How Palliative Care Supports the Quadruple Aim of Improving Patient’s Experience
Introduction
Over the previous years, the health care industry has accomplished a shift to the quadruple aim of health care that involves patience, improvement, and population health, such as the elderly in society. Other is reducing the cost of health care- reducing the per capita of health services and improving the provision of services, such as using contemporary and digital technology to offer services, such as using electronic health records (Bodenheimer & Sinsky, 2014). However, out of these four segments, this paper will focus on patients’ experience that includes the satisfaction of the patients. Patient experience entails a range of engagements and interactions with the patients and various health care personnel, such nurses, physician, health care business plans, clinical methodologies and practices, and other health care facilities (“What Is Patient Experience? | Agency for Healthcare Research & Quality,” 2016). As a comprehensive aspect of quality health care, patients’ experience involves various aspects of healthcare delivery systems that put the care and values of patients primarily when they arrive at the facilities to seek health care services. An example of this is ensuring that patients receive timely appointments, patients being able to access their reports and information effectively and readily, and ideal communication with the health care stakeholders.
Getting to understand this aim (patients’ experience) is a significant step towards providing patient-centred care. By examining several aspects of patient experience, I note that palliative care delivery system is ideal for solving the issue. That is because palliative health care delivery can significantly reduce the risk of emotional and physical burden or discomfort of a patient (Dy et al., 2015). Palliative health care is “an approach that improves the quality of life of patients and their families facing the problem associated with a life-threatening illness, through the prevention and relief of suffering utilizing early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual” (“WHO | WHO Definition of Palliative Care,” 2012). Its four main principles are affirming life, regarding death as a normal process, not hastening or postponing death, relieving pain and other symptoms, and integrating spiritual and psychological care aspect (Cruz-Oliver, 2017). Due to its firm and integrative principles, palliative health care delivery generally improves a patient’s experience. Many health care facilities, patients, and health care professionals regard palliative care as the central delivery system that promotes the patient’s delivery through testimonies (Schroeder & Lorenz, 2017). The Project aims to discuss how palliative care delivery system supports or instead promotes patients’ experience in the health care industry.
The Project shall follow the following plan: first, I will provide a rationale for selecting patients’ experience selection as my quadruple aim. Second, I will offer a comprehensive and synthetic scholarly literature review that will give an overview of how palliative care has promoted the aspect of the patient’s experience. The third section shall discuss the financial analysis pertinent to my framework and Project. Finally, the last part shall be an executive summary that shall include the Project’s overview and the anticipated or expected benefits and importance of the Project.
The rationale of the Project
Patients’ experience is even more important than medical costs and other financial claims, as they are associated with their care. Eventually, patients have to change their perspective to be more involved in the processes of decision-making, where they are most likely ensuring that they receive quality care as part of their investment. It often involves making comparisons of the services provided by health care facilities. Patients have changed their perspective on health care. They have transformed into a model where they compare it to shopping where patients seek the best possible experience whenever they need the services. As a result, “large” health care organizations are gaining more and more profits not by cutting the costs to attract clients but by improving patients’ experience and more so satisfaction.
In modern times, many patients are always willing to seek healthcare services from organizations that charge more costs but offer excellent patients’ experiences and neglect those hospitals that charge fewer fees but offer poor patients’ experience. Health care facilities that use the palliative care system tend to record higher or excellent patients’ experience. Many other hospitals are on the rush to adopt this system, as there is a steady growth of such programs while others are still waiting because access to palliative care is dependent on geographical accidents and ownership of the hospital (Dumanovsky et al., 2016). This Project aims at providing them with a brief but comprehensive overview of how palliative care delivery system supports or improves health care patients’ experience and what benefits they should expect after adopting this kind of delivery.
Literature Review
Palliative care delivery systems are a high touch-driven mechanism that promotes patients’ experience and also the family experience and effective utilization of health care available resources, including the financial ones. Health care services continue to dive into a value-based framework that typically benefits palliative care (Masterson, 2018). Payers are always willing to pay more for quality health providers and quality care, improving outcomes and reducing costs rather than how many services the many caring services they provide. That makes a hospital attract and retain more customers and clients who will refer other friends to acquire their services. It helps the hospital gain reputation and more profits that not only benefit the shareholders but also increase the values of the investment (Masterson, 2018). As mentioned earlier, palliative health is value-based; thus, it values the health and service they offer to the patient, which improves the patients’ experiences. With the substant,ial cost, slinked with end-of-life care, the definitive account of life for nearly a quarter of Medicare Dollars is spent on in-patient services, post-acute services, and hospice (Masterson, 2018). Hospitals are increasingly using palliative care programs to reduce avoidable costs and offer end-of-life services needed by clients. This implies that palliative care improves patients’ experience due to their end-of-life care to the patients. Palliative care is also able to attract more people into the same “room” for both specialists and family members. It also promotes health care provision, hence an excellent patient experience (Masterson, 2018). Therefore, palliative care promotes and enhances care delivery, and expertise for both patients and providers helps a facility to ground or affirm its existence.
