Posted: June 17th, 2022

Accountable Care Organizations

Accountable Care Organizations
Give an introduction utilizing the under article.
The Medical Nurse Chief: Ready for an
Period of Healthcare Reform
Brenda Recchia Jeffers, PhD, RN, and Kim S. Astroth, PhD, RN
Brenda Recchia Jeffers, PhD, RN, is Chancellor and Dean, St. John’s Faculty, Springfield, IL; and Kim S. Astroth, PhD, RN,
is Assistant Professor, Mennonite Faculty of Nursing, Illinois State College, Regular, IL.
Key phrases
Medical nurse chief, healthcare
reform, built-in care supply,
nursing training
Correspondence
Brenda Recchia Jeffers, PhD, RN,
Division of Nursing, St. John’s
Faculty, Springfield, IL
E-mail: Brenda.jeffers@
stjohnscollegespringfield.edu
Jeffers Astroth
PROBLEM. Passage of the 2010 Affected person Safety and Reasonably priced Care
Act would require change within the healthcare programs. The medical nurse
chief have to be ready to steer and form the altering atmosphere to
obtain most outcomes for sufferers and households. Motion towards
built-in care supply throughout the care continuum, the transition of the
Facilities for Medicare & Medicaid Providers to a value-based funding
mannequin, and accountability for high-quality, cost-effective care are simply
a few of the drivers of this new built-in healthcare system.
IMPLICATIONS. Reimbursement fashions that reward these well being
programs which might be in a position to meet benchmark efficiency requirements will
end in main shifts in how well being programs function. Experience in care
coordination throughout the healthcare continuum is crucial for optimum
reimbursement. Fee for worth as an alternative of quantity delivered is a significant
reimbursement transition coming to the acute care setting, necessitating
elevated consideration to mining information essential to seize high quality affected person
outcomes for optimum reimbursement.
CONCLUSIONS. The medical nurse chief is ideally suited to operate
inside these built-in programs of the longer term, and possesses the talents
wanted to help healthcare programs to satisfy this problem.
The healthcare system, as we all know it, is altering
quickly. With these modifications, the nurse have to be ready
to form and lead the rising atmosphere to
obtain the best outcomes for sufferers and households.
A number of the drivers of this rising system are as
follows: (a) motion towards built-in care supply
throughout the care continuum, (b) the Facilities for Medicare
& Medicaid Providers’ (CMS) transition to a brand new
value-based funding mannequin, and (c) accountability
for high-quality, cost-effective care. Reimbursement
fashions that reward well being programs assembly benchmark
efficiency requirements will end in main shifts
on how well being programs function. The medical nurse
chief (CNL), a brand new nursing position launched by the
American Affiliation of Schools of Nursing (AACN)
in 2003, is ideally suited to help healthcare environments
to satisfy this problem. The CNL is a grasp’sprepared
nurse generalist educated with competencies
wanted on this new time to guarantee high quality healthcare
supply. The CNL focuses on security, high quality outcomes,
evidence-based follow, care coordination, advocacy,
and monetary stewardship (AACN, 2007). This focus
makes this care supplier uniquely ready to steer
change and excessive efficiency throughout the well being
system.
The Institute of Medication (IOM) report, The Future
of Nursing (2010), challenges the nursing occupation, as
effectively as the complete healthcare system, to look at the
implications of their suggestion that each one nurses
work to the utmost extent of their training
and management competencies. Examination of the
grasp’s-prepared nurse generalist educated inside
the CNL curricular framework offers a possibility
to mirror on the graduate competencies, optimum
operate, and management alternatives for this nursing
position. Whereas the CNL position was designed previous to The
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Way forward for Nursing report and the passage of the 2010
Affected person Safety and Reasonably priced Care Act, IOM
stories, such because the Well being Professions Schooling: A
Bridge to High quality (2003), influenced the event of
the CNL position (AACN, 2007). The current IOM spherical
desk on the educational well being system (IOM, 2011)
articulates that using high-quality proof is
crucial to realize value-based care supply inside
an improved healthcare system. The healthcare
reform transitions going down now and anticipated in
the close to future resonate with the academic competencies
and position preparation of the CNL. The aim
of this text is to overview main reforms coming to
healthcare programs and to look at the match of the CNL
position to steer change throughout a time of system reform and
transition.
