You are the Case Coordinator. You have 300 patients that need to be scheduled for outside specialty appointments every month. You are tasked by the Administrator to develop a strategic plan organizing the out of the facility appointments without impairing internal services.
Correctional Health Care Assignment

You applied and were accepted in an internship program of a state-level, Female Correctional Health Care Operation in the South Eastern United States and your primary responsibility is to work on the assigned projects related to the provision of inmate health care.

Associated materials:

The Health and Health Care of US Prisoners: Results of a Nationwide Survey

Public Health Behind Bars

Sample Tool Control Policy

Inmate Sick Call Procedures-Corrections

For the incarcerated population in the United States, health care is a constitutionally guaranteed right under the provisions of the eight amendment which is the prohibition against cruel and unusual punishment (see Estelle v. Gamble). This particular prison can hold in excess of 1,728 offenders and routinely houses between 1,600 and 1,700 women on any given day. This institution incarcerates all custody classes to include minimum security, medium security, close custody, death row, and pretrial detainees.

The health care operation provides the highest level of care for the female offender in the state. The health care facility is a 101 thousand square foot, 150 bed, three-story building that cost the taxpayers $50 million dollars to construct and is a hybrid of an ambulatory care center, long-term care center, and a behavioral care center. The health care facility also houses an assisted living dorm.

The patient demographic includes women who have multiple co-morbidities including substance abuse, seriously persistent mental illnesses (SPMI), diabetes, cardiovascular disease, cancer, morbid obesity, HIV / AIDs, hepatitis, etc. On any given day there will also be 30 to 60 offenders who are pregnant, with 98% of those offenders having a history of substance abuse; all pregnant offenders are considered high-risk. The dental health of this patient population is exceptionally horrendous because of excessive drug abuse coupled with a sugary diet and poor oral hygiene practices. It is not uncommon for a 23-year-old to need all of her teeth extracted.

There are approximately 300 FTEs to include correctional staff that operate the facility and provide care to the offender population. The healthcare facility is comprised of the following directorates: (a) Medical, (b) Nursing, (c) Behavioral Health, (d) Pharmacy, (e) Dental, (f) Medical Records, (g) Health Service Support, and (h) Operations and Security.

Although the health care facility has a vast amount of capability, there limitations: (a) This facility does not have advanced cardiac life support capability (ACLS), (b) no surgical capability, (c) no ability to conduct telemetry, (d) no oral surgery beyond simple extractions, (e) no obstetrical capability beyond out-patient clinics, (f) MRI, (g) level 2 ultrasound, and the list goes on.

Those inmates who have medical needs that cannot be addressed by the health services staff at the correctional facility will need appointments with external health care providers who have a business relationship with the prisons in this area. On any given month, there will be approximately 300 offenders who will go to outside medical appointments and making certain that these appointments take place this is where the challenge lies. Similar to many health care operations, the prison Utilization Review / Case Management Department facilitates all external appointments and form the lynchpin between the correctional facility health care providers who refer offenders for specialty appointments, and the outside organization providing that appointment.

Your assignment: You are the Case Coordinator. You have 300 patients that need to be scheduled for outside specialty appointments every month. You are tasked by the Administrator to develop a strategic plan organizing the out of the facility appointments without impairing internal services.

As the first step, develop a Memorandum addressing:

1. Provide an overview of Estelle v. Gamble and how that 1976 Supreme Court ruling pertains to the provision of inmate health care.

2. Examine the challenges of providing health care in a correctional environment.

3. What are the challenges of providing health care to a female offender population that may not exist in a male prison?

4. What framework would you apply to the strategic planning? Why? (HINT: Remember all the available frameworks that you learned in the previous classes as well as in this class to make a correct choice).

Make sure to cite in APA format when appropriate. Support your statements with credible evidence.
Delivery Models Essay – Rubric

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Triple Aim

19.2 points

Criteria Description

Triple Aim

5. Excellent

19.2 points

The essay thoroughly and skillfully identifies the triple aim as it relates to population health management and delivery models.

4. Good

17.66 points

The essay thoroughly identifies the triple aim as it relates to population health management and delivery models.

3. Satisfactory

16.9 points

The essay identifies the triple aim as it relates to population health management and delivery models.

2. Less Than Satisfactory

15.36 points

The essay vaguely identifies the triple aim as it relates to population health management and delivery models.

