Assessing the Problem: Quality, Safety, and Cost Considerations 

Heart disease is the most prominent healthcare challenge around the world. Every 33 seconds, a person dies due to heart disease. However, heart disease affects millions of people every year in the U.S. (Centers for Disease Control, 2022). The major causes of heart disease are aging, a sedentary lifestyle, and unhealthy diets. Due to such a high prevalence of this disease, it affects the quality of care, healthcare costs, and also risks associated with improper treatment (Santos, 2022). Patient awareness, preventive measures, and better treatment strategies are needed to improve the quality of treatment. This assessment will focus on the problems associated with heart disease and the quality, safety, and cost associated with the treatment interventions. 

Impact on Quality of Care, Patient Safety, and Costs 

The quality of care impacts heart disease through gaps in care coordination that result in fatal consequences. For instance, patients experiencing chronic heart failure commonly have frequent readmissions due to inadequate follow-up and improper management (Wideqvist et al., 2021). This pattern emphasizes the importance of follow-ups, nursing care, and proper communication in the healthcare setting to avoid readmission and promote the safety of the patients. According to research conducted by Chen & Gong (2022), the issue of fragmented care models caused an increase in adverse events, including medication errors and delayed treatment, which poses a significant threat to patient safety. In this case, such inefficiencies cause family members to cope with the emotional and financial burden of chronic illness and a complicated healthcare system. 

From the cost point of view, heart disease remains a tremendous burden for both the healthcare system and the population. The American Heart Association estimated that the total direct cost of cardiovascular diseases in the U.S. would increase and reach 1 trillion by 2035 (American Heart Association, 2021). This will increase hospitalization rates, the need for long-term care services, and the cost of medications. Due to this reason, families living in poverty, dealing with illnesses such as coronary artery disease, are forced to choose between food and medical expenses. Furthermore, a study conducted by Virani et al. (2021) shows increased cost pressures from lost productivity and disability in the employed population. Such costs are alarming for advocating preventive interventions, early identification, and policy changes that address the total system cost and safer patient care outcomes.

The Impact of State Board Nursing Practice Standards and Policies on Heart Disease Management

State board nursing practice standards and organizational or governmental policies are relevant factors involved in determining the quality of care, patient safety, and the cost of handling heart disease conditions. The American Heart Association’s (AHA) 2019 guidelines require implementing nurse-led interventions in caring for cardiovascular patients in which evidence-based practice and patient-centered care are mandatory. These guidelines compel the nurses to undertake constant professional development, particularly in the techniques that are pertinent when dealing with complicated cardiovascular issues. The Affordable Care Act (ACA) prioritizes preventive measures such as focusing on proactive measures such as management of heart diseases cheaper in the long run. Furthermore, ACA promotes the use of community-based interventions such as the provision of screening services and organizing workshops that may help in the early identification of risk factors and also help minimize hospitalization. Through promoting these practices, the state boards guarantee that the healthcare providers conform to the standards of quality and safety while cutting the cost burden on both patients and the healthcare subsystem (CDC, 2021). 

Moreover, Centers for Medicare & Medicaid Services (CMS) policies play an important role in reducing the cost for patients with heart disease. Programs like the Hospital Readmissions Reduction Program that financially penalizes hospitals with high rates of readmissions serve to drive improved post-discharge planning, patient understanding, and patient care. Thus, value-based reimbursement has shifted concern towards the implementation of protocols that have accurate safety measures for the patients. For example, telehealth services under Medicare, especially with the COVID-19 outbreak, increased remote cardiac access, minimizing the pressure faced by emergency treatments and the cost of treatment. Consequently, patients benefit from early interventions that reduce adverse outcomes and decrease the rate of readmissions (Centers for Medicare & Medicaid Services, 2023). Therefore, such policies positively influence its delivery in health care by supporting activities that raise the quality of care and patient safety with the added benefit of lowering system costs.

