Confronting the Top Issues Facing Hospitals
Question
Confronting the Top Issues Facing Hospitals
As the healthcare paradigm shifts from treating illness
toward preventing illness, providers are challenged to adopt new models of care
delivery and to embrace evolving concepts of value-driven reimbursement
strategies. Moreover, healthcare providers must give increased attention to the
need to improve healthcare in a manner that improves health outcomes across
population groups and the entire nation as part of the population health
approach.
There are a variety of challenges facing healthcare leaders.
With a growing emphasis on value based care, there are several barriers to
success in population health. Read the article, Top 6 Challenges Healthcare Executives Will Face in
2020 (Links to an external site.) (Appold, 2020).
For this assignment, you are tasked with discussing how the
issues on this list relate to population health, analyzing why these challenges
exist, discovering research-based proposed solutions to these challenges, and
debating the pros and cons of each of these solutions.
The assignment consists of three parts.
Part 1: Identify Challenges (2-3 pages)
- Choose
five of the issues on the ACHE survey list and discuss 3-5 challenges
surrounding each issue to analyze from a population health perspective.
- Each
challenge should be a sub-heading in this part of the paper. Present the
challenge, describe it, and provide some history or background, based on
credible research sources. If you need writing assistance, see the Writing
Center in the CSU Global Library.
Part 2: Analysis of Challenges (3-4 pages)
- Explain
each challenge you identified in Part 1 and provide a comprehensive
discussion on why each has broad and far-reaching implications for
improving the health of the U.S. population.
- Use
data and scholarly research to support your thinking and bolster your
discussion.
Part 3: Proposed Solutions and Recommendations (3-4
pages)
- Discuss
how the population-health paradigm can contribute to solutions for each of
the five ACHE survey issues you selected.
- For
each issue from the survey you discussed, make a specific recommendation
you have identified in the research.
- Create
a table to analyze the recommendations that identifies the following
components:
- Pros
and cons of this solution you have located.
- Arguments
for and against this solution.
- Proponents
or critics of this solution.
- Narrative
discussion of your analysis.
- Discuss
your analysis from the table. This requires critical analysis. You will
want to assess the solution as well as their detractors and supporters
and any possible biases in each. You will want to think through how solutions
would be implemented, funded, supported, and received by various
stakeholders, such as medical professionals, government, and the public.
Requirements:
- The
complete paper should consist of eight to ten pages double spaced,
excluding the required title and reference pages.
- You
must include at least eight credible sources, five of which must be
peer-reviewed, scholarly sources. You may not use the textbook as one of
your scholarly sources.


Solution
Confronting the Top Issues Facing Hospitals
ACHE’s survey found evidence of
broad-based improvement in quality. In 2019, 62 percent of hospitals expected
pressures on operating margins and revenues to continue; 69 percent will face
increased demands on labor resources; 63 percent will contend with staffing
shortages, and 44 percent will need to reduce acquired services provided by
their affiliated health systems. ACHE's most recent Top Issues Confronting
Hospitals Survey polled more than 2,000 healthcare facilities across the United
States (Bahl, 2020).
This paper seeks to explain the top issues facing hospitals based on the ACHE
survey list while also presenting possible solutions and recommendations.
Part 1: Identify Challenges
Financial
Challenges
Hospitals are under financial
pressure due to narrowing margins, rising costs, and new payment models that
threaten reimbursement levels. Evolving patient and customer demands: Due to
demographic shifts and new technology, patients and consumers want more
integrated care, and they want it now. Ensuring adequate staffing is a
challenge: A shortage of nurses, particularly in some specialties, exacerbates
staff turnover rates and causes hospitals great concern about patient safety (Meneses et al., 2020).
Health systems' competition only comes from other hospitals or physician
groups. Efficiently managing clinical quality improvement initiatives:
Hospitals are under pressure to reduce readmissions, hospital infections and
other quality measures that could affect reimbursement rates or star ratings
from CMS or the Joint Commission.
