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There are both advantages and disadvantages to increasing the number of physicians who limit their activities to narrower fields of practice. The advantages include the fact that because there are more specialists and there are more options for patients who actually need truly specialized care. As such, scheduling appointments and even time spent traveling to appointments is more manageable as specialists are considerably more accessible in the modern era, which was one of the goals of the Affordable Care Act (Hawkins and Grove, 2014, p. 90). The disadvantage, of course, is that there is now a specialist culture within health care. As such, patients have to pay to see a doctor twice before they can get what they need done. Most health insurance companies do not allow patients to simply go to a specialist without a referral from their primary care physician first. As such, the patient ends…
Hawkins, D. Groves, D. (2014). The future role of community health centers in a changing health care landscape. The Journal of Ambulatory Care Management. 37(2), 90-99.
Lee, C.T., Fitzgerald, B. (2013). Model of care and pattern of nursing practice in ambulatory oncology. Canadian Oncology Nursing Journal. 23(1), 19-22.
Ambulatory Care Unit
Designing your own healthcare unit
Designing a health care unit
The health care system in the world continues to grow amid the several challenges it faces from the developments in the related sectors. The world health organization puts strict restrictions on the quality of services that hospitals and all other care units should abide. It is in this resolution that the sector is changing tremendously from the federal centered and directed care units to privatization sector. Consequently, it increases the need for introduction of quality care units in hospitals to ensure that patients and all other needy people receive the deserved attention. The emergency care system is one sector that needs critical improvement and increment of services to cater for the rising incidences of emergencies. Thus, an ambulatory care unit best fits for introduction into the current hospital to ensure quality attendance to patients.
The mission statement…
Wolper, L.F. (2011). Health care administration: Managing organized delivery systems. Sudbury, Mass: Jones and Bartlett Publishers.
Fisher, A., & OCR (Organisation). (2005). Health & social care. Oxford: Heinemann
Niemcryk, S.J., Joshua-Gotlib, S., & Levine, D.S. (2005). Outpatient experience of patients with GERD in the United States: Analysis of the 1998-2001 national ambulatory medical care survey. Digestive Diseases and Sciences, 50(10), 1904-8. doi: http://dx.doi.org/10.1007/s10620-005-2959-0
Mangione-Smith, R., DeCristofaro, A.H., Setodji, C.M., Keesey, J., Klein, D.J., Adams, J.L., . . . McGlynn, E.A. (2007). The quality of ambulatory care delivered to children in the United States. The New England Journal of Medicine, 357(15), 1515-23. doi: http://dx.doi.org/10.1056/NEJMsa064637
Ambulatory Care, Community Health Centers, Complementary and Alternative Medicine, And Mental Health: Case Assignment
n an effort to effectively address significant health care issues facing the United States, medical professionals necessarily address the significant issue of mental health. The disparities in access to and quality of mental health care in America necessitate comprehensive steps to adequately treat traditionally underserved populations such as racial/ethnic minorities, the elderly, the uninsured/underinsured, the less educated and rural populations. n the forefront of health care, primary care providers are often best able to encounter, assess, treat and refer patients with mental illness. As a result, experts are suggesting comprehensive steps to enhance the ability of primary care providers to address our nation's mental health issues.
Barriers and Disparities for Patients Seeking Mental Health Care
n the context of health care reform, governmental, organizational and individual health care providers are discussing key issues relevant to…
In the context of health care reform, governmental, organizational and individual health care providers are discussing key issues relevant to improving access to and quality of health care in the United States. One key issue is the availability and quality of mental health care for all Americans. Though the ideal is equal access to high quality mental health care, researchers have found disturbing disparities among our population in access to and quality of mental health care. According to the Center for American Progress, racial/ethnic minorities, the elderly, the less educated, the uninsured/underinsured and rural residents tend to suffer considerable disparities in both access to mental health care and in the quality of mental health care received (Russell, 2010, p. 3); (Proser & Cox, 2004, pp. 9-11).
Regarding racial/ethnic minorities, specific data reveals that psychiatric services are underutilized, engagement and retention in treatment is problematic; schizophrenia is over-diagnosed in the African-American population; depression is over-diagnosed among Latinos; antipsychotic medications are over-dosed for African-Americans and under-dosed for Latinos; very high rates of substance abuse and suicide occur in Native American populations (Russell, 2010, p. 29). In addition, there are longstanding barriers to treatment in the form of inadequate insurance, inadequate health care workforce, inadequate diagnoses by primary care physicians, under-referral of patients to mental health care, high dropout rates from treatment and a high percentage of missed appointments (Russell, 2010, p. 29), all creating significant impacts on the mental health of racial/ethnic minorities. Experts have suggested reforms to reduce the disparities in access and quality. These include: improving access by expanding health insurance coverage; counteracting providers' biases and stereotypes of minorities by educating providers and enhancing communication between patients and providers; and enhancing more diversity among mental health providers by encouraging and creating greater opportunities for minority members to join the mental health care profession (Russell, 2010, p. 30). In a comprehensive effort to deal with disparities affecting racial/ethnic minorities, §10334 of the ACA establishes the Office of Minority Health, several minority-focused departments and transforms the National Center on Minority Health and Health Disparities from a mere center to an institute. In addition, in a specific effort to reach youth who suffer mental health care disparities due to their race/ethnicity and/or lack of education, the Comprehensive Community Health Services Program for Children and their Families was established in 1992 and has since funded 92 grant communities, 61 of which are still in existence (Russell, 2010, p. 25).
