Case management and outcome improvement
Interview one of the following: i.e. manager, director, advanced practice nurse, educator who works within the micro system to identify the key outcome indicators measured for the microsystem.
The outcomes can be related to clinical, safety, satisfaction, or cost indicator.
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Share these outcome indicators.
Cronenwett, L. et al. (2009). Quality and safety education for advanced nursing practice. Nursing Outlook, 57(6), pg. 338-348.
AACN 2012 Graduate Level QSEN Competencies Knowledge
1. Answers the question posted on the discussion board and expands the discussion by bringing in other experiences. Depth and breadth of topic is explored.
2. Three references with citations are included beyond the class readings and can include book chapters, journal articles (primary or secondary) and web based readings, You-Tubes or TED talks.
3. Consistently focuses responses/discussion on class/seminar topic.
4. Critically examines conceptualizations presented in readings/web-based discussions.
Koloroutis, M. (2004). Relationship-based care: a model for transforming practice. Minneapolis, MN: Creative Health Care Management.
The person I chose to interview is a family nurse practitioner, Samantha Marqueas, in the city of Saint Louis. Many of the patients she serves including the majority of them being children, have Medicaid Insurance. Key outcome indicators measured for the microsystem that she says are important to her facility are patient satisfaction, safety, and financial relief of her patients. She reports that patient satisfaction is at the center of everything she does. She wants her patients who consist of mostly pediatrics to trust her and to also have fun while they visit her. She focuses her facility on fun and good humor. “Assessing the quality of care has become increasingly important to providers, regulators, and purchasers of care. In recent years, providers have begun to be interested in evidence-base medicine and purchasers have begun to focus on the cost-effectiveness of health care in producing health outcomes” (Nelson, 2008, p. 32). As a part of her primary care she prioritizes time to hear the parents concerns about their children and listens to them to see if there are any indicators she could pick up on as to what is causing them to be ill. She gives out surveys specifically on quality and safety of care to learn what ways they can improve. Monthly, they take this information and use it to better the facility and treatment they are giving to their patients.
Common obstacles that she runs into is a lack of communication among her co-workers. To utilize communication they undergo retreats to bond and improve the workplace environment.
To incorporate safety into her facility each team member has to go through and watch a video/ quiz to be able to stay up to date on patient safety. “A safety culture requires strong, committed leadership, along with the engagement and empowerment of all employees” (Cronenwett, 2009, 339). Marqueas NP says, “Effective teamwork is essential to accomplish the goal of safe, high-quality patient care.”
Since most of these patients are on Medicaid their are many financial burdens that she and the patients have to use. Many dont even have insurance and have to pay out of pocket. “Uninsured individuals that are unable to pay often get the care they need through emergency departments when they are sick, after the opportunity to avoid preventable conditions has long passed” (Sadeghi, 2013, p.11). She reports that many of her patients use the Emergency Department because of the free healthcare that they can receive. This has been a burden for her to be able to receive pay from these individuals without insurance. She wants to help those who are uninsured by developing her practice of Family Medicine to be not-for-profit. She provides free and reduced health care to St. Louis areas most undeserved clients. Her areas of medical interest are refugee and immigrant health, community health education, and health policy. She has a dedication to improving patient health that is focused on patient safety, care, and financial relief.
Cronenwett, L. et al. (2009). Quality and safety education for advanced nursing
practice. Nursing Outlook, 57(6), pg. 338-348.
AACN 2012 Graduate Level QSEN Competencies Knowledge Skills and Attitudes.
Nelson, E. (2008, July 1) Retrieved November 18, 2015, from
(Links to an external site.)microsystem.org/wp01-content/uploads/quality_safety.pdf
Sadeghi, S. (2013). Integrating quality and strategy in health care organizations.
Burlington, Mass.: Jones & Bartlett Learning.