[marie-francoise]

Paper by The George Washington University:

"A Summary of the Impact of Reforms to the Hospital Inpatient Prospective Payment System (IPPS) on Nursing Services"

http://www.aannet.org/policy/ippswhitepaper.pdf

[oramar]

This is important document. Hope others take the time to read it.

[Emmanuel Goldstein]

• Anticipating a reduction in reimbursement, some hospital leaders may identify ways to reduce expenditures and realign resources, which could result in budget cuts, staffing reductions, and restructuring. Evidence demonstrates that hospitals reacted similarly when prospective payment was first introduced in the 1980s.

• Research outside of health care suggests that, in the event of avoidable adverse events, managers are likely to identify a responsible party to hold accountable. Because these preventable inpatient complications are fundamentally linked to nursing care, when these events occur, it is likely that in at least some institutions, nursing may be held accountable for failing to prevent their incidence. This may lead to “blame” being placed, in whole or in part, on nurses. Among hospital nurses who have historically reported high levels of job stress, dissatisfaction, and intentions to leave, added insults to morale could lead to increased voluntary turnover.

It's gonna be déjà vu all over again...

[gonzo1]

I see multiple new forms I will have to fill out on each new patient.

[RN1980]

pay for performance, ha,ha.. like this is all for the well being of the patinet.. bullcrap, it's all about money. in a few years medicare will figure out another way to not reimburse the hospitals and we as nurses will be held accountable for it. i find it so ironic that in many, many cases we have little to no direction of healthcare and its future ethier in the historical hospital setting or gov't implementation of us health policies, but yet we are held accountable for the follow through and failure of the "in many times" unatannable outcomes..