The Role of Policy in Shaping Nursing Scope of Practice and Guiding Intervention

Policy plays a great role in determining the nursing scope of practice particularly in the management of heart disease since it establishes the roles and responsibilities of nurses in their clinical practice. Nurse Practice Act (NPA) allows Authorize Advanced Practice Registered Nurses (APRNs) to play the primary role in managing chronic illnesses including heart disease, especially in states that provide full practice. These regulations increase nurse’s ability to prescribe drugs, create patient care plans, and promote lifestyle changes independently. This broader role is significant in providing heart disease interventions, where there may not always be easy access to a cardiologist in rural areas (AANP, 2020). For instance, APRNs are now at the forefront of community health programs including preventive education, self-management, and early screening which are major strategies in managing the occurrence and effects of heart diseases. 

Other governmental policies like Chronic Care Management (CCM) Services influence how these nurses develop and implement their interventions. As per this policy, nurses are directly involved in managing patients with multiple comorbidities such as heart disease through continued patient assessment and support. This approach also serves to enhance clinical performance, especially when implemented in line with value-based care frameworks which also propose a cost and quality-focused strategy (CMS, 2023). Thus, policy integration into the nursing practice ensures clients receive safe, evidence-based, and patient-centered interventions and also addresses systemic issues impacting the healthcare system for the betterment of patient outcomes. 

Strategies To Improve The Quality Of Care, Enhance Patient Safety, And Reduce Costs

Following is the list of some strategies that can be incorporated in the nurse’s practice to improve the quality of patient care, and safety, and also reduce costs for treatment interventions. 

Value-Based Care Model

The shift from fee-for-service to value-based care management is one of the most significant changes in the healthcare sector as it focuses on patients’ results rather than the quantity of services produced. For instance, accountable care models in cardiac care can encourage patients, physicians, and hospitals to get rewarded based on the quality of care and not the quantity increasing the efficiency of their services and reducing the instances of ineffective procedures. It can also increase the adoption of preventive measures.

Patient Safety Programs

One approach that can be applied to improve patient safety is safety checklists and the use of protocol-based care for cardiology patients. For example, using a surgical safety checklist has been found to decrease the occurrence of post-operative adverse events and hospital readmissions which can translate to a large reduction in costs. Checklists implemented in hospitals have seen a decrease of 36% in severe conditions. Moreover, standardized protocols also guarantee that information passed between caregivers is precise hence avoiding adverse effects on the safety of the patients.

Technology Use 

The analysis of Electronic Health Records (EHR), with the help of predictive analytics, makes it easier and quicker to find the patients who require a higher level of attention to care quality and safety. Technologies, such as high-risk patient identification algorithms, allow for earlier intervention that would prevent the risk of adverse cardiac events and shorten the hospital’s stays. Furthermore, telemedicine solutions are cost-effective as the need for constant face-to-face visits is reduced.

Chronic Disease Management Programs Quality 

Disease prevention and management decrease long-term healthcare costs because they do not admit patients often or visit the emergency room frequently. For instance, incorporating Community Health Workers (CHWs) into the primary care teams for diabetic patients has resulted in better glycemic control and lowered hospitalizations. Community Health Workers (CHWs) offer patient education, medication adherence, and follow-up visits that reduce the cost burden of chronic diseases.

Care Coordination Optimization

The fragmented care system limits the effectiveness of patient care because it leads to repeated testing, a higher risk of medical mistakes, and higher costs. Effective coordination of care especially when the patient is transferred from one level of care to another or discharged from the hospital is vital to minimize hospital readmissions. Transitional Care Model (TCM), which offers advanced practice nurses to manage the care of high-risk patients, has also demonstrated a decrease in 30-day readmissions by 25% (Morkisch et al., 2020). This model entails coordinating post-hospitalization plans, follow-up, and patient education which helps in increasing care quality and also decreasing health costs.