Patient
Satisfaction
The public demands more and higher
quality healthcare while also expecting to pay less and less, which creates a
serious dilemma for hospitals. The Affordable Care Act (ACA) provides funding
for quality initiatives, but the money can only be used in the hospital to
demonstrate sufficient patient satisfaction. Patient satisfaction includes
patient experience, patient safety, and timeliness of care, among other
factors. Hospitals need to demonstrate that they improve their patient
experience to qualify for additional ACA funding. Treating patients with
respect is a must in this new era of healthcare. Nurses are on the front line
to provide exceptional care and a positive patient experience, but nurses can't
do it alone. A hospital needs a culture that supports and encourages nurses to
improve the patient experience (Herath and Herath, 2020). Hospital administrators need to allow
nurses to listen to patients' concerns and address them effectively. Nurses
also need management support when navigating difficult situations with
difficult patients or families.
Personnel
Shortages
The U.S. healthcare system is facing
two major personnel challenges. The first is a nursing shortage, and the second
is a physician shortage. These shortages affect the patients who receive care
and the hospitals where they receive it. I will discuss both of these shortages
and what needs to be done to alleviate them to improve the health of Americans.
The shortage of nurses in the United States is at an all-time high. The US
Bureau of Labor Statistics (BLS) estimates that there will be a shortfall of
1.2 million nurses in the next decade, and the situation will become
increasingly worse by 2023. The United States faces a shortage of nurses that
has reached crisis proportions. The U.S. Bureau of Labor Statistics (BLS)
reports that the number of nurses in the workforce is expected to increase by
more than 70 percent in the next decade, yet the number of people entering the
profession has steadily declined over the past two years (Chopra, Toner, Waldhorn, and
Washer, 2020). The need for nurses across all settings, especially in
hospitals and other care facilities, will continue to grow as the population
ages and more people gain access to health insurance under the Affordable Care
Act (ACA).
Part 2: Analysis of Challenges
Financial
Challenges
The financial challenges facing
hospitals in the U.S. are broad and far-reaching in their implications for
improving the health of the U.S. population but also complex and difficult to
deal with. There is a need to first identify these challenges to create
solutions and improve the overall health of the general population. Hospital
administrators face several challenges that threaten their ability to provide
quality healthcare services to patients. Hospital executives have had to contend
with numerous disruptive changes over the last several years, including
changing regulations from federal and state governments, increasing competition
from non-acute care providers and evolving technology. Hospitals must remain
flexible enough to respond quickly to changes in healthcare delivery to remain
competitive and offer high-quality care. The United States spends more on
health care than any other country globally, yet the U.S. population has poorer
overall health than other wealthy countries. Indeed, the U.S. is ranked 37th in
life expectancy among the top 42 countries of the Organization for Economic
Cooperation and Development (OECD) (Mohindra et al., 2020). This situation is not simply a matter of
insufficient funds. Health care spending per capita in the U.S. exceeds that of
any other country by 25 to 50 percent or more and accounts for nearly 18
percent of GDP, nearly twice as high as in most other OECD countries. Despite
this high level of spending, Americans have lower life expectancies than people
in many other wealthy nations and face higher death rates from heart disease
and cancer even after risk factors are taken into account.
Patient
Satisfaction
Health care in the United States
faces several challenges, and patient satisfaction is among the biggest. The
issue is complicated by a lack of transparency in health care pricing, which
has led to confusion and frustration among patients. It's an ongoing challenge
that concerns hospitals and health systems around the country. According to the
American Customer Satisfaction Index (ACSI), Americans are less satisfied with
health care than other industries except for airlines. However, satisfaction
levels vary greatly depending on the type of care received. For example, adults
who have seen doctors for medical checkups or routine visits are satisfied at a
rate of 77 percent, but only 54 percent of adults who have had surgery say
they're satisfied with their experience (Chopra, Toner, Waldhorn, and Washer, 2020). This
dissatisfaction varies from inadequate communication with physicians to long
wait times at clinics and hospitals. Patients expect to be treated like
customers, not just another chart in a doctor's office or procedure in a
hospital's schedule. Patient satisfaction is based on patients' emotional
response to the services and products they receive from the hospital. Patient
satisfaction measures can be useful for assessing the effectiveness of
different services and improving service quality. It is a good tool for
measuring patient perception and response to hospital care. Hospital
satisfaction is important for hospitals and other stakeholders like government
agencies, accreditation bodies, insurance companies, employers, professional
associations, and individual consumers.