1. Unsatisfactory

0 points

The essay does not sufficiently identify the triple aim as it relates to population health management and delivery models.

Current Trends in Health Care Delivery Models

18.4 points

Criteria Description

Current Trends in Health Care Delivery Models

5. Excellent

18.4 points

The essay thoroughly and insightfully describes current trends in health care delivery models.

4. Good

16.93 points

The essay describes current trends in health care delivery models.

3. Satisfactory

16.19 points

The essay thoroughly describes population current trends in health care delivery models.

2. Less Than Satisfactory

14.72 points

The essay does not clearly describe current trends in health care delivery models.

1. Unsatisfactory

0 points

The essay does not adequately describe current trends in health care delivery models.

Quality and Safety

18.4 points

Criteria Description

Quality and Safety

5. Excellent

18.4 points

The essay expertly explains how quality and safety impact delivery models in health care.

4. Good

16.93 points

The essay adequately explains how quality and safety impact delivery models in health care.

3. Satisfactory

16.19 points

The essay soundly explains how quality and safety impact delivery models in health care.

2. Less Than Satisfactory

14.72 points

The essay vaguely explains how quality and safety impact delivery models in health care.

1. Unsatisfactory

0 points

The essay does not adequately explain how quality and safety impact delivery models in health care.

Thesis Development and Purpose

5.6 points

Criteria Description

Thesis Development and Purpose

5. Excellent

5.6 points

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

4. Good

5.15 points

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

3. Satisfactory

4.93 points

Thesis is apparent and appropriate to purpose.

2. Less Than Satisfactory

4.48 points

Thesis is insufficiently developed or vague. Purpose is not clear.

1. Unsatisfactory

0 points

Paper lacks any discernible overall purpose or organizing claim.

Argument Logic and Construction

6.4 points

Criteria Description

Argument Logic and Construction

5. Excellent

6.4 points

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

4. Good

5.89 points

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

3. Satisfactory

5.63 points

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

2. Less Than Satisfactory

5.12 points

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

1. Unsatisfactory

0 points

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

4 points

Criteria Description

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5. Excellent

4 points

Writer is clearly in command of standard, written, academic English.

4. Good

3.68 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

3. Satisfactory

3.52 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

2. Less Than Satisfactory

3.2 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

1. Unsatisfactory

0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Paper Format (Use of appropriate style for the major and assignment)

4 points

Criteria Description

Paper Format (Use of appropriate style for the major and assignment)

5. Excellent

4 points

All format elements are correct.

4. Good

3.68 points

Template is fully used; There are virtually no errors in formatting style.

3. Satisfactory

3.52 points

Template is used, and formatting is correct, although some minor errors may be present.

2. Less Than Satisfactory

3.2 points

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

1. Unsatisfactory

0 points

Template is not used appropriately or documentation format is rarely followed correctly.

Documentation of Sources

4 points

Criteria Description

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

5. Excellent

4 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

4. Good

3.68 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

3. Satisfactory

3.52 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

2. Less Than Satisfactory

3.2 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

1. Unsatisfactory

0 points
Write a 1,250-1,500-word essay about delivery models in health care. Include the following in your essay: (DO NOT ADD THE QUESTIONS IN THE ESSAY!)

1. Address the triple aim as it relates to population health management and delivery models.

2. Discuss current trends in health care delivery models.

3. Describe how quality and safety impact delivery models in health care.

Include at least three peer-reviewed/academic references in your essay, including the HealthyPeople website (https://health.gov/healthypeople).

