[Solved] Week 5 Discussion Response- Delivery of Healthcare

Assignment Prompt & Instructions

**Respond** to **at least two** posts by members of your group as follows:
– Continue engaging in the Discussion.
– Follow up on the peer feedback that was provided to you.
– Review the feedback that was provided to other colleagues and provide your perspective based on what you came across in your research.
**Colleague 1**
Angel Smith
My analysis focuses on Atlanta, Georgia, addressing unintentional injuries (accidents) as the identified health issue, with Russia used as the international comparison country.
**Value-Based Care Improvement: Measure Outcomes and Cost for Every Patient**
One improvement Atlanta’s healthcare system could make is implementing **standardized, patient-level outcome and cost measurement for unintentional injuries across the full care cycle**, including emergency response, acute treatment, rehabilitation, and follow-up care. According to the Harvard Business School Institute for Strategy & Competitiveness, value-based care requires measuring outcomes that matter to patients alongside the true costs of delivering care, rather than focusing on individual services or departments (Harvard Business School Institute for Strategy & Competitiveness, n.d.).
Currently, injury care in many U.S. communities is fragmented, with cost and outcome data siloed across emergency departments, trauma centers, and post-acute services. Establishing integrated injury registries and episode-based cost tracking would allow providers to identify high-value interventions, reduce unnecessary variation in care, and improve long-term functional outcomes (Shi & Singh, 2022).
**IOM Aim Improvement: Be Effective**
To better meet the Institute of Medicine (IOM) aim of **being effective**, Atlanta could strengthen the consistent use of **evidence-based injury prevention and treatment protocols**, particularly for high-risk populations. The IOM defines effective care as services based on scientific knowledge and delivered to those who will benefit, while avoiding underuse and overuse (Institute of Medicine [IOM], 2001).
For unintentional injuries, this could include standardized trauma care pathways, evidence-based fall prevention programs, and data-driven injury surveillance to guide targeted interventions. Heslip (n.d.) emphasizes that effectiveness improves when healthcare systems reduce unwarranted variation and ensure that clinical decisions are grounded in best available evidence rather than provider preference.
**Comparison of Healthcare Delivery Models: Atlanta vs. Russia**
Russia’s healthcare system more closely aligns with the value-based care principle of **measuring outcomes and cost at the population level**, particularly through its centralized data collection and national injury surveillance systems. While Russia faces challenges related to access and quality, its centralized approach allows for consistent tracking of injury outcomes and costs across regions, supporting large-scale public health interventions (Shi & Singh, 2022).
In contrast, Atlanta’s healthcare delivery model is highly decentralized, which can make comprehensive outcome and cost measurement more difficult. However, Atlanta benefits from advanced trauma centers, greater access to specialized care, and higher clinical quality standards. A key lesson Atlanta could learn from Russia is the value of **system-wide data integration** for injury outcomes, while Russia could learn from the U.S. model’s emphasis on patient-centered care, innovation, and quality improvement initiatives.
**References**
Harvard Business School Institute for Strategy & Competitiveness. (n.d.). _Measure outcomes and cost for every patient_. [https://www.isc.hbs.edu/health-care/value-based-health-care/key-concepts/Pages/measure-outcomes-and-cost.aspxLinks to an external site.](https://www.isc.hbs.edu/health-care/value-based-health-care/key-concepts/Pages/measure-outcomes-and-cost.aspx)
Heslip, N. (n.d.). _Crossing the quality chasm_. PolicyMedical. [https://assets.hcca-info.org/Portals/0/PDFs/Resources/library/Crossing%20the%20Quality%20Chasm.pdfLinks to an external site.](https://assets.hcca-info.org/Portals/0/PDFs/Resources/library/Crossing%20the%20Quality%20Chasm.pdf)
Institute of Medicine. (2001). _Improving the 21st-century health care system_. In _Crossing the quality chasm: A new health system for the 21st century_ (pp. 39–60). National Academy Press. [https://nap.nationalacademies.org/read/10027/chapter/4Links to an external site.](https://nap.nationalacademies.org/read/10027/chapter/4)
Shi, L., & Singh, D. A. (2022). _Delivering health care in America: A systems approach_ (8th ed.). Jones & Bartlett Learning.
**Colleague 2**
Keona Wilson
**Continuum of Care Evaluation and Country Comparison**
         In this discussion post, I intend to continue evaluating the continuum of care for unintentional motor-vehicle crashes in Des Moines, Iowa, and to compare it with the U.S. healthcare delivery model and Sweden’s outcomes-driven approach to trauma care.
