Interprofessional Organizational and Systems Leadership
Interprofessional Organizational and Systems Leadership
A healthcare issue in the United States is access and cost of medications. Pharmaceutical costs are exponentially rising and making it difficult for consumers to buy much-needed medications. According to Luo et al. (2019), the expansion of health insurance and prescription drug coverage, availability of newer classes of prescription medicines, and increased prices of existing brand name medications contribute to the growth in prescription drug spending more than the growth in spending for physician services and hospital care. If a medication price is too high, health insurance will refuse to cover the drug or require cheaper alternative medicines. The cost of drugs becomes an issue because when a patient cannot purchase the drug because out-of-pocket is too expensive or the insurance will not cover the prescription drug because it is not formulary; hence, the patient readmits to inpatient care or the patient’s health worsens without the appropriate medication. Interprofessional Organizational and Systems Leadership
The cost of pharmaceutical medications continues to be an issue. Lockwood (2019) identifies reasons why pharmaceutical drugs have a high cost, such as Medicare’s inability to negotiate drug prices or import inexpensive foreign drugs and financial incentives drug companies offer physicians to prescribe high-cost medications. Lockwood (2019) also states pharmaceutical companies are keeping a high-profit margin within the drug supply chain, and federal regulations also contribute to the high costs.
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Necessary medications such as EpiPens, insulin, and Seroquel have had significant price increases. Two EpiPens costs have increased by 545% from $113.27 to $730.33 from 2007 to 2016 (Pepper et al., 2017). Insulin has seen an increase of over 1,000% from $21 in 1999 to $332 in 2019 for one vial of Humalog (Rajkumar, 2020). In mental health, Seroquel is such a medication with a 52% increase in cost (Robertson et al., 2017). A practitioner may order Seroquel 50mg three times a day upon discharge, but the insurance will only cover it if it is two times a day. The dosage will not be beneficial for the patient, and their mood may worsen and disrupt the patient’s condition. The next step is to have a prior authorization completed where a practitioner completes a form explaining why this patient needs this specific medication three times a day. Prior authorizations can become a tedious process and delay a patient from receiving their medication promptly. Ideally, prior approval should be completed before discharge to avoid medication disruption.
A method to address insurances covering medications is for a practitioner to familiarize the insurance’s formulary. Broome and Marshall (2021) state that clinicians face constant changes in information, expectations, and conditions that can influence patient care. A practitioner needs to have updated knowledge of an insurance’s formulary, saving time in addressing medications available to treat various diagnoses. Also, knowing the preferred formulary can prepare a practitioner’s need to complete a prior authorization for a drug before a patient discharges, so there is no delay in medication distribution from the pharmacy. Knowing an insurance’s formulary falls in line with the four C’s of primary care presented by Park et al. (2018), first contact, continuity, comprehensiveness, and coordination to improve patient care. Interprofessional Organizational and Systems Leadership
Broome and Marshall (2021) promote utilizing resources for innovation and improvement. There are apps like Good Rx and Optum Perks that offers medications at a discounted rate where pharmaceutical companies and pharmacies work together for lower-cost prescription drugs. Until there are better regulations and reform, medication costs will continue to be an issue in the United States.
References
Broome, M., & Marshall, E.S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.) Springer Publishing Company.
Lockwood, C. (2019). Ensuring medications are more affordable without stifling innovation (Part 2): In the second part of this series, potential solutions to fix the rising drug cost problem are examined. Contemporary OB/GYN, 64(7), 3–6. https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=137726804&site=eds-live&scope=site
Luo, J., Kulldorff, M., Sarpatwari, A., Pawar, A., & Kesselheim, A. S. (2019). Variation in prescription drug prices by retail pharmacy type: A national cross-sectional study. Annals of Internal Medicine, 171(9), 605–611. https://doi-org.ezp.waldenulibrary.org/10.7326/M18-1138
Park, B., Gold, S. B., Bazemore, A., and Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the quadruple aim. The Journal of the American Board of Family Medicine. 31(4) 588-604. https://doi.org/10.3122/jabfm.2018.04.170388
Pepper, A. N., Westermann-Clark, E., & Lockey, R. F. (2017). The high cost of epinephrine autoinjectors and possible alternatives. The Journal of Allergy and Clinical Immunology. In Practice, 5(3), 665. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jaip.2016.12.018
Rajkumar, S. V. (2020). The high cost of insulin in the United States: An urgent call to action. Mayo Clinic Proceedings, 95(1), 22. https://doi-org.ezp.waldenulibrary.org/10.1016/j.mayocp.2019.11.013 Interprofessional Organizational and Systems Leadership
Robertson, L. J., Miot, J. K., & van Rensburg, B. J. (2017). A retrospective record review and assessment of cost of quetiapine use in a community psychiatric setting in the Sedibeng district of Gauteng. The South African Journal of Psychiatry : SAJP : The Journal of the Society of Psychiatrists of South Africa, 23, 1057. https://doi-org.ezp.waldenulibrary.org/10.4102/sajpsychiatry.v23i0.1057
| Excellent | Good | Fair | Poor | |
|---|---|---|---|---|
| Main Posting |
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
35 (35%) – 39 (39%)
Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
| Main Post: Timeliness |
10 (10%) – 10 (10%)
Posts main post by day 3.
|
0 (0%) – 0 (0%)
|
0 (0%) – 0 (0%)
|
0 (0%) – 0 (0%)
Does not post by day 3.
|
| First Response |
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
13 (13%) – 14 (14%)
Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. |
| Second Response |
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. |
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. Interprofessional Organizational and Systems Leadership |
12 (12%) – 13 (13%)
Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. |
| Participation |
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
|
0 (0%) – 0 (0%)
|
0 (0%) – 0 (0%)
|
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
|
| Total Points: 100 |
|---|
Module 1: Healthcare Environment (Weeks 1-2)
Laureate Education (Producer). (2018). The Healthcare Environment [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
- Analyze current national healthcare issues/stressors
- Analyze the impact of national healthcare issues/stressors on healthcare organizations
- Analyze strategies for addressing national healthcare issues/stressors
| Due By | Assignment |
|---|---|
| Week 1, Days 1–2 | Read the Learning Resources. Compose your initial Discussion post. |
| Week 1, Day 3 | Post your initial Discussion post. Begin to compose your Assignment. |
| Week 1, Days 4-5 | Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment. |
| Week 1, Day 6 | Post two peer Discussion responses. |
| Week 2, Days 1–6 | Continue to compose your Assignment. |
| Week 2, Day 7 | Deadline to submit your Assignment. |
Learning Resources
Required Readings
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.