Effectiveness of Strategies and Benchmark Data

Value-based models have proven useful in reducing costs and improving patient health due to a better focus on prevention and incentives for the providers. For instance, bundled payment models in cardiac care have been proven to reduce treatment costs by up to 20% while at the same time offering care quality at the same or even better standards (Navathe et al., 2020). Furthermore, the adoption of standardized safety practices like surgical checklists has improved postoperative morbidity and readmission rates, resulting in patient safety improvement and unnecessary utilization of healthcare services (Storesund et al., 2020). Technology-enhanced approaches, such as predictive analytics and telemedicine, have resulted in lower hospitalizations when patients receive timely follow-up and can manage chronic conditions more effectively (Kubes et al., 2021). These strategies are backed up by updated benchmark data, highlighting the crucial role they play in achieving effective care for patients with heart diseases. The inclusion of safety measures and equipment has proven to be very useful in enhancing the quality of the services.

Conclusion

Cardiovascular diseases are still a major problem for the healthcare system, which has a significant impact on patient safety, quality, and costs. The approaches examined in this assessment, encompass value-based care models, patient safety programs, technological solutions, preventive care measures, and effective care management, showing that they bear the potential to tackle these challenges successfully. These approaches can help build new more efficient models of care delivery concentrating on patient-centered and integrated care, better health outcomes, and less ineffective expenses.

References

Chen, Y., & Gong, Y. (2022). Teamwork and patient safety in intensive care units: challenges and opportunities. MEDINFO 2021: One World, One Health–Global Partnership for Digital Innovation. https://doi.org/10.3233/shti220120 

Kubes, J. N., Graetz, I., Wiley, Z., Franks, N., & Kulshreshtha, A. (2021). Associations of telemedicine vs. in-person ambulatory visits and cancellation rates and 30-day follow-up hospitalizations and emergency department visits. Preventive Medicine Reports, 24, 101629. https://doi.org/10.1016/j.pmedr.2021.101629 

Morkisch, N., Arango, L. D., Cardona, M. I., van den Heuvel, D., Rimmele, M., Sieber, C. C., & Freiberger, E. (2020). Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review. BMC geriatrics, 20, 1-18. https://doi.org/10.1186%2Fs12877-020-01747-w 

Navathe, A. S., Liao, J. M., Wang, E., Isidro, U., Zhu, J., Cousins, D. S., & Werner, R. M. (2021, August). Association of patient outcomes with bundled payments among hospitalized patients attributed to accountable care organizations. JAMA Health Forum 2(8). American Medical Association. https://doi.org/10.1001%2Fjamahealthforum.2021.2131 

Santos, L. (2022). The impact of nutrition and lifestyle modification on health. European Journal of Internal Medicine, 97, 18-25. https://doi.org/10.1016/j.ejim.2021.09.020 

Straus, S., Barodi, B., Zarrintan, S., Willie-Permor, D., Vootukuru, N., & Malas, M. (2024). A contemporary evaluation of the centers for medicare and medicaid services high-risk Indicators for Carotid Endarterectomy. Annals of Surgery, 280(3), 444-451. https://doi.org/10.1097/sla.0000000000006397 

Storesund, A., Haugen, A. S., Flaatten, H., Nortvedt, M. W., Eide, G. E., Boermeester, M. A. & Søfteland, E. (2020). Clinical efficacy of combined surgical patient safety system and the world health organization’s checklists in surgery: A nonrandomized clinical trial. Jama Surgery, 155(7), 562-570. https://doi.org/10.1001/jamasurg.2020.0989 

Virani, S. S., Alonso, A., Aparicio, H. J., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., & Tsao, C. W. (2021). Heart disease and stroke statistics-2021 update: a report from the American Heart Association. https://doi.org/10.1161/cir.0000000000000950 

Wideqvist, M., Cui, X., Magnusson, C., Schaufelberger, M., & Fu, M. (2021). Hospital readmissions of patients with heart failure from the real world: timing and associated risk factors. ESC Heart Failure, 8(2), 1388-1397. https://doi.org/10.1002/ehf2.13221