Shadowing Ms. Jennifer Dreher, Clinical Nurse Specialist (CNS) and Patient Educator at Bethesda North Hospital, provided insight on her daily tasks and the profession. Ms. Dreher works in the Orthopedics department where she is actively involved in several meetings and performs coordination of care for numerous patients. She is also training Mrs. Laura Moffat, a floor nurse at the hospital studying to become a CNS.
During my shadowing experience, I attended two meetings and accompanied Ms. Dreher on rounds to patient rooms. One meeting was a seminar planning committee meeting and the other an Orthopedics Center of Excellence (OCE) meeting. The planning committee meeting consisted of seven nurses, including Ms. Dreher and her trainee. Ms. Dreher …show more content…
Most notable was the upcoming Medicare Bundle payment program and an electronic patient education program implementation. Mrs. Moffat presented the electronic patient education program to the group. She argued that patients have unrealistic expectation about how they should feel after surgery, so implementing the program would contribute to resetting patient expectations and awareness. The program uses informative videos to educate patients on what to expect after a procedure. Additionally, the Medicare Bundle payment discussion was most intense, administrators and physicians discussed at length about the issue. The orthopedics department is struggling to determine how best to address the issue of quality of care, a major influencer in Medicare reimbursements. Bob Pritts, the department administrator, argued that Patients who are smokers, diabetic, and have a BMI of 40 - 45 greatly impact the quality of care for their orthopedic surgery patients, which could increase LOS and decrease reimbursements. On one hand, if the department follows most institutions and limits services to patients with these factors, their reimbursements will be better. On the other hand, accepting patients with these factors will decrease their Medicare reimbursements; however, accepting these type of patients is an opportunity to build a brand helping these high risk patients, …show more content…
Implementing the electronic education program could affect quality reporting by patient. If the patient is educated on what to expect after surgery, their quality reporting on how they felt after a procedure will be more realistic. That is, after an arthroscopic knee surgery, a patient should not expect to be fully mobile and report a negative score when they are not. This realistic quality reporting score could increase Medicare reimbursements. Additionally, I believe the department should focus on accepting patients with the smoking, diabetic, and BMI of 40 – 45 risk factors; this would allow the institution to specialize working with the high risk group. These patients represent a large proportion of the population and denote a large source of revenue, given that most institutions will not provide service to maintain good quality scores. Though their reimbursement will be reduced initially, the institution could make more funds from high patient volumes, and increase the quality of care overtime as the department becomes more specialized by decreasing the number of
During my shadowing experience, I attended two meetings and accompanied Ms. Dreher on rounds to patient rooms. One meeting was a seminar planning committee meeting and the other an Orthopedics Center of Excellence (OCE) meeting. The planning committee meeting consisted of seven nurses, including Ms. Dreher and her trainee. Ms. Dreher …show more content…
Most notable was the upcoming Medicare Bundle payment program and an electronic patient education program implementation. Mrs. Moffat presented the electronic patient education program to the group. She argued that patients have unrealistic expectation about how they should feel after surgery, so implementing the program would contribute to resetting patient expectations and awareness. The program uses informative videos to educate patients on what to expect after a procedure. Additionally, the Medicare Bundle payment discussion was most intense, administrators and physicians discussed at length about the issue. The orthopedics department is struggling to determine how best to address the issue of quality of care, a major influencer in Medicare reimbursements. Bob Pritts, the department administrator, argued that Patients who are smokers, diabetic, and have a BMI of 40 - 45 greatly impact the quality of care for their orthopedic surgery patients, which could increase LOS and decrease reimbursements. On one hand, if the department follows most institutions and limits services to patients with these factors, their reimbursements will be better. On the other hand, accepting patients with these factors will decrease their Medicare reimbursements; however, accepting these type of patients is an opportunity to build a brand helping these high risk patients, …show more content…
Implementing the electronic education program could affect quality reporting by patient. If the patient is educated on what to expect after surgery, their quality reporting on how they felt after a procedure will be more realistic. That is, after an arthroscopic knee surgery, a patient should not expect to be fully mobile and report a negative score when they are not. This realistic quality reporting score could increase Medicare reimbursements. Additionally, I believe the department should focus on accepting patients with the smoking, diabetic, and BMI of 40 – 45 risk factors; this would allow the institution to specialize working with the high risk group. These patients represent a large proportion of the population and denote a large source of revenue, given that most institutions will not provide service to maintain good quality scores. Though their reimbursement will be reduced initially, the institution could make more funds from high patient volumes, and increase the quality of care overtime as the department becomes more specialized by decreasing the number of