Healthcare Reform and Transitions
Creating an built-in healthcare system that performs
as a seamless system and serves the affected person is
the aim of main reform initiatives going down right this moment.
Experience in care coordination throughout the healthcare
continuum is crucial for optimum reimbursement
for Medicare and Medicaid sufferers. Integration of
well being companies and patient-centered medical houses
are two organizational fashions poised to supply
sufferers the best well being care on the proper time within the
proper setting with the perfect final result. Fee for worth
as an alternative of quantity delivered is a significant reimbursement
transition coming to the acute care setting, necessitating
elevated consideration to mining the information essential to
seize high quality affected person outcomes for optimum reimbursement.
A short overview of those transitions follows.
Integrating the Healthcare System
A serious shift in healthcare supply is the deal with
built-in healthcare companies. The idea and definition
of built-in care have been evolving (Cortese
& Korsmo, 2009; Kodner, 2009), and at the moment are the important thing
methods to realize the standard and worth imperatives
of the Affected person Safety and Reasonably priced Care Act. Provisions
inside the Act determine particular methods to
obtain patient-centered, built-in well being care that,
and if achieved, will present monetary incentives to the
healthcare supplier. For instance, new provisions in
the Act will develop the care coordination in Medicaid
and introduce for the primary time care coordination for
Medicare sufferers (Thorpe & Ogden, 2010). Consequently,
getting old shoppers with a number of however doubtlessly
preventable continual diseases would require extra strategic
coordination of care each out and in of the hospital.
Well being programs are aligning with physicians, and impartial
doctor practices are aligning practices to
have the optimum alternative for care coordination
and for offering sufferers the best care on the proper
place (Fisher, 2008). Interprofessional healthcare
groups should work collectively to guarantee that when the
particular person interacts with the system, healthcare wants
are shortly recognized, care is coordinated, and a welldefined,
follow-up course of is in place (Thorpe &
Ogden, 2010).
Affected person-Centered Medical Properties and Accountable
Care Organizations (ACO)
The wholesome residence or patient-centered medical
residence mannequin offers a coordinated care atmosphere
that assists sufferers to maneuver by means of this new built-in
system (Related Press, 2011; Fisher, 2008).
The medical residence aligns with a major care follow,
is patient-centered and team-driven, and serves to
coordinate sufferers’ care to obtain essentially the most acceptable
care inside essentially the most acceptable setting (Cassidy,
2010). The usage of digital well being information and the
capability to watch the medical outcomes of sufferers are
a key to creating such a coordinated effort a hit.
The Affected person Safety and Reasonably priced Care Act (2010)
outlines that the aim of the patient-centered medical
house is to make use of well being groups to higher coordinate and
handle continual illness, in addition to lower hospital
readmissions.
The idea of accountability is a crucial driver
in healthcare reform reorganization. Whereas the ACO
has acquired a lot consideration, there continues to be a
lack of readability round the advantages and disadvantages of
changing into a chosen ACO (Johnson, 2011). An
ACO is accountable not just for care coordination, however
additionally for the standard and prices for a specific affected person
inhabitants (Rittenhouse, Shortell, & Fisher, 2009).
Not all organizations will meet the for or
need to turn out to be an ACO as quantity and attainment of
care benchmarks should each be demonstrated to
qualify for this designation (Johnson, 2011). Moreover,
the ultimate determination concerning if a company
qualifies to turn out to be an ACO is made by the CMS, not
the group itself. In all circumstances, accountability
inside a high-quality, high-value atmosphere
stays a key part for the well being system of the
twenty-first century.
