NR 506 Week 5: Drivers of High Performance Healthcare Systems

NR 506 Week 5: Drivers of High Performance Healthcare Systems

NR 506 Week 5: Drivers of High Performance Healthcare Systems

Drivers of high performance health care systems include quality, cost and access; each of these affect work places positively and negatively depending on a myriad of factors surrounding the workplace. When considering my own workplace quality and access are our major determinants in high performance. My work place is an urban hospital in a low socio-economic bracket. Quality of care is extremely important due to the fact that our patients cannot afford medical mistakes and often rely on us for health promotion. For example my hospitals policy is to have two patient identifiers and to always check the patient’s wristband while asking whenever a procedure or medication is to be given. When nurses give medication, it is vital that they identify patients correctly, including first and last name; DOB and this should be verified in conjunction with their wristband (Jo et al, 2013). This policy ensures our patients get maximum quality in patient safety. Another example of how quality is beneficial in our hospital and in our patients lives is through our community outreach programs; my workplace hosts a bike rodeo every year that teaches parents and children bicycle safety and proper helmet usage. Access is important in our health care system we use this by engaging social work to help aid patients on receiving and maintaining health care. Our social workers help us nurses better understand the resources patients need and have, we also utilize outside community help such as farm to families. This organization is obtained through our emergency department and relies on nurses realizing a need for fresh food in families that visit our hospital (St. Christopher’s foundation, 2018). This resource brings the fresh food to the patient’s door on a weekly basis that either cannot get to supermarkets or cannot afford fresh food (St. Christopher’s foundation, 2018). In conclusion the two drivers that have a positive influence on my hospitals performance are quality and access.

 Jo, J., Marquard, J.L., Clarke, L.A., & Henneman, P.L. (2013). Re-examing the requirements for verification of patient identifiers during medication administration: no wonder it is error-prone. llE transactions on healthcare systems engineering, 3 (4), 280-291. doi: 10.1080/19488300.2013.862329 St. Christopher’s Foundation (2018). Farms to Family. The Rollins Family Foundation. (Links to an external site.)

Select two drivers (for example quality, cost, and access) of high performance healthcare systems and apply it to your current work situation. The application could demonstrate the presence of the driver in a positive manner or it could acknowledge the presence of a concern.

 In my opinion two drivers such as quality and cost are the most importance in high performance healthcare systems. However, it is hard for the two drivers to go hand in hand. One would think that in order to get high quality healthcare, it would cost more. In my current work situation there is always a staffing shortage in the ICU, probably because other departments RN cannot float to ICU since it is a specialty unit. It costs hospital to staff RNs in order to provide quality care and maintain the patients to nurse ratios. Not having adequate staff due to cost containment can jeopardize efficient quality healthcare. “Nurse staffing has a significant impact on both quality of care and cost due to nurses’ vital role as front‐line care providers, and insufficient staffing and unreasonable home healthcare costs can thus reduce health benefits through missed opportunities to improve patients’ health status” (Park, 2017).

People tend to associate things that are not costly with poor quality. Which comes to mind, the objective of the “Patient Protection and Affordable Care Act (ACA)” was to attain virtually worldwide health insurance coverage in the United States. ACA helped a lot of people get insurance for an affordable price. “On the supply side, concerns have been raised about whether there are sufficient numbers of primary care physicians to treat all of these newly insured patients” (Courtemanche et al., 2018). Now that everyone could be insured, the question is how will the quality of care be affected? What types of physicians will care for these patients. Time with patients will be compromised due to lack of time to see patients. I believe there must be a medium for quality of healthcare and cost.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS NR 506 Week 5: Drivers of High Performance Healthcare Systems:


Courtemanche C., Marton J., Ukert B., Yelowitz A., & Zapata D. (2018). Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self-Assessed Health. Southern Economic Journal. 84(3), p660-691. 32p. DOI: 10.1002/soej.12245. Park, C. S. (2017). Optimizing staffing, quality, and cost in home healthcare nursing: theory synthesis. Journal of Advanced Nursing. 73(8): 1838-1847. 10p.

“Value-based purchasing strategies, primarily (1) pay-for-performance (P4P); (2) accountable care organizations (ACOs), and (3) bundled payments, are geared towards achieving value by reducing costs while improving quality based on a predetermined set of performance standards including quality and cost measures” (Walter et. al., 2015). The government motivates hospitals by paying out incentives when quality care is met through patient satisfaction surveys or statistics. At our hospitals we have core measures sets, which are things to focus on such as CHF, sepsis, stroke, and etc. made by the The Joint Commission to provide quality care. Lowering the cost of health insurance makes it affordable for everyone, at the same time bringing more businesses to providers, and having incentives to motivate these providers to give great quality care.


Walter A.W., et. al. (2015). The Affordable Care Act and Value-Based Purchasing: What’s at Stake for Children with Medical Complexity? The Catalyst Center. p1-13.

Reading your response I agree with you, utilizing the Just culture algorhythm is an appropriate approach to deal with something like this.  I have used this tool before and it really helps to decide which route is best take when dealing with the situation.  It can help separate repeat offenders or continued at risk behaviors from innocent wrong doing most likely due to the systems and processes in place needing to be evaluated.  

I can say with certainty that the travelers who work in my organization do not get very much orientation to the unit they’re working in.  When someone is coming to help cover staffing for only 6-13 weeks not very much time can be utilized for orientation.  It does make me consider the fact that maybe the 2 to maybe 3 shifts that an traveler gets may not be sufficient, very hard to know what is best.  Although, this could definitely happen to anyone, traveler or not, especially in times of being rushed and understaffed.  I have seen unfortunate outcomes happen to the best and most experienced nurses I have worked with. It’s very humbling and reminds me of how important it is to be vigilant to provide high quality of care to my patients.