Regarding all underserved groups, including racial/ethnic minorities but also including the elderly, uninsured/underinsured, poorly educated and rural individuals, among others, researchers have suggested reforms such as better long-term planning of the mental health care workforce by acknowledging the high level of unmet needs, appropriately training
In the current era of managed care in medicine, physicians and other healthcare providers and institutions have been under tremendous pressure to reduce costs. In that regard, avoiding unnecessary hospitalization is one of the most important goals of lowering the costs of healthcare delivery (Stanhope & Lancaster, 2004). Toward that end, diverse strategies have evolved to provide as many healthcare services as possible on an ambulatory basis.
Hospitals and insurance companies now encourage patients to participate in preventative medicine and routine testing intended to lower the costs associated with hospitalization over the long-term. The strategy is simply to reduce the incidence of serious illnesses, particularly those that typically develop over many years and which are capable of prevention through behavior modification and early detection through diagnostic testing (Stanhope & Lancaster, 2004).
Because state and federal governments must absorb much of the costs of uncompensated medical services, the many administrative agencies…
References Stanhope, M., Lancaster, J. (2004) Community and Public Health Nursing (6th ed.) St. Louis: Mosby.
VA Ambulatory Care
When it comes to the job and duty of the Veteran Affairs (VA) Administration, there are many forms and types of care that commonly come up and that are discussed or debated. Just one of those, and perhaps one of the less commonly mentioned ones, is that of ambulatory care. However, it is a very important topic and it is an integrated and vital part of the healthcare chain, both when it comes to veterans and non-veterans. This report shall briefly summarize what the VA has to say about the subject. There will then be an evidence-based approach that looks at the issue, there will be a discussion about how the author of this brief report feels about the material offered and how the rest of the medical world might align (or not align) with what is described on the site. While there are many people that…
Chen, J. Q., & Benusa, A. (2017). HIPAA security compliance challenges: The case for small healthcare providers. International Journal Of Healthcare Management, 10(2), 135-146.
Edward, A., Osei-Bonsu, K., Branchini, C., Yarghal, T. s., Arwal, S. H., & Naeem, A. J. (2015).
Enhancing governance and health system accountability for people centered healthcare:
nurses deliver evidence-Based care?
Define main ideas within the title supported from the literature
Nurse instructors confront many hurdles in the present healthcare environment. Educational methods, philosophies, and the content of curricula is required to reviewed to cater to the requirements of the professional nurses who would practice in the coming millennium. (Kessenich; Guyatt; DiCenso, 25) Evidence-based practice or EBP has currently emerged to be a remarkable attribute in nursing literature along with a key impetus in restructuring nursing practice. (Elizabeth; Pyle, 64) Evidence-Based Nursing or EBN is the strategy by which the nurses formulate clinical conclusions applying the best available research evidence, their clinical skill and patient prioritization. (Evidence-Based Nursing: University of Minnesota) It could be narrated as the meticulous, unequivocal and judicious application of the current best evidences in formulating decisions about the care of individual patients. When clinicians formulate health care conclusions for a population or group…
Asking Clinical Questions: Introduction. Retrieved from http://www.poems.msu.edu/InfoMastery/Questions/Questions.htm Accessed on 18 June, 2005
Beyers, Marjorie. About Evidence-Based Nursing Practice. Nursing Management. October, 1999. Vol: 11; No: 1; pp: 103-105
Code of professional Conduct. Retrieved from http://www.nmc-uk.org/nmc/main/publications/reqForPre-regNursing.pdf Accessed on 17 June, 2005
Cronenwett, L. Research, Practice and Policy: Issues in Evidence-Based Care. Journal of Issues in Nursing. February 19, 2002. Vol: 7; No.2; pp: 57-61
Lee is only the first step in the process of building a team that is able to cover all aspects of Mrs. Lee's care. The team approach involving a social worker, nurse, physician, pharmacist, and physical therapist affords Mrs. Lee a full range of professionals attending to her various needs.
Although Mrs. Lee has a number of problems that need to be addressed the one problem that must be addressed immediately is her elevated blood pressure. Hypertension is an important risk factor for the development and worsening of many complications of diabetes and an elevated blood pressure is like walking around with a detonated bomb. Within moments, and with little warning, a diabetic patient can suffer a stroke or heart attack as a result of an elevated blood pressure. Well over fifty percent of diabetics suffer from hypertension and proper treatment of hypertension can minimize most of the tangential problems…
Calle-Pascual, A.L. (2002). A preventive foot care programme for people with diabetes with different stages of neuropathy. Diabetes Research and Clinical Practice, 111-117.
Caminal, J. And Barbara Starfield, et. al.(2004). The role of primary care in preventing ambulatory care sensitive conditions. European Journal of Public Health, 246-251.
Deichmann, R.E. (1999). Improvements in Diabetic Care as Measured by HbA1c After a Physician Education Project. Diabetes Care, 1612-1616.
Epstein, M. (1997). Diabetes and hypertension: the bad companions. Journal of Hypertension, 55-62.
Contracts with doctors often contain a clause which doesn't allow the doctors to discuss
Health care 7 with their patients financial incentives to deny treatment or about treatments not covered by the plan (Glazer, 1996). This has caused many consumers, especially those with chronic illnesses, to form organizations with the American Medical Association and physician specialty groups to promote legislation forbidding "gag rules" (Glazer, 1996). One group, Citizen Action, has 3 million members and "has been lobbying in state legislatures for laws that would require plans to disclose how they pay their doctors; give patients the right to choose specialists outside the plan; and provide appeals for patients who get turned down for expensive treatments" (Glazer, 1996).