Medical Nurse Chief Ready Healthcare Reform B. R. Jeffers and Okay. S. Astroth
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Reimbursing for Worth
A serious problem dealing with healthcare programs will probably be
to shift from reimbursement for quantity to reimbursement
for top efficiency and high quality outcomes.
Starting in fiscal 12 months 2013, a proportion of Medicare
reimbursement will probably be withheld except hospitals
meet benchmark efficiency measures in outcomes
and affected person satisfaction. The share withheld is
anticipated to extend within the coming years, however at this
time the rise is unknown. Hospitals can earn
monies again when efficiency is at or above benchmark
(Lloyd, 2011). Measures of care processes,
together with medical measures for surgical and cardiac
care, and sufferers’ satisfaction with their care experiences
have been designated as the first worth indicators
in fiscal 12 months 2013. Further worth measures,
together with effectivity and outcomes, will probably be tracked in
subsequent years. Measures of affected person experiences
embody however should not restricted to nurse communication,
ache administration, communication about drugs,
and discharge info. Healthcare analysts
are emphasizing that for hospitals to realize these
high quality outcomes, a deal with assuring dependable measures,
use of evidence-based follow, and ability in care
coordination is required (Well being Care Advisory Board,
2010; Huron Consulting Group, 2011; Lloyd, 2011).
Implications for the CNL Function
The healthcare system modifications, and reimbursement
fashions require elevated emphasis on care integration,
care continuity, and supply of the simplest
evidence-based take care of the perfect worth. The built-in
care system requires care suppliers to own a
patient-centered focus, and expertise in care coordination
and expertise in interprofessional crew care supply.
Likewise, the medical residence follow could also be seen as a
driver for care integration, with one aim being the
lower in readmissions by means of interprofessional
care coordination. ACOs and acute care services want
care suppliers who’ve an understanding of reimbursement
for medical outcomes, evidence-based care,
and expertise in patient-centered care coordination.
How then can nursing greatest lead the system
to satisfy these challenges The next sections
will describe the preparation of the CNL, and description
why the CNL is a key nursing position possessing the
training and management competencies to steer profitable
transition on this period of healthcare reform.
CNL preparation, roles, and present documented
impression will probably be highlighted.
Present CNL Preparation
Whereas undergraduate training for the registered
nurse introduces the generalist to altering healthcare
system challenges, and offers a strong basis in
many areas, resembling evidence-based follow, informatics,
and management, the competencies acquired by
the newly baccalaureate-educated nurse should not enough
to steer the transformations occurring inside
the present system. The nurse ready on the undergraduate
degree is educated to supply direct affected person
care to people and teams, and to show
an preliminary understanding of evidence-based follow
and informatics. Nonetheless, given the undergraduate
program focus and size, it’s not attainable to supply
superior competencies and expertise on the degree wanted
for main the altering system calls for, for
instance, superior well being evaluation, group
programs, high quality enchancment, threat administration, and
info administration to trace affected person outcomes.
Graduate preparation and a complicated nursing diploma
are wanted to arrange the nurse to completely achieve these
competencies.
