Introduction
Providing high-quality care services entails various elements such as safety, equity, and inclusivity. The provision of such services is a key objective within health care systems. Regulatory benchmarks are crucial for the achieving of these goals. The identification of the necessary system policy to apply concerning the benchmarks is essential in the realization of the goals. Advanced practice nurses (APNs) are critical allies in implementing policies aligned to such benchmarks that improve healthcare outcomes and promotes system performance. However, the analysis of the benchmarks that govern the policy is essential before its implementation. This paper seeks to explain an external benchmark, to study its implications for quality, equity, and inclusivity in health care, to offer a policy strategy focused on the system for its support and to assess its implications for advanced nursing practice.
Quality Benchmark
The identified quality benchmark Hospital Readmission Reduction Program (HRRP) is a quality benchmark that was set out by the Affordable Care Act (ACA) in 2012 (Onder, 2022). This program is a turning point in the effort to reduce readmissions. It aims to tackle specific conditions such as heart failure, pneumonia and cardiac disorders. The disorders and illnesses addressed by the benchmark have higher chances for having a readmission. Being concerned with such infections puts the healthcare institution and the nurses at high alert to ensure that the readmission rates are not ranked as high. The central purpose of the HRRP is to encourage hospitals to improve transfer of care. Furthermore, the benchmark promotes the coordination processes in order to avert needless readmissions leading to better patient outcomes and optimal use of healthcare resources. This promotes the care quality, equality and safety in the healthcare institutions.
The program punishes hospitals with the higher-than-expected readmission rates. This endeavors to create a culture of accountability and quality improvement within the healthcare organizations. For the healthcare institutions to achieve the required low rates of readmissions, they adopt measures such as implementing evidence-based interventions and best practices. Also, the HRRP highlights the role of patient-oriented treatment (Sana et al., 2023). The healthcare setup is to be oriented towards continuity and coordination of care in order to avoid harmful events and improve in general patient experience. The measures and policies implemented by the healthcare practitioners are aimed at ensuring that these factors are implemented and the strategies to improve the performance of the healthcare institutions. Through such strategies the healthcare sector promotes quality of care and ensures that there is safety for the patients.
Systems-Focused Policy Strategy
A systems-based multi-faceted policy strategy that targets the goals of the HRRP includes implementation of comprehensive transition care programs. Such programs range a multitude of interventions from interdisciplinary collaboration to medication reconciliation, patient education, and post-discharge follow-up initiatives. The multidisciplinary collaboration ns are key in promoting the quality of care (Dankoly et al., 2021). The communication and sharing of patient information between different departments in the healthcare institutions is essential in ensuring that there is high-quality care. Furthermore, the decisions on the treatment of the patient are enhanced with the information obtained through collaboration in different departments. Patient education is also essential in adhering to the HRRP benchmark. Educating the patient about their illness and providing them with detailed precautions will reduce the risks of readmission. Furthermore, it is recommendable that the healthcare institution offers post-discharge follow-ups for the patients with specific infections, mostly those with high risks of readmissions such as heart failure.
Through supporting effortless transitions between care settings and allowing patients to be actively engaged in their care, transitional care programs seek to decrease the probability of negative incidents and prevent avoidable readmissions. Furthermore, exploiting health information technology(HIT) solutions is also a key factor in the policy. Technologies in healthcare such as electronic health records(EHRs), and telehealth platforms increase the communication and sharing of clinical data among healthcare providers. In return, this plays a crucial role in ensuring that there is timely intervention for the patient care. Also, the keeping of patient records in EHRs provides the continuity of the patient care (He et al., 2021). Moreover, strategizing partnerships with community resources and social support networks will offer additional help to the effectiveness of transitional care programs. The effective partnerships address the social determinants of health and ensures access to vital services, thereby attaining health equity and inclusivity.
Implications for Advanced Nursing Practice
Specific to the HRRP, advanced practice nurses can be instrumental in the leadership of policy direction. Also they are key in the development of policy strategy to improve patients’ outcomes and to reduce the risk of hospital readmissions. APNs are strategically situated to provide patient-centered care that address the needs of the patient holistically. This is the progressive approach in healthcare. The APNs achieve their roles in the policy making and implementation using their expertise, the advanced training and specialized knowledge. Proper assessments, individualized care plans and coordination of care transitions are important to the APNs in delivering high-quality care. The APNs can facilitate smooth transition between care settings and prevent further gaps that may be missed resulting into readmissions. By identification of such gaps, the APNs also ensure that they promote equity in the provision of care. This promotes patient safety, quality of care and equity in the healthcare provision.
Additionally, APNs have special skills in health promotion and disease prevention. Such skills are essential in educating patients and their families on self-management strategies, medication adherence, and lifestyle modifications that minimize the risk of remaining hospitalized (Davidson-Corbett et al., 2023). The education of the patients also plays a crucial role in preventing the readmissions for some reasons that could have been avoided. Furthermore, APNs can be champions for disadvantaged groups by pushing for policies that deal with social determinants of health and promote equitable access to quality healthcare (Wheeler et al., 2022). For instance, ensuring that the minority are not discriminated in terms of the accessibility of the healthcare services. The minority groups might have financial issues, which are key in determining the affordability of the healthcare services., however, ACA ensures that there are affordable healthcare services, available for every individual. It is the role of the APNs to ensure that they adhere to the policies for the provision of affordable care. Through supporting the development of evidence-based programs and building teams that are multidisciplinary, APNs can promote the innovation within the system. This brings about the changes in care delivery that meet the objectives of HRRP while improving the quality, inclusion, and equity in healthcare.
Conclusion
HRRP serves as an important external benchmark in the quest for high-quality, equitable healthcare delivery by incentivizing hospitals via the reduction of avoidable readmissions. Implementation of integrated discharge procedure programs and utilization of health information technology are two important policy options that can help the HRRP to achieve its objectives and improve patient outcomes. APNs are the ones who run these efforts, advocate for evidence-based approaches and ensure social determinants of health are addressed to give all patients access to quality care. Through the policy strategies that are consistent with regulatory benchmarks and the APNs’ expertise in patient-centered care, the system can be pushed toward positive change, and the achievement of healthcare quality, equity, and inclusivity goals are facilitated.
References
Dankoly, U. S., Vissers, D., El Farkouch, Z., Kolasa, E., Ziyyat, A., Rompaey, B. V., & Maamri, A. (2021). Perceived barriers, benefits, facilitators, and attitudes of health professionals towards multidisciplinary team care in type 2 diabetes management: a systematic review. Current diabetes reviews, 17(6), 50-70.
Davidson-Corbett, D., Godwin, C., McNeely, H., Ramirez, J., & Smith, J. (2023). CPD providers can positively impact practice by better understanding how APNs are educated, licenced, and certified. Journal of CME, 12(1), 2160531.
He, X., Cai, L., Huang, S., Ma, X., & Zhou, X. (2021). The design of electronic medical records for patients of continuous care. Journal of infection and public health, 14(1), 117-122.
Onder, O. (2022). Hospital Survivability and Government Policies: The 2010 Affordable Care Act.
Sana, M. K., Kumi, D., Park, D. Y., Asemota, I. R., DeAngelo, S., Yilmaz, M., … & Vij, A. (2023). Impact of HRRP Policy on 30-day and 90-day Readmissions in Patients with Acute Myocardial Infarction: A Ten-Year Trend from the National readmissions database. Current Problems in Cardiology, 101696.
Wheeler, K. J., Miller, M., Pulcini, J., Gray, D., Ladd, E., & Rayens, M. K. (2022). Advanced practice nursing roles, regulation, education, and practice: A global study. Annals of global health, 88(1).
write