The IHI module TA 103: increasing value and reducing waste at the point of care, is important for all healthcare professionals to view. Healthcare cost are continuously on the rise from a global standpoint and there are ways to reduce cost without impact quality of care. Common barriers to cost management include, per the module, established habits such as providers being trained to order test, disapproval of doing nothing, lack of feedback, time pressure, discomfort with diagnostic uncertainty, ease of access to service, and lastly incentives for overuse. Prescription medication is a large cost. Bouayad et al. (2020) suggest a common approach for reducing medication costs without compromising on outcomes is through the use of generic drugs.
The role of a DNP prepared nurse in managing cost can include utilizing resources effectively, therapeutically communicating with patients about necessity of test or procedures while still maintaining their autonomy. Providing proactive care with an emphasis on prevention and health promotion, keeping up to date with evidenced based practice recommendations and risk vs benefits of procures and testing. “Healthcare settings provide opportunities for nurse scholars prepared with a DNP degree to explore and address practice gaps where evidence-based practice (EBP) could be implemented to support patient safety and quality outcomes. Practice scholarship led by nurses enables healthcare organizations to build cultures that support value-driven care and sustain quality and safety initiatives” (Kesten et al., 2022).
One of the biggest barriers suggested in the module was time pressure. The physician described a scenario in which the emergency department resident needed an open bed and there were a lot of outside pressure for things needing to be done right away. In this situation the provider defaulted to an easier time saving tactic which presents as a system challenge within the organization. Solutions include creating new delivery system and point of care services, increased staffing, improved hours and support services.
Lewin’s change theory is applicable to healthcare including healthcare economics. His major concepts include driving forces, restraining forces, and equilibrium. The stages in his theory include unfreezing, change, and refreezing. Change in any organization has multiple phases and stages to become an integrated part of sustainability including evaluation. With healthcare cost and changes to reduce barriers for improved value of care, change needs to occur at multiple levels and be sustained. Globally healthcare is continuing to rise but there are areas to save on cost. Change theories can help guide the process and anticipate any opposing forces to help crate solutions for a smooth transition through planning.
References
Bouayad, L., Padmanabhan, B., & Chari, K. (2020). Can Recommender Systems Reduce Healthcare Costs? The Role of Time Pressure and Cost Transparency in Prescription Choice. MIS Quarterly, 44(4), 1859–1902. https://doiorg.lopes.idm.oclc.org/10.25300/MISQ/2020/14435
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