**Measure Outcomes and Cost for Every Patient (Value-Based Care Element)**
Based on my week 3 community profile, as we talked about in part one, individuals who are injured in motor vehicle-related crashes in Des Moines progress through multiple sectors across the continuum of care, including medical services, acute trauma care at a level 1 trauma center, inpatient rehabilitation, outpatient specialty clinics, and prevention initiatives. As we know, the services listed above address immediate and long-term needs, outcomes, and costs, which are often measured separately within settings rather than across the entire continuum of care model. A possible improvement would be to include episode-based outcome and cost measures for individuals affected by motor vehicle injuries, including measures of recovery, readmission rates, rehabilitation duration, and total cost per patient. Porter & Lee suggested that value-based care should be emphasized by measuring outcomes and costs for each patient, which is essential for improving efficiency and quality. (Porter & Lee, 2013) Without measuring these indicators, it will likely be difficult for healthcare leaders in Des Moines to identify inefficiencies or to evaluate which interventions should be implemented to achieve positive outcomes by establishing shared data systems across EMS hospitals, rehabilitation centers, and outpatient services, this would enable healthcare providers to make better decisions and allocate resources more effectively.
**Be Effective (Institute of Medicine Aim)**
          IOM’s primary focus is to provide evidence-based care that improves all health outcomes for patients. Although Des Moines offers high-quality trauma and rehabilitation services, variability in follow-up care and rehabilitation access may reduce overall effectiveness. One key improvement would be the use of standardized, evidence-based trauma recovery protocols, including timely referrals to rehabilitation and structured follow-up evaluations to assess functional outcomes. Research from the Institute of Medicine and the Berwick article indicates that trauma systems that use standardized clinical guidelines and continuous outcome monitoring can improve patient recovery and reduce complication rates. (Institute of Medicine, 2001; Berwick et al., 2008). By ensuring that the continuum care model guides all decisions, this approach will be consistent with evidence-based practices. Des Moines could improve recovery outcomes for individuals involved in motor vehicle crashes while reducing unnecessary care.
**Comparison with Sweden’s Healthcare Delivery Model**
Using the same country as last week compared to Des Moines, Sweden has a healthcare delivery model that closely aligns with our value-based care principle for measuring outcomes and costs for every patient that they have affected by motor vehicle crashes. As we know Sweden utilizes national trauma registries and population level data system that tracks injury outcomes long term recovery and health care appendages across the full continuum of care. This approach supports continuous quality improvement and accountability at both the provider and system levels. Evidence indicates that Sweden emphasizes outcome measurement and injury surveillance, which have contributed to lower traffic-related mortality rates and more efficient trauma care delivery. (OECD,2022; World Health Organization [WHO], 2023).
In contrast, the United States has a system that relies on fragmented data resources, which limit the ability to evaluate total costs and patient outcomes across care settings. Des Moise could learn from Sweden's integrated data infrastructure and its commitment to transparent reporting of patient outcomes. However, it is worth noting that we do have differences in health care financing and data governance, which may also pose challenges for implementation and necessitate adaptation rather than direct replication.
**References**
Berwick, D. M., Nolan, T. W., & Whittington, J. (2008). The Triple Aim: Care, health, and Cost. _Health Affairs (Project Hope)_, _27_(3), 759–769. [https://doi.org/10.1377/hlthaff.27.3.759Links to an external site.Links to an external site.](https://doi.org/10.1377/hlthaff.27.3.759)
Institute of Medicine. (2001). _Crossing the Quality Chasm: A New Health System for the 21st Century_. National Academies Press. [https://doi.org/10.17226/10027Links to an external site.Links to an external site.](https://doi.org/10.17226/10027)
OECD. (2022). _Road safety annual report._ Organisation for Economic Co-operation and Development
Porter, M., & Lee, T. (2013). _The strategy that will fix health care_. Harvard Business Review. [https://hbr.org/2013/10/the-strategy-that-will-fix-health-careLinks to an external site.Links to an external site.](https://hbr.org/2013/10/the-strategy-that-will-fix-health-care)
World Health Organization. (2023, December 13). _Global status report on road safety 2023_. Www.who.int. [https://www.who.int/publications/i/item/9789240086517Links to an external site.Links to an external site.](https://www.who.int/publications/i/item/9789240086517)
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