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Tammy Leigh

Tammy Leigh

Emergency Service and Critical Care
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Tammy Leigh has 35 years experience and specializes in Emergency Service and Critical Care.

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  1. The focus of this case study was very interesting. ChristianaCare used three different quality initiatives to improve and enhance patient care. ChristianaCare identified nursing staff felt that with the insertion of a catheter device there was a significant risk of a patient developing a bloodstream infection. They also were concerned about the length of time it took a stroke patient to receive surgical intervention. Lastly, they felt that patient safety was should be a top concern within their organization. ChristianaCare adopted the Agency for Healthcare Research and Quality (AHRQ) tools. The Comprehensive Unit-Based Safety Program (CUSP), TeamSTEPPS, and Surveys on Patient Safety Culture (SOPS) to improve the care of their patients. These are evidence-based resources that reduced catheter infections and cut the time to surgical intervention in half (AHRQ, 2020). The SOPS surveys provided staff and physicians with information about the culture of safety and promoted strategies within the organization. Identifying Data ChristianaCare saw a reduction in bloodstream infections due to the strategies of CUSP. The goal of CUSP is to emphasize the safety culture by reporting and learning from errors. It promotes working as a team and supporting and engaging staff (Pitts, et al., 2017). In the ICU they decreased from 21 cases in 2011 to four cases in 2019 (AHRQ, 2020). This reduction reduced the catheter days from 12,627 to 6,574 days in 2019 (AHRQ, 2020). The nurse became engaged and aware of the interventions the CUSP tool provided. The TeamSTEPPS was initiated and expedited the stroke patient care through improved staff communication. Using the TeamSTEPPS tool resulted in faster care and treatment of the stroke patient. The time was cut in half. Utilization of this tool encouraged teamwork and clear communication among staff and improved patient care. Patient safety is the utmost important factor in healthcare. The SOPS survey allows staff to remember the importance of patient safety and the survey allows staff to share their perception. The SOPS survey is conducted every two years. The survey provides an organization with internal information that can provide insight. Contrast Outcomes of the Study The AHRQ, Joint Commission, and the National Quality Forum are just some examples of regulatory agencies that require patient safety to be collected and reported. Hospital organizations held to higher standards are expected to meet these standards. Process changes are initiated based on the findings that are discovered during data collecting and data sharing (Hughes, 2008). Industry standards hold hospitals accountable. Evaluate and Implementation of a New Practice ChristianaCare implemented evidence-based tools and resources that will provide safe and quality care. Providing quality and safe care should be the goal for all hospital organizations. Communication tools have been proven to promote patient safety. Employee engagement in process change is essential. These tools can allow staff to become self-driven and responsive. Implementing new practices within an organization can be a challenge but if rolled out properly it can be very successful and sustainable. Conclusion In today’s society patients are smart consumers. Patients can pick where they want to go for medical care. They can use social media to inform other patients about their care or lack of care. Healthcare organizations need to be providing quality and safe care. The culture has changed in healthcare and hospitals are responsible for collecting and sharing data to ensure patients that they are receiving the best care possible. References ChistianaCare Used AHRQ Resources to Reduce Blood Infections, Expedite Stroke Care. (2020) Agency for Healthcare Research and Quality, Rockville, MD. Hughes, R.G. (2008). Tools and strategies for quality improvement and patient safety. Patient Safety and Quality: An Evidenced-Based Handbook for Nurses. Rockville, MD. King, H.B., Battles, J., Baker, D.P., Alonso, A., Salas, E., Webster, J., Tooney, L., Salisbury, M. (2008). TeamSTEPPS: Team strategies and tools to enhance performance and patient safety. Advance in Patient Safety: New Directions and Alternatives. 3(1), 1-19. Pitts, S. I., Maruthur, N. M., Luu, N. P., Curreri, K., Grimes, R., Nigrin, C., Sateia, H. F., Sawyer, M. D., Pronovost, P. J., Clark, J. M., & Peairs, K. S. (2017). Implementing the Comprehensive Unit-Based Safety Program (CUSP) to Improve Patient Safety in an Academic Primary Care Practice. Joint Commission journal on quality and patient safety, 43(11), 591–597.
  2. Tammy Leigh

    The Cost of the Health Care Workforce

    Healthcare is changing constantly to provide better care to its consumers. These changes include monetary consequences. Hospitals have seen a shift of consumers to Urgent Care facilities which affects a hospital bottom line. There are key drivers to this crisis in the cost of the healthcare workforce. Three Drivers that are Increasing the Labor Costs Lack of professionals to fill the positions: nurses and physicians Supply chain demands Lack of retention of nurses and staff 1- The lack of professionals is related to the cost of education or lack of resources. The Advisory Committee on Student Financial assistance reports there has been an increase in financial barriers due to policies of the federal and state levels. There has been a shortage of student aid (Advisory Committee on Student Financial Assistance). The cost of medical school is unbelievable and prevents many students from even attempting to pursue medical school. 2- Supply and demand is a driver that has been increasingly become an issue in healthcare, especially recently during the pandemic. Supplies in a hospital setting are crucial to the operation of the organization; that being said there is an exorbitant amount of waste. IV bags are opened and never used. During the pandemic, we wasted supplies that were left in the patient’s room after discharge because they were considered dirty and had to be thrown away. The cost of getting supplies during the pandemic was incredible. An isolation gown before the pandemic was 30 cents; the pandemic cost was $9.30 each (Berklan, in press. This waste leads to high workforce costs. Supplies are an area of the hospital where cost can be contained if managed approximately. 3- The third and most important driver to the workforce cost is staff retention. Staff turnover can affect productivity and hospital revenue. Recruiting and orientation of a new employee requires staff time and money. According to the Bureau of Labor Statistics (2021), healthcare has one of the highest turnover rates. These drivers all play an important part in the cost of the workforce. Solutions to Address Labor Cost The key drivers discussed all have solutions that would decrease the workforce costs. A solution to recruiting professional staff is to provide bonus incentives and invest in an educational program to enhance the employee's personal and professional growth. Involve the Human Resource (HR) department and provide programs to staff about advancement. Happy staff will stay in an organization in which they are invested. The HR department can work with senior leadership to implement retention techniques. Tuition reimbursement programs should be designed to encourage staff to be life-learners. A team should be formed to review and manage the supply chain demands. A tracking system should be put into place to track supplies and waste. Addressing these areas will identify areas of cost containment possibilities. Predicting Future Changes The future can hold many options for cost-saving with the help of the government: A governmental incentive for the future professional to want to pursue a career in healthcare. Provide cost reduction for those who seek higher education careers such as doctors and other clinicians. Hospital organizations should seek funding from the regulatory agency. The use of data collecting and reporting will help capture the much-needed information to improve cost The changes that occur in the future will be the driving force in the reduction of cost to the workforce. Conclusion The cost of the healthcare workforce needs to be evaluated and changes need to be implemented. The drivers that were discussed need to be addressed and can produce a cost reduction. If we do not speak to the issue regarding the cost we are seeing in the workforce it will continue to grow and become a financial burden to all Americans. References/Resources A Report of the Advisory Committee on Student Financial Assistance. Empty promises: The Myth of College Access in America Berklan, J. (in press). Analysis: PPE costs increase over 1000% during COVID-19 crisis. McKnight’s Long-Term Care News Bureau of Labor Statistic. (2021)