Introduction
BHA FPX 4003 Assessment 2 Attempt 1 Managing Quality Across Various Health Care Settings
Agenda
- Efficiency
- Teambuilding
- Communication
- Patient care
- Care quality
- Continuum care
- Operations
Continuum of Care
Overview
BHA FPX 4003 Assessment 2 Attempt 1 Managing Quality Across Various Health Care Settings
When we talk about continuum care we are referring to a level of unified care that the patient experiences over a course of time through a broad lineup of healthcare services that are tailored to accommodate the patient’s needs. In this article, the example of substance abuse patients is used to examine the level of commitment, coordination, and organization. This article will emphasize the need to understand when they need for outpatient, intensive outpatient, in-patient, intensive inpatient, or the collaboration of all are necessary and whom that responsibility falls to judge and decide based on education and experience. This article will also offer an examination of why providing encouragement and positive settings, services, and treatment philosophies optimize the continuum of care. Today’s lunch and learn session will also explain the importance of collaboration of the physicians and healthcare team with clear communication systems, organized regular meetings, and providing non-stop training opportunities. This article will analyze exactly what “care coordination” provides to an environment where the concept of the continuum of care can thrive.
Continuum Care refers to a system of care created in which the patient enters that is appropriate to their needs. When a patient initiates care from their physician, whether that be in-patient or outpatient, it is the role of the physician to take medical histories and performs a physical examination to assess the patient to determine a possible diagnosis for both acute and chronic conditions. (UTA, 2022). To ensure that happens, every physician-based company must identify the level of care the patient requires overtime. This level of care can increase or decrease depending on the patient’s needs. The level of intensity needed to ensure satisfied care is an integral part of the process of the continuum of care.
The management of these responsibilities falls on the physician’s practice and the hospital. They manage and treat a variety of medical conditions from minor cuts to mental health to palliative care to surgery. They are required to manage complexity and risk in situations that often are uncertain and changing. Diagnosis is a key feature of a physician’s expertise in medical practice and is based on strong assessment skills. Diagnosis is a core cognitive skill, based on both knowledge and judgment. (UTA, 2022).
Further Reading
ASAM. (2022). ASAM Continuum. The Decision Engine for The ASAM Criteria.
https://www.asam.org/asam-criteria/asam-criteria-software/asam-continuum
In each sector of the healthcare system, it starts with the patient where
an assessment is conducted to identify what the physician is going to treat. Once that is identified, an integrated system of care is created to guide and track the patient’s treatment over time. That system of care is different depending on the sector within the healthcare system. The Rockville, 2022 article states that the ASAM has established five primary levels in a continuum of care for substance abuse treatment:
Level 0.5: Early intervention services
Level I: Outpatient services
Level II: Intensive Outpatient/Partial hospitalization services (Level II is subdivided into levels II.1 and II.5)
Level III: Residential/Inpatient services (Level III is subdivided into levels III.1, III.3, III.5, and III.7)
Level IV: Medically managed intensive inpatient services
Care Quality
Overview
To further reinforce the concept of the continuum of care, it goes beyond the integral system created. The quality of care provided naturally plays a large role in how the patient responds. We can assume, that in the example of patients who seek treatment for substance abuse; someone suffering from substance abuse, whether outpatient or inpatient may not respond well to treatment if the patient is not provided with settings, services, and treatment philosophies that are encouraging and positive. The physician works collaboratively with the healthcare team to provide optimal care. This includes providing referrals to other practitioners or services that the patient may need. They provide reports and updates on patients’ conditions and needs to other services such as physical therapy, home health services, and other specialists. (UTA, 2022). Physicians who take care to mitigate the issues of referrals are another key aspect to creating a quality of care as this is a key administrative issue within the healthcare system.
BHA FPX 4003 Assessment 2 Attempt 1 Managing Quality Across Various Health Care Settings
Further Reading
The University of Texas at Austin (UTA). (2022). Physician Role.
https://healthipe.utexas.edu/physician-role
The Treatment Improvement Protocol sheds light on administrative issues that can
decrease patient response to treatment, and how it can be mitigated to ensure the quality of care is maintained. Any change of setting, staff, or peers interjects a risk of the client’s dropping out of treatment. Experience suggests that the administrative paperwork and approvals needed to transfer a client between levels of care within the same organization can be accomplished with less disruption for the client than a referral to a new provider organization. Consequently, when referrals are made to a nonaffiliated provider organization, coordination and case management need to increase. (Rockville, 2006).