The doctor-patient relationship is also affected if a patient must switch to a new doctor under managed care. Having a longterm relationship with a primary doctor is important because he or she is…
Bennett Clark, Jane (1996, July). What you should ask your HMO.
Kiplinger's Personal Finance Magazine. pp. 92-93.
Glazer, Sarah (1996, April 12). Managed Care. CQ Researcher, 6,
Koop, C. Everett (1996, Fall). Manage with care. Time. pp. 69.
Within this section of Chapter One, a historical perspective of NHS will be provided. This discussion will identify problem areas that have emerged in relation to NHS with an attempt made to address the manner in which such problems have historically influenced reform efforts.
With the passage and associated provisions of the NHS Act of 1946, NHS was implemented in the UK in 1948. The NHS Act of 1946 served as the means by which a pattern of health service finance and provision was established in the UK following World War II (Baggot, 1998). According to Baggot, on the basis of the Act, the principle of collective responsibility by the state for the establishment of a comprehensive health service system was introduced, allowing for the planned use of services by the entire population at no cost. It was also intended that equality of access to services would be…
Baggott, R. (1998). Health and Health Care in Britain. London, Macmillan,
Barlow, M. (1998). The Fight of My Life. Toronto: Harper Collins
BMA Central Consultants and Specialists Committee (1990). Guidance on Clinical
Directorates London: BMA.
In doing so, organizations:
advance the idea of public assurance that the organization is concerned for patient safety and the quality of care present a safe and capable work environment that adds to worker satisfaction negotiate in regards to sources of payment for care in regards to data on the quality of care pay attention to patients and their families, value their rights, and connect them in the care process as partners produce a culture that is open to learning from the timely reporting of unfavorable events and safety concerns set up joint leadership that sets precedence's for and unremitting leadership for quality and patient safety at all points (Introduction, n.d.).
In 2012 Joint Commission made quite a few changes to the 2012 accreditation decision rules. These rules present the consistent structure that the Joint Commission uses to deliver an accreditation decision limiting unpredictability or prejudice. The first thing that…
2012 Accreditation Decision Rules. (2011). Retrieved from www.jcrinc.com/common/PDFs/fpdfs/.../JCP-01-12-S8.pdf
About Joint Commission International. (2011). Retrieved from http://www.jointcommissioninternational.org/About-JCI/
Common Questions and Answers Regarding JCI Accreditation, Clinical Laboratories, and These Standards. (n.d.). Retrieved from http://www.jointcommissioninternational.org/common/pdfs/jcia/QuestionsandAnswer
Identify the three types of health organizations? Please explain
Three types of health organizations include managed services organizations (MSOs), preferred provider organizations (PPOs), and independent practice associations (IPAs). MSOs refer to organizations like Medicare, which usually serve as gatekeepers to patients by seriously limiting their choices with regards to medical care. PPOs refer to the generally contracted services, such as those garnered through the employer's plan or personal insurance. IPAs are private practices that bill directly to clients.
Identify the 4 levels of service. (hint: the 4th is rarely used)
The four levels of services include primary, secondary, tertiary, and quaternary care. Primary care is often of a routine nature, and pertains to standard procedures such as diagnostics or treatment interventions. Secondary care refers to areas of specialization in medicine. Because the consumer generally needs a referral to access secondary care, and because the consumer has usually already seen…
Others include delays in data accessibility, albeit shorter delays and the continued need for source data verification (Donovan, 2007).
Other obstacles have occurred in the developing of mobile healthcare applications. These have included mobile device limitations, wireless networking problems, infrastructure constraints, security concerns, and user distrust (Keng and Shen, 2006).
A third problem that has been encountered is that of a lack of education on not only the importance of the information technology but also training on how to use the specific pieces of equipment. The tools that are provided to people are only as good as the training that is provided on how to use them. The tools may be able to do wonderful things, but if those that are using them do not know how to get the best use out of them they will in the end be less efficient.
According to an Institute of…
Al-Assaf, Al F., Bumpus, Lisa J., Carter, Dana, and Dixon, Stephen B. (2003). Preventing Errors
in Healthcare: A Call for Action. Hospital Topics. 81(3), 5-12.
Brommeyer, Mark. (2005). e-nursing and e-patients. Nursing Management -- UK. 11(9), 12-13.
Damberg, Cheryl L., Ridgely, M. Susan, Shaw, Rebecca, Meili, Robin C., Sorbero, Melony E.,
Figure 1 portrays the state of Maryland, the location for the focus of this DR.
Figure 1: Map of Maryland, the State (Google Maps, 2009)
1.3 Study Structure
Organization of the Study
The following five chapters constitute the body of Chapter I: Introduction
Chapter II: Review of the Literature
Chapter III: Methods and Results
Chapter IV: Chapter V: Conclusions, Recommendations, and Implications
Chapter I: Introduction
During Chapter I, the researcher presents this study's focus, as it relates to the background of the study's focus, the area of study, the four research questions, the significance of the study, and the research methodology the researcher utilized to complete this study.
Chapter II: Review of the Literature in Chapter II, the researcher explores information accessed from researched Web sites; articles; books; newspaper excerpts; etc., relevant to considerations of the disparity in access to health care services between rural and urban residence in Maryland…
Potter, S. (2002) Doing Postgraduate Research. London: Sage.