Lately, the AACN launched an up to date model of
the Necessities of Grasp’s Schooling in Nursing. This
doc outlines the important elements of a
program granting a grasp’s diploma in nursing. These
necessities present requirements for the grasp’s degree
preparation of the nurse to achieve the mandatory data
and expertise to operate as an professional practitioner in
the brand new healthcare period. The beneficial preparation
of the CNL is mirrored in these 9 necessities:
science and humanities background, programs and
organizational management, high quality enchancment and
security, translation and integration of scholarship
into follow, informatics and healthcare know-how,
well being coverage and advocacy, interprofessional collaboration,
medical prevention, and grasp’s-level nursing
follow (AACN, 2011). The core curricular components
of the CNL preparation embody content material encompassing
the nursing management, medical outcomes administration,
and care atmosphere administration (AACN,
2007). Extra particularly, the CNL preparation contains
administration of shopper outcomes inside a framework
of evidence-based high quality enchancment and shopper
security. Preparation begins with a strong basis in
the liberal arts, which permits for the event of
B. R. Jeffers and Okay. S. Astroth Medical Nurse Chief Ready Healthcare Reform
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problem-solving expertise, a capability to interpret and
handle information, using data to develop vital
considering expertise, and the applying of social, financial,
political, and moral ideas to affected person care issues
(AACN, 2007). Different areas included within the training
of the CNL are superior bodily evaluation,
pathophysiology, and pharmacology, along with
superior rules of communication, management,
high quality enchancment, threat administration, evidencebased
care, info administration, and alter
idea. The preparation additionally features a minimal of
300 medical hours of immersion studying and training
within the CNL position. Finally, these instructional
elements facilitate the CNL pupil in offering
the care to greatest meet the wants of a microsystem of
shoppers. After or close to profitable completion of an
accredited CNL training program, the CNL pupil is
eligible to take the voluntary nationwide CNL certification
examination. This examination accommodates content material on areas such
as nursing management, medical outcomes administration,
and care atmosphere administration (Fee on
Nurse Certification [CNC], 2008). Profitable completion
of this examination confers the best to make use of “CNL” as half
of the nurse’s credentials (CNC, 2008).
Though some anticipate some overlap between the
position of the CNL and different superior roles, the CNL is
ready as a generalist with enhanced data in
pathophysiology, pharmacology, and bodily evaluation.
The superior follow nurse, such because the nurse
practitioner, and the medical nurse specialist (CNS)
sometimes deal with particular affected person populations and
operate in a complicated supplier position with prescriptive
authority. Whereas the CNS has training in healthcare
programs, the CNL generalist training focuses, to
a better extent, on the talents wanted to achieve the
period of system reform. The CNL offers and coordinates
care on the level of care, and focuses on microsystem
change and management, whereas the CNS has a
extra specialised inhabitants focus and works throughout
the well being system (AACN, 2004). The doctorate of
nursing follow (DNP) is anticipated to be the foundational
preparation for the superior follow nurse.
Whereas the CNL sometimes will present care coordination
for a bunch of sufferers on the microsystem degree, the
DNP could present or oversee care from a macrosystem
perspective. For instance, the CNL considers affected person
metrics on a bunch of sufferers in a hospital unit and
will develop high quality initiatives to handle these metrics
that want enchancment. The DNP may be instrumental
in serving to implement the profitable high quality initiatives
all through the hospital. A DNP could deal with nursing
programs administration, whereas the CNL is just not supposed
for nursing administration positions. As a substitute, the CNL is
a affected person care-focused chief and has a pivotal position
in coordinating affected person care from an interprofessional
crew.
Standing of the CNL Inside Our Present System
Since 2005, there have been over 1,300 graduates
from CNL packages throughout the nation (AACN, 2010).
Lammon, Stanton, and Blakney (2010) indicated that
CNLs may be employed efficiently in a wide range of
settings, together with acute care, rural well being care, veteran’s
well being care, public well being, and residential care. There
are some preliminary information describing the worth of the CNL
position with improved shopper outcomes. For instance,
CNL follow in a number of veteran’s administration (VA)
well being services has resulted in total promising
enchancment in outcomes resembling reductions in
affected person falls, hospital-acquired stress ulcers,
ventilator-associated pneumonia, and cancelled
scheduled surgical procedures (Ott and Walter, 2009).