Prepare this essay according to the guidelines found in the APA Style Guide

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Title of Essay

Name

Grand Canyon University

NUR-621

Dr. Barbara Brophy

Date

Click or tap here to enter text. 1

2

Delivery Models Essay

Why are some populations healthier than others? Why do those who live in a lower socioeconomic part of the United States have poor health outcomes? A society in which all people can achieve their full potential for health and well-being across their lifespan which requires eliminating health disparities, achieving health equity, and attaining health literacy is the vision and health goals of Healthy People 2030 (Jackson et al., 2020). The United States spends less on addressing socioeconomic factors that influence population health, and more on medical care, $3.35 trillion in 2016, which accounts for 18.1% of gross domestic product (Wilkinson et al., 2017). Ineffective care, overtreatment, and failure in care coordination has contributed to more than $1 trillion in waste each year (Wilkinson et al., 2017). Health inequities, such as race and ethnicity, need to be addressed, and the elimination of these two disparities alone could reduce medical care costs by $230 billion in one year (Wilkinson et al., 2017). People of color and individuals of low income face more barriers to care, which contributes to limited healthcare access and outcomes, at an unnecessary cost (Salmond & Echevarria, 2017). For this country to achieve health equity, we need to invest in housing, food security (this is true now more than ever), maternal and early childhood development, digital technologies, and income to improve overall population health (Wilkinson et al., 2017). Health equity is an important and necessary part of the puzzle when looking at health care reform and Triple Aim. Triple Aim as it relates to population health management, current trends in health care delivery models, and how quality and safety impact the ways in which health care is delivered will be discussed in this paper.

Triple Aim and Population Health Management

Population health is becoming one of the most popular concepts studied when looking at how to optimize the healthcare system in the United States. Population health is part of the key components of the Institute for Healthcare Improvement’s (IHI’s) Triple Aim, a framework which focuses on improving the patient experience, improving health outcomes for populations of patients, and reducing the cost of healthcare per capita (Swarthout & Bishop, 2017). Population health encompasses the impact of educational differences, unjust disparities, and income inequality by focusing on the underlying cause of the illness (Swarthout & Bishop, 2017). Population health management is a patient-centered, integrated care delivery model based on collaborative and coordinated processes built upon disease management protocols as well as evidence-based prevention, with a goal to improve health outcomes (Swarthout & Bishop, 2017). To achieve population health equity based upon a conceptual framework for population health, it needs to encompass public health, population health, population health improvement, and population health management. Population health management looks at a patient’s risk factors, then tailors the intervention they offer based upon whether the risk factor is high or low. By providing interventions early on in a low-risk patient population, this slows the progression of the disease in the patient, further minimizing costly visits either by admission to a hospital or being seen in the local emergency department.

To improve quality of care, improve outcomes, and reduce spending, we need to continue as a country to provide greater coordination of care both by providers and the settings in which patients are seen in the United States (Salmond & Echevarria, 2017). For nurses to continue to contribute to the changes happening in healthcare and be more aware of the goal of the Triple Aim and population health management initiatives, more training and education needs to be on team-based and seamless patient-centered care (Salmond & Echevarria, 2017). Focusing on cost containment, improved population health, and improving the patient experience is what Triple Aim is all about.

It is hard for an organization to achieve or work on all three aspects of Triple Aim, but if one is to be successful, it needs to develop population health management strategies. The infrastructure should include developing care models that detect early signs of health deterioration and start early interventions, develop preventive services, and develop community-based programs that address mental health issues or health inequities (Swarthout & Bishop, 2017). For population health management to be successful, looking at reaching the population who do not seek healthcare through traditional delivery models and focus on items not related to healthcare (Salmond & Echevarria, 2017). If healthcare systems partner with their communities and focus on creating healthier work environments, health education, and creating healthier places to live and play, then they are investing in population health and focusing on patient-centered care wellness and improving social determinants of health throughout a person’s life. The IHI has a six-step change process that focuses on identifying target populations, developing project work that is strong enough to produce system-level results, definition of system aims and measures, and the ability to adapt to local needs and conditions with rapid testing (The Ihi Triple Aim | Ihi – Institute for Healthcare Improvement, 2021).

Trends in Healthcare Delivery Models

Current trends in the delivery of healthcare include growth in complementary and alternative medicine therapies, greater use of technology and social media, an increase in self-care, and the utilization of artificial intelligence from grocery shopping to healthcare in the marketplace, all with implications that affect the quality of the patient experience with the provider they are seeing (Poirier & Deevraj, 2019). Patient-focused care or patient-centered care became a model based on four concepts where patients and families are active participants in the decision-making process about their care. The four concepts incorporate dignity and respect, participation, collaboration, and information sharing (McEwen & Wills, 2014). It has been shown that patients with long-term conditions benefit from patient-centered care, and healthcare providers treat the patient as an equal partner in the development of their treatment plan (Moore et al., 2016). Hospitals that participate in this model focus on quality indicators such as patient satisfaction, continuity of care, direct patient care time, which had a direct correlation in the improvement of patient and staff satisfaction (McEwen & Wills, 2014).