Palliative health services care is mostly preferred for older people and most cancer patients. Palliative health care is linked to reduced stay period for patients and cut of death chances for the sick. Furthermore, palliative care facilities promote an understanding of diagnosis models and prognosis for the families and patients, along with the appropriate discharge resulting from the consultation (Sganga et al., 2019 & Black, McGlinchey, Gambles, Ellershaw, & Mayland, 2018). It implies that discharge from the hospitals means that there is no congestion of patients in the hospital, thus improving the quality-working environment for the patients and the providers (Sganga et al., 2019). It also creates more space for the admission of other patients into the hospital that helps them increase their costs, although indirectly. This kind of delivery service facilitates fast¸ appropriate for clients at the end-of-life stage (Sganga et al., 2019). This framework helps reduce the occurrences of hospital deaths and ensures excellent patients’ experiences by allowing them to die in the most suitable care services for them. It also promotes a family to take the loss of the patients positively through supportive conversations when conducting the planning phase of an adequate discharge.
Besides, palliative care delivery programs are associated with hospitals savings their costs due to avoidance of readmission into the hospital due to the appropriate hospital discharge (Black, McGlinchey, Gambles, Ellershaw, & Mayland, 2018). Additionally, this illustrates that there is a need for excellent palliative care examination in all phrases due to the number of complexities experienced by the patients, such as comorbidities (Sganga et al., 2019). Although their research focused on cancer patients, it does not mean that palliative care only means that palliative care is not appropriate for other patients, particularly advanced chronic patients. For example, patients with chronic diseases are populations with high possibilities of growing and developing in the future (Sganga et al., 2019). The outcomes offer excellent and firm fiscal benefits for healthcare facilities and other decisions and policymakers to implement or expand existing palliative care delivery systems that are evident as demonstrated to have improving clients’ experience. It also satisfies the victim’s family and further promotes the hospitals’ activities by reducing their costs (Sganga et al., 2019).
With many palliative care services provided by healthcare programs being delivered in the modern days, new services under the plans are still evolving. Evidenced-based research shows that palliative health care services reduce the time of stay in hospitals (Yosick et al., 2019). There are small effects of patient outcomes though it primarily or somewhat significantly affect the patients’ experiences. In modern days, such moves in the United States are being promoted to help move the country toward a value-based cot framework (Yosick et al., 2019). Many hospitals or rather the health care facilities generally focus on the quality of care they offer, such that they are offering high quality health care services, standardized, and subsidized costs. That is because palliative care eliminates a non-beneficial and wasteful provision of healthcare services (Black, McGlinchey, Gambles, Ellershaw, & Mayland, 2018). Community-based palliative programs or hospital-based palliative care are linked with decreased hospitalization and costs in the last period of a patient’s life. Taking the patient at home in these previous days helps the victims with serious illnesses to survive for long, where they are likely to progress the longer they are in the strategies such that they eventually meet the requirement such as that for the hospice program (Yosick et al., 2019).
Palliative care delivery systems incorporate critical aspects of the quadruple aims that involve patience experience improvement, improving population health, for example, the elderly in the society (Yosick et al., 2019). Other is reducing the cost of health care- reduction of the per capita of health services, and improvement of the provision of services, for example, use of contemporary and digital technology to offer services, for example, use of electronic health records (Yosick et al., 2019). This system’s delivery is done by multidisciplinary team care management, home, and phone conversations, focusing on care management and coordination, effective and efficient collaboration of the patients, families, and health plans, and application of a mobile platform for supporting the flow of work and reports. It promotes the hospital’s activities to offer the quality of services to ensure that there is always quality care being provided to patients, hence developing the patients’ experience; thus, good the reputation of the health care organizations (Yosick et al., 2019). The clinical team also uses consistent healthcare facilities and organizations guided by the quality assessment due to the based intervention processes and specific clinical programs.
Palliative care delivery system identifies candidates involved through an analytic form that removes and eliminates the subjectivity and is time-consuming in making decisions of the appropriate people for the care programs or platforms (Yosick et al., 2019). The palliative care delivery system provides care and supports patients in the earlier stages of disorders processes. The services are streamlined and made as to the new normal as part of the continuum of healthcare services (Yosick et al., 2019). If adopted by a hospital, the program concentrates on supporting and assisting patients and their families as they integrate health and social support and services to giving support in the communities and at home and less unplanned provision of services. Also, these teams or programs are enlightened and have strategic goals for care and assisting patients by providing care through advanced care strategy documentation that enhances shared decision-making processes (Yosick et al., 2019). Palliative care services also develop a strategy of care based on cultural and spiritual distinction and specific illness elaboration.
