The Poudre Valley Hospital is locally owned, independent, not-for-profit organisation, located in Fort Collins, Colorado. Larimer County Hospital, Poudre Valley Hospital ‘s original name, was built in 1925 to function the citizens of Northern Colorado. It began as a little, 40-bed medical infirmary surrounded by farming area. Over clip it has expanded. It has grown into a system of infirmaries and clinics. The most recent add-on to the Poudre Valley Health System was the Medical Center of the Rockies that opened in 2009. PVHS is a leader in supplying high quality health care to non merely Colorado, but citizens of Wyoming and Nebraska every bit good. The focal point of this analysis will be the original Poudre Valley Hospital and the greater Poudre Valley Healthcare System ( PVHS ) .
Supplying high quality health care is the foundation of Poudre Valley Healthcare System ‘s mission. A health care system ‘s mission states its intent and what it wishes to carry through for its clients. It tells the public what it does, why it exists and who it exists for. The PVHS mission serves all its installations and is stated as such ; “ Our mission is to supply advanced, high quality, comprehensive attention that exceeds client outlooks. Taking attention of patients is why Poudre Valley Health System exists. Taking great attention of patients is why Poudre Valley Health System excels ” ( “ Poudre vale wellness, ” 2009 ) . PVHS exists for patients, to take attention of patients and purposes to supply its patients with the highest quality attention. High quality attention is besides mirrored in PVHS ‘s vision.
An organisation ‘s vision states what it plans to make for the hereafter. PVHS ‘s vision is to supply universe category health care to the populations it serves ( “ Poudre vale wellness, ” 2009 ) . World category health care means that it will use the most current and advanced engineering and evidenced-based protocols when caring for its patients. PVHS ‘s values besides play a function in the manner it cares for the people that seek attention in its infirmaries and associated clinics.
While prosecuting its mission and vision, PVHS abides by several nucleus values. These values include ; quality, compassion, confidentiality, self-respect, regard, equality and unity ( “ Poudre vale wellness, ” 2009 ) . These values are indispensable to a health care organisation that aims to supply the high quality, comprehensive attention its patients.
The PVHS ‘s mission and vision demands excellence. There is grounds of theory-in-action in the multiple awards PVHS has won for excellence in patient attention and patient results. Poudre Valley Hospital received a Five Star Inpatient Care Award which reflects the highest mark for inpatient satisfaction study consequences in Avatar International Inc. ‘s national informations base. PVHS received an Innovation Award in 2009 ( “ Poudre vale wellness, ” 2009 ) . Theory-in-action is besides demonstrated in the quality awards the organisation has won. In 2008, PVHS received the Malcolm Baldrige National Quality Award which is the highest presidential award given to the United States concerns that demonstrates the highest excellence in public presentation results. PVHS has won the Colorado Peak Performance award twice. This award is given to the organisation with the highest public presentation excellence ( “ Poudre vale wellness, ” 2009 ) . The espoused theory is hard to see in this organisation as it besides has first-class Press Ganey and other patient satisfaction tonss every bit good as employee satisfaction evidenced by PVHS ‘s Magnet acknowledgment ( “ Poudre vale wellness, ” 2009 ) . While Magnet involves merely nursing satisfaction, nurses make up the bulk of the organisation. It appears that from the multiple awards that PVHS has won over the old ages for quality, invention and public presentation in patient attention outcomes that is lives up to its mission, vision and values.
As aforementioned, PVHS is an independent, not-for-profit organisation. This means that it serves the community around it by reinvesting its net net incomes to better its services and installations. PVHS earns a net income to profit its patients, non stockholders, as PVHS does non hold stockholders who own it. It is besides an independent organisation. PVHS does non have local belongings revenue enhancement gross from occupants in the country it serves.
PVHS serves a broad assortment of patients with both chronic and acute unwellness. Therefore, it takes patients who have private insurance and those with Medicare or Medicaid. “ At Poudre Valley Hospital we have a batch of chronic unwellness patients so we see a batch of patients with Medicare and Medicaid. Medical Center of the Rockies is the trauma infirmary in the country and it besides does a batch of forte work hence they see more patients with private insurance and some with no insurance. Due to this mix, we have really come out on top this twelvemonth in respects to gain ” ( R. Detlefsen, personal communicating, June 6, 2010 ) . Poudre Valley Hospital is besides near to several primary attention clinics so that many of the chronic unwellness patients can hold continuity of attention. “ If there doctors need to acknowledge them, they can besides follow them in house since its one system ” ( R. Detlefsen, personal communicating, June 6, 2010 ) . Since Poudre Valley Hospital is portion of a larger, connected private system, it has a diverse group of leaders.
