How would you change Healthcare Delivery?

Nurses General Nursing

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We live in a time where getting ANY bill through the Congressional Process is a (pun intended) Act of Congress!!!

I want you to assume YOU could change the current ways things are done in your Country, Region, or Facility. I hope to hear from a range of Nursing Arenas. Also, this is broad spectrum, so think out of our scope, you can change ANYTHING.

Here is my example:

The Urgent Care Centers, After Hours Clinics, and "Doc-In-a-Box's" that are popping up everywhere now, Urban Areas, Suburban Areas, Small Towns, and even Pharmacies! (seen several at major department stores now!)

PROs

Easy Access to Healthcare that is more affordable than ERs

Huge Pressure of Emergency Departments when Utilized, or "Triaged-To"

Higher Insurance Reimbursement

Quicker than ERs in most cases for lower and Moderate level Medical Needs

Greater utilization of APNs

Wonderful for ACUTE problems that are not emergent

CONs

No Consistant Primary Care Provider for the patient on an ongoing basis

Fractured or Partial Care for Chronic Conditions "Bandaid Effect"

Less Follow-Up, and Familiarity with patients

Largely Profit Driven

According to the New England Journal of Medicine they miss complex diagnosis such as various cancers, Rheumatic Conditions (e.g. Lupus) , Nerve Problems, and Mental Illnesses).

My Grandmother is notorious for using these Facilities. She has a Co-Morbid Factor that drives me crazy for her to use these places (yes, MORE than one) for their ease of access, and rarely sees the same one again! This leads her COPD to be treated like Colds, and it's nothing to find her going 2-3 fails before being hospitalized for Pneumonia!

NOW MY SOLUTION: Get Rid of the "Doc-in-a-Box?" . . . . . No Way!!!!!!

Before they came about, sometimes I couldn't get her into a Physician anywhere in a 4 county area!!!! These are God Sent! But, there's the continuity of care issue.

I would Repeal HIPAA:yeah:, and create a new Rider Bill with Privacy for the patient, but a new Information Highway for your Health History- Just like your Credit History. It would only be dispensed AT YOUR PERMISSION!!!!!!!!!!! (Just like your Credit History) I know this needs much more thought, and could mean some really negative things, (I REALIZE THAT PROSPECTIVE EMPLOYERS ALREADY CHECK CREDIT HISTORY!) But, you do sign a form giving them that liberty. So I would have in the bill that it would TOTALLY BE FOR MEDICAL REASONs ONLY, and could only be accessed for the duration of your care, could be contested/corrected/updated. It would have your vaccination history, all medical tx, surgical tx, Allergies, Negative Responses to therapies, fails, What works for chronic conditions, XRays, Laboratories, Endoscopy Results, Scheduled Procedures, Preventive Medicine for "At Risk Populations," and Genetic Predispositons and more! You could Opt out for religious reasons, or Political Disagreements.

Please understand I have NO Political Intentions, and any intention is to advocate for the BEST outcome for the patient. "Above All Do No Harm!"

Disclaimer: For the greatest freedom of my posters on this thread, PLEASE don't criticize what another poster would do, I want to know WHAT YOU WOULD DO! Just want to keep it clean, and not get anyone excited NEGATIVELY. If you want to add or say you would like that IF . . ., that's fine, just please keep it courteous.* Let's play Congress and start a discussion by people who REALLY WALK the halls, areas, and rooms where healthcare is delived.

*I KNOW THIS IS A SUPER SENSITIVE SUBJECT. This could potentially include Abortion, Stem Cell Research, Sterilization/Eugenics, Population Control/Child Bearing Limitations, Obamacare (USA), Socialized Medicine, Addictions/Chemical Abuse, Religous Issues, Privacy, Promoting Dignity, Assisted Suicide, and many more sensitive issues. NO :argue: ALLOWED, LOL!!

:redlight:HOW or WHAT would you change about Healthcare?

Specializes in FNP, ONP.

Advanced directives should be mandatory, even if they say "I want it all." Everyone should have something on paper.

Specializes in Adult/Ped Emergency and Trauma.

I knew you guys would blow my mind, another reason this site is so addicting, . . .Binge Thinking!!!!

It also blows my mind still that a Physician can work the hours safely, legally, and ethically! We found out after an investigation at a local hospital that a surgeon began an open heart surgery- 23 hours into a shift. It was a "wrong-site surgery."

Impaired? I am not judging, and if he was the only thing standing between me and my grave, Cut Away!!! but, try to squeeze a cup of coffee and some blow in before!

Nothing like the pair of stats on an Xray.

That said, Lol, I would cap damages, and make mandatory. I would cut down the Nurse:Patient Ratio to 5:1 maximum.

I would let LPNs with 2 years experience or greater sit for the NCLEX-RN. If anyone can prove they know the basic standards, why hold them back?

Specializes in MICU - CCRN, IR, Vascular Surgery.

Get rid of pt satisfaction being more important than anything and everything.

Some sort of centralized database for medical histories. It gets really old having to do an admission database on a pt that was just discharged in the last week.

Like someone said above, mandated advanced directives for everyone, even if it's just "I want everything possible done" because then you know it's been addressed.

Mandatory ratios and safe staffing.

Charging for nursing care separately so maybe we would be considered to be important instead of just another expense to cut willy nilly.

Standardize point of entry, just make it all BSN already and do away with ASN programs. Also, make people with a previous Bachelor's degree in something else count as having a BSN. (This is coming from an ASN with a previous BA in something else).

Specializes in Hospital Education Coordinator.

Standardized medicine scares me. What if your situation is not standard? Not opposed to single-payor system but am opposed to deadbeats and foreigners being included at my expense. Please remember that in EVERY country where medicine is socialized the healthcare workers earn far less than American healthcare workers.

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