Qualitative research: Approaches, methods, and rigour, (2008, Nov. 7). Microsoft PowerPoint Qualitative Research AdvC08 RS.PPT. Retrieved March 10, 2009 from www.unimaas.nl/bestand.asp?id=11629
Wolvovsky, Jay. (2008). Health disparities: Impact on Business and Economics Summit. Maryland's healthcare at a glance. The Heart of Community Health Baltimore Medical Syste. Retrieved March 10, 2009 at http://dhmh.maryland.gov/hd/pdf/2008/oct08/Jay_Wolvovsky.pdf
Management Project in the Health Care Organization Setting
This study describes the implementation of a syndromic surveillance system. The syndromic surveillance system collects and analyzes prediagnostic and nonclinical disease indicators, drawing on preexisting electronic data that can be found in systems such as electronic health records, school absenteeism records and pharmacy systems. The systems are utilized to identify specific symptoms within a population that may indicate a public health event or emergency such as signaling an outbreak of an infectious disease. school absenteeism records and pharmacy systems. The systems are utilized to identify specific symptoms within a population that may indicate a public health event or emergency such as signaling an outbreak of an infectious disease.
Informatics Management Project In The Health Care Organization Setting
Part One - Introduction
The objective of this study is to describe the implementation of a syndromic surveillance system. Syndromic surveillance systems collect and analyze…
Buckeridge, DL, et al. (2005) An Evaluation Model for Syndromic Surveillance: Assessing the Performance of Temporal Algorithm. Vol. 54 MMWR Supplement.
Chen, H, Zeng, D, Ping, Y and Ping Y (2010) Infectious Disease Informatics; Syndromic Surveillance for Public Health and Biodefense. Springer Medical 2010. Retrieved from: http://books.google.com/books?id=5BdCfSxtNJMC&dq=syndromic+surveillance+system:+state+of+the+art&source=gbs_navlinks_s
Hurt-Mullen, K and Coberly, J. (2005) Syndromic Surveillance on the Epidemiologist's Desktop: Making Sense of Much Data. MMWR Supplement 26 Aug 2005. Retrieved from: http://www.cdc.gov/MMWR/preview/mmwrhtml/su5401a22.htm
Public Meaningful Use (2013) Arkansas Department of Public Health. Retrieved from: http://www.healthy.arkansas.gov/programsServices/MeaningfulUse/Pages/default.aspx
California Clinics, an investor-owned chain of ambulatory care clinics, just paid a dividend of $2 per share. The firm's dividend is expected to grow at a constant rate of 5% per year, and investors require a 15% rate of return on the stock.
What is the stock's value?
PO = D 1 / ( KS - G )
P PO = Price
D1 = The next dividend. D1 = D0 (1 + G)
KS = Rate of Return
G = Growth Rate=D1/(Ks-G)
P = 2.10 / (15% - 5%)
P = $
Suppose the riskiness of the stock decreases, which causes the required rate of return to fall to 13%. Under these conditions, what is the stock's value?
P = 2.10 / (13% - 5%)
P = $26.25
Return to the original 15% required rate of return and assume a dividend growth rate estimate increase to 7% per year, what…
Which hospital did you select and why?
The hospital selected is Mount Sinai Hospital. The Health System is aimed to increase competences and economies of scale, enhance levels of quality and results, and develop accessibility to cutting-edge primary, specialty, and ambulatory care services all the way through a comprehensive clinical network (Mount Sinai, 2017). The healthcare organization is a general medical and surgical facility that consists of over 1,100 beds. In the past financial year, the healthcare facility admitted more than 60,000 patients. In addition, the organization conducted more than 30,000 inpatient surgeries throughout the year and over 33,000 outpatient surgeries. Moreover, the emergency room of the healthcare organization experienced over 100,000 visits. The healthcare organization is not only a facility that offers general medical care, but is also a teaching hospital. With an amazing assortment of resources for the delivery of considerate, up-to-date care, the Mount Sinai Health System…
care in regards to EM when patients go from outpatient to inpatient to specialists
The CMS (Centers for Medicare and Medicaid Services) uses the phrase 'care transition' to refer to patient transference between care settings (like hospitals, nursing facilities, home care, primary care, specialist care, or long-term patient care). Care coordination throughout the continuum of healthcare proves critical to patient treatment management, execution and assessment. Transferring health information of patients from one care location or level to another during patient transfers guarantees care continuity and fosters effective patient treatment. Direct communication between different healthcare providers is vital to smooth patient transition across healthcare settings. Partial knowledge of patient health details and absence of an EH (electronic health record) that may be accessed anywhere will restrict acute care professionals' capacity of accessing the patient's community pharmacy and ambulatory care records, especially if the professional is not the patient's primary…
Rupal Patel Mansukhani, Mary Barna Bridgeman, Danielle Candelario, & Laurie J. Eckert. (2015). Exploring Transitional Care: Evidence-Based Strategies for Improving Provider Communication and Reducing Readmissions. Pharmacy and Therapeutics, 690-694.
Sharon Silow-Carrol. (2012). Using Electronic Health Records to Improve Quality and Efficiency: The Experiences of Leading Hospitals. Commonwealth Fund.
The ole of Ambulatory Setting Nursing Staff in Discharge Planning: An Application of Driscoll's eflection Model
Nurses at all levels and in all areas of practice have been increasingly involved in developing, recommending, an carrying out patient care over the course of the twentieth and twenty-first centuries, and the rate at which knowledge and acknowledgement in the field is growing has itself picked up the pace tremendously. This can be seen in nursing research and in simple day-to-day nursing activities in standard nursing wards and situations; nurses are now often the primary care providers for patients in a variety of situations, which entails a great deal more decision-making authority and capability than was expected or granted early in the twentieth century and in decades prior. Unquestionably, nurses have now become a well-respected and well-integrated part of medical practice.
