Preeti Jhawar

 Skills for Learning in Healthcare Use the Arden university cover page Contents Use the Arden university cover page1 INTRODUCTION3 JOURNAL ARTICLES3 TEXTBOOKS4 TASK 28 PERSONAL DEVELOPMENT PLAN:13 SWOT ANALYSIS16 REFERENCES18 INTRODUCTION Health definition comprises of three individual components, physical, mental, and social wellbeing that ought to be organised in the provision of the medicinal services. The emergence of ceaseless ailments in aged groups has been an obstruction to the acknowledgement of a more advantageous society (Cherry and Jacob, 2016). Value-Based healthcare appears by the legitimate care objective: expanding the value of healthcare. Value comes when the health outcomes are more as compared to the cost spent on achieving those. The following study aims to identify the credible sources that can explain the understanding of Value-based healthcare and then identifies my own SWOT analysis with a Personal Development Plan. TASK 1 It focuses on discussing the resources that have been utilised to understand the impact of value-based care. JOURNAL ARTICLES 1. Reflective practice in health care and how to reflect effectively - The reason for choosing this journal article is because it is a peer-reviewed article that allows us to identify the skills required for learning in healthcare easily. With this article, the author allows healthcare learners to build the discipline and strengths that are required for developing good clinical practice. Credibility: Koshy, et al. This article is credible as it is a peer-reviewed journal article Currency: 2017. This states that the article is relevant for the current research as it has been published recently with all updated information about the meaning and requirement of value-based healthcare. Scope: We often do not recognise that we follow and learn from our past mistakes and learnings: contemplating, comparing and gaining from the previous exposures to maintain a strategic distance from things that could not turn up well and manage and replicate the things that did. Therefore, this discusses the learnings that are made out of our mistakes which can help to imbibe the decision making ability and essence of value-based care. Intended audience: This journal article intends to direct the reflective practices for the students of healthcare like nursing students who are in their initial years of learning 2. Evaluating evidence-based health care teaching and learning in the undergraduate human nutrition; occupational therapy; physiotherapy; and speech, language and hearing therapy programs at a sub-Saharan African academic institution This article is chosen as the author is highly credible and this article intends to capture evidence-based learning by initiating focus group discussions, detailed interviews from the lecturers who have practical experience about EBHC (Evidence-based healthcare) practice. Credibility: Schoonees, et al.This is a credible article as the author holds advanced degrees along with the article being a peer-reviewed one. Currency: 2017. The article was published with all updated information in the recent past that indicates meaningful results for a similar study. Scope: Through this article, the author attempts to assess the attitude of the final year and undergraduate students about EBHC education. Intended audience: Undergraduate healthcare students TEXTBOOKS 1. The first chosen textbook source is Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences – This resource is chosen because it is an exceptionally renowned book that covers the significant challenges that are faced by nursing students during clinical practice. Credibility: Cherry and Jacob.This textbook is credible as it is written by authors who hold advanced academic degrees and the textbooks are also well renowned. Currency: 2016. This textbook is relevant for the current research as it addresses the existing issues in nursing along with the required management principles. Scope: this textbook intends the learners to understand the complex issues and critical care practices that require decision-making ability and implementation strategies for improving patient care. Intended audience: The nursing students and practising nurses who face legal, moral, cultural, ethical and social issues in their daily clinical practice 2. Communication in nursing – This resource is chosen as it encompasses one of the significant soft skill details for a nurse that forms the base of every nurse-patient relationship.Proper communication forms the basis of value-based healthcare for patients. Credibility: Riley, J.B. The author is credible here as he holds experience and academic knowledge about the way with which nursing skills can be meaningful and value-based for the patient. Currency: 2015. This article would help here to identify the way soft skills can help to make the nurse-patient relationship value-based. Scope: The scope of this textbook includes the communication needs and practical approach that should be adopted by the practising clinical and healthcare staff through the provision of different examples, techniques and exercises. The content here also includes ways how communication techniques can be applied in different clinical settings for ensuring safe, value-based and quality care of patients. Intended audience: The practising healthcare staff, majorly nurses WEBSITES 1. As per the www.healthaffairs.org, the health caretakers must perform appropriate steps to ensure the availability of health obligations, both in the new models of social insurance conveyance and inpatient emergency clinic organisation. Credibility: John O'Shea. The website is credible as the devoted content is based on real-life examples and the website also received appreciation across the globe. Currency: October 2018. The source is suitable as it is recently published and would involve the current standards of value-based health care. Scope: This website means to give ground to further discourse on various components identified with constant training and expert advancement of wellbeing administrators, principally dependent on their own perceptions and attitude. Intended audience: Newly practising nurses. In the majority of the healthcare organisations, there are a limited number of healthcare staff who are aware of their job responsibilities and the same culture is less practised within the organisation. Even though there is a low agreement on the arrangement of essential capabilities and abilities expected of wellbeing supervisors, no one inquires the need of extra-scholastic improvement and expert advancement for a skilful exhibition of healthcare capacities in the existing dynamic condition, for example, human services. 