- Chapter 2, “Transformational Leadership: Complexity, Change, and Strategic Planning” (pp. 34–62)
- Chapter 3, “Current Challenges in Complex Health Care Organizations and the Quadruple Aim” (pp. 66–97)
Read any TWO of the following (plus TWO additional readings on your selected issue):
Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians—Implications for the physician workforce. New England Journal of Medicine, 378(25), 2358–2360.
Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN-prepared workforce goal. American Journal of Nursing, 118(2), 43–45.
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231–245.
Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner–physician comanagement: A theoretical model to alleviate primary care strain. Annals of Family Medicine, 16(3), 250–256. Interprofessional Organizational and Systems Leadership
Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’ work settings, roles, and education preparation? Journal of Professional Nursing, 33(6), 400–404.
Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple Aim. Journal of the American Board of Family Medicine, 31(4), 588–604.
Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14(56), 1–15. doi:10.1186/s12960-016-0154-3. Retrieved from
https://human-resources-health.biomedcentral.com/track/pdf/10.1186/s12960-016-0154-3
Poghosyan, L., Norful, A., & Laugesen, M. (2018). Removing restrictions on nurse practitioners’ scope of practice in New York state: Physicians’ and nurse practitioners’ perspectives. Journal of the American Association of Nurse Practitioners, 30(6), 354–360.
Ricketts, T., & Fraher, E. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874–1880.
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Required Media
Laureate Education (Producer). (2015). Leading in Healthcare Organizations of the Future [Video file]. Baltimore, MD: Author
Discussion: Review of Current Healthcare Issues
If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?
These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.
In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.
To Prepare:
- Review the Resources and select one current national healthcare issue/stressor to focus on.
- Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.
By Day 3 of Week 1
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
By Day 6 of Week 1
Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.
I share your concerns about the increased cost of medications. It would appear that the cost of prescription medications is up all around, but it is particularly bad within the diabetic medications segment as you highlighted in your post. My father experienced a similar problem with the Victoza he uses to control his own blood sugar levels, because his Medicare part D coverage on the medication ran out ¾ of the way through the year. He was left with an inability to pay nearly $1000 for what was left for the year and had to use less effective oral medications instead. Interprofessional Organizational and Systems Leadership
The article I researched at the Peter G. Peterson Foundation sites that the cost per capita on prescription drugs increased 30% from 2007 to 2017, and authors predict that by 2027 this per capita cost could increase 60% as compared to 2007 (2019). This is a rate of increase that vastly outpaces normal income increases a person would expect from year to year and vastly outpaces the normal rate of inflation. Essentially, if we do not do something, the problem will only get worse and could be unmanageable within about 7 to 10 years.
Recent changes in national politics could result in the enactment of new laws such as Medicare for All, in which strict limits could be placed on both the starting cost of new medications as well as on year to year cost increases on existing drugs (Lawson, 2019). While Medicare for All might not solve all the problems with increased healthcare costs, any new legislation that will put limits on the cost of new and existing drugs will reduce the burden on patients.
References
Lawson, Alex. (2019). Medicare For All will drastically lower prescription drug prices by taking on Pharma’s greed. Retrieved December 3, 2020 from https://www.salon.com/2019/03/03/medicare-for-all-will-drastically-lower-prescription-drug-prices-by-taking-on-pharmas-greed_partner/#:~:text=The%20Medicare%20for%20All%20Act,lower%20drug%20prices%20with%20corporations.
Peter G Peterson Foundation. (2019). Why are Prescription Drug Prices Rising and how does that Effect the US Fiscal Outlook?. Retrieved December 3, 2020 from https://www.pgpf.org/blog/2019/11/why-are-prescription-drug-prices-rising-and-how-do-they-affect-the-us-fiscal-outlook#:~:text=U.S.%20spending%20on%20prescription%20drugs,an%20increase%20of%2060%20percent.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 1
To participate in this Discussion:
Week 1 Discussion
Assignment: Analysis of a Pertinent Healthcare Issue
The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.
Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time. Interprofessional Organizational and Systems Leadership
In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.
To Prepare:
- Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.
- Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.
- Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.
The Assignment (3-4 Pages):
Analysis of a Pertinent Healthcare Issue
Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:
- Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
- Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations. Interprofessional Organizational and Systems Leadership
- Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.
Looking Ahead
The paper you develop in Module 1 will be revisited and revised in Module 2. Review the Assignment instructions for Module 2 to prepare for your revised paper.
By Day 7 of Week 2
Submit your paper.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
- Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
- Due to the nature of this assignment, your instructor may require more than 7 days to provide you with quality feedback.
Grading Criteria
To access your rubric:
Week 2 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment Draft for Authenticity:
Submit your Week 2 Assignment draft and review the originality report
Submit Your Assignment by Day 7 of Week 2
To participate in this Assignment:
Week 2 Assignment
Next Module
To go to the next module:
Module 2 Interprofessional Organizational and Systems Leadership
