RSSArchive for July, 2012

Outsourcing healthcare, but at what cost?

The Los Angeles Times reported this week that healthcare firms are increasingly shifting clinical services and decision-making on medical care overseas, including nursing functions.  WellPoint, Inc., a major health insurer, has begun to outsource pre-service nursing jobs, in which “nurses at insurance firms … help assess patient needs and determine treatment methods,” according to the article. This is a huge step beyond sending some data-processing or accounting services overseas, and it has raised some concerns among nursing organizations.

Beyond the issue of foreign insurers having a say in patient care, the outsourcing of healthcare jobs raises concerns about patient privacy. According to the article, the Iowa Health System and several other hospitals throughout the country have begun outsourcing the job of transcribing physician’s notes and other records. Despite claims that “nearly all countries have laws for protecting patient privacy,” it seems like a risk that outweighs the potential cost-savings. But one could see the appeal, particularly as electronic health records become the standard and eliminate the need for patient information to be stored physically.

Proponents of outsourcing argue that it not only cuts costs, but also enables U.S. companies to “tap global talent and efficiencies” and turn a greater profit. Ultimately, this is supposed to create more opportunities for American workers while keeping costs low for consumers. Perhaps that’s the case for industries such as manufacturing or technology, but it seems like healthcare is something that should be kept closer to home.

What are your thoughts on outsourcing healthcare jobs to other countries? Are there certain healthcare tasks that can be outsourced?  Leave a comment to weigh in.

Nurses identify barriers and facilitators for clinical practice guideline use

Nurses’ adoption and use of clinical practice guidelines is largely affected by external barriers such as social and organizational factors, according to a study published in this month’s issue of American Journal of Nursing.  Clinical practice guidelines, which the Institute of Medicine defines as “systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances,” are designed to close the gap between evidence for best practice and actual patient care. Researchers chose to focus on nurses’ applications of clinical practice guidelines due to several previous studies that found that nurses were most often identified as being primarily responsible for ensuring patient safety.

Researchers examined responses to open-ended survey questions asking nurses about barriers and facilitators to using clinical practice guidelines. The top three most-identified categories for facilitating the use of guidelines were education/orientation/training, communication, and time/staffing/workload; similarly, these were also identified as categories in which there were barriers to guideline use. 44% of nurses responded that their ability to use guidelines was impeded by a lack of time and a heavy workload, while 25% cited a lack of education, orientation, and training and 22% cited poor communication as barriers. Researchers found that 91% of nurses identified at least one external barrier, or those outside of the individual nurse’s control, and 53% of nurses identified more than one external barrier.  Fewer than 10% of nurses identified internal barriers such as lack of awareness of guidelines or willingness to change practice to better adhere to guidelines.

The research suggests that social and organizational factors can be crucial in the use of clinical practice guidelines. Organization leaders should find ways to ensure that nurses receive sufficient education and adequate time to successfully implement guidelines. In addition, effective communication and cooperative teamwork should be encouraged and practiced by everyone within an organization. The study’s researchers conclude that nurses should ideally be involved in all stages of guideline development, implementation, and use.

How do your nurses respond to clinical practice guidelines? What are some ways you have found to ensure guideline use among your nurses? Share your thoughts in the comments section!

Social media as a healthcare business tool

American Medical News released a story last month highlighting four ways that social media can be used to improve a medical practice. By now, many people in the healthcare industry recognize that social media can be a powerful tool for communicating with patients, albeit a tool that can have terrible consequences when used incorrectly. The article from American Medical News focuses its attention on social media as a business intelligence resource and customer service tool, as well as a means for reporting to move toward improved care and outcomes. Although the article is primarily focused on how physicians can use social media, the principles discussed can be applied by any leaders within a healthcare organization.

One of the main topics of discussion in the article is using social media to gain insight into what services patients are seeking and what obstacles patients are facing. By identifying health trends and reacting with targeted programs and informational posts, healthcare leaders can use social media to address patient needs quickly and effectively.

Similarly, social media can be a platform for addressing complaints, negative comments, and feedback from patients. Practitioners should exercise caution in keeping specific details about patients offline and out of the public sphere, but can nonetheless use social media channels to provide an apology and offer to correct a situation. Ideally, the disgruntled patient feels as though his or her complaints are being addressed in a timely manner, while other patients see that customer service is a priority for the organization.

Given the ubiquity of social media in most patients’ lives, as well as the nearly non-existent cost of creating and maintaining social media sites, using these resources makes sense for any organization looking to improve patient engagement and interaction. As for any business, developing and implementing an effective social media initiative for a healthcare organization requires careful planning, proper management, and constant monitoring and maintenance. But the benefits of improving overall quality and patient satisfaction could make social media engagement well worth the effort.

What are your thoughts on social media as a tool for healthcare organizations? Does your organization use social media in the ways described here? Leave a comment and share your thoughts!

Core curricula, examinations, and national certification on the horizon for preceptors

The American Academy for Preceptor Advancement (AAPA) has selected The College Network® and LearnScale™ Solutions to develop core curricula and examinations for certifying individuals as preceptors. A lack of national standards, national certification, and consistency in development has made it difficult for the healthcare industry to validate the abilities of preceptors. AAPA, The College Network, and LearnScale aim to prepare nurses and other healthcare providers for successful careers as certified preceptors following the completion of their formal education, according to a June 14 press release from The College Network.

“Precepting is a unique specialty with its own core of knowledge and expertise associated with competent and engaged preceptors,” Diana Swihart, PhD, DMin, MSN, APN CS, RN-BC, said in the press release. Swihart has written multiple books on nurse preceptor programs and training, and has spoken at national conferences on topics related to nursing, shared governance, and staff development.

AAPA started out in 2009 as The Preceptor Certification Steering Committee, which began developing drafts of standards for preceptors, criteria for preceptor advancement, and core curriculum for certifications. AAPA was officially established earlier this year. Swihart serves as chief executive officer for the group, with Solimar Figueroa, MSN, MHA, BSN, RN, acting as chief nursing officer.