PVHS requires diverse expertness from its leading as it governs a broad array of inmate and outpatient scenes. Every organisation has a alone construction to its leading in order to outdo function its demands. Many private infirmaries have what is called a professional bureaucratism construction and PVHS is no different. The professional bureaucratism construction has an operating nucleus of professionals such as doctors and nurses with a strong support staff ( Fiorelli, 2010 ) . The leading at PVHS consists of a Board of Directors, physician leading and a senior direction group. In the senior direction group there are multiple Vide Presidents of different sections. Examples include ; ambulatory services, nursing, human resources and medical specialty. Below the aforesaid leading are nurse leaders. Each unit in Poudre Valley infirmary has a Nurse supervisor every bit good as a Clinical Nurse Specialist. There are besides leaders over other sections, directors, in for illustration dietary, housework and lab. The Mintzberg diagram that demonstrates this is shown below ( Fiorelli, 2010 ) .
In order for a complex organisation such as this to work decently, its demands to be guided by policy and regulative boards. PVHS is accredited by the Joint Commission on Accreditation of Healthcare Organizations ( JCAHO ) . JCAHO evaluates PVHS ‘s conformity with the nationally recognized Joint Commission criterions of attention. JCAHO must measure each installation in the system individually as each type of installation has its ain criterions required for accreditation. For illustration, what is expected in clinic may be different than what is expected in a infirmary in respects to medicine storage. Legislation besides governs policy at PVHS.
When alterations occur in healthcare statute law, it affects the health care systems and furthermore infirmary policy and protocols. Changes in statute law can hold big or little impacts on patient attention. For illustration, in June of 2009, Governor Bill Ritter Jr. signed into jurisprudence Senate Bill 09-244 ( “ Autism society, ” 2010 ) . This Bill requires insurance companies to supply coverage of for intervention of autism. No longer would coverage be a inquiry when sing intervention in Colorado infirmaries. While this has a slightly little impact on PVHS straight except for extinguishing the inquiry of payment, it affects patients with autism and their households in a enormous manner.
There are several societal and cultural influences in an organisation. At PVHS, nursing is specifically influenced by the American Nurses Association and the American Nurses Credentialing Center. Poudre Valley Hospital has been awarded Magnet position multiple times. A infirmary is awarded Magnet position when nursing delivers first-class patient results, has high occupation satisfaction, and has a low staff nurse turnover rate and appropriate grudge declaration. The Medical Center of the Rockies has been awarded the Beacon Award. The Beacon Award is awarded by the American Association of Critical Care Nurses to the infirmary that achieves high quality results. It is a plan in which an person unit applies. The plan is an chance to acknowledge excellence in professional pattern, patient attention and results ( “ Poudre vale wellness, ” 2009 ) .
As aforementioned, PVHS has won assorted awards and has been recognized for its quality, first-class patient attention and satisfaction of both nurses and patients. As stated in its mission, PVHS desires to supply advanced, high quality, comprehensive attention. The Press Ganey tonss, Avatar inpatient satisfaction tonss and quality indexs that PVHS provides for public screening on its website demonstrate that the organisation ‘s intended mission is a true world ( “ Poudre vale wellness, ” 2009 ) . An unintended impact on those seeking health care at PVHS is the continuity of attention. With the strive for comprehensive attention in its mission, PVHS supplies clinics in which patients can follow-up with their doctors every bit good as see them when the unfortunate circumstance of hospitalization occurs. This provides first-class continuity of attention that is non mentioned in the organisation ‘s mission straight but has an unintended positive impact on patient attention.
The Advanced Practice Nurse Role
In the turning universe of health care advanced pattern nurses ( APNs ) are get downing to be utilized at a greater capacity. The function of the APN is being implemented in a assortment of health care installations and PVHS is no exclusion. “ The bulk of our nurse practicians are used in the primary attention and forte clinics, the remainder map in the Clinical Nurse Specialist ( CNS ) or educator function ” ( R. Detlefsen, personal communicating, June 6, 2010 ) . The paragraphs to follow will depict the function of the APN at PVHS including criterions, enfranchisement, organisational relationships, patient interaction and liberty.
