Executive summary
The given paper revolves around the idea of implementing BIS monitors as the standard of care during general anesthesia to decrease intraoperative awareness, increase customer satisfaction, and reduce post-operative complications. The given goal is analyzed from the perspective of quadruple aim as one of the fundamental paradigms for the improved provision of services to patients that exist nowadays. The main aspects of quadruple aim, its importance, and its mission are analyzed to improve the vision of the idea. Moreover, there is a detailed description of the proposed project with the framework for its implementation, its benefits, financial aspects, the rationale for the selection, and benefits justifying the given choice. In such a way, the work concludes about the importance of quadruple aim for the healthcare sector, and the necessity of its use to achieve the improved standards of care in different units.
Introduction
Quadruple Aim
The modern healthcare sector faces multiple challenges coming from the increased diversity of problems patients have. Additionally, the growing level of demands peculiar to patients means the health workers have to select new methods of care delivery and new approaches that would help them to achieve both positive outcomes and desired satisfaction levels among clients. Under these conditions, there are vigorous debates about the effectiveness of the Triple Aim idea as professional burnout imperils it and creates dangerous situations when health workers are not motivated to function. The concept of Quadruple Aim is expected to replace the previous one because of its increased effectiveness and the emergence of a new goal of improving the work-life of specialists functioning in the healthcare setting and responsible for enhanced results (Bodenheimer & Sinsky, 2014). The high practical use of the new framework comes from several premises.
The Quadruple Aim rests on the idea that the three patient-centric aspects of the Triple Aim concept cannot be fully covered without an improved clinical experience among the workers of the healthcare sector. For this reason, the model is expanded and includes the four central components, such:
- Improved clinical experience
- Better outcomes
- Lower costs
- Improved patient experience
Adding a new element, it is possible to reconsider the outdated idea and achieve better outcomes by assisting specialists in their functioning. The statistics show that the gap between societal expectations and the current professional reality results in increased burnout rates (46%) among physicians in the USA (Bodenheimer & Sinsky, 2014). A survey conducted in 2014 shows that 68% of family physicians and 73% of general internists would prefer to change their occupation if they could start everything again (Bodenheimer & Sinsky, 2014). In such a way, the lack of attention to specialists’ needs, their motivation, problems, and stress became a significant factor in deteriorating outcomes and preconditioned failures of multiple attempts to reconsider the existing approaches (Bodenheimer & Sinsky, 2014). The Quadruple Aim includes the necessity to care about health workers because of their critical importance to the sector.
Mission
The main mission of the discussed concept comes from the elements it includes. The Quadruple Aim is designed to enhance the patient experience, and population health, decrease spending, and improve the work life of specialists involved in the functioning of the healthcare sector, including clinicians and staff (Lapaine, 2020). The high value of the given model is explained by the fact that it is widely accepted by multiple organizations in the country to optimize the performance of health units and guarantee that workers will benefit from the improved conditions offered to them in terms of the Quadruple Aim model. Today, a substantial number of nurses, therapists, and other health workers do not achieve their full potential because of the burnout and other factors reducing motivation and their desire to work. The discussed model aims at managing this dangerous situation and reducing the level of stress peculiar to specialists in the sphere.
From the perspective of quality assurance (QA) segment and patient experience, the Quadruple Aim might also guarantee improved outcomes because it focuses on several factors important for clients. First of all, increasing customer satisfaction is one of the major goals of the given method, which is also achieved by providing clinicians with better working conditions and new means for the provision of care (Bearnes et al., 2020). Under these conditions, the Quadruple Aim can be applied to the QA segment as the method to monitor the existing standards of practice and check if they comply with the assumptions offered by the model and vital for the achievement of improved results. At the same time, the observation of the model of QA means the ability to avoid growing dissatisfaction among patients and guarantee their devotion and trust.
Project Purpose
Altogether, considering the information mentioned above, the central goal of the given project is the investigation of the following Quadruple Aim:
Implementation of BIS monitors as the standard of care during general anesthesia to decrease intraoperative awareness, increasing customer satisfaction, and reducing post-operative complications.