In a single VA system, Hix, McKeon, and Walters (2009)
reported important enhancements in high quality indicators
after CNL implementation, together with reductions
in inpatient readmission charges, size of keep, affected person
falls, hospital-acquired stress ulcers, and surgical
an infection charges. Stanley et al. (2008), analyzing the
impression of CNL over a Three-month time interval, reported
enhancements in a number of medical outcomes in three
hospitals: enhancements in affected person satisfaction, optimistic
impression on new nurse retention, decreased size
of keep, and improved care coordination. A rise
in high quality for CMS core measures was current throughout
all case research. Stachowiak (n.d.) reported outcomes
from a 2-month CNL pilot in a progressive medicalsurgical
acute care unit. Outcomes indicated a rise
in Press Ganey nurse measures and a decreased size
of keep within the 2-month time interval. The lower in
size of keep was reported to supply a financial savings of over
$100,000. Moreover, the writer introduced a affected person
case research of continual sickness administration, which illustrated
a financial savings of just below $300,000 when a CNL
was coordinating care. A lot of the literature gives
case research and qualitative information to report the impression
and return on funding of the CNL, and the preliminary
information are promising.
CNL follow companions are recommended for his or her
imaginative and prescient on using the CNL to enhance shopper outcomes
in a cost-efficient method. The standard enchancment,
threat anticipation, and monetary consciousness in
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Desk 1. Options of the Healthcare System Environments Matched With Medical Nurse Chief
(CNL) Competencies
Options of the altering
healthcare system Key options of the atmosphere CNL competenciesa
Built-in well being care • Reimbursement for care coordination in
continual sickness
• Alignment of physicians and acute care
• Affected person receives the best care in the best
setting
• Interdisciplinary
• Digital communication important for
coordination
Identifies medical and price outcomes that
enhance security, effectiveness, timeliness,
effectivity, high quality, and the diploma to which
they’re client-centered.
Makes use of info programs/supplies/
methods to facilitate shoppers’ studying
and enhance their well being outcomes.
Communicates successfully to realize high quality
shopper outcomes and lateral integration of
take care of a cohort of shoppers.
Assimilates and applies research-based
info to design, implement. and
consider shopper plans of care.
Makes use of info programs and know-how at
the purpose of care to enhance healthcare
outcomes.
Affected person-centered
medical residence
• Affected person-centered
• Major care focus
• Interdisciplinary crew strikes affected person
by means of well being
system in response to wants
Results change by means of advocacy for the
interdisciplinary healthcare crew and the
shopper.
Assumes accountability for healthcare
outcomes for a particular group of shoppers
inside a unit or setting, recognizing the
affect of the meso- and macrosystems
on the microsystem.
Correctly delegates and makes use of the assets
(human and monetary), and serves as a pacesetter
and companion within the interdisciplinary
healthcare crew.
Accountable care
atmosphere
• Accountable care organizations
• Give attention to outlined inhabitants
• Care coordination
• Excessive volumes
• Monitoring outcomes
• Prices and high quality
Assumes accountability for healthcare
outcomes for a particular group of shoppers
inside a unit or setting.
Makes use of info on the level of care to
enhance shopper outcomes.
Synthesizes information, info, and
data to judge and obtain
optimum shopper and care atmosphere
outcomes.
Reimbursement for worth • Outcomes decide reimbursement
• Knowledge-driven
• Affected person expertise metrics
• Monitoring medical processes and outcomes
Implements cost-effective, high quality outcomes
which might be protected, well timed, environment friendly, and
client-centered.
Participates in programs overview to critically
consider and anticipate dangers to shopper
security to enhance high quality of shopper care
supply.
Synthesizes information, info, and
data (e.g., affected person satisfaction and
different high quality indicators) to judge and
obtain optimum shopper and care
atmosphere outcomes.
Facilitates shopper care utilizing evidence-based
assets.
Observe: aAdapted and/or reprinted from White Paper on the Schooling and Function of the Medical Nurse Chief by the American Affiliation of
Schools of Nursing, 2007, pp. 34–38. Copyright 2007 by the American Affiliation of Schools of Nursing.