All APNs at PVHS are required to hold a Master ‘s Degree in Nursing. The occupation rubrics listed for APNs are Advanced Practice RN/CNS or Clinic APRN. The occupation description is reasonably standard for both functions:
Uses the nursing procedure at the advanced pattern degree to supply direct/indirect patient attention for a specific population.A The advanced pattern nursing procedure includes appraisal, diagnosing, outcome designation, planning, execution and rating of a specific population in the ague attention setting.A The APRN integrates instruction, research, direction, leading, and audience into clinical functions, and they function in collegial relationships with members of the wellness attention team.A PVH encourages engagement in infirmary related or other community activities that improves the well being of the community ( “ Poudre vale wellness, ” 2009 ) .
The enfranchisement demands are besides reasonably standard for all APNs employed with PVHS. This allows for consistence of outlooks among APN health professionals. The enfranchisement and other demands are as follows:
Master ‘s of Science grade required.A Minimum of 5 old ages acute attention nursing experience in the identified country of expertness preferred.A A Certification in forte country preferred.A Current BLS required at hire, or preparation will happen during orientation or at the following available training.A Active Colorado Nursing License.A Unrestricted medical staff rank at Poudre Valley Hospital and/or Medical Center of the Rockies, with appropriate pattern privileges ( “ Poudre vale wellness, ” 2009 ) .A
The function of the APN requires credentialing. As mentioned in the enfranchisement demands above, APNs hired there must hold the appropriate pattern privileges. Certification exams step the APN ‘s competence. These tests are accepted by regulating boards and insurance companies. It assures that APNs have met an established set of criterions. The American Nurses Credentialing Center, a subordinate of the American Nurses Association, provides APNs with the enfranchisements they need in forte countries for illustration, the Adult CNS test and the Adult Nurse Practitioner test ( “ American nurses credentialing, ” 2010 ) .
The APN function in this organisation falls under the operating nucleus of professionals. The APNs study to a supervisor every bit good as their collaborating doctors. In this establishment, the APNs are hired through the PVHS, they are non straight employed by the doctors they work in coaction with. Therefore the APNs must describe to both doctors are their direct supervisor. Their direct supervisor so, studies to disposal ( R. Detlefsen, personal communicating, June 6, 2010 ) . The APNs that map in the CNS function collaborate with the unit supervisor to educate and take the nurses in their section. For the nurses in the clinic function, they are required to join forces with the doctor. Regardless of the function of the APN, communicating is cardinal. The APN must be an first-class communicator in order to organize attention with doctors or in the pedagogue function, train and educate nurses.
Not merely must the APN collaborate with nurses and doctors, they have other duties. They must be able to pass on with insurance companies when medicines and interventions need blessing. They must be able to suitably pass on with pharmaceutics when clear uping prescriptions or finding with medicine is covered under a peculiar patient ‘s insurance.
As for the liberty of the APN, it varies depending upon the function. Those APNs that map as pedagogues or in the CNS function have autonomy in the manner that they make their ain determinations on how to educate the nurses but no existent liberty in patient attention determination devising. To clear up, they do non order and prescribe in the manner an APN working straight with a doctor would. The liberty of the clinic nurses is more recognizable as they make patient attention planning determinations and write prescriptions as they assess, diagnose and treat patients on their ain. “ Normally, one time the doctor has an initial visit the patient will follow up with an APN, although more late the APNs have their ain patients ” ( R. Detlefsen, personal communicating, June 6, 2010 ) . With that said, the APN has important power to impact patient results. With his or her cognition of evidenced-based pattern, they can impact patient attention in a positive manner. As for the CNS, he or she can deeply impact a unit in the infirmary. If he or she has a accomplishment in instruction, the nurses will profit from it and in bend, so will the patients they care for.
There are strengths and failings to both functions. The strengths of the clinic APN function would be the advanced cognition and accomplishments in direct patient attention, cost decrease and bettering patient results ( Wyckoff, Houghton & A ; LePage, 2009 ) . The failings of the function would be deficiency of society consciousness and physician indifference. The major strength of the APN in the CNS function would be conveying evidenced-based pattern to the bedside nurses in the unit. Other strengths include conveying cognition and expertness to new nurses and the function of the go-between when nurses and doctors have dissensions. They besides serve as a resource when unfamiliar diagnosings present in the unit. The failings of the function include those with hapless instruction abilities and hapless communicating accomplishments. While this may non be true of all CNS ‘s, it genuinely does occur are apparent failings in the function.
The function of the APN is a dynamic function. The APN maps in multiple scenes both inmate and outpatient. So far, PVHS has used the APN in the functions of CNS inmate and nurse practician in primary and forte clinics. With its devotedness to high quality, advanced and comprehensive attention, it would non be a surprise to see nurse practicians taking on more functions in the inmate puting as they cut down costs and better results ( Wyckoff, Houghton & A ; LePage, 2009 ) .