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{"id":66656,"date":"2023-02-02T13:19:27","date_gmt":"2023-02-02T13:19:27","guid":{"rendered":"https:\/\/nursingwritersbureau.com\/?p=66656"},"modified":"2023-02-02T13:19:27","modified_gmt":"2023-02-02T13:19:27","slug":"peers-response","status":"publish","type":"post","link":"https:\/\/nursingwritersbureau.com\/peers-response\/","title":{"rendered":"peer’s response"},"content":{"rendered":"Hirons,Hi professor and classmates! Value based healthcare is the focused on the quality of care and patient satisfaction. Volume based healthcare focuses more on profit. Patients are charged one large fee for any service they might need from a single provider.\u00a0The goal in value based healthcare to improve patients\u2019 experiences and outcomes and reduce the extraordinary costs of healthcare services (Caron, 2019).I am a nurse leader in a psychiatric hospital. We talk about patient safety constantly, but the\u00a0context\u00a0for a psychiatric population is much different than other patient\u00a0populations. The most common reason for admission to the psychiatric hospital is suicidal ideation. Usually when safety is discussed, we are considering the patients\u2019\u00a0ability\u00a0and likelihood of harming themselves or others. I teach a training about de-escalation, self-defense, and restraints. All staff are required to attend the training annually to stay updated on the most\u00a0recent evidence-based safety measures. In this class, I emphasize the importance of maintaining safety. My organization does promote a culture of safety for both patients and staff. This is evident in frequent education, policies, safety protocols, and comprehensive discharge planning\u00a0(Sanchez et al., 2021).To improve safety outcomes, I would like to implement a discharge program in which we call to check in on patients upon discharge. Patients admitted to a psychiatric hospital are at extremely high risk for suicide completion upon discharge. This is why safety planning is so crucial to patient safety. Our social work team makes sure each patient has a support system, outpatient\u00a0appointments, medications, and an action plan in case suicidal thoughts return. However, I think adding in an extra precaution, checking on our recently discharged patients, would benefit our patients and reduce the risk of suicide completion(Sanchez et al., 2021).My strategy for implementing this plan is\u00a0create an\u00a0inter disciplinary\u00a0committee of nursing staff, providers, and social workers. My proposal would be to\u00a0assign one social worker to be our discharge coordinator, who is responsible for making\u00a0these\u00a0follow up calls. He or she would touching base with our\u00a0recently\u00a0discharged patients. This social worker would document the conversation in the patient\u2019s chart. If the patient need assistance with resources, the social worker could help them. If the patient is voicing hopelessness or\u00a0suicidal\u00a0ideation, the social worker could encourage the patient to come back to the hospital. If the patient is voicing suicidal ideation and refusing to go to the hospital, the social worker would need to contact the police for a welfare check. We are a hospital with 60 beds and I do not think this would require another full time social worker. In considering a budget proposal, I would\u00a0initiallysuggest that this added role would be 50% of a full time social worker\u2019s responsibilities or a part time social worker\u2019s full responsibilities\u00a0(Conti et al., 2020).Current technology used to support patient safety includes the use of video monitoring throughout the hospital, except for in the bathrooms. The goal is to allow patients to have privacy, so staff members aren\u2019t following them, but can still monitor the patients at all times. Unintended consequences include patients experiencing paranoia. To address this consequence, I am honest and genuine with patients. I say \u201cthese cameras are only here to keep you safe. We want to make sure that other patients don\u2019t go to the wrong room and that we can come help you if you need it.\u201d I also assure the patients that there are no cameras in the bathroom, so to change clothes in there. If the patient is based in reality, the patient is usually\u00a0satisfied. However, if a patient is very paranoid or experiencing psychosis, this is a little more difficult. If this is the case, I resort to active listening skills and validating the patient\u2019s feelings. I also emphasize that the patient is safe\u00a0(DeMasi, 2018).Working in mental health, I experience daily frustration over insurance companies\u00a0power over\u00a0the treatment we can provide to mentally ill patients.\u00a0I had a patient who was admitted to the psychiatric hospital for a few weeks. The utilization review department (who communicate with insurance companies) said the patient had \u201cexhausted his days\u201d and would need to be discharged. The patient was not safe to leave. He had a very specific plan to die by suicide, no support system, and no place to go. Thankfully, the provider and other members of the treatment team were not willing to risk the patient\u2019s safety based on an insurance company\u2019s willingness to pay. However, this was an eye opening experience. It seemed like volume based care focused on the amount of days the patient was in the hospital, rather than the patient\u2019s actual safety (Caron, 2019).ReferencesCaron, R. M. (2019). Co-producing healthcare in a volume vs. value-based healthcare system: perspective of a parent of a patient and a health professions\u2019 educator.\u00a0Patient Experience Journal,\u00a06(2), 16\u201319.https:\/\/doi.org\/10.35680\/2372-0247.1373\u00a0(Links to an external site.)Conti, E. C., Jahn, D. R., Simons, K. V., Edinboro, L. P. C., Jacobs, M. L., Vinson, L., Stahl, S. T., & Van Orden, K. A. (2020). Safety planning to manage suicide risk with older adults: Case examples and recommendatioms.\u00a0Clinical Gerontologist,\u00a043(1), 104\u2013109.https:\/\/doi.org\/10.1080\/07317115.2019.1611685\u00a0(Links to an external site.)De Masi, F. (2018).\u00a0Working with difficult patients\u202f: from neurosis to psychosis\u00a0. Routledge, an imprint of Taylor and Francis.S\u00e1nchez-Teruel, D., Robles-Bello, M. A., Muela-Mart\u00ednez, J. A., & Garc\u00eda-Le\u00f3n, A. (2021). Resilience assessment scale for the prediction of suicide reattempt in clinical population.\u00a0Frontiers in Psychology,\u00a012, 673088\u2013673088. https:\/\/doi.org\/10.3389\/fpsyg.2021.673088<\/p>\n \n
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