Personnel
Shortages
According to the American
Association of Colleges of Nursing (AACN), there was a shortage of 1 million
nurses by 2020, in part due to the aging population and an increase in demand
for healthcare services. This shortage impacts rural hospitals more than urban
hospitals because urban populations are more likely to have more diverse
hospital systems that can provide specialized care; likewise, a larger local
community allows for greater access to healthcare services. Rural hospitals
have fewer options for referral and rely on neighboring hospitals for medical
resources. Healthcare facilities face a significant shortage of nurses and
other healthcare professionals, especially as the U.S. population ages and
requires more care. The increased demand for healthcare is due to an aging
population, an increase in chronic conditions, such as diabetes and heart
disease, and the prevalence of lifestyle-related diseases, such as obesity (Abuelgasim et al., 2020).
The physician shortage is an
American phenomenon, but it is a worldwide challenge affecting all developed
countries. However, there are some differences between the physician supply in
the U.S. versus other countries around the globe. In 2011, the Organisation for
Economic Co-operation and Development (OECD) reported that although most
developed countries had similar issues with physician supply and demand, the
U.S. was one of only three countries with a net outflow of physicians to other
OECD countries. This suggests that there may be unique factors leading to
physician shortages in the U.S., independent from those in other countries with
similar economic profiles, such as Canada and Australia.
Part 3: Proposed Solutions and Recommendations
Challenge |
Solution |
Recommendations |
Financial Challenges |
Expansion into other markets |
Renegotiating contracts with
insurance companies and finding new ways to generate revenue also comes with
its one hurdles and financial implications |
Patient Satisfaction |
Focusing on customer engagement
and satisfaction |
Contributes to increased death
rates, and high levels of inpatients which is expensive |
Personnel shortages |
Implementation of recruitment
strategies Employing part-time employees is
another strategy |
Increasing pay and recruiting more
employees is expensive |
Financial
Challenges
With the advent of the Affordable
Care Act, the role of hospitals has changed from being care providers to more
of a business role. Hospitals need to renegotiate contracts with insurance
companies and find new ways to generate revenue. With hospital profits at an all-time
low and health insurance premium rising steadily, hospitals need to find new
ways to generate revenue and improve the bottom line. To remain profitable in a
declining market will require hospitals to rethink their overall strategies.
The health care industry is looking for new ways to improve efficiency and
reduce costs while maintaining patient satisfaction. As a result of this shift
in focus, many hospitals are now looking for new ways to expand into other markets.
One major way is through expansion into rural areas that health care facilities
have traditionally underserved (Abuelgasim et al., 2020). Rural communities have long relied on
local clinics and emergency rooms as their main sources of medical attention.
However, these areas have seen a rise in preventable death rates over several
decades. This affects the quality of life for these rural communities and
increases their financial burdens as they are now forced to travel miles to
receive proper medical attention. Hospitals are noticing this trend and are
finding ways to expand.
Patient
Satisfaction
Hospital leaders need to be
intentional about improving the patient care experience. Shifting paradigms is
never easy, but it can be done by developing an innovative culture that
promotes change and empowers staff to be more involved in providing exceptional
care to patients. Actively encouraging physicians and other key staff members
to lead quality improvement efforts will help engage them in changing hospital
systems for the better. Therefore, to meet these expectations, health care
providers must make changes that focus on patient engagement and satisfaction (Appold, 2022). By providing
patients with more information about their options and treatment plans, health
care providers can help their patients take control of their care and
ultimately achieve better outcomes.
