Access, cost, and quality
Introduction
In contemporary times there has risen an increased need for quality care. Diseases are becoming more prevalent. Chronic illnesses continue to increase with new ones like Covid-19 emerging. There is a rise in demand for emergency care, expected to be provided by Advanced Practicing Nurses. In this age, and era acuity of care is needed more than anything else. Patient outcomes are an essential area that requires the involvement of Advanced Practicing Nurses. In this analysis, the objective is to analyze the role of Advanced Practice Nurses to patient’s access to care, quality of care, cost of care, and quality to the environment. This discussion further identifies the possible quality initiatives that APNs have put to place to contribute to easy access, affordable cost, and quality care for quality environment meant to uplift patient care, and quality of the situation. The assessment of the role of APNs is also a clear way of measuring the performance, and evaluation that the APN’s play in giving patients the quality care that they deserve. Below are further discussions on the contributions of APNs to access, cost, and quality of a quality care environment.
Discuss the access, cost, and quality of the quality environment
To analyze the evaluation, measurement, and performance of APNs in quality healthcare, it is essential to understand the measures used to evaluate quality care. There are a lot of criteria that determine quality care. However, in this discussion, the focus is on a quality environment, and factors that make up a quality environment. Due to the complex nature of measurement, one can only measure a couple of elements simultaneously. However, it does not matter the provider of the healthcare, analysis, and evaluation of a quality environment is an obligation. Three factors make up a quality environment (Kleinpell, & Kapu, 2017). These factors are access, cost, and quality of a quality care environment. Further discussion of these three elements are found below:
Access is the ability of an individual to obtain quality health care. Quality health care is any related services embedded within the environment of nursing care. In many nations, access is narrowed down to issues like insurance and health cover. Access is considered an aspect of a quality care environment because improved health status, and outcome of an individual is only possible when they can receive the needed healthcare services. The first issue embedded within the access is insurance or health coverage. Insurance is an issue for most patients because the cash payments method has proven quite difficult for most patients. Under access, the role of Advanced Practice Nurses is realized through the nurses achieving they are limited to the kind of care and environment they can give to a patient regarding the type of insurance policy that the patient is registered. Under-insured or uninsured patients limit the patient’s access to the quality health care environment. As explained payment levels, and the insurance company of a patient is an essential consideration to access the quality care equation placed on a quality environment. It is these deficiencies that require the input of APN to ensure a quality environment of care is accessible to all patients.
The second element is the cost. In this health care context, the price is discussed as the amount of charges placed on the individual paying for the healthcare services to cater for the role played by the healthcare service provider. Cost is a second issue, along with access and quality that influences the environment. Cost issues are essential in delivering quality healthcare to patients. The critical approach of the cost that affects APNs is the health charges places on the value of pharmaceuticals and services by different healthcare institutions. Health care institutions also have expenses to pay their personnel, pay their administrators, supply their physical plant, and have equipment provided to the hospital. All this factor contributes to the service that a patient or a group of patients receive. To achieve quality care, APNs affect the cost of a quality health care environment. APNs affect the price by contributing to the societal, organization, and educational structures that provide to the determinant of what the charges will be put on those who seek access to healthcare. APNs play a leadership role and might be responsible for addressing cost issues that affect customers and their organizations. APNs have a massive role in determining outcomes of the way health organizations place charges on their individuals to learn to care about the level of care they receive.
The third issue is the quality of a quality environment. Quality is the input placed on service so that there are increased chances to get the desired outcome. The excellence of quality environment in healthcare institutions is highly used to assess and evaluate the work rate of APNs, and their contribution to quality care.
Based on the above-analyzed roles, there are identified roles of APNs in the provision of a quality environment for healthcare. Functions of APNs on cost and access display themselves on structural and process elements. For quality care, APNs take leadership in an administrative role. Below are some of the recent quality initiatives by APNs, and other groups have taken to ensure access, cost, and quality of a quality healthcare environment is achieved.
Quality initiatives by APNs to improve access, cost, and quality of the quality environment
There have been many recent initiatives targeted to improve the quality of the health environment within the health care system. Even though many groups might initiate these initiatives, the discussion below mostly highlights efforts by APNs. APNs, before supporting health care initiatives, introduced a discourse of creating standards and expectations of what entails quality care. The APNs identified that quality care, cost-effective care, and one that is accessible by everyone are where patients’ expectations can be specified, performance and, the outcome of the nurses can be made public. When the mentioned issues are adequately met, then a quality environment and care are met.
There are two outstanding initiatives by APNs that will be discussed. The first initiative is known as AHRQ (The American Health Care Quality) initiative. The objective of the action was to reduce costs and promote the quality outcome of care. AHRQ was an initiative where APRNs contributed to a drug design where prescriptive drugs are designed with high outcome power. The presence of big issue will mean proper quality care, and reduction in cost. The initiative seems to contribute to reducing the cost of drugs for patients and also giving improved outcomes that lead to quality care on the part of the patient. The AHRQ initiative also introduced a guideline called “Child Health Tool Box.” With this tool, clinicians, including APNs, could measure the rate of the outcome of their care and regulate their own established performances.
