ORGANIZATIONAL LEADERSHIP BUSINESS PRACTICES IN
PATIENT AND FAMILY CENTERED CARE
Organizational Leadership and Interprofessional Team Development
Western Governors University
August 9, 2018
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Business Practices in Patient and Family Centered Care
Business Practices
The business of providing healthcare is just like any other business. It derives benefits
from the practices that support innovation; from practices that support growth. A successful
business is one that can do so much more with less. Any successful healthcare provider, whether
it be a hospital, clinic, private practice or community health center, strives to be effective while
being efficient. Being an effective healthcare business must incorporate satisfaction
measurements of staff, family and patients. Without all of these to some degree, a healthcare
business will struggle and then ultimately fail. The reasoning behind this is that these three
groups of people are the backbone of a healthcare business. If any of these groups is dissatisfied,
they won’t return. Dissatisfied patients will go elsewhere for their care, families won’t bring their
loved ones back, and unhappy staff will find other jobs. Without the patient, there is no one to
provide care for. Without the families of patients, there is no one to support outside of the facility
the care that was begun inside the facility. And without the staff, there is no one to provide the
care at the level expected and deserved by the patients.
A successful healthcare business model is based on patient-centered care. Patient-
centered care has been researched and shown to contribute to the improvement in safety and
quality of care, while reducing care-related costs (Akinci & Patel, 2014). Decreased costs include
costs for training and retraining staff due to inefficient practices, costs for excess supplies
wasted, and readmissions due to ineffective treatment. A successful healthcare business is guided
by the needs of patients and families. This framework, paired with consistent patient and family
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engagement has been shown to improve hospital performance and business outcomes (Burger,
2014).
Regulatory Requirements
The concept of improving the American healthcare system by instituting 6 goals was
discussed in a 2001 report by the Institute of Medicine. One of these goals was notably patient-
centerdness. This specific concept leads to lower overall costs, a higher quality of care and better
health (Millenson & Berenson, 2015). In recent years since this report was published, new laws
have been instituted in the US, aimed at putting specific practices into place that are centered
around the patient. The Health Information Technology for Economic and Clinical Health Act, or
HITECH, includes regulatory standards for the implementation and use of electronic health
records (EHR). These standards are one type of Meaningful Use (MU) standards implemented as
laws and regulations to improve the efficiency of the American healthcare system. An additional
MU standard is the patient’s engagement with and viewing of their EHR (Millenson & Berenson,
2015).
Initiatives for patient and family engagement, patient satisfaction and shared decision
making are included in the Affordable Care Act (ACA). This piece of legislation was signed into
law and implemented in 2010 to expand quality and affordable healthcare to more Americans.
Within the ACA law are provisions that move the Medicaid and Medicare payor systems from
“fee-for-service” to payments based on the quality of the service delivered (McMorrow &
Polsky, 2016).
The Centers for Medicare and Medicaid Services (CMS) is a federal agency that assesses
accountable care organizations (ACOs) on a static list of 33 quality measures. Twenty-five
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percent of these quality measures directly relate to the experience of the caregiver and the patient
(Millenson & Berenson, 2015). Several regulatory standards enforced by The Joint Commission
(TJC) relate specifically to patient-centered care. Within those standards, healthcare
organizations are required to effectively communicate with patients when treatment and services
are being provided, coordinate a patient’s care, treatment and services based on a patient’s needs,
and respecting a patient’s right to receive information in an understandable manner for each
individual patient (AHRQ, 2013).
Reimbursement
When a healthcare organization or hospital implements policies that places at the center
of their care model the patient and their needs, and educates and empowers patients to be an
integral part of their own care, patient outcomes improve and patient satisfaction increases
(AHRQ, 2013). Patient satisfaction is measured by surveys conducted as part of the Hospital
Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and required by the
Centers for Medicare and Medicaid (CMS). These survey scores also tie into the reimbursement
paid to hospitals by CMS. Based partly on these survey scores, hospitals can prepare to either
lose or gain 2% of their CMS payments in the fiscal year (Letourneau, 2016).
The implementation of HITECH in 2009 resulted in incentive payments to hospitals and
physicians totaling more than $28 billion for the adoption of electronic health records that meet
Meaningful Use stage 1 and stage 2. Patient engagement goals are included in Meaningful Use
stage 3, which will carry its own set of incentives for both private practice physicians and
hospitals (Mellenson & Berenson, 2015). These incentives will eventually expire when
Meaningful Use becomes mandatory. When this happens, CMS payments to providers will be
based on these same goals. In theory, once this change occurs, providers risk losing payments for