2. As per the healthmanagement.org, it is imperative that all undergrad therapeutic services understudies are furnished with proof based social insurance (EBHC) information and aptitudes to have strong basis leadership ability after graduation. They evaluated EBHC educating and learning in undergrad human nourishment (HN), word related treatment (OT), language and hearing treatment (SPLH) programs, and physiotherapy (PT) at an African college. Credibility: Michelle Fakkert, The website is credible as it is supported by the authors who hold incredible experience working for value-based healthcare. Currency: 2017. This is appropriate for this study because it includes all the self-observed methods of providing value-based health care to patients. Scope: They have utilised methodological triangulation to acquire an extensive comprehension of EBHC instructing and learning with the help of explaining essential skills like interpersonal abilities, communication skills, problems solving ability, programming knowledge and the ability to work with healthcare systems. Intended audience: Practicing staff, including new nurses. TASK 2 Value-based healthcare is identified as a healthcare model where the healthcare providers, including doctors and hospitals, are paid dependent on patient's clinical outcomes, lesser incidence of impacts and occurrence of chronic clinical infection, and an increase in the life expectancy (Burwell, 2015). Dealing with chronic health conditions like malignancy, diabetes, hypertension, COPD, etc. can be expensive and tedious for patients. Schoonees, et al., suggested in 2017, that value-based care aims to help patients by recovering them from their health conditions more rapidly. Subsequently, patient’s faceless specialist's visits, therapeutic tests, and systems, and they spend less cash on doctor prescribed prescription with the constant improvement in both short term and long-term health condition. While healthcare providers may have to invest more time and energy in new, anticipation-based patient needs, they will invest less time in managing the chronic health outcome (Schoonees et al., 2017). A definitive objective of healthcare services is to make a healthy society. Short-term goals, for example, improving access to medicinal services and expanding benefits have been mere distractions. Cherry and Jacob, 2016, suggested that as healthcare is something that affects the patients, the objective here should be the provision of patient-centred care rather than provider-centred. The idea of value-based healthcare is to create patient outcomes in a proficient way (Cherry and Jacob, 2016). Porter expressed that quality evaluation, some way or another, does not mirror the genuine "quality" but rather, it is an estimation of a procedure that complies with the rules, evidence-based practice and focuses on patients' wellbeing. Riley, 2015, advised that the expansion of value-based healthcare is changing how care is given. New care delivery models stress upon a team-situated approach to deal with patient care and data so that healthcare is coordinated in a way that the results can be estimated effectively. Two models are audited here: 1. The medical homes in value-based care model do not exist separately instead the acute, primary and intensive care services are incorporated, regularly in a model called a patient-centered medical home (PCMH). A medical home is a planned way to deal with patient care, driven by a patient's primary doctor who coordinates and directs the complete clinical team of the patient (Cherry and Jacob, 2016). 2. Accountable care organisations (ACOs) were structured to give the best care to Medicare patients. In an ACO, specialists, medical clinics, and other medicinal services suppliers’ function as an organised group to convey the ideal facilitated care at the least conceivable expense. Every individual from the group shares both hazards and rewards, with measures to improve access to quality care and patient wellbeing results while decreasing expenses (Colla et al., 2015). The primary point to be noted here while conveying value-based healthcare services is characterising the service that is valued by the patients. However, patients value great clinical results which are reflected not by more visits, techniques, or tests;however, by better wellbeing status and outcomes (Reiss-Brennan et al., 2016). We need a system to report and assess risk-associated results for every ailment along with the expenses to accomplish those results. Further, the clinical results are not only determined from mortality and morbidity rates but rather additionally by other multi-factorial perspectives critical to patients, including the time required for recovery, mobility, complexities, and the requirement for further medications (Kaplan et al., 2014). Porter depicts value-based healthcare results in three levels. Level 1 includes wellbeing status accomplished, including mortality and practical status. Level 2 includes the idea of care and level of recovery, including a return to the usual daily life activities and re-admission to the hospital. Level 3 identifies with the maintainability of wellbeing (Reiss-Brennan et al., 2016). Consequently, Patient-reported outcomes (PROs) estimation has been presented. The Patient-Reported Outcomes Measurement Information System (PROMIS) offers a productive method to assess results after healthcare