The second initiative by the APNs and other healthcare agencies are targeted to promote access to healthcare as one of the essential elements of a quality healthcare environment. The APNs through an association known as CAHMI (Child and Adolescent Health Measurement Initiative) evaluated the role that health systems and institutions take in providing care for children and parents covered by Medicaid and other private insurances (Joel, 2017). The group intervenes against the possible gaps that could exist within the healthcare system and the expected provision of access that ensures quality environment within the healthcare institutions. This initiative makes health care institutions and systems accountable by fostering their involvement in analyzing how their patients get access to healthcare. In the discussion above, two significant actions have been discussed, each contributing to quality healthcare by addressing the three elements of a quality environment. Below is a further study on the relationship between quality measures, evaluation, and role development of APNs.
Reflection on the relationship between quality measures and evaluation and role development
A lot of professional parts are developed to ensure quality measures, evaluation of healthcare practitioners, and the kind of quality care they provide. The first relationship is that the dissemination of these roles has done to ensure the delivery of high-quality health care services. These role developments also ensure that healthcare delivery professionals make better decisions regarding the treatment and care of patients.
Additionally, the development of health care association groups develops roles for consumers of health care services to channel their expectations and what they consider to be quality care (Joel, 2017). Through the healthcare consumer’s expectations, it would be able for clinicians to come up with measures and evaluate quality care.
Even though many reflections measure and evaluate quality care, the last one under this discussion is the role disseminated to legal, and funding fraternity. The legal and funding part directly measures the structural process and performances of clinicians, including APNs. The developed character initiates long and short-term outcomes that should be achieved by clinicians, failure of which it leads to legal or financial implications on the part of the clinicians. Short-term consequences contain accessibility to quality care, patient satisfaction, and improved health behavior on the part of the nurse. Morbidity, mortality, and optimal health status are some of the legal and financial health objectives needed to be achieved in the newly developed roles that inform health quality measures and evaluation.
Having reflected on role development caused by quality measures and evaluation, below is further analysis describing the relationship that APNs have in achieving quality measures.
Description of the relationship between APNs and quality measures
The relationship that APNs have with quality measures are found on four levels. The first level is the individual level, where an APN is required by independent and inter-professional bodies to ensure that each patient has access to quality care, patient-centered expectations are met, and the competencies to measure their performances over the others (Towers, 2004). Many individual nurses measure their quality care through the annual evaluation that focuses on their productivity as individuals. When the effectiveness of costs, care, and patient satisfaction is measured, they mostly focus on individual nurses. Depending on the feedback that the hospital receives from its consumers regarding the targetted nurse.
The most frequent feedback used in the USA is the Medicaid consumer feedback that generally comes from the Medicaid insurance subscribers.
The second relationship is the group-level relationship in which an APN is considered a member of the professional practice. As a group, they then pile pressure on other bodes like the government to standardize quality measurements that can be used in health care institutions. For example, the CMS designed a long-term program that measures the quality of care that could improve Medicaid insurance, making access to child insurance easy (Towers, 2004).
The third relationship is the systems-level, where health care plans are by APNs and held accountable concerning consumers. For example, a group known as Consumer Assessment of Health proposes a health care provision expectation. In the hope, the APNs react through a report providing an assessment of the system’s quality measurement. The last relationship, which is societal, is mostly about advocacy. APNs relate to quality measures, and evaluation societally through advocating for better health and quality environment care policies. Having analyzed the role of APNs on quality measures, below are some recommendations for change of characters in cases where there is a lack of or total inexistence of quality measures.
How the Role of the APNs change without effective quality measures
Without adequate quality measures, nurses’ autonomy increases, which is likely to affect both quality care and a patient-centered approach to care (Joel, 2017). Two roles are likely to change. First, innovations to strengthen the APNs workforce to achieve quality care will be limited to a considerable perspective. Secondly, evidence-based measurements and structures that develop field tests, if abandoned, will define the research and development role that nurses contribute to ensuring that access, cost and, quality environment are achieved.
In conclusion, the discussion above displays an in-depth analysis that agrees with the thesis statement on the critical role that APNs have in achieving quality measures and evaluation in reached health care institutions. Three elements that have been used to elaborate on the critical care and part of APNs are access, cost, and quality of care of a quality healthcare environment. Lastly, the final analysis narrows down to APN’s contribution as an individual, as part of a professional group, as part of a system, and as a member of the society. In the role change discussed, it is proof of how vital the role of APN is to quality measure that it cannot be made less efficient.