coor&inator.


64/79


65/79

• Re(ers to an atte t to se aratenursing ractice roles base& one&ucation or e6 erience or aco bination o( both.


66/79

7 5ASI( DIFFEREN(IATED

PRA(TI(E MODELS1. #&ucation Mo&el

• i erentiation is base& on ty e o( e&ucational

re aration HAN 9 SN9 MSNI• $o onents: Pro+ision o( $are9 $o unicationan& anage ent.

2. $o etency Mo&el• ase& on in&i+i&ual nurse s*ill le+el9 e6 ertise an&

e6 erience.• enner s 8I an& > ANA

stan&ar&s o( nursing. Also suggests the 21 Pe'Eealth Pro(essional $o ission $o etencies.


67/79

Rati"na#e• "o atch atient nee&s 'ith nursingco etencies.

• Facilitate the e ecti+e an& e4cient useo( nursing resources.

• Pro+i&e e%uitable co ensation base&on e&ucation9 ro&ucti+ity an& e6 ertise.

• ncrease nurse satis(action.• uil& loyalty an& increase the restige o(

the nursing ro(ession.


68/79

T e F%t%re 1"r Patient (are andDe#iver, M"de#s

•

Nurse as clinical e6 ert lea&ing othere bers o( a tea o( artners.


69/79

• $reation o( a ne' nursing role Htheclinical-nurse lea&erI that is oreres onsi+e to the realities o( the

o&ern health care syste .H"ornabeni9 Stanho e9 an& iggins2@@ I


70/79

• A coo erati+e o&el o( care &eli+erythrough lay care artners. "hey aretaught to recogni)e syste s9 i&enti(y

roble s an& ta*e action.


71/79

8 ("$!"nents "1 Deter$ining t eM"de# "1 N%rsing (are De#iver,

Ren" et4 A# 7998.A. $on+ersion o( anual syste s intoauto ate& ones.

. i erentiate& le+els o( nursingractice.$. ncrease& *no'le&ge base o(

nursing ractitioners.. e+elo ent o( 3e6ibility an&ni bleness.

#. Attraction o( nursing can&i&ates


72/79

: en Eva#%ating

t e (%rrent S,ste$and ("nsidering a( ange/


73/79


74/79

• ill it satis(y the atient an& their(a ilies

• ill it ro+i&e so e &egree o((ul


75/79

•

oes it ro ote an& su ort thero(ession o( nursing as bothin&e en&ent an& inter&e en&ent

• oes it (acilitate a&e%uateco unication a ong all e bers

o( the health care tea


76/79

•

Eo' 'ill it change the atient care &eli+erysyste 9 alter in&i+i&ual an& grou &ecision

a*ing ill autono y increase or&ecrease

• Eo' 'ill social an& inter ersonalrelationshi change

• ill the e loyees +ie' their unit o( 'or*&i erently


77/79

•

ill the change re%uire a 'i&er orore restricte& range o( s*ills an&abilities on the art o( the caregi+er

• ill it change ho' e loyees recei+e(ee&bac*

• ill co unication atterns change


78/79


79/79

Documents

organizingpatientcare-130707231102-phpapp01.pptx