Collaboration and Care Coordination in Healthcare: An Analysis Overview
The structure of a bureaucratic healthcare organization can garner improvements in partnerships leading to increased care quality as a result of key collaboration efforts, and coordination. The data indicates that a 30 percent ratio of traditional Medicare payments will gradually tie to value, or quality models, like accountable care organizations. Bundled payments are anticipated as optional choices in this scenario by the end of 2016, as well. Secondly, 50 percent of payments will tie to these models by 2018 especially considering that the U.S. Department of Health and Human Services has a goal of attaching 90 percent of all traditional Medicare payments to the quality/value protocol by the end of 2018 altogether. The Hospital Value Based Purchasing situation must also be kept in mind, along with how the Hospital Readmissions Reduction programs will function. Nevertheless, this paper is an article review of “The challenges of uncertainty and interprofessional collaboration in palliative care for non-cancer patients in the community: A systematic review of views from patients, carers and health-care professionals” by experts Ai Oishi and Fliss Murtagh.
It is generally known among healthcare management professionals in the United States that the payment-for-performance type program reflected an implemented initiative required by the Affordable Care Act (ACA). While it is true that Medicare applies to citizens in the America, in the article Oishi and Murtagh (2014) discuss how palliative care will be delivered to non-cancer patients, in terms of primary care provision services. Palliative care, as defined by the World Health Organization, simply means that an approach is taken which focuses on improvement of quality of life for patients and their families by trying to prevent further suffering through early identification, and thus treatment. The main idea in the article was to critically analyze the attitudes and challenges surrounding how primary care plays a role in the community, in terms of palliative care. For example, when many people fall sick unto an impending death they do not wish to die in a hospital – but, rather feel more comfortable at home. The idea is that although collaboration and coordination are necessary aspects to integration of primary care professionals, and providers in terms of operational realities, the authors wanted to explore the relationships of how general practitioners would demonstrate compassion and knowledge.
The article was arranged in a systematic way. Clearly in the Abstract the sections were labeled as: Background, Aim, Design, Data sources, Results, and Conclusions. Even though their data was drawn from the United Kingdom, the researchers were quite thorough and really did strive to close any gaps in the literature on the topic. Oishi and Murtagh (2014) used thirty studies to evaluate patient and caregivers’ attitudes, representing “the views of 719 patients, 605 carers and over 400 professionals” (p. 1081). They reminded the audience that certain facts were already known. For example, they acknowledged an already-known fact that there are gaps in both continuity and coordination of healthcare provision, as well as uncertainty as an aspect in terms of “good palliative care” (Oishi et al. 2014, p. 1082). In other words, their article focused on a concern about how the needs of palliative patients are being met.
In collecting all their sources and data for the article, the authors gathered resource materials from CINAHL, MEDLINE, PsycINFO, and a couple of others by using four search terms. The search terms included ‘disease diagnoses,’ ‘palliative care,’ ‘primary care,’ and ‘attitude.’ In this way the method for their article was able to be established, helping them to create a tool as a table to explain and show a visualization of criteria. Terms were divided and grouped (Hawker’s) wherein the article stated that a narrative synthesis was the best way to tackle their undertaking. The main non-cancer diseases of patients undergoing palliative care in the rubric of gathered studies Oishi and Murtagh (2014) reviewed represented chronic obstructive pulmonary disease (COPD), Parkinson’s disease, heart failure, dementia, and stroke (p. 1084). The bulk of the informational case resources were drawn from the UK, as indicated earlier in this report, but the researchers did include one from the United States as well as three other Western nations.
The participants and relevant findings were quite interesting and presented in Table 3 of the article. At this point in the discussion, it is important to understand that in theory healthcare partnerships should be a smooth affair to improve care quality with collaboration and coordination – but, often practice in real-life sometimes fails to meet expectations in service value that patients deserve. The Hospital Value Based Purchasing Program (VBP) according to Schroeder (2013) is being funded by “a 1 percent reduction from participating hospitals’ Diagnosis-Related Group” payments, but if some hospital facilities do not have enough volume to meet the regulated minimum requirements – their payments will not have reductions (p. 290). Challenges and decisions need to be made to implement a high quality of care, in terms of collaboration and care coordination in healthcare. The Oishi and Murtagh (2014) article on palliative care examines what some challenges exist in all healthcare parties cooperatively handling their abilities to collaborate together – for the good of the patient.
Common knowledge dictates that the American healthcare system has been a huge mess for a long time. No matter what country one is in, collaboration and cooperation hold the critically shared aspect of the kind of attitude caregivers bring to the service of their patients’ needs. Oishi and Murtagh (2014) list some patient observations of health care professionals attitudes listed on a ‘Quality-Score’ basis; for example, some patients remember “negative messages such as ‘self-inflicted’, ‘nothing could be done’ at the diagnosis” (p. 1085). However, some of the positive attitudes and experiences patients reported on showed great hope when general practitioners demonstrated concern and an understanding demeanor towards them. The break in communication came, in some instances, when general practitioner physicians when continuity was a problem. In other words, this occurred when there were actual gaps in collaboration and coordination of the healthcare in the first place. In conclusion, the article gave an excellent set of findings that contributed to the body of literature on coordinated care. The goals of Medicare and the U.S. Department of Health and Human Services to render linking the new payment models, to improvement in care quality is admirable. But challenges persist in smoothing the path for collaboration and care coordination.
Oishi, A., & Murtagh, F.M. (2014). The challenges of uncertainty and interprofessional collaboration in palliative care for non-cancer patients in the community: A systematic review of views from patients, carers and health-care professionals. Palliative Medicine, 28(9), 1081-1098. doi:10.1177/0269216314531999
Schroeder, S.D. (2013). Hospital value-based purchasing. South Dakota Medicine: The Journal of the South Dakota State Medical Association, 66(7), 290.