Operational Approach
Overview
When constructing a continuum of care framework, it must start with facility-based operational guidelines that create programmatic approaches to patient-based needs given by assessment results over time. This creates fluidity and allows all healthcare physicians, nurses, and other support staff to collaborate as a team to ensure the patient is provided with satisfactory care. This can be done through an effective communication system, organized regular meetings, and providing non-stop training opportunities to ensure the workforce is systematically in sync with each patient’s needs. This approach is also known as “care coordination.”
Further Reading
Continuum Health Alliance. (2022). Coordinated Care: Key to Successful Outcomes. https://www.continuumhealth.net/coordinated-care-key-successful-outcomes/
The Continuum Health Alliance, 2022 article states that the Agency for
Healthcare Research and Quality defines care coordination as “deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care.” This includes determining the patient’s needs and preferences and communicating them “at the right time to the right people.” Although the terms are often used interchangeably, care coordination is different from care navigation. Navigation is narrower in scope and is usually confined to a brief checklist for such tasks as verifying that an ER patient has scheduled a follow-up visit with his physician or confirming that the patient has obtained prescribed medications. Care coordination is more comprehensive and may also include:
- Creating an individual care plan in conjunction with the patient and/or caretaker
- Ensuring the patient and/or caretaker understand the plan and are equipped to follow it
- Identifying and addressing all barriers that might impede the patient’s or caretaker’s ability to care for himself/the patient
- Helping to assemble an appropriate team of health professionals to meet the patient’s needs
- Assisting the patient/caretaker in navigating the health system and addressing any insurance coverage issues
- Ensuring the patient’s electronic health record is accurate and accessible to all caregivers and the patient/caretaker
- Facilitating complete and timely communication between care team members
- Following up regularly with the patient/caretaker to ensure the patient’s needs are being met and to identify any changes to the patient’s circumstances
- While the needs of each practice and its patients vary, a registered nurse is typically the most appropriate person to manage care coordination services.
Conclusion
The American Society of Addiction Medicine (ASAM) provides an electronic assessment tool that allows clinicians, counselors, and other staff to leverage a computerized clinical decision support system (CDSS) to assess individuals with addictive substance use disorders and co-occurring conditions. ASAM CONTINUUM guides interviewers through a whole-person comprehensive assessment aligned with the six dimensions of The ASAM Criteria to determine service planning, and transfer recommendations, and produces a level of care recommendation for the least intensive, but safe and appropriate setting. (ASAM, 2022).
BHA FPX 4003 Assessment 2 Attempt 1 Managing Quality Across Various Health Care Settings
A comprehensive analysis such as this perfectly summarizes the level of care that can be taken to give the patient a user-friendly, effective, and efficient continuum of care. This concept is fundamental and detrimental to the success of each patient which in turn results in a level of success for the physician practice or hospital. Each patient’s duration of care will vary based on the level of ambulatory services needed, continuum of care is not a one size fits all mentality. This is the beauty of the continuum of care. The Treatment Improvement Protocol, 2022 article, states that other aspects of continuing care include involvement with selected community resources as needed, such as vocational training, recreational therapy, family therapy, or medical care. Understanding that the patient’s true success may at times rely on continued care provided by outsourcing into the community.
For instance, if the patient has suffered from substance abuse and has successfully recovered from the alignments involved with that issue, this type of patient may relapse. Continuum of care may include weekly meetings, a sponsor to help maintain abstinence, and also maintain employment and social network connections. Establishing a strong connection with support groups and pursuing healthy community activities, (Treatment Improvement Protocol. 2022) would be essential for this patient to continue to live at their highest level of function.
In conclusion, understanding the need for outpatient, intensive outpatient, in-patient, intensive inpatient or the collaboration of all falls on the physician to judge and decide based on education and experience. During that process, providing encouragement and positive settings, services, and treatment philosophies optimize the continuum of care. Assisting in that is the collaboration of the physicians and healthcare team ensuring they stay organized with clear communication systems, organized regular meetings, and providing non-stop training opportunities. This level of “care coordination” creates an environment where the concept of the continuum of care can thrive.
ASAM. (2022). ASAM Continuum. The Decision Engine for The ASAM Criteria.
https://www.asam.org/asam-criteria/asam-criteria-software/asam-continuum
Continuum Health Alliance. (2022). Coordinated Care: Key to Successful Outcomes.
BHA FPX 4003 Assessment 2 Attempt 1 Managing Quality Across Various Health Care Settings
Niles, N. J. (2019). Basics of the U.S. Health Care System (4th Edition). Jones & Bartlett
Learning. https://capella.vitalsource.com/books/9781284203882
Treatment Improvement Protocol (TIP) Series, No. 47. Center for Substance Abuse Treatment.
Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006.
The University of Texas at Austin (UTA). (2022). Physician Role.
