DNP 835 Recent Unsuccessful Change in Healthcare DQ

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DNP 835 Recent Unsuccessful Change in Healthcare DQ

DNP 835 Recent Unsuccessful Change in Healthcare DQ

 

DQ1 Discuss a recent unsuccessful change in healthcare that
you have experienced. Discuss how you would improve the outcome.

DQ2 Discuss how you would use value-based healthcare
delivery to influence a change behavior on a nursing unit.

Every innovation is built on a foundation of a thousand failures. When success finally comes, it’s easy to lose sight of all the mistakes it took to get it right.

It’s the same story in healthcare innovation: there have been many new healthcare models claiming to be the next big thing despite ultimately failing.

Some of them were popular for a time — but all of them produced important lessons that helped us get to where we are today. These failed innovations share at least one common fault: models that rewarded inconsistent participation in primary care and preventive services.

It’s in this spirit that we’re sharing the stories behind three major healthcare innovations — what they are, why they ultimately failed, and what we can learn from these failures.

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Managed care has served as a framework for benefits plans for decades. It promises to centralize patient care within a single network or provider system aimed at containing costs and improving patient health outcomes. The problem is, the traditional version of managed care never fully delivered on its promise.

While traditional managed care helped control access to care, it also constrained patients to a network that, no matter how large or small, couldn’t guarantee better health outcomes. Instead of managing patients’ care with primary care resources, providers were forced to act as referral machines — steering patients to specialists. 

The focus on specialist-care resulted in gaps that became significant risks for patients who didn’t receive ongoing primary care. These patients often felt stranded after visiting with a specialist — while specialists were unaware of patients’ underlying health issues because the referral was made too quickly.

And of course, specialists were (and are) more expensive than primary care providers, so getting treatment that otherwise could have been provided through primary care meant paying more when it wasn’t necessary — and created, over time, a tremendous amount of waste.

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But the theory behind managed care has the potential to be effective, especially when it empowers primary care providers and care teams to do their jobs. This is about being less like a gatekeeper and more like a hub that plans and coordinates a patient’s entire care journey.

When primary care is done right as a part of an updated managed care model, each patient works with their provider and health coach to develop a personalized care plan. Once a plan is in place, the care team guides them through the program and coordinates their care from start to finish.

Patients can get most of the care they need from their primary care center — reducing costly urgent care, pharmacy expenses, and emergency room visits.

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