The patient-centered medical home (PCMH) model is a healthcare delivery model that incorporates patient care advocates and health care practitioners working together to improve the quality of patient care and their experience among the interdisciplinary team (Poirier & Deevraj, 2019). The PCMH model is being recognized as the centerpiece to reform healthcare delivery services and is acknowledged as the best practice model for primary care (Freeman et al., 2018). The Agency for Healthcare Research and Quality (AHRQ) defines a medical home not simply as a place, but as a model of the organization of primary care that delivers the core functions of primary health care and is based on five functions and attributes (Defining the Pcmh | Pcmh Resource Center, n.d.). Patient-centered, comprehensive, coordinated, accessible services and quality and safety make up the PCMH model. Benefits of this model include improved health outcomes, higher patient and provider satisfaction, reduction in overall health costs, and with the addition and realization of the importance of behavior health professionals as part of the primary team, care coordination and interventions have been enhanced for the patient (Freeman et al., 2018).

Healthcare delivery systems are also recognizing that social determinants of health, such as education, employment, and income are an important piece in achieving health equity and are incorporating social workers into the patients care team and utilizing technology to obtain data on the population surrounding their organization (Gottlieb & Alderwick, 2019). The term (non)bench-to-bedside pathway is utilizing social determinants of health based on scientific evidence and improving health and health equity by changing clinical practice (Gottlieb & Alderwick, 2019). Growing awareness of social determinants of health has led to prediction models based on incorporating social risk factors into data that will help improve treatment and resources, as well as predict who will respond to treatment and who is more likely to become ill (Gottlieb & Alderwick, 2019). What we are missing in today’s healthcare delivery model is one that focuses on the patient experience and the importance of human connection, or the true art of caring, between a patient and their provider. With the advancement of technology and social data, we can now predict that owners of a Cutlass Ciera tend to have poorer health outcomes compared to other car owners, and this is all based upon a person’s banking history, where they shop, education level, and their neighborhood (Gottlieb & Alderwick, 2019). To me, this is not the way we should be utilizing data in healthcare and seems counter intuitive for the ethical guidelines in healthcare.

Other current healthcare delivery models are focusing on how to give high-quality care to the aging population in the United States, as well as those who are dealing with chronic conditions. New care delivery models should focus on outcomes, preventative measures and place a higher emphasis on delivering care in the most efficient way (Bartlett et al., 2017). There are new healthcare delivery models that focus on patients out of the hospital, and those that focus on patients care in the hospital. Out of the hospital care models include a proactive, systematic, and intensive care approach for people with long-term conditions and complex health needs, as well as access to local urgent care seven days a week, alternatives to acute care admission, and lastly, access of care for children (Bartlett et al., 2017). By giving patients options to go to the local urgent care or health clinic at the local Walgreen’s, this is helping to reduce the number of emergency department visits and admission rates. With the general population aging, and the increase in people participating in unhealthy lifestyle choices, allowing them to see multiple specialists in one location within their community improved patient outcomes and reduced hospitalization rates by 18 percent, readmission by 17 percent, and cholesterol levels for people on statins by 22 percent (Bartlett et al., 2017). When it comes to children, the ability to see a specialist via telehealth, multiple providers across disciplines in one day, or access to a telephone triage line is another example of high-quality care that can be delivered out of the hospital (Bartlett et al., 2017).

Hospital care models include more efficient models for planned care, looking at community-based facilities, and specialist’s centers for excellence (Bartlett et al., 2017). Attention to people allows those working in an organization to perform at the top of their scope and invest in their leadership as well as their employees (Bartlett et al., 2017). For any new healthcare delivery model to be successful in continuing to provide high-quality and efficient care, it needs to focus on patients, pay attention to people, increase its operating scale, and standardize clinical and operational processes (Bartlett et al., 2017).

