Introduction Healthcare organizations with a focus on patients and families must demonstrate a strong an effective approach to managing operations and the development of new ideas and strategies to facilitate greater quality of care. This process must serve as an opportunity to explore the different dimensions of healthcare practice and offer a means of supporting family-centered care at a high level. This is an encouraging approach to family practice healthcare because it provides individuals and families with the tools and resources that are required to achieve the desired outcomes and to address gaps in knowledge and resources that may have positive benefits for the organization. In this capacity, it is important for patients to receive consistent care and treatment in a timely manner to meet the needs of the organization and to have a significant impact on their lives across all age and population groups.

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Healthcare organizations must be able to demonstrate a high level of understanding of the needs of their patients, particularly when they focus on family-centered care. Organizations must be fully prepared to address the challenges of patient-centered care and to facilitate improvements in healthcare delivery and quality that include meeting patient needs, improving comfort, supporting educational endeavors, encouraging continuity upon transition to a different setting, and including family in plans of care (Luxford, Safran, & Delblanco, 2011). This reflects the importance of shaping an environment in which there are significant opportunities to improve care delivery and quality in an organized manner that will have lasting benefits for patients over the long term (Luxford, 2011). There are many regulatory issues that influence how patient care is administered in facilities; therefore, issues such as prescribing authority for nurses, access to specialty care, and other concerns are of critical importance (Fox & O’Bear, 2012). In this context, there must be a greater emphasis on improving quality of care and on the development of new perspectives to accommodate patient needs within these organizations so that gaps in care are minimized and care is reflective of the highest possible quality (Fox & O’Bear, 2012).

From a financial perspective, patient-centered care is a critical factor in supporting the dynamics of the organization and in advancing the objectives that are required to improve outcomes; therefore, accurate reporting using electronic health records, timely administration of medications, and routine monitoring of patients are essential. It is important to focus on the number of physicians and nurses available to treat patients, while also considering other factors that will influence patient care in a direct manner, such as outcomes of care that include measures of quality, screenings, patient satisfaction, revenue per visit, and patient documentation, among many others (Day, 2013). It is important to evaluate the context of pay for performance systems, which also have an influence on healthcare operations, using Medicare data from the Premier Hospital Quality Incentive Demonstration (HQID) to address mortality rates, to facilitate improvements in quality of care, and to address Medicare-based payments for organizations and physicians to meet or exceed performance standards (Jha, Joynt, Orav, & Epstein, 2012). As a result, these issues will continue to grow and expand as likely markers in meeting healthcare needs for patients and in advancing the objectives of an organization that will have lasting outcomes for patient care quality (Jha, 2012).

In the State of Massachusetts, the Executive Office of Health and Human Services is instrumental in regulating hospitals and other healthcare organizations in order to support the primary objectives of patient care and treatment (2015). Furthermore, the Joint Commission has established its own precedent and objectives for achieving patient-centered care, using communication tools and other resources in order to effectively improve patient-centered care at a high level (2010). This requires healthcare providers to be effective facilitators in the delivery of patient care and to enable patients to be able to share their concerns or questions regarding the care and treatment that they receive (The Joint Commission, 2012).

Expanding the model of patient-centeredness requires a critical understanding of the dynamics of healthcare organizations and the need to expand knowledge and resources to improve quality of care at a consistent level. For example, the process of rounding in the emergency department requires a clear understanding of the issues that are experienced in this environment and must have a precise approach to address the problem in an effective manner that will contribute to improved outcomes for patients. Rounding is used as a means of engaging patients in their plans of care, along with including family members in these opportunities; therefore, it is important for patients to receive optimal effort and consideration from healthcare providers in order to effectively meet these objectives in a timely manner with the intent to improve patient satisfaction rates (Emerson, Chmura, & Walker, 2014). This reflects a need to further examine how patient and family involvement in their plans of care may be effective in supporting improved satisfaction rates and greater communication between healthcare providers and their patients (Emerson, 2014).

Although rounding has become an increasingly relevant option in emergency departments to engage patients and family members in strategies of care, it is also important to note that this process is not entirely proven effective in many organizations; therefore, it is experimental to some degree and requires further analysis and consideration in order to effectively meet the desired outcomes in organizations where this concept is new. As a result, the financial implications of the strategy have yet to be fully determined, so it requires a careful examination of the potential issues that may arise with its implementation. At the same time, the strategy may have positive impacts on patients and family members and may enhance the delivery and quality of care as provided by the organization and its employees; as a result, the strategy is worthy of further analysis and consideration.

The financial implications of rounding in the emergency department must be addressed further as a means of exploring the dimensions of care and treatment and what might be available to support and enhance quality of care on a continuous basis. It is believed that this type of strategy may require dedicated staff to initiate strategic implementation, but this must also demonstrate a need to explore the options that are available to acquire the support that is necessary to implement the program effectively. However, the use of existing staff who will allocate time to the strategy may be an alternative that will be more cost effective and appropriate for the implementation, rather than recruiting new staff for this purpose. The latter approach is likely to have a greater impact on organizational leadership because it is a more cost effective approach to care and treatment.

In proposing a strategy to implement rounding in the emergency department, it is necessary to evaluate the existing conditions under which this project is a possibility, given the limitations that exist and the resources that are required to develop a strategy of this nature. Therefore, the costs of a pilot study for this program must be considered, using existing staff who would allocate a specific amount of time to the study in order to reduce programmatic costs. There must be a strategy in place that will have a significant impact on operations and provide the organization with the tools that are necessary to make an informed decision regarding the potential benefits of this strategy.

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