At the same time, the roles that nurses can and…
Burden, N., Quinn, D. & Dawes, B. (2000). Ambulatory surgical nursing. Philadelphia: Saunders.
Davis, N. (2010). Learning skills for nursing students. Exeter: Leanring Matters.
Lundy, K. & Janes, S. (2009). Community health nursing: caring for the public's health. Sudbury, MA: Jones & Bartlett.
Quinn, F. (2000). Principles and practice of nurse education. New York: Nelson Thornes.
Practice Experience Interviews
Interview with "Jennifer," RN, MPH, director of quality assurance at a Veterans Affairs medical center.
In a telephonic interview with this nursing professional, questions were posed concerning how research is found, accessed and applied for quality assurances purposes. According to Jennifer, Veterans Affairs medical centers (VAMCs) typically feature up-to-date medical libraries that can be used by any staff member. The library resources at this VAMC included numerous peer-reviewed journals and Internet access for additional relevant journal articles. In addition, Jennifer reported that her office had Internet access as well as access to the hospital's intranet (the decentralized hospital computer program or DHCP) that links this VAMC with other VAMCs as well as regional offices and the VA's Central Office in Washington, DC.
When queried concerning how research was applied in her practice, Jennifer noted that her office was responsible for coordinating peer reviews of questionable medical practices…
Healthcare Database for esearch and Analysis
South Carolina is amongst states that take part in the Health Cost and Utilization Program (HCUP). Sandra Kelly, the person to contact regarding all matters pertaining to the program is the Operations Manager in the Demographics and Health department. The evenue and Fiscal Affairs of South Carolina under which it operates is situated on 1919, Blanding Street in Colombia, SC 29201. (803) *** is her phone number and (803) *** her fax number. One can also contact her online through Sandra.- --, her official email-id. The data from South Carolina entails stays by inpatients from hospitals offering care for acute health. The data recorded from the hospitals does not cover a whole calendar year as some experience technical defects (SID File Composition - South Carolina, n.d.), while others close at some point in the year.
The HCUP is the state's main source of gathering…
Healthcare Cost and Utilization Project (HCUP). (n.d). Retrieved July 10, 2016, from http://www.ahrq.gov/research/data/hcup/index.html
HCUP Partners. (n.d.). Retrieved July 10, 2016, from https://www.hcup-us.ahrq.gov/partners.jsp?SASD
SID File Composition - South Carolina. (n.d.). Retrieved July 10, 2016, from https://www.hcup-us.ahrq.gov/db/state/siddist/siddist_filecompsc.jsp
components of value-based purchasing (VBP) that are most pertinent to the U.S. Department of Veterans Affairs (VA) based on its vital mission to provide high-quality health care services to the nation's veterans while identifying opportunities to reduce costs and improve efficiencies in ways that promote improved clinical outcomes in measurable ways. The study also describes the three departments of a VA medical center that will be most important in implementing VBP, purchasing services, nursing services, and ambulatory care services and provide appropriate goals for this purpose. Because the three selected departments are at different stages of their VBP implementations, the preparation needed to achieve their VBP-related goals will vary, but staff will need to be educated and trained concerning the basics of VBP and how they apply to their unique departmental situations and all three departments must develop appropriate performance measures that can be used to determine the cost-effectiveness of…
Ambulatory care. (2016). FierceHealthcare. Retrieved from http://www.fiercehealth care.com/topics/ambulatory_care.asp.
Burgess, J. F. (2011, August). Value-based purchasing in VA. VA Forum, 17.
Chernof, B. (2016, January 1). Value-based purchasing creates opportunities for effective partnerships. Aging Today, 37(1), 1-4.
Hoar, W. P. (2014, June 23). The VA proves adept at doctoring-of data. The New American, 30(12), 41-44.
Family Nurse Practitioner
The expansion of healthcare coverage through the Affordable Care Act (ACA) is expected to create an enormous increase in the number of people seeking medical treatment and healthcare. A number of demographic issues exacerbate the situation: An aging population requiring more extensive treatment and care, a rising national population, and a shortage of primary care physicians (Iglehart, 2013). The shortage of primary care physicians is one of the most crucial for national medical care because of two substantive dynamics: 1) The number of graduates from medical school who plan to enter careers as primary career physicians is currently estimated at 25%; and 2) the care that advanced practice registered nurses (APN) can provide is constrained by the current scope-of-practice laws on the books in any states (Iglehart, 2013).
An enduring tension exists between the American Medical Association and nursing advocates regarding the scope of practice that should…
Iglehart, J.K. (2013, May). Expanding the role of advanced nurse practitioners: Risks and rewards: Health policy report. New England Journal of Medicine, 368(20), 1935-1941.
National Organization of Nurse Practitioner Faculties (NONPF) (2002). Family nurse practitioner primary care competencies in specialty areas: Adult, family, gerontological, pediatric, and women's health. Pp. 21-24. U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/primarycarecomps02.pdf
Naylor, M.D. And Kurtzman, E.T. (2010, May). The role of nurse practitioners in reinventing primary care. Health Affairs, 29(5), 893-899. DOI: 10.1377/hithaff.2010.0440.
Savrin, C. (2008). Growth and development of the nurse practitioner role around the globe. Journal of Pediatric Health Care, 23(5), 310-314. DOI: 10.10.1016/j.pedhc.2008.10.005.
This is an essay converted to a powerpoint presentation on Ambulatory Service Centers.
Slide 1: Industry Overview
The Ambulatory Service Center industry is a part of the healthcare industry focused on providing same-day surgical care, including diagnostic and preventative procedures (ASCA, 2016). The industry is facing a number of challenges, including the need for increased patient turnover, but with high patient satisfaction as well.
