Assessment 1: Triple Aim Outcome Measures Overview ✓ Solved

Assessment 1 Triple Aim Outcome Measures Overview: Develop

Develop a presentation, containing 10–15 slides, on the Institute for Healthcare Improvement's Triple Aim, how current and emerging health care models support the Triple Aim, and how governmental regulatory initiatives and outcome measures can be applied in the care coordination process to achieve the Triple Aim in a population. The Triple Aim is a framework for "simultaneously improving the health of the population, enhancing the experience and outcomes of the patient, and reducing per capita cost of care for the benefit of communities." Care coordinators must have a model and framework to guide their practice and enable them to achieve the Triple Aim.

Presently, many rural hospitals are using archaic models that must be updated to achieve the Triple Aim. For example, the patient-centered medical home model has been around for 30 years, but it has evolved during that time. By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: Competency 1: Apply care coordination models to improve the patient experience, promote population health, and reduce costs. Explain how the Triple Aim contributes to population health, improves the patient care experience, and reduces health care costs on a regional, state, and national level. Analyze the relationships between various current and emerging health care models and the ways in which they support the Triple Aim.

Explain how the structure of particular health care models contributes to the process of gathering and evaluating the quality of evidence-based data. Describe governmental regulatory initiatives and outcome measures that can be applied in the care coordination process to achieve the Triple Aim within a population. Competency 2: Explain the relationship between care coordination and evidence-based data. Explain how evidence-based data shapes the care coordination process in nursing. Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.

Present process improvement recommendations to a stakeholder group clearly and concisely. Support main points, arguments, and conclusions with relevant and credible evidence, correctly formatting citations and references using current APA style.

In preparation, assume the role of a case manager at a small rural hospital, Sacred Heart. You have been asked to deliver an evidence-based presentation about how the care coordination process at Sacred Heart can be modified to achieve the Triple Aim within the hospital's rural population. Examine and compare various health care models such as the Patient-centered medical home (PCMH), Transitional care, Patient self-management, Guided care, and Care coordination.

Explain how the Triple Aim contributes to population health, improves the patient care experience, and reduces health care costs. Analyze the relationships between health care models and the support they give to the Triple Aim, and describe regulatory initiatives that can be applied in care coordination. Your presentation should be 10–15 slides, not including the title slide, purpose slide, and references slide.

Paper For Above Instructions

The healthcare sector continually strives to improve patient outcomes while managing costs effectively. The Institute for Healthcare Improvement's (IHI) Triple Aim framework serves as a guiding standard in this pursuit. It aims to simultaneously enhance the health of the population, improve patient care experience, and reduce per capita costs of care. This presentation will explore how various emerging healthcare models align with the Triple Aim, particularly in the context of rural hospitals such as Sacred Heart. Additionally, we will delve into governmental regulations and measures that support these objectives.

Overview of the Triple Aim

The Triple Aim framework, introduced by IHI, is foundational in guiding healthcare innovations. According to the IHI, the model's core objectives are to improve population health, enhance patient experiences, and decrease healthcare costs (Institute for Healthcare Improvement, n.d.). The relevance of this framework is profound as healthcare systems navigate the complexities of service delivery, especially in rural settings where resource constraints often impact service quality.

Current and Emerging Healthcare Models

Several healthcare models have emerged that resonate with the principles of the Triple Aim. Among them, the Patient-Centered Medical Home (PCMH) model places the patient at the center of care. This model organizes care around patient's needs and coordinates across different services, addressing holistic health concerns (Bodenheimer & Pham, 2010). Research suggests that PCMH practices can lead to better patient experiences and improved health outcomes, thus aligning with the Triple Aim (Gonzalez et al., 2020).

Transitional care models also play a critical role by bridging gaps during transitions from one care setting to another, reducing readmissions and enhancing continuity of care (Hesselink et al., 2014). Guided care, a team-based approach, offers ongoing support for chronically ill patients, which directly contributes to improved population health by effectively managing chronic conditions (Naylor et al., 2004).

Evolving Healthcare Models

The evolution of these models reflects a larger trend towards value-based care, which prioritizes quality and outcomes over volume. For instance, the PCMH model has undergone continuous improvements based on emerging evidence and technology integration (Miller, 2019). Key enhancements include the adoption of health IT to streamline care coordination and increase access to patient data, facilitating more informed decision-making (Walker et al., 2016).

Evidence-Based Data in Care Coordination

Evidence-based practice is crucial in shaping the care coordination process within nursing. It allows nurses to utilize the best available evidence to direct patient care, thereby ensuring quality outcomes. For example, integrating guidelines from the IHI can serve as benchmarks to evaluate care coordination efficacy (Melnyk & Fineout-Overholt, 2018).

Data collection through electronic health records (EHR) enables the evaluation of care quality. By employing standardized outcome measures and tracking performance metrics, care coordinators can identify areas for improvement and ensure adherence to evidence-based care protocols (Blumenthal & Tavenner, 2010).

Governmental Regulatory Initiatives

Several governmental initiatives support the implementation of the Triple Aim. For instance, the Centers for Medicare & Medicaid Services (CMS) have enacted programs like the Value-Based Purchasing Program, which incentivizes hospitals to improve quality care and reduce costs (CMS, 2021). The Affordable Care Act also promotes models that enhance care coordination, which ultimately supports population health efforts (KFF, 2019).

Additionally, the National Quality Strategy aims to align public and private sectors towards common goals in improving healthcare quality, which echoes the Triple Aim’s objectives (HHS, 2020). These regulations provide frameworks that are crucial in the practical application of care coordination strategies aimed at fulfilling the Triple Aim within populations.

Conclusion

The integration of the Triple Aim within healthcare delivery models presents a viable path forward for improving care quality and efficiency, particularly in rural hospitals like Sacred Heart. By leveraging evidence-based practices, adapting to emerging models, and adhering to regulatory guidelines, healthcare providers can enhance population health outcomes, optimize the patient experience, and manage costs effectively.

References

• Bodenheimer, T., & Pham, H. H. (2010). Primary care participation in ACOs: The role of the patient-centered medical home. Health Affairs, 29(3), 474-480.
• Blumenthal, D., & Tavenner, M. (2010). The “Meaningful Use” regulation for electronic health records. The New England Journal of Medicine, 363(6), 501-504.
• Centers for Medicare & Medicaid Services (CMS). (2021). Value-Based Programs. Retrieved from https://www.cms.gov
• Gonzalez, J. S., et al. (2020). The impact of the patient-centered medical home model on ambulatory care quality and access: A systematic review. American Journal of Managed Care, 26(3), e91-e98.
• Hesselink, G., et al. (2014). Improving patient discharge and reducing hospital readmissions by using intervention approaches: A systematic review. Journal of Clinical Nursing, 23(11-12), 1490-1508.
• HHS (Health and Human Services). (2020). National Quality Strategy: Annual Progress Report. Retrieved from https://www.ahrq.gov
• KFF (Kaiser Family Foundation). (2019). The Affordable Care Act: A Brief Summary. Retrieved from https://www.kff.org
• Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-Based Practice in Nursing & Healthcare. Wolters Kluwer.
• Miller, D. R. (2019). Evolving the patient-centered medical home in an era of value-based care. The American Journal of Surgery, 217(5), 1008-1011.
• Naylor, M. D., et al. (2004). Comprehensive discharge planning for the hospitalized elderly. New England Journal of Medicine, 350(26), 2860-2868.
• Walker, J., et al. (2016). Health IT: Enhancing the role of nurse care throughout the continuum of care. The Journal of Nursing Administration, 46(6), 323-329.