1008 Healthcare professions. Systems thinking and trade offs: delays and quality vs efficienct

clinical care personnel

physicians, physician extenders, nurses, allied health professions

Clinical care positions

physicians

Allopathic:mainstream medicine

Emphasis on treating through medication, surgery, or other intervention

Osteopathic:originated with musculoskeletal manipulation and emphasizes preventative medicine and a holistic approach

Allopathic

mainstream medicine

Emphasis on treating through medication, surgery, or other intervention

Osteopathic

originated with musculoskeletal manipulation and emphasizes preventative medicine and a holistic approach

Physician extenders

not a physician but performs medical activities typically done by a physician

Diagnose, prescribe, and treat

Nurse practitioner

Physician assistant

Nurse midwifes: specialize in pregnancy, labor, and childbirth

nurses and nurses support

registered nurses

Licensed practical nurses

Patient care techs

Allied health professions

professions focused on:

Disease diagnosis

Treatment

Dietary and nutrition

Rehab

Hospital operations

Administrative roles

HR

Management

Executives

Accounting

Educational requirements

Important management skills

communication and relationship management

Leadership competencies

Professionalism

Knowledge of the healthcare enviornment

Business skills and knowledge of

Aging population

will increase demand for healthcare workersl

licensure

nearly all license is regulated by state and local authorities

Provides the legal authority to work in a profession

Nearly ¾ of all healthcare professionals hold a license w

Why licensure

protect the public from uscrupulous, incompetent, and unethical practitioners

Assure the public of a minimum level of competence from healthcare providers

Provide a mechanism to discipline providers who fail to comply with professional standards

common challenges to licensure

some claim that licensing laws increase the costs of and diminish access to healthcare

Licensures may unreasonable restrict the scope of many healthcare professionals

Differences in state licensing ensures proved challenging during covid as many hospitals had difficulty brining nurses and doctors across state lines to help with staff shortages

What is systems thinking

system thinking examines

Relationships

Interdependence

Feedback loops

delays

Trade offs

Healthcare outcomes are usually produced by systems, not individuals

Remembering our major stakeholders in healthcare

patients

Providers

Payers

Government Agencies

Public health organizations

What is quality

according to IOM

Safety

Effectiveness

Patient centeredness

Timeliness

Efficiency

Equity

Efficiency

delivering desired outcomes while minimizing waste

Time

Supplies

Labor

Hospital beds

Financial resources

common quality vs. efficiency dilemmas

quality focus:

Longer visits

Redundant safety checks

More staffing

More diagnostic testing

Efficiency focus:

Shorter visits

Faster workload

Less labor cost

Reduced resource use

nurses staffing

higher staffing often improves:

Safety

Monitoring

Patient satisfaction

Higher staffing also

Increases labor costs

Creates financial pressure

emergency department throughput

hospitals want:

Short waits

Accurate care

High satisfaction

Low costs

→improving one measure may affect the other

system thinking concept:delays

a systems delay means: the time between an action and observable outcome

Healthcare contains delays everywhere

common delays in hospitals

staff hiring

Residency training

Quality improvement projects

Population health initiatives

Technology implementation

delays example:nursing workforce development

Problem:nurse shortage

Intervention:expand nursing schools and recruitment

Reality:benefits may not appear for several years

delays example:preventive care

hospitals invest in:

Screenings

Health education

Vaccination

Benefits may occur years later

delays create management problems

Leaders may:

Cancel effective programs too early

Expand ineffective programs

Misinterpret outcomes