Radiation oncology

Answer

Introduction

The continued reimbursement reduction on radiation oncology centers has led to various challenges to the specialty. Radiation oncology is among the advanced specialties involving treatment of cancer, which require careful attention in terms of procuring modern technologies and equipping the department with adequate personnel for system based care (Johnson et al., 2008). Reduction of funding causes several challenges such as poor services to patients due to reduced hiring of qualified practitioners. Some of the problems associated with reduction of reimbursement to oncology hospitals include overworking of existing personnel to care for increasing number of cancer patients. This leads to problems when preparing shift reports that are expected to be given at the patient’s bedside.

This research paper applies system theory to explore the problem that makes the practitioners to deliver the required services effectively and efficiently.

It is a major challenge to every professional oncologist working at Harris Health System while undertaking their duties of caring the increasing number of patients. Frequent review of compliance procedures and adoption of complex regulation to be followed in oncology departments causes various challenges to deliver healthcare services effectively. As a major hospital in Harris County, Harris Health System accommodates the largest number of patients in different healthcare centers offering various special treatments such as heart attacks. Little financial support and complex compliance procedures can inhibit the practitioners to deliver the required services. Harris Health System comprises of Ben Taub Hospital, Lyndon B. Johnson Hospital, and Quentin Mease Hospital. Additionally, the hospital has 18 different community health centers and 2 large multi-specialty clinics.

The hospital consists of several practitioners in oncology department including medical oncologists, nurses, nutritionists, pathologists, genetics counselor, surgeons, interventional radiologist, and radiation oncologists. They work as a team in order to provide optimal care to cancer patients. The department emphasizes on using open communication with other practitioners through the Electronic Medical Record system. The hospital has Cancer Resource Centers that are open to every patient in need of help related to cancer diagnosis.

The increased regulatory changes by Medicare and Medicaid Act as inputs as they act as procedural measures that must be complied. Using the Nursing Services Delivery Theory identifies the staff, materials such as supplies, Information such as procedural regulations and resources such as funding (Meyer & O’Brien-Pallas, 2010). The reduction of inputs that was caused by regular reimbursement cuts causes challenges in service deliver. Another system concept in Nursing Service Delivery Theory is throughput that entails provision of services through nursing interventions. The increasing number of patients in comparison to the resources available in each department warrants the movement of patients to other facilities in order to receive adequate care. In this case, the movement of patients to external environments is regarded as outputs in Nursing Services Delivery Theory. For instance, the regular reimbursements cuts and accreditation criteria leads to repetitive series of activities. Additionally, Negative feedback is another system concept outlined in the applied system theory that refers to information given about the system’s functionalities for effective adjustment and expenditure valuation. The negative feedback can be obtained through institution’s performance indicators.

Focusing on the problem of writing shift reports, it is apparent that the issues is caused by use of limited resources that are very strained by frequent reimbursement reductions and change of coding metrics as per Medicare requirements. According to Manley et al. (2014), sharing a common purpose require the organization to adopt effective and convenient practices and cultures at workplace to ensure improve collaboration for provision of quality care services. Regulations adopted in oncology departments for strict policies such as collecting hand off reports at the patient’s bedside has caused various challenges to nurses who are expected to meet deadlines in preparing shift reports. The unit with 18 patients gives each practitioner hard time to prepare shift report effectively and at the same time evaluate all the patients within the given period.

The application of Open System Theory requires every stakeholder in the hospital setting to adapt both internal and external demands, as well as the feedback. The external demands for healthcare settings include legislations, labor markets, and characteristics of the population. Healthcare organization continues to adapt to functioning of systems as a responsive measure to negative feedbacks and informational signals. Fortunately, the standardization of health care policies across the country’s health system help organizations to meet targets in terms of performance, as set my external agencies.

Increased reimbursement cuts lead to reduction of operational materials such as supplies, poor status of radiation machineries due to reduced maintenance financing, and reduction of personnel because of reduced hiring of personnel. The reduced operation costs can also affect the hospital from procuring advanced technologies that addresses reporting problems. The application of Nursing Services Delivery Theory in Harris Health System will create an effective and efficient institutional strategy for addressing all the issues that are faced when delivering care services. According to Doran et al. (2006), considering the use of Nursing Services Delivery Theory in healthcare setting provides an integral benefit to the organization and implementation of nursing health services.

The fact that oncology department involve collaboration of different specialties, applying Nursing Services Delivery Theory will help in addressing relation issues between patients, nursing interventions, and clinical outcomes. Additionally, using the theory will help to create adequate inventories for responding to unpredictable staffing demands. The current health care problem of challenges in writing shift report is contributed by lack of adequate practitioners that may be caused by lack of finances, poor planning, limited infrastructure, or increased demand for oncology services. The use of agency and float pool nurses are beneficial for lowering organization costs, although they might affect clinical outcomes in hospitals in certain conditions. The agency or pool nurses may be less trained or experienced as compared to permanent employed nurses thus might be less with unit practices or team functioning.

When considering the hospital’s organizational setting, applying Nursing Services Delivery Theory shows that throughputs include coordination mechanism, capacity of patients, and specialized admission of patients. Having difficulties in preparing shift reports can be caused by poor consideration of inputs and throughputs. The inputs play a greater role in healthcare setting by coming up with clear organization structure for managing staff, care provision, ensure effective supply of materials, and funding. Through this aspect, the Harris Health hospital needed to come up with clear strategies of solving care delivery. A nurse shift change is supposed to transfer the care information between nurses to prevent medical errors and adverse events (Lamond, 2000). The standardized policy of bed-shift change is to partner with other nurses by exchanging information rather than transferring, as a way of improving collaborative relationship between practitioners. A nurse is supposed to give all information about the health conditions of all patients, which makes it harder for practitioners to give reports for over 18 patients at a go. Adequate staffing is directly related enough resources such as funding to hire highly skilled personnel.

The recent reimbursement reduction by Medicare and Medicare had a negative impact to oncology departments, as the cuts were more than 5 percent depending with care setting. This means that hospitals need to strategize on ways of reducing operation costs such as reducing the workforce or even increase the costs of service delivery to patients. According to Marquis & Huston (2015), adequate resources with better planning also lead to improved work environment but minimal resources can disintegrate the workforce due to competing leadership interests between various specialties in the department. Integrating Nursing Services Delivery Theory into the hospital would be a great solution to the problem, as the inputs, throughputs, outputs, systems, and feedback will be highly considered when making decisions. Harris Health System’s mission is to deliver high-quality healthcare and train the next generation of professionals. The hospital values patients, partners, and employees with trust, integrity, communication, and compassionate care. Therefore, addressing the problems associated with shift change report will help to maintain the hospital’s mission and values while improving the culture and work environment.