Besides, critically ill patients are likely to survive when placed in the community and home-based palliative care than those admitted in the intensive care unit or several other end-of-life treatment processes (Yosick et al., 2019). For instance, patients who receive palliative care with advanced illnesses and receive consistent and precise reports about the diseases give insights regarding their diagnosis and prognosis (Yosick et al., 2019). Furthermore, palliative care builds and promotes trust between patients and health providers and all other stakeholders quality planning and strategies and attending to the advanced provision of care. It can also shift or transfer their area of focus away from curative or preventive centers to comfort and excellent experience for the patients. It builds intense patient experiences where healthcare organizations invest appropriately since they all ensure quality care and encouragement (Yosick et al., 2019). It is also because health care not only consists of curing and preventing diseases and other ailments but also comforting and ensuring that the patients feel comfortable regarding the health condition or circumstances (Yosick et al., 2019). For example, not all cancer patients are curable; most of them eventually lead to the death of the victims; thus, the health care providers in palliative care delivery systems provide comfort to them.
Increasing but limited evidence shows that the palliative care delivery system, as used in the disease progression, may result in improved life quality, better management of the patients’ symptoms, reduced aggressive treatment mode at the end of life framework, and increases in the rates of survival. Studies show that it is strengthened and improved patient outcomes, better experiences, and sufficient quality of health care provided by profound effects of the quality of life (Oliver, 2018 & Sampson, Finlay, Byrne, Snow, & Nelson, 2014). The home palliative care framework also reduces admission to hospitals and raises people’s involvement, frailty, advanced heart failures, and cancer. Besides, in Australia, for example, the provision of health care services at home reduces the period of bed stays and the cost of critical or acute care at the end of life stages when the patient is just about to die with reduced charges (Oliver, 2018).
Palliative care enhances collaboration between health care stakeholders due to their high interactions. These stakeholders include doctors, nurses, specialists, and other primary care providers. It requires improved education and teamwork opportunities where collaboration shall be needed to develop teamwork collaborations (Oliver, 2018). According to the research, this may appear complex and complicated as to whether everyone assumes teams in the same mechanisms. That is because there are main ethos distinction, distinction in styles of leadership, diverse culture that leads to different working cultures and practices, and finally attitudes (Oliver, 2018). However, these complicated aspects must be achieved first for the achievement of palliative care to follow (Sampson, Finlay, Byrne, Snow, & Nelson, 2014) besides, if the clarity is maintained on how to improve interactions among the stakeholders and how it will be done (Oliver, 2018). The application of examinations and triggers in palliative care should also be enhanced to have a clear path towards the program’s success. This case implies that palliative care is professional, helping a hospital expand its activities because patients spend fewer days in hospitals.
Additionally, due to its principle of treating deaths as a natural process by not desiring to hasten and postpone it, palliative care relieves pain and other distressing conditions and symptoms (Santos et al., 2019). It enhances social, physiological, and spiritual components when caring for patients, giving support framework so that the clients can have a long life as possible until their death and gives the family of the patient the strength it needs during the moment of grief. Furthermore, various researches show that the survival of a patient who is receiving neoplasia treatment equals or maybe even higher than those that acquire treatment to cure a disease until the end of life period, exhibiting better aspects of life qualities (Santos et al., 2019). Besides, patients and healthcare providers regard palliative care as capable because it justifies the concept of investments in human resources in the hospitals and those that can be considered as service structures. Today, the human resources training and the health care services provision of health care services are a significant problem in both developed and developing nations with already established or formed an organized framework for providing such a program or a framework for providing quality health care (Santos et al., 2019).
Conclusively, it can be noted that palliative care provides quality services to patients who, in turn, gain better satisfaction that not only benefits them but also benefits the health care organizations. It may be rare that the health care industries care about the service they offer to their clients- patients. The healthcare industry is entering an era of customer awareness due to an increased number of healthcare facilities across the world. In this era, many healthcare facilities are increasingly starting to publicly post their data concerning the quality and cost of their services. Excelling at customer service provision was not a necessity in the past. Still, it has become a significant area of concern for hospitals (“The Importance of Patient Experience for Hospitals: Why it Pays to Excel,” n.d.). Health facilities now have to adopt delivery systems that will eventually help them receive their dream of providing quality health care. According to evidence-based research, palliative care is increasingly improving the patients and family concerns, and its application is steadily growing and increasing not only across the United States but also in the rest parts of the world. A doctor, Mr. Spiegelman, suggest that in five years to come, patients’ experience will be one of the critical issues in the executive board rooms and various budgets attached to them (“The Importance of Patient Experience for Hospitals: Why it Pays to Excel,” n.d.). Therefore, hospitals and other health care organizations should adopt palliative care delivery system as it provides ideal patients’ experiences (“The Importance of Patient Experience for Hospitals: Why it Pays to Excel,” n.d.).