treatments. This estimation incorporates three areas of wellbeing (physical, mental and social space) (Schwartz et al., 2014). The healthcare professionals must be educated for delivering patient-centered care as members of the interdisciplinary team. For achieving this, the healthcare committee forwards a series of easy and core competencies that should be possessed by all the healthcare professionals of the 21st century, regardless of their core discipline in healthcare, which is: Providing patient-centered care: This would involve sharing responsibility and power with the patients and their caregivers equally by engaging them in an open discussion, thereby leading to agreement, acceptance, the cooperation of common goals and associated healthcare plans. It would also involve guiding and supporting care to the caretakers and family members that enable them to take appropriate decisions thereby making them comfortable in the care settings and recognising their contributions (Alley et al., 2016). The healthcare professionals must be actively involved in strengthening the patient’s self-management activities, providing physical and emotional comfort, reduce their pain and other sufferings like fear and anxiety, and provide them time for developing core strength (Reiss-Brennan et al., 2016). Communication skills also play an essential role in delivering value-based healthcare services that should be open and allow the patients to have easy access to all the information that is present in their own medical records (Reiss-Brennan et al., 2016). The healthcare professional should also communicate with the patients in a way that is easy to understand and in a language that can be comprehended by the patient (Kvedar et al., 2014). Different forms of communication channels like email, face-to-face interactions, web-based technologies, etc. should be used to make the patients understand their health conditions and treatment strategies (Neumann et al., 2016). Value-based care also involves considering the patient’s individual, emotional, moral and life needs before planning care strategies. Value-Based healthcare provides care to patients according to their culture, health beliefs, and after considering society and individual’s needs (Kvedar et al., 2014). Value-based healthcare team involves an interdisciplinary team that is composed of different team members having professional experience in their core fields of healthcare and specific skills, knowledge, and competencies (Reiss-Brennan et al., 2016). The team members also integrate their observations and expertise by making decisions to coordinate, communicate and collaborate for optimising healthcare (Schwartz et al., 2014). Value adds to healthcare here as with the involvement of interdisciplinary team, there is a reduction in service duplication, and it leads to innovative solutions to the more complex patient needs, thereby less financial burden on the patient (Schoonees et al., 2017). Value-based healthcare utilises the regularly growing evidence base; healthcare experts can reliably promote best healthcare procedures and avoid the underuse, abuse, and abuse of consideration (Schwartz et al., 2014). On the other hand, a survey that was done to study found that payers and suppliers are directing around one quarter to 33% of medicinal services IT speculation dollars to buyer commitment. In any case, 72 percent of the customers surveyed showed their involvement with suppliers and wellbeing plans has not improved – and some shown it has exacerbated in the course of the most recent two years. Only 21 percent announced an improved encounter (Schoonees, et al., 2017). While the overview demonstrates payers and suppliers are contributing around one quarter to increase the patient base, 72 percent of the purchasers surveyed said their involvement with suppliers and wellbeing plans has not improvedor has declined – in the course of the most recent two years (Schoonees, et al., 2017). Just around 21 percent of those buyers revealed an improved encounter Clinical aptitude is achieved from the learning and experience gained after continuous practice, including inductive thinking. Patient's values and conditions include their unique identities, concerns, desires, monetary assets, and social backings that are conveyed by every patient to the clinician (Colla, et al., 2015). vidence-based healthcare does not imply that all choices must be founded on the consequences of randomised controlled trials; accordingly, results are not continually sustained, but it involves practising the best possible clinical practice (Schoonees et al., 2017). Value-based healthcare applies quality improvement by continually understanding the qualitative aspects and measuring the service quality in terms of its structure, system inputs, and achieved outcomes or the available pieces of evidence about the change in patient’s health as per the community demands (Reiss-Brennan et al., 2016). CONCLUSION The healthcare results ought to incorporate all spaces of wellbeing in a full cycle of consideration. To execute value-based healthcare services, changes should be furnished by both the healthcare suppliers and the patients: setting up actual care results, building incorporated wellbeing frameworks, strengthening the primary care services, actualizing secure payment instalment schemes that promote valued care and reduce the extent of hazards, thereby, making an approach that fits well with a network (Cherry and Jacob, 2016). FEEDBACK PERSONAL DEVELOPMENT PLAN: Personal Development Plan is an organised and supported process embraced by a person to ponder their learning, execution as well as accomplishment and to get ready for their own, instructive and vocation improvement. My Personal Development Plan aims to turn out as a competent, confident and independent learner and practising nurse. Vision My vision is to attain excellence in my professional career with the incorporation of all necessary skills and knowledge that can help me to work as a consultant with the WHO or the UN. Ideal job role The ideal