One article discussed inter professional communication and collaboration among nursing, pharmacy, medicine, dentistry, and public health working together to improve the quality, outcomes and cost of care, all part of the Triple Aim (Bender, 2017). The part that resonated with me is the need to reconceptualize our traditional professional values in healthcare to utilize collaboration as an ethically necessary part of patient-centered care (Bender, 2017). Clinical Nurse Leader (CNL) integrated care delivery has been identified by AHRQ as well as the Institute of Medicine as an innovative strategy to improve care delivery (Bender, 2017). Clinical nurse leaders are professionals that focus on patient advocacy, teamwork, promote care delivery on the front lines, and perform competencies which are incorporated into care delivery models. Clinical Nurse Leaders understand the need for collaboration among disciplines to promote efficient, quality care in patients. Nurses in leadership are being asked to be innovative in their staffing models, as well as continue to deliver the same quality of care while being cost-efficient within their organization. CNL-integrated care delivery is one example of a nursing-led care model that can promote inter professional communication and collaborative dynamics all while improving the safety, the patient’s experience with healthcare, and quality of care (Bender, 2017).

Quality and Safety

When looking at patient-centered care, an environment that is both evidence-based and of high quality, will create a culture that produces change in practice by focusing on continuous improvement which will increase patient satisfaction, and decrease costs over time (DeNisco, 2019). Clinical experience, quality improvement data, reasoning, authority, and the patient’s situation, values, and experience is what quality improvement needs to be based upon (DeNisco, 2019). According to the Centers for Medicare and Medicaid Services (CMS), quality measures are tools that help us measure healthcare processes, patient perceptions, and outcomes, with the capability to provide effective, safe, efficient, patient-centered, equitable, and timely care (Quality Measures | Cms, n.d.). Quality healthcare is a high priority in the United States, and CMS uses quality measures such as quality improvement, pay for reporting, and public reporting in its various quality initiatives (Quality Measures | Cms, n.d.). When it comes to quality within our healthcare system, it has unacceptable levels of error, difficult to navigate, and barriers still exist for racial and ethnic minorities or those with low-socioeconomic status to access care involving multiple providers (Swarthout & Bishop, 2017). Predictive modeling will be important to achieve the triple aim in population health, and the ability to track outcomes over time related to psychosocial status, behavior change, clinical and health status, satisfaction, quality of life, productivity, and cost are all contributing factors (Salmond & Echevarria, 2017).

Patient reported outcome measures (PROMs), and patient reported experience measures (PREMs), are two new concepts in population management when it comes to health and quality of care at both the individual and aggregate levels (Hendrikx et al., 2016). PROMs and PREMs are internationally recognized as a means for patients to provide information about their quality of life, experiences with care, and symptoms (Schick-Makaroff et al., 2019).

The CNL-integrated care model is another example of validated quality improvement in healthcare. The elements that validated an improved care environment included effective communication processes across the profession, a perception that multi-professional clinicians work together to solve problems, perception of staff ownership when it came to their own practice, and a perception that clinical nurse leader practice changes the interactions as well as the dynamics between clinicians for the better, and lastly an overall satisfaction with the care environment (Bender, 2017). Improvement in quality was validated by less errors in patient care, prevention of an error prior to reaching the patient, the ability of staff to spend more time with the patient (patient-centered care), better care coordination (communication improvement), and an improvement in nursing sensitive care quality indicators (Bender, 2017). These are both examples how quality and safety impacted the delivery of care for the patient as well as for the team taking care of them.

Going back to the PCMH model, one article addressed incorporating Maslow’s hierarchy of needs to improve the quality of patient care and enhance the patient-provider experience. Maslow’s hierarchy of needs includes physiological, safety, love and support, self-esteem, and self-actualization. Physiological needs are met with the advances in technology and the ability to receive medications via delivery or mail order, knowing the pharmacists are still available by phone for basic patient assessment and consultation if desired (Poirier & Deevraj, 2019). Safety needs can be enhanced by use of an electronic health record integration within the PCMH to promote communication and sharing of information, as well as counseling still provided by the pharmacist (Poirier & Deevraj, 2019). Love and support needs in the hierarchy are met with a health care provider who will be genuinely concerned about them as a person, showing self-awareness and empathy towards them as well as partnering with the community to support those with chronic health conditions (Poirier & Deevraj, 2019). Self-esteem is met by providing individualized education and coaching, so patients have confidence in self-monitoring and adherence with their medications and stay active in their health care decision-making (Poirier & Deevraj, 2019). And lastly, self-actualization is achieved when patients are advocating independently to seek their own care needs (Poirier & Deevraj, 2019). With the accessibility of a pharmacist, quality measures are met in every step of the hierarchy, by decreasing costs, improving utilization of preventive services, improve access and lastly enhance patient satisfaction (Poirier & Deevraj, 2019).