It is expected that the given solution will help to improve both patient and clinical experience and help to achieve better outcomes. Under these conditions, the project offers the framework for the successful implementation of the given method in practice and discusses the benefits and rationale for the choice. The given paper also aims at revealing the major conceptions linked to the idea of Quadruple Aim and how they can be applied to the selected solution to achieve desired outcomes. Finally, the paper summarizes all information related to the issue and creates the basis for further discussion.
Framework
The aim mentioned above presupposes the choice of the appropriate framework that will help to achieve the full potential and implement the desired solution in practice. Regarding the basic aspects of the healthcare sector, such as the need for adequate care delivery and positive outcomes, a value chain framework becomes the most appropriate choice for the project. It guarantees the correct understanding of the existing goal, its importance for various units. It also outlines the contribution of major actors to the attainment of success and acquisition of the ability to minimize adverse effects or post-operative complications (Tan et al., 2020). At the same time, the value chain framework suffices the ideas of the Quadruple Aim and ensures that both patients and clinicians are covered, and their needs are taken into account.
The value chain can be determined as all activities and processes needed to add value to the final product (Salminen & Rajavuori, 2019). From the perspective of the healthcare sector, the value chain framework can be viewed as the contribution of all actors involved in the process of care delivery aimed at the achievement of positive outcomes and patients’ recovery (Brown-Johnson et al., 2019). The given concept includes such factors as the infrastructure of a health unit, effective human resource management, existing equipment, financial aspect, provision of services, and QA (Tan et al., 2020). Thus, because of the basic components of the value chain, it becomes vital for the healthcare sector today and can be applied to the offered Quadruple Aim to ensure that the desired outcomes are achieved. Additionally, the value chain framework shows the steps needed to add value, which can be used for troubleshooting and analysis of the solution.
Speaking about the idea of implementing BIS monitors as the standard of care during general anesthesia, the utilization of the value chain has some benefits. First of all, it outlines all actors responsible for working on the given proposal and lists their basic functions necessary for desired outcomes. At the same time, the value chain can help to structure all activities and rank them according to their importance and impact on results (Salminen & Rajavuori, 2019). Moreover, it shows the stakeholders related to the desired goal. The implementation of BIS monitors demands the additional equipment, specialists, training for staff, and finances to sponsor this incentive. From the value chain perspective, the given steps should be given significant attention as they are vital for the achievement of desired outcomes and generation of additional value.
The information mentioned above means that for the selected project and the healthcare sector in general, the application of the value chain framework can be viewed as a beneficial method to understand the current problems and help to manage them by introducing effective solutions and analyzing steps that should be made to avoid undesired outcomes. At the same time, its integration into the functioning of health units guarantees that all stakeholders and actors responsible for decision-making, selection of sources, and their use in different situations will act realizing the final goal and its importance for the achievement of higher levels of client satisfaction, their improved outcomes, and readiness to cooperate. Furthermore, because of the basic principles of the Quadruple Aim, the value chain becomes a more powerful tool needed to consider four aspects and avoid adverse effects.
Project Overview
As stated above, the central goal of the given project is the implementation of BIS monitors as the standard of care during general anesthesia to decrease intraoperative awareness, raise client satisfaction levels, and reduce post-operative complications. The achievement of the given goal demands the utilization of resources available in hospitals, mobilization of human resources, and reconsideration of the existing approaches to practice to ensure better outcomes. At the same time, it follows the idea of Quadruple Aim as the final success will help to improve the clinical experience by providing workers with a tool that can help them to avoid high levels of stress, to achieve improved outcomes by preventing complications, reduce costs due to the absence of the need to pay compensations or provide additional care, and improve the patient experience as they will benefit from a lower number of complications.