job role for me would be a head nurse at one of the leading healthcare centres. What are my development objectives? What activities do I need to undertake to achieve my objectives? What support/resources do I need to achieve my objectives Target date for achieving my objectives Actual date of achieving my objectives To complete the degree and achieve all Learning Objectives For this, I should stay focused on my job role and initiate activities that can help me to learn beyond the theory and clinical parameters I feel that for achieving this, I would require support from my teachers and seniors who can show me the correct guidance and path To diversify my knowledge that can help me to get trained across multiple cultures and languages For achieving this, I should get trained in different languages and cultures which can help me to build knowledge of patient preferences and choices I would seek support from my friends and colleagues who belong from other cultures and countries and will be able to share their experience To utilise the opportunity that is available for getting the best placement For this, I feel that I should stay focussed and apply for all openings and stay prepared for the upcoming interviews I would again seek support from my seniors here who have been placed in different organisations to understand the way of appearing for clinical placements To develop skills of value-based care like providing patient-centric care For achieving this, I should be able to evaluate the choices of my patients over clinical outcomes and be able to engage them in open discussions that can allow them to express their desires and choices freely Since I feel that I hold proper communication skills, I seek minimal support here. I feel that I will be able to engage my patients in open discussions To be able to utilise the growing technological equipment without any fear I feel that I should start utilising new equipment to the maximum extent and for the ones that are not available in my current clinical setting, I should read and watch videos about their utilisation so that once there is an opportunity, I will be able to use them easily I would seek support here from my teachers and guides. Along with this, my friends in other institutes can also help me here to discuss different equipment and technological advancements SWOT ANALYSIS Strengths: Weaknesses: I have clear and good communication skills I can work well in team settings I can engage well with my patients I hold a sense of creativity, at times required for handling some patients I have strong sense of leadership that has been utilised in my past personal achievements I do not have enormous experience of working with an established care setting It is difficult for me to define the line between personal life and professional life due to which time management gets disturbed I do not give up my control easily I am at times too soft-spoken (which is often overlooked in a crowd) Opportunities: Threats: I am studying right now and completed my graduation degree to score extraordinary good grades This will help me to get placed in an established care setting where I will develop my career I am utilizing my communication skills to improve my patient’s care experience and this is helping me to spread my work and skills by mouth publicity I feel that I am entering into a competitive world which is extremely saturated already and there are several good healthcare staffs already practising I also feel that although this degree will help me to initiate my career however I should continue this development and personal achievements throughout my future Also, I feel that the healthcare setting is looking for more diverse specialists who are trained across different languages and specializations REFERENCES Reflective practice in health care and how to reflect effectively, Koshy, Kiron, BSc, MBBSa; Limb, Christopher, MBBS, MRes; Gundogan, Buket, BSc, MBBSc, Whitehurst, Katharine, BSc, MBBSd; Jafree, Daniyal, J., BSc, 2017 Schoonees, A., Rohwer, A. and Young, T., 2017. Evaluating evidence-based health care teaching and learning in the undergraduate human nutrition; occupational therapy; physiotherapy; and speech, language and hearing therapy programs at a sub-Saharan African academic institution. PloS one, 12(2), p. e-. Cherry, B. and Jacob, S.R., 2016. Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences. Riley, J.B., 2015. Communication in nursing. Elsevier Health Sciences. Burwell, S.M., 2015. Setting value-based payment goals—HHS efforts to improve US health care. N Engl J Med, 372(10), pp.897-899. Colla, C.H., Morden, N.E., Sequist, T.D., Schpero, W.L. and Rosenthal, M.B., 2015. Choosing wisely: prevalence and correlates of low-value health care services in the United States. Journal of general internal medicine, 30(2), pp.221-228. Kaplan, R.S., Witkowski, M., Abbott, M., Guzman, A.B., Higgins, L.D., Meara, J.G., Padden, E., Shah, A.S., Waters, P., Weidemeier, M. and Wertheimer, S., 2014. Using time-driven activity-based costing to identify value improvement opportunities in healthcare. Journal of Healthcare Management, 59(6), pp.399-412. Reiss-Brennan, B., Brunisholz, K.D., Dredge, C., Briot, P., Grazier, K., Wilcox, A., Savitz, L. and James, B., 2016. Association of integrated team-based care with health care quality, utilisation, and cost. Jama, 316(8), pp.826-834. Schwartz, A.L., Landon, B.E., Elshaug, A.G., Chernew, M.E. and McWilliams, J.M., 2014. Measuring low-value care in Medicare. JAMA internal medicine, 174(7), pp-. Alley, D.E., Asomugha, C.N., Conway, P.H. and Sanghavi, D.M., 2016. Accountable health communities—addressing social needs through Medicare and Medicaid. N Engl J Med, 374(1), pp.8-11. Kvedar, J., Coye, M.J. and Everett, W., 2014. Connected health: a review of technologies and strategies to improve patient care with telemedicine and telehealth. Health Affairs, 33(2), pp.194-199. Neumann, P.J., Sanders, G.D., Russell, L.B., Siegel, J.E. and Ganiats, T.G. eds., 2016. Cost-effectiveness in health and medicine. Oxford University Press.