Conclusion

Our healthcare system is still a work in progress. We need to continue to look at care models that can detect early signs of healthy deterioration, invest in community-based programs that address social determinants of health, continue to improve our behavioral health system, and make preventative services a top priority (Swarthout & Bishop, 2017). In the United States, we need to have health equity and health literacy be a guiding light in the continued framework of Triple Aim and health reform. We need to make accessing a person’s health records easy to attain, we need to make sure people understand what they are reading in their medical records, we need to increase patient involvement in their providers in their decision-making process, we need to verify at each visit our patient understands what we are asking or saying to them, and we need to increase health literacy in the population (Health Literacy Online: a Guide to Simplifying the User Experience, 2015).

Nursing shortage is a big concern in the United States, and with the population aging, and the increased use of complex technologies, the shortage is likely to make the demand for nursing higher and intensify the shortage (Penner, Susan J., 2017). Nurses are the main denominator in a health care delivery model and drive the patient experience by focusing on satisfaction and quality. Triple Aim is now focusing on how to improve job satisfaction, as they are recognizing it takes a motivated and committed workforce to achieve their goals (Freeman et al., 2018). Maintaining care for the individual and better health for the population should be the goals of our health care system.

The PCMH model is an excellent concept of having a primary care provider advocate the patient among the disciplines involved in care. Jean Watson’s concepts of the science of human caring play an important role in this delivery model. The patient, or human being, is a person of value and is being cared for in a respected, nurtured, understood, and assisted way (McEwen & Wills, 2014). The concept of health is looking at the whole picture, starting with preventive care, primary care, and community care bring harmony to the patient’s mind and body. The concept of nursing are the experiences mediated by the professional, scientific, ethical, and personal human to human care transactions (McEwen & Wills, 2014). The actual caring occasion is the moment the patient and nurse discuss the choices and actions involved in the diagnosis, treatment, and intervention of care the patient desires. The trans personal concept is when the patient and nurse are affected by one another and fully invested in one another’s care going forward, the true art of caring (McEwen & Wills, 2014).

As nurses, we are contributing to patient satisfaction, patient outcomes, cost, and quality of care every time we encounter a patient. Many of us do not realize that we are working towards the goals of Triple Aim unless we are educated about it in school or have a need to know it for our jobs.

Bartlett, R., Dash, P., Markus, M., McKenna, S., & Streicher, S. (2017). https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/new-models-of-healthcare Bender, M. (2017). Clinical nurse leader–integrated care delivery. Journal of Nursing Care Quality, 32(3), 189–195. https://doi.org/10.1097/ncq.0000000000000247 DeNisco, S. M. (2019). Advanced practice nursing: Essential knowledge for the profession: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning. Health Literacy Online: A guide to simplifying the user experience. (2015). U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.. https://health.gov/healthliteracyonline/ Hendrikx, R. J., Drewes, H. W., Spreeuwenberg, M., Ruwaard, D., Struijs, J. N., & Baan, C. A. (2016). Which triple aim related measures are being used to evaluate population management initiatives? an international comparative analysis. Health Policy, 120(5), 471–485. https://doi.org/10.1016/j.healthpol.2016.03.008 Moore, L., Britten, N., Lydahl, D., Naldemirci, Ö., Elam, M., & Wolf, A. (2016). Barriers and facilitators to the implementation of person-centred care in different healthcare contexts. Scandinavian Journal of Caring Sciences, 31(4), 662–673. https://doi.org/10.1111/scs.12376 Poirier, T., & Deevraj, R. (2019). Pharmacy in an Improved Health Care Delivery Model Using Maslow’s Hierarchy of Needs. American Journal of Pharmaceutical Education, 83(8), 1664–1667. Quality measures | cms. (n.d.). https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures Schick-Makaroff, K., Thummapol, O., Thompson, S., Flynn, R., Karimi-Dehkordi, M., Klarenbach, S., Sawatzky, R., & Greenhalgh, J. (2019). Strategies for incorporating patient-reported outcomes in the care of people with chronic kidney disease (pro kidney): A protocol for a realist synthesis. Systematic Reviews, 8(1). https://doi.org/10.1186/s13643-018-0911-6 The ihi triple aim | ihi – institute for healthcare improvement. (2021). http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx
Sources are not documented.

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