The proposed intervention presupposes the use of BIS monitors as the tool to attain improved outcomes during anesthesia. In general, the Bispectral Index (BIS) is one of the most effective technologies to control the depth of anesthesia (Seo et al., 2019). The use of the given equipment during surgeries or other interventions allows anesthetists with the improved opportunity to adjust the amount of anesthetic agent and ensure that it meets the needs of the patient (Seo et al., 2019). Statistics show that the use of BIS monitors contributes to better outcomes and the more rapid recovery from anesthesia (Seo et al., 2019). Moreover, using BIS monitors, clinicians can reduce intraoperative awareness and attain much better outcomes. In such a way, the proposed solution can be viewed as a beneficial one as it meets several goals simultaneously. It reduces the number of negative outcomes, and, at the same time, helps patients to feel better after interventions.
In such a way, it is expected that the implementation of this strategy into practice will contribute to significant improvement. BIS monitors are an important tool providing anesthetists with multiple opportunities to control the state of patients. At the same time, the given equipment is effective in reducing the number of mistakes during the operations and, at the same time, helping health specialists to manage their stress levels as they are more confident in the success of their interventions and are ready to resist pressure and other challenges that might emerge in the course of treatment (Zhou et al., 2018). At the same time, the improvement can also be viewed if to speak about patients as the number of adverse effects will significantly reduce, which is the key to better patient experience and their satisfaction with results.
The Rationale for the Selection
There are several factors that can be used as the rationale for the selection of the discussed topic. First of all, the problem of intraoperative awareness and the development of adverse outcomes during anesthesia remains a vital concern for the healthcare sector. Statistics show that a significant number of patients might suffer from various problems or issues during surgeries (Gottshalk et al., 2011). For instance, 46,6% of all deaths were associated with the inappropriate dosage of anesthesia (Gottshalk et al., 2011). For this reason, the introduction of BIS monitors can help to improve the statistics and reduce the incidence, which is vital for the achievement of desired outcomes. Additionally, regarding the Quadruple Aim, there is a need to reduce stress among clinicians, which can be achieved by providing them with additional tools to minimize the risk of mistakes. Finally, the reduction in the number of adverse effects can be viewed as another rationale for selecting the given project.
Proposed Project Framework
The financial framework for the given project is linked to the cost of BIS monitors. At the moment, they range in cost from $4,000 to about $5,000 (Seo et al., 2019). Because of the existence of several surgeries in one health unit, their cost can be high. However, the risk of side effects and treatment of complications that emerge during the anesthesia will demand even more investment (Zhou et al., 2018). Additionally, the inappropriate use of drugs and medicines during interventions can be used as a cause for filing a lawsuit against a hospital. From this perspective, the offered project meets the Quadruple Aim as the final costs will be reduced, while patients and health workers will benefit from better outcomes preconditioned by the use of BIS monitors.
In such a way, the financial analysis of the project shows that consideration of this solution can be viewed as a beneficial tool for the healthcare sector to cope with the problem and guarantee that all four goals of the current paradigm will be achieved. The reduction of costs, better outcomes, patient, and clinician experiences will be enhanced by relatively low cost presupposing the purchase of new BIS monitors for various units.
Expected Benefits
There are several benefits that can be associated with the given project. First of all, the costs needed to provide care to patients with complex conditions after surgeries or to mitigate the adverse effects will be reduced because of the lower incidence and the improved quality of care delivery. Second, the ability to monitor the depth of anesthesia will guarantee better outcomes, help to save patients, and protect them from adverse effects. At the same time, in accordance with the principles of the Quadruple Aim, the experience of patients and clinicians will be improved because they will benefit from the reduced level of stress and better outcomes. Finally, another significant benefit for the project is the creation of the environment for new improvements as the employment of BIS monitors will open space for further achievements and upgrades during surgeries.
Conclusion
Altogether, it is possible to conclude that the proposed project is vital for the modern healthcare sector, and it follows the central ideas of the Quadruple Aim, which include the focus on patients, health providers, and satisfaction of their basic needs. Implementation of BIS monitors and their use to manage intraoperative awareness, increase customer satisfaction, and reduce post-operative complications is a beneficial solution that should be supported by the value chain framework. The expected outcomes, such as the reduced costs, higher satisfaction levels, and the better health of the nation, justify the need for the proposed intervention.
References
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