Slide 2: A Question of Priorities
In choosing the right balance between bringing in more patients and patient satisfaction there are two dynamics to consider. One is that higher patient satisfaction is often associated with more referrals others in health care are more likely to refer to you if you have a good reputation. The other factor is that low satisfaction is associated with higher malpractice suit incidences (Stelfox et al, 2005). Given what malpractice insurance costs, let alone a successful suit, reducing malpractice risk…
Marketing in Healthcare
Catholic Healthcare West
Catholic Healthcare West (CHW) is a not-for-profit healthcare organization serving parts of Arizona, Nevada and the majority of California. With 42 hospitals it is the largest Catholic hospital system in this part of the United States. The organization focuses its services upon the poor, who cannot afford private hospital services. Regardless, the aim is also to provide high-quality healthcare to those in need. The target market is thus the poor in the western areas of the United States.
Taking into account the size of Catholic Healthcare West, it should not be a problem to implement new services without a loss of either mission or customers. New services should however be implemented with the proper care to ensure that the focus remains as originally intended.
The service management strategy of CHW has always been collaborative. y collaborating with other groups who share the vision and…
Allen, G. "New Product Development." 1999
Catholic Healthcare West. 2003. http://www.chwhealth.com/
Rice, T., B. Biles, E.R. Brown, F. Diderichsen & H. Kuehn. "Reconsidering the role of competition in health care markets." Journal of Health Politics, Policy and Law. Durham, Oct 2000
Strategic Management of a Healthcare Facility in St. Louis
In the late 1800's and early 1900's St. Louis was a major center for automotive and other heavy manufacturing but the industrial restructuring of the Midwest during the latter half of the century has resulted in consistent economic decline of the St. Louis region. Today however as the rest of the country faces a slowing economy this region is showing new signs of growth. [Kotkin, 2002] Due to changing socio-demographics, the demand for health care and advanced medical technologies is growing consistently with a concomitant rise in health expenditure. [Zhou 2001] Health expenditure in the U.S. has risen from 7.4% of the GNP in 1970 to 15% of the GNP in 1995.[Zhou, 2001] The Health care sector deals with not only the clinical medical services, but also include methods which finance them, for e.g. insurance, benefit schemes, Medicare and Medicaid. eforms…
1. Kotkin, J, 2002 St. Louis: On the Way to Somewhere? Rebuz Inc.
2. Author not available, 1997, Economic Report of the President. Government Printing Office, Washington, D.C. [accessed on 4/4/03]: http://www.umsl.edu/services/govdocs/erp/1997/chap3.htm
3.Author not available, 1996, Focus... Non-Elderly Missourians without Health Insurance, March 1996, Vol. 30, No. 1 [accessed on 4/4/03]: http://www.dhss.state.mo.us/MonthlyVitalStatistics/March96Vol30No1.html
4. Author not available, January 1999, Focus... Managed Care (MC+) in Medicaid Population, January 1999 Vol. 32, No. 11[accessed on 4/4/03] at http://www.dhss.state.mo.us/MonthlyVitalStatistics/Jan99Vol32No11.html
Healthcare Quality Management
PDCA Modeling in Healthcare
Psychiatric emergencies in medical settings may be particularly challenging since the staff does not encounter them frequently and may not have experience dealing with behavioral crisis intervention. The purpose of this exercise is to help staff improve understanding and coping with nonmedical emergencies that occur in medical settings using the PDCA cycle.
X is a 41-year-old male admitted to a medical unit with a diagnosis of possible stroke. The patient is ambulatory, 5'10," and 350 lbs. Mr. X presented to the emergency department the day before after apparently losing consciousness at home. The initial CAT scan of his head was negative. It is suspected that Mr. X may be an IV drug user since his urine toxicology screening came back positive for opiates. The medical staff thinks that Mr. X had a seizure prior to admission, but he has shown no abnormal signs…
Bennet, L., & Slavin, L. (2009, April 3). What Every Health Care Manager Needs to Know. Retrieved from Continous Quality Improvement: http://www.cwru.edu/med/epidbio/mphp439/CQI.htm
i Six Sigma. (N.d.). Focus - PDCA. Retrieved from I Six Sigma: http://www.isixsigma.com/dictionary/focus-pdca/
Pestka, E., Hatterberg, D., Larson, L., Zwygart, L., Cox, A., & Cox, D. (2012). Enhancing Safety in Behavioral Emergency Situations. Medsurg Nursing, 335-341.
" (2004, p.159) Activities have included:
(1) Development and promotion of industry-wide standards;
(2) Funding of research for investigation of the impact of IT on quality;
(3) Provision of incentives that provide encouragement of investment in IT;
(4) Giving grants to investors in IT; and (5) Development of strategies to improve the flow of information across providers. (Report to Congress, June, 2004, p.159)
Stated additionally in the Report to Congress is that there are multiple functions that must be considered when purchase IT and hundreds of applications that various vendors offer. The various IT applications are stated to be within three categories including those of:
(1) Administrative and financial systems that facilitate billing, accounting and other administrative tasks;
(2) Clinical systems that facilitate or provide input into the care process; and (3) Infrastructure that supports both the administrative and clinical applications. (Report to Congress, June 2004, p.160)
The work published…
BC Medical Association. Getting IT Right: Patient Centered Information Technology [discussion paper]. Vancouver: BCMA. 2004:39-40.