B. R. Jeffers and Okay. S. Astroth Medical Nurse Chief Ready Healthcare Reform
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Nursing Assignment help – Discussion board Quantity 48, No. Three, July-September 2013
CNL preparation match properly with the challenges of
value-based buying. Along with the size of
keep cost-savings reported with CNL pilots, the stories
of the CNL impression in enhancing core measures and
Press Ganey nurse measures present promise for acute
care services to seize extra Medicare reimbursement
in value-based buying. The lateral
integration of care (care coordination), useful resource administration,
and advocacy inherent within the CNL position will
be essential in accountability for discharge planning
that may decrease early readmission. The CNL consideration
to microsystem information will promote development on the
use of data know-how at a microsystem degree
as a way for monitoring affected person outcomes, the last word
measure of the CNL position. Desk 1 illustrates a few of
the important thing options of the brand new healthcare programs and
choose competencies of the CNL position which might be greatest
suited to satisfy the wants of those new programs. Extra
analysis is required to show the worth of this
new nursing position and its impression on outcomes important to
the calls for prompted by healthcare reform.
Abstract
The CNL is effectively suited to take a number one position inside
the recognized domains of change for and the brand new
healthcare system. The CNL has a preparation and
focus in a number of areas which might be vital to the profitable
transition to the brand new period of well being care. Particularly, the
CNL deal with care coordination throughout the healthcare
continuum is significant in guaranteeing effectivity in managing
take care of the shopper. Moreover, the emphasis on information
administration and on using metrics to trace shopper
outcomes is vital to make sure cost-effective, high quality
shopper care with acceptable outcomes.
References
American Affiliation of Schools of Nursing. (2003). 2003
Annual report. Retrieved from https://www.dissertationapp.com/write-my-essay/aacn.nche.
edu/publications/annual-reports/AR2003.pdf
American Affiliation of Schools of Nursing. (2004).
Working assertion evaluating the medical nurse chief and
medical nurse specialist roles: Similarities, variations and
complementarities. Retrieved from http://aacn.nche.edu/
cnl/CNLCNSComparisonTable.pdf
American Affiliation of Schools of Nursing. (2007). White
paper on the training and position of the medical nurse chief.
Retrieved from https://www.dissertationapp.com/write-my-essay/aacn.nche.edu/Publications/
WhitePapers/ClinicalNurseLeader07.pdf
American Affiliation of Schools of Nursing. (2010). The
future of upper training in nursing: 2010 annual report.
Retrieved from https://www.dissertationapp.com/write-my-essay/aacn.nche.edu/publications/
annual-reports/AR2010.pdf
American Affiliation of Schools of Nursing. (2011). U.S.
nursing faculties remodel grasp’s training by adopting new
requirements reflecting up to date nursing follow. Retrieved
from https://www.dissertationapp.com/write-my-essay/aacn.nche.edu/information/articles/2011/
necessities
Related Press. (2011, July 20). “Medical residence” well being
care mannequin, specializing in prevention, reveals outcomes and
cuts prices. The Washington Submit. Retrieved from http://
www.commed.vcu.edu/IntroPH/Primary_Care/2011/
medical-home-health-care-model-focusing-onprevention-
shows-results-and-cuts-costs.pdf
Cassidy, A. (2010, September 14). Affected person-centered medical
houses. Well being Affairs. Retrieved from http://healthaffairs.
org/healthpolicybriefs/brief_pdfs/healthpolicybrief_25.
pdf
Fee on Nurse Certification. (2008). The CNL Certification
Information. Retrieved from https://www.dissertationapp.com/write-my-essay/aacn.nche.edu/
cnl/cnl-certification/pdf/ExamHndbk.pdf
Cortese, D., & Korsmo, J. O. (2009). Well being care reform:
Why we can not afford to fail. Well being Affairs, 28(2), w.173–
w.176. doi:10.1377/hlthaff.28.2w173
Fisher, E. S. (2008). Constructing a medical neighborhood for
the medical residence. New England Journal of Medication, 359,
1202–1205.