Moreover, it is also significant to
identify the current problems within the hospital and take steps to correct
them. Increasing staff communication efforts and investing in organizational
improvements may help improve overall efficiency and reduce patient wait times
for medical attention. Not only do patient satisfaction scores help hospitals
attract new patients, but they also play an important role in how much money
their facilities can expect to receive from Medicare (Crosby, 2015). So, if the hospital wants to
stay competitive and financially healthy, it must do everything it can to
create positive experiences for patients. However, patient satisfaction leads
to high use of inpatient services, expensive prescription drugs, and high death
rates.
Personnel
Shortages
There are many solutions to tackle
these problems, which help both hospitals and healthcare professionals like
doctors and nurses. To address this nursing shortage, hospitals have
implemented numerous recruitment strategies. However, these attempts have
fallen short because most only focus on attracting new nurses instead of
retaining current nurses. Furthermore, retention strategies are often limited
to compensation increases, promotions and other incentives. Many health care
organizations fail to realize the underlying reasons nurses choose to remain
with or leave their organizations (Crosby, 2015). The first, and most obvious solution, is to
increase the pay of current staff members and offer incentives for employees
who stay longer than a year. The third solution would be for hospitals to
employ more part-time workers who can fill in gaps during hours when no
full-time employees are available. Part-time jobs can be stressful because they
offer little job security and often require employees to work long hours at
many different locations. However, part-time workers are much easier to find
than full-time workers who can fulfill specialized positions like nurses or
doctors.
Conclusively, Hospitals in the US
face challenges like financial problems, patient satisfaction and personnel
shortages. Financial issues are one of the biggest challenges for hospitals in
the US today. In addition, patients are more aware of the services provided by
hospitals and are becoming more demanding about them. More and more patients
expect hospitals to provide high-level quality care, which hospital staff must
meet. This is exactly why it is so difficult for hospital staff to satisfy all
the patients' needs and meet their expectations. Another challenge that
hospitals face is the lack of personnel. Many qualified people prefer to work
in other industries where salaries are higher and better working conditions.
Hospitals need to do more to control costs to address the financial problems.
This can be done by using the latest technology to become more efficient and
creating a culture where employees are encouraged to take a long-term approach
to cost containment. Improving levels of patient satisfaction is also important
because this can lead to increased numbers of repeat visitors, which in turn
brings in additional revenue.
References
Appold; K. (2022). Top 6 challenges healthcare executives will face in 2020. Managed
Healthcare Executive. Retrieved February 1, 2022, from https://www.managedhealthcareexecutive.com/view/top-6-challenges-healthcare-executives-will-face-2020
Abuelgasim, E., Saw, L. J., Shirke, M.,
Zeinah, M., & Harky, A. (2020). COVID-19: Unique public health issues
facing Black, Asian and minority ethnic communities. Current problems in cardiology, 45(8),
100621.
Bahl, S., Singh, R. P., Javaid, M., Khan,
I. H., Vaishya, R., & Suman, R. (2020). Telemedicine technologies for
confronting COVID-19 pandemic: a review. Journal
of Industrial Integration and Management, 5(04), 547-561.
Chopra, V., Toner, E., Waldhorn, R.,
& Washer, L. (2020). How should US hospitals prepare for coronavirus
disease 2019 (COVID-19)?. Annals of
internal medicine, 172(9),
621-622.
Herath, T., & Herath, H. S. (2020).
Coping with the new normal imposed by the COVID-19 pandemic: Lessons for
technology management and governance. Information
Systems Management, 37(4),
277-283.
Crosby, J. (2015, June 18). Ache survey: Top issues confronting
hospitals in 2014. Strategic Healthcare Partners. Retrieved February 1,
2022, from
https://shpllc.com/ache-survey-top-issues-confronting-hospitals-in-2014/
Meneses-Navarro, S., Freyermuth-Enciso,
M. G., Pelcastre-Villafuerte, B. E., Campos-Navarro, R., Meléndez-Navarro, D.
M., & Gómez-Flores-Ramos, L. (2020). The challenges facing indigenous
communities in Latin America confront the COVID-19 pandemic. International Journal for Equity in Health,
19, 1-3.
Mohindra, R., Ravaki, R., Suri, V.,
Bhalla, A., & Singh, S. M. (2020). Issues relevant to mental health
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