Blum E. Paperless medical record not all it's cracked up to be AMNews; 17 February 2003. Online available at: www.ama-assn.org/sci-pubs/amnews/pick_03/bica0217.htm
Brookstone A, Braziller C. Engaging physicians in the use of electronic medical records. Electronic Healthcare 2003;2:23-27.
Brookstone, Alan. 2004. Electronic Medical Records: Creating the Environment for Change. BCMJ, Vol. 46, No. 5 June 2004. Online available at: http://www.bcmj.org/electronic-medical-records-creating-environment-change
sleeping under a rock the issue of health care in the United States has been on the minds of everyone. In a society where health costs have spiraled, employer sponsored health insurance is rapidly disappearing, and millions are going untreated the overall issue of health care has everyone concerned (ichmond, 2005). Virtually no one is untouched by its reaches.
Over the last several decades the federal government has become increasingly more active in the health care field and now it is being proposed that this involvement may become more extensive as federally funded health insurance is being proposed. This involvement by the national government began during the New Deal when Social Security was originally enacted and has increased gradually ever since (James G. Haughton, 1968). Some of this involvement is obvious such as Medicare and Medicaid but other forms of involvement are less obvious such as research funding and regulatory…
Baranoff, E. (2009). Issues and Global Trends in Social Security. In E. Baranoff, Risk Management for Enterprises and Individual. Irvington, NY: Flat World Knowledge.
Callan, P. (2007). Will Higher Education pass: A test of leadership. Change, 39.
Chan, S. (2010, April 7). Bernanke Says Nation Must Take Action Soon to Shape Fiscal Future. New York Times, p. B3.
Congressional Budget Office. (2006). Immigration Policy in the United States. Washington D.C.: U.S. Government.
Managed care and utilization review (U) play an integral part in patient care and reimbursement (Mahmoud, E and ice, G, 1998). Scott echoes it experts Brian P. Bloomfield, od Coombs, David Knights, and Dale Littler (2000), who say:
IT system enjoys what one might call a special relationship with esource Management. Its role as depicted in the review is one centred on the improvements and furtherance of a 'balanced' dialogue between doctors and managers. A corollary of this is that it must be neutral politically speaking (see Bloomfield 1995). Thus the review authorizes the introduction of the new it system by subordinating it to the cause of dialogue between doctors and managers. The review represents the information requirements of hospital doctors and management and thereby portrays the it system as fulfilling a preexisting need. The narrative structure here is founded on the discovery of a state of readiness on the…
Bloomfield, B.P., Coombs, R., Knights, D., & Littler, D. (Eds.). (2000). Information Technology and Organizations: Strategies, Networks, and Integration. Oxford: Oxford University Press. Retrieved October 16, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=79104777 http://www.questiaschool.com/PM.qst?a=o&d=5001408217
Mahmoud, E., & Rice, G. (1998). Information Systems Technology and Healthcare Quality Improvement. Review of Business, 19(3), 8+. Retrieved October 16, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=5001408217 http://www.questiaschool.com/PM.qst?a=o&d=57140362
Smith, H.J. (1994). Managing Privacy: Information Technology and Corporate America. Chapel Hill, NC: University of North Carolina Press. Retrieved October 16, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=57140363
Healthcare Case Study Schuylkill County, PA
County Overview - Schuylkill County, Pennsylvania is located in the heart of the anthracite Coal region of Pennsylvania where the Schuylkill iver originates. Pottsville is the county seat, and the county showed a population of just under 150,000 as of 2010 with a density of 190 persons per square mile. The total area of the county is 782 square miles, almost all land, less than 1/2 a per cent water. The county's history, likely due to large coal deposits, focused on the railroad and industrialization (Schuylkill Chamber of Commerce, 2011).
The county experienced the high point of its population during the 1920s and 1930s, and has been losing people ever since, most between 1950 and 1970, with about a 1-2% population loss since the turn of the century. This is likely due to the lack of appropriate jobs and opportunities within the county. Schuylkill…
County Health Statistics - Healthcare 2010. (2009, March). Retrieved from Pennsylvania Department of Health: http://www.portal.state.pa.us/portal/server.pt-in_hi_groupoperator_1=or&in_hi_req_objtype=18&in_hi_req_objtype=17&in_hi_req_objtype=512&in_hi_req_objtype=514&in_hi_req_objtype=43&in_hi_req_objtype=1&in_hi_req_apps=7&in_hi_req_page=10&in_ra_topoperator=or&
Comprehensive Plan. (2010, March). Retrieved from City of Pottsville, PA: http://www.city.pottsville.pa.us/html/cp1.htm
Election Statistics. (2010, June). Retrieved from Pennsylvania Department of State: http://www.dos.state.pa.us/portal/server.pt/community/running_for_office/12704
Schuylkill County. (2010, June). Retrieved from Sperling's Best Places USA: http://www.bestplaces.net/economy/county/pennsylvania/schuylkill
Inpatient Care to Outpatient Care
Explain the advantage or disadvantage of the movement away from inpatient care to outpatient care. Do you think this trend will eventually reverse or stabilize?
Medicare's compensation solutions for out-patient as well as in-patient services and Medicare's out-patient as well as in-patient prospective payment systems (PPSs) possess a corresponding fundamental framework. The two include a basic rate revised for variations in kinds of situation or program in addition to geographic variations in income. Nevertheless, along with various systems of service, every PPS features a distinct group of compensation controls (ossi et al., 2004).