A potential one-year business plan for improving patients’ experience would include the following aspects using the Lean methodology:
First, ensuring that there are distinctive strategies and challenged trust by prioritizing rapid quality improvements by all health care providers in specific measures, supporting different improvement programs financially shall promote Patients’ experience. Hospitals should work intensively with physicians, nurses, and other healthcare personnel to help them offer quality care. It shall also develop an improvement package that shall use collaborative features, and the hospitals tailor part of their broader. The comprehensive patient experience helps address the requirements of distinct trust by the use of palliative care.
Offering services in all days of the week ensures trust from the patients or clients by providing they have access to the facility. This measure can be made easily possible by adopting palliative care service delivery and home-based care where the health care professional interacts with the patients via digital technology while health care providers are at home. Hospitals should help health care provides meet the proposed clinical standards, coordinate support from the improvement teams (Tortorella, Augusto, França, & Sawhney, 2019). Patient experience is developed and strengthened by the aspect of accessibility and quality services that entail openness and other related services. This framework involves enhancing support to ensure that the goal shall be realized and the all-day flow of service delivery. That shall promote potential effect to impact the departments’ performance and enhance the effective utilization of resources each day.
The third aim is to ensure that a hospital fulfills the statutory safety concerns of patients, collecting and analyzing reports regarding any challenging aspect in the hospitals. Patience experience primarily reflects ensuring that patients’ safety is the first or critical aim of the hospitals and all health care providers (Tortorella, Augusto, França, & Sawhney, 2019). It may entail the development of collaborative teams involving health care providers and patients and their families. This strategy shall ensure that key stakeholders of an issue are required in decision-making processes that consist of the treatment of a patient.
Offering mental health and learning disability services shall also improve the patients’ experience. Today, there is an increased number of mental illnesses and disabilities (Tortorella, Augusto, França, & Sawhney, 2019). Patients in a hospital must include a certain amount of mental illness or the disabled; therefore, hospitals should ensure they provide these services to create a definite peace of mind of the patients since this Project does not have a specific ailment. It can also be made even more effective and efficient by the adoption of palliative care service delivery.
Quality programs in the clinics, preferably for cancer end-of-life care and maternity, are on the outlook when patients are rating hospitals as they are some of the world’s critical diseases. Besides, all these three strategies are involved in palliative care where during the end life period, physicians discharge a patient to home-based care where they shall receive care from their families.
Finally, leadership is a significant area of concern due to clinical advances, management, and leadership. Hospitals should ensure they have the best guidance for providing high quality improvement in the hospital for patients’ experience. Good leadership shall provide the clinical workforce by ensuring that they have the necessary equipment and knowledge for better quality health services. Patient experience is a significant area of the quadruple aims that encompasses all the activities of a healthcare facility.
Financial Pertinent
First, there shall be costs associated with ensuring and implementing special measures and trust among healthcare providers. Improving quality shall involve employing a specialist to train the health care providers for a better understanding of the aspect of patients’ experience. Second, there shall be costs to cover up for the provision of health care services for all the days of a week, especially for the acute clinical complications on patients. These costs shall cover and build stronger, embedded, and resilient workforce. Of course, working over the weekends shall attract more payments to the care providers. Thirdly, there are costs associated with patient safety programs such as maternity and cancer projects. For a project to run, there must be enough cash for operational expenses such as visiting the communities for training and awareness. Even if it is access from home, health care providers will require the necessary resources for the same also if it is under palliative care. Fourth, mental and disabilities services require extra funds for their resilience and operations. They involve clinical quality programs that promote the services delivered to the mentally ill or the disables people. This move, however, will effectively lead to patients’ experience because it is not only service delivery but also an act of faith. Improving such service delivery results in partnerships with other stakeholders where funds are also required.
Executive Summary
Patients’ experience as a comprehensive aspect of quality health care, patients’ experience involves various aspects of health care delivery systems that put the care and values of patients mainly when they arrive at the facilities to seek health care services. It is made effective by incorporating palliative care through a comprehensive review of relevant literature. Palliative care delivery promotes the quadruple aim of improving patients’ experience. Besides, through the business plan proposed, the Project may be costly. Still, the expected results are nothing to compare with when a health care facility gains patients’ experience, the particular health care facility. The Project will likely have a significant burden due to the costs; however, the benefits will outweigh the charges because the facilities will attract and retain patients or rather clients who will be willing to receive health care facilities services at any cost. Therefore, the return on investment will be very high; it will increase the facility’s profitability and profits. The facility shall also have high and improved access, as many patients will be willing to seek services from there, for example, the mentally ill and the disabled.
References
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