Well being Care Advisory Board. (2010). Well being care’s accountability
second: 15 imperatives for fulfillment below risk-based reimbursement.
Washington, DC: Advisory Board Firm.
Hix, C., McKeon, L., & Walters, S. (2009). Medical nurse
chief impression on medical microsystems outcomes. Journal
of Nursing Administration, 39(2), 71–76. doi:10.1097/
NNA.0b013e318195a612
Huron Consulting Group. (2011). Key healthcare reform initiatives:
Timing and implications. Retrieved from https://www.dissertationapp.com/write-my-essay/
huronconsultinggroup.com/occasion.aspxinstanceId=
2368
Institute of Medication. (2003, April 18). Well being professions
training: A bridge to high quality. Retrieved from http://
iom.edu/Studies/2003/Well being-Professions-Schooling-ABridge-
to-High quality.aspx
Institute of Medication. (2011). Digital infrastructure for the
studying well being system: The muse for steady enchancment
in well being and well being care. Retrieved from http://
www.iom.edu/Studies/2011/Digital-Infrastructure-fora-
Studying-Well being-System.aspx
Johnson, A. (2011, April 1). Guidelines goal to reshape medical
practices. The Wall Road Journal. Retrieved from http://
on-line.wsj.com/article/SB100014240527487045302045
76235153525838820.html
Kodner, D. (2009). All collectively now: A conceptual
exploration of built-in care. Healthcare Quarterly, 13,
6–15.
Lammon, C. A. B., Stanton, M. P., & Blakney, J. L. (2010).
Revolutionary partnerships: The medical nurse chief position in
various medical settings. Journal of Skilled Nursing, 26,
258–263. doi:10.1016/j.profnurs.2010.06.004
Lloyd, D. (2011). Hospital value-based buying program:
What’s within the new CMS ultimate rule Retrieved from http://
www.huronconsultinggroup.com/Insights/Perspective/
Healthcare/Timing_and_Implications
Medical Nurse Chief Ready Healthcare Reform B. R. Jeffers and Okay. S. Astroth
228
© 2013 Wiley Periodicals, Inc.
Nursing Assignment help – Discussion board Quantity 48, No. Three, July-September 2013
Ott, Okay. M., & Walter, S. E. (2009). The medical nurse chief:
Influence on follow outcomes within the veterans’ well being
administration. Nursing Economics, 27, 363–383.
The Affected person Safety and Reasonably priced Care Act of 2010.
(2010). Pub. L. No. 111-148, 124 Stat. 119. Retrieved
from https://www.dissertationapp.com/write-my-essay/gpo.gov/fdsys/pkg/PLAW-111publ148/
pdf/PLAW-111publ148.pdf
Rittenhouse, D. R., Shortell, S. M., & Fisher, E. S. (2009).
Major care and accountable care: Two important components
of delivery-system reform. New England Journal of
Medication, 361, 2301–2303.
Stachowiak, M. (n.d.). Medical nurse chief: Quantative(sic) and
qualitative outcomes. Unpublished manuscript.
Stanley, J. M., Gannon, J., Gabuat, J., Hartranft, S., Adams,
N., Mayes, C., . . . Burch, D. (2008). The medical nurse
chief: A catalyst for enhancing high quality and affected person
security. Journal of Nursing Administration, 16, 614–622.
doi:10.1111/j.1365-2834.2008.00899.x
Thorpe, Okay. E., & Ogden, L. L. (2010). Evaluation and commentary:
The muse that well being reform lays for improved
fee, care coordination, and prevention. Well being
Affairs, 29, 1183–1187. doi:10.1377/hlthaff.2010.04
B. R. Jeffers and Okay. S. Astroth Medical Nurse Chief Ready Healthcare Reform
229
© 2013 Wiley Periodicals, Inc.
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