Calling the Shots: Nursing News and Notes

Affordable Care Act Healthcare Reform Keeps Rolling

Affordable Care Act Healthcare Reform Keeps Rolling

Tuesday, November 18, 2014

The Affordable Care Act (ACA) is no longer looming—it's in full effect. Signed into law by President Barack Obama on March 23, 2010, the Affordable Care Act (ACA) includes numerous healthcare reform adoption measures that must take place over several years. 

The ACA aims to increase the quality and affordability of healthcare, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of healthcare for individuals and the government. It provides a number of measures—including mandates, subsidies and insurance exchanges—to increase coverage and affordability.

One measure of the ACA is the Hospital Readmissions Reduction Program, which requires the Centers for Medicare and Medicaid Services (CMS) to reduce payments to hospitals with excess readmissions. It is in the best interests of hospitals, primary care and long-term care providers to work together to reduce hospital readmissions and create seamless transitions from acute care to senior living.

Healthcare leaders believe some of the ways to achieve this include following quality of care best practices, comprehensive assessments, and care planning. But most importantly, communication is the key to reducing hospital readmissions. Communication is important in many forms throughout the continuum:

  • Communication between referral sources: Identify what each organization can do to improve care transitions.
  • Communication between the healthcare team and the patient/family: Starting day one, explain condition and plan of care, focusing on goals. 
  • Communication between nursing staff: From one shift to another and from nurse to nursing assistants, point out any high-risk patients and signs/symptoms to monitor.
  • Communication between nurses and physicians: Follow protocols such as SBAR (situation, background, assessment, recommendation), INTERACT (interventions to reduce acute care transfers), and clinical pathways prior to calling the physician.
  • Communication/education prior to discharge: Provide appropriate recommendations to patient/family to ensure success with medication management post-discharge.
  • Communication between nursing and the patient's personal care provider: Provide discharge paperwork, including labs, nursing and therapy notes, hospital and doctor’s notes, and confirm follow-up appointments.

In an effort to improve the quality and relevance of evidence available to help patients, caregivers, clinicians, employers, insurers, and policy makers make informed health decisions, the Patient-Centered Outcomes Research Institute (PCORI) is another product of the ACA healthcare reform.

PCORI funds comparative clinical effectiveness research and supports work that will improve the methods used to conduct such studies. The goal is to determine which of the many healthcare options available to patients work best in particular circumstances. They do this through patient-centered outcomes research that addresses the questions and concerns most relevant to patients.

PCORI focuses on comparative-effectiveness studies and research procedures that involve patients, caregivers, and clinicians, with acute care nurses playing a leading role. PCORI's mission is to improve healthcare delivery and outcomes by producing and promoting high-integrity, evidence-based information that comes from research guided by patients, caregivers, and the broader healthcare community.

Learn more about PCORI and how nurses can get involved by going to http://www.pcori.org.

 

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