University of Florida
The Medias focus regarding the Affordable Care Act has been on its expansion of coverage with little attention given to the provisions that seek to strengthen the delivery system by increasing transparency, encouraging efficient models of delivery and embracing innovation. The Affordable Care Act has within it provisions created the Center for Medicare and Medicaid Innovation, with the intent to focus on better care by “enabling anyone who wants to help join us on this endeavor” (U. S. Department of Health and Human Services, 2011b, p.1). Americas National Health Expenditure (NHE) continues to increases while quality outcomes decline, in 2009 there was an increase of $2.5 trillion ($8,086 per person) accounting for 17.6% of Gross Domestic Product (HHS & Centers for Medicare Medicaid Services, 2011). Hospital acquired infections are a large source of the expenditure, resulting in thousands of preventable deaths and an estimated cost of 28-33 billion health care dollars. Nursing has long been a leading stakeholder in the cost of care and the journey to create quality of care for patients within the inpatient setting. A profession which continues to be held at high esteem, as the most trusted professionals in health care, lacks the influence over policy to effectively change frontline processes. Policy makers have the opportunity to make history by empowering the frontline line and providers the opportunity and challenge to improve patient care while vehemently measuring outcomes with a concurrent devolution of government health care constraints. This action would serve two fold to help create a more sustainable workforce as Florida approaches a population boom in 2030 of adults over age 65. Frontline personnel and especially nurses have historically been advocating for their point of service and who else better to identify waste and produce more effective delivery care models then the people who actually ‘care’ for the patient.
Medicare payment penalties will incur beginning in the fiscal year of 2015 for hospitals that have patient that are in the top 25th percentile of preventable conditions which have incurred while hospitalized (Social Security Administration, 2011). Hospital acquired infections have untoward consequences to the lives of patients with an increase in hospital length of stay, long term injury and death. “Health care-associated infections are among the top ten leading causes of death in the United States, accounting for an estimated 1.7 million in infections and 99,000 associated deaths in 2002” (U.S. Department Of Health and Human Services, 2009). The Department of Health and Human Services (HHS) has established a public action plan to decrease hospital acquired infections on a national scale. The categories for which seventy five percent of hospital acquired infections (HAIs) are attributed to are surgical site infections, central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections (U.S. Department of Health and Human Services, 2009). It has been estimated, hospital acquired infections cost America anywhere from $28 to $33 billion in health care dollars (U.S. Department of Health and Human Services, 2009). Florida falls fourth only behind California, New York, and Texas in overall health care expenditure dollars (95,136 million in 2004) and fifth in hospital care expenditure (15,788 million) which included the latter states and Pennsylvania (HHS & Centers for Medicare Medicaid Services, 2007) , these numbers combined with an aging population makes the need for innovation at the frontline of Florida’s workforce more imperative then ever. Policy Implications
Within the Affordable Care Act it states; “The secretary shall, to the extent practicable, publicly report on measures for...