Fiscal and Value Quantification of Nursing Services
Nursing is shifting to outcome-based service. Hence, to enhance the nursing role in patient safety, the hospital can apply value-based purchasing by conducting the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) to establish satisfaction levels of patients. The hospital can then create funds by decreasing payments through Medicare by 2%, and then allocate those funds to the nurses based on measures of performance on patient safety and experience (“What is Pay for Performance Healthcare?” 2018). Hence, the services are then scored based on achievement in comparison to other services for distribution of financial awards.
Nurse staffing influences the patients’ outcome. Nursing leaders can apply Skilled Nurse Value-Based Program (SNFVP) to assess the nursing role in the patients’ outcome. In this case, the nurse leaders can consider nurses’ characteristics, such as those with a Bachelor of Science in Nursing (BSN) degree and higher nurse experience. For instance, a 10% increase in BSN nurses can lead to a 5% decrease in deaths and complication of patients (Lindrooth et al., 2015). If the health facility has a Medicare payer-mix, the Affordable Care Act value-based provisions of purchase on complications would move the incentives to hire BSN qualified nurses (Lindrooth et al., 2015). Hence, this would improve health care outcome for patients.
Nurse leaders can rate patient-nurse communication to help in estimating value for money. To evaluate the value of communication, nurse leaders can apply Cost-Utility Analysis (CUA). The effectiveness of communication is computed by cost per unit ratio and comparing communication levels across different patients. The ratio can assist in providing evidence on the cost side of communication. These costs can be attained using a resource-costing method, which entails data collection on health communication from patient charts, case report forms, and hospital records and then multiplying them with price weights. Thus, to select the price weight, the nursing leaders could apply a micro-costing approach by breaking down all costs items (Bergmo, 2015, 3). Notably, this information would assist in decision-making and facilitate systems for payment within the hospitals.
