article2.pdf - Nursing Economic$ Impacts and Innovations...

May/June 2020 | Volume 38 Number 3
158
Nursing Economic$
Impacts and Innovations
T
he Institute for Healthcare
Communication reports a strong correla-
tion between the healthcare team’s ability
to communicate and the patient’s ability to par-
take in care appropriately (Institute for Healthcare
Communication [IHC], 2011). Without purposeful
communication between the healthcare team and
the patient, the patient’s capacity to follow simple
medical recommendations, participate in self-care
of chronic conditions, adopt preventative health
behaviors, and report satisfactory care are
reduced (IHC, 2011). Interprofessional communi-
cation, defined as communication that occurs
between more than one healthcare discipline and
the patient, supports collaboration, discussion,
and timely interventions to reduce occurrences of
miscommunication that may lead to adverse
patient events or patient dissatisfaction with care
(Ashcraft et al., 2017).
To ensure quality healthcare services are pro-
vided, there is public support for efforts to
improve communication between both healthcare
providers and patients (The Joint Commission,
2018). Hospitals participating in the Centers for
Medicare & Medicaid Services (CMS) Value-Based
Purchasing system receive either a bonus or
penalty each year based on quality of care pro-
vided to patients, not quantity. Specifically, under
the Inpatient Prospective Payment System, facili-
ties can experience up to a 2% reduction in
Medicare severity diagnosis-related group pay-
ments if performance in four domains is subpar:
clinical care, patient and caregiver experience,
safety, and efficiency and cost reduction (CMS,
2018).
With hospital reimbursement from CMS tied to
inpatient patient satisfaction of care, facilities may
experience a significant fiscal impact if satisfactory
and quality care are not provided (CMS, 2018).
Institutions scoring below the national benchmark
on the Hospital Consumer Assessment of
Healthcare Providers and Systems (HCAHPS)
patient satisfaction survey increase the risk of
incentive and reimbursement loss (Hudson-
Covolo et al., 2018). For March, April, and May
2019 at the project facility, HCAHPS scores were
below the institutional benchmark of the 75th
percentile on 73.6% of questions on the primary
medical-surgical floor. For the medical-surgical
project floor, the 3-month average before imple-
mentation for most positive answers in the nurs-
ing communication domain was 74.80%, display-
ing scores 9.20% below the 75th percentile. For
the medical-surgical project floor, the 3-month
average before implementation for most positive
answers in the physician communication domain
was 76.63%, displaying scores 8.37% below the
75th percentile. A nurse leader-physician bedside
rounding protocol was implemented on a 34-bed
medical-surgical unit at an academic medical cen-
ter in the southeastern United States to reduce the
risk of reimbursement loss related to reduced
patient satisfaction. Analysis of the protocol will
be detailed.