Acute in-patient compensation method
Medicare's acute in-patient PPS (IPPS) compensates medical facilities with a fixed quantity for the majority of discharges. The cost price stands out as the unit of the basic cost rate along with a related weight that demonstrates the anticipated costliness associated with cases in a specific medical category…
Barry, D.M., Luband, C.A. And Lutz, H.T. (2013). The Impact of Healthcare Reform Legislation on Medicare, Medicaid and CHIP. Accessed from: http://www.healthlawyers.org/Events/Programs/Materials/Documents/HCR10/barry_luband_lutz.pdf
Rossi, P.H., Lipsey, M.W. And Freeman, H.E. (2004). Evaluation: a systematic approach. 7th edition, Thousand Oaks: Sage Publications.
Based upon the fact the baby boomers are all approaching retirement age, it would be a good idea for the organization to pursue programs that are geared towards seniors. Programs that are geared towards seniors are a great way to produce quality comprehensive health care for those in the community that need it. The organization might pursue the idea of opening a PACE program. " The Program of All-Inclusive Care for the Elderly (PACE) is a capitated benefit authorized by the Balanced Budget Act of 1997 (BBA) that features a comprehensive service delivery system and integrated Medicare and Medicaid financing" (Program of All Inclusive Care for the Elderly (PACE), 2009). The PACE program features complete medical and social services that rely on an interdisciplinary team approach in an adult day health center that includes in-home and referral services depending on the person's needs (Program of All Inclusive Care for the…
Baker, J. Judith & Baker, R.W. (2006). Healthcare Finance, Basic Tools for Nonfinancial
Managers. Maryland: Aspen Publications, Inc.
Bury, Elizabeth, Carter, Kara S., Feigelman, Masha and Grant, Jennifer M. (n.d.). Retrieved June
2, 2009, from Web site:
In 2004, a Ten-Year Plan to Strengthen Health Care was announced, primarily intended to improve access to medical services, decrease wait times, and update medical equipment and ensure accurate reporting and enhance public health promotion and prevention programs. Shortly thereafter, the Canadian Supreme Court affirmed the nation's health care philosophy and the immediate need to implement further improvements envisioned by the ambitious 2004 plan in striking down a Quebec law that had prohibited private medical insurance for covered services:
The evidence in this case shows that delays in the public health care system are widespread and that in some serious cases, patients die as a result of waiting lists for public health care...In sum, the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services."
According to legal experts, the decision could "open the door to a wave of lawsuits challenging the…
Canadian Medical Association Journal.
1939 September; 41(3):
Chaoulli v. Quebec: Judgments of the Supreme Court of Canada Accessed, September 2, 2007, at http://scc.lexum.umontreal.ca/en/index.html
Kraus, C. (2005) Canada's Supreme Court Chips Away at National Health Care.
Health Care -- Regulatory Scheme and Licensure Requirements -- Operating a Health Care Organization
California's licensing process for health care organizations is governed by the State's Health and Safety Code, with responsibility for licensing, licensing, inspecting, regulating and/or certifying shouldered by State and Federal agencies. In a straightforward yet rigorous process aided by online application packets and checklists, these agencies are intent on ensuring compliance with State and Federal laws and regulations.
The process for becoming licensed to operate as a health care organization in California is governed by §1200 -- 1209 of the California Health and Safety Code (California State Legislature, 2003). These code sections broadly deem the term "clinic" or "primary care clinic" to mean an "organized outpatient health facility," whether a community clinic, free clinic, specialty clinic or clinic corporation required to be licensed (California State Legislature, 2003). The requirements and processes outlined in these code sections…
If the area wage index is greater than 1, the labor share equals 69.7%. The law requires the labor share to equal 62% if the area wage index is less than 1.0.
2) the wage adjusted labor share is added to the non-labor share of the standardized amount.
3) the wage adjusted standardized amount is multiplied by a relative weight for the DG. The relative weight is specific to each of 746 DG's (for fiscal year [FY] 2009) and represents the relative average cost of a beneficiary in one DG compared to another.
4) if applicable, additional amounts will be added to the IPPS payment for hospitals engaged in teaching medical residents, hospitals that treat a disproportionate share of low income patients, and for high cost outlier cases" (Acute Inpatient Prospective Payment System, 2009).
Physician services include office visits, surgical procedures, and other diagnostic services. These services are usually performed…
Acute Inpatient Prospective Payment System. (2009). Retrieved April 2, 2009, from Centers
for Medicare and Medicade Service Web site:
Physician Services Payment System. (2008). Retrieve April 3, 2009, from MedPac Web site:
The delivery health care system takes into account the assimilation of physicians, healthcare facilities, together with other medical services with plan to facilitate the provision of the total continuum of medical care for its consumers. In a whole incorporated system, the three fundamental components including physicians, medical facilities and the membership to health plans are counterpoised in terms of equating medical resources with the necessities of patients and purchasers (Coddington, Moore, and Fischer., 1994). One of the key concerns in the present delivery of healthcare is cost. Increasing costs of healthcare has been a major worry in the past number of years, making the United States to have one of the most expensive systems of healthcare. The main objective of this paper is to analyze the different costs linked to healthcare delivery system, and delineate the manner in which these costs impact different populations and how it also affects…
Experts in the field claim that the activity of accreditation represents a key mechanism to evaluate healthcare facilities' performance and enhance care delivery safety and quality. The term "accreditation" describes the external assessment process for evaluating hospitals' and other healthcare centers' performance by studying their adherence to a number of pre-established, well-defined written performance benchmarks. It aims at encouraging ongoing quality improvements instead of merely upholding least-required performance levels. Accreditation also refers to public approval that stems from a healthcare institution's achievement of certain care standards, validated following an autonomous external organizational performance appraisal. (Jaafaripooyan, Agrizzi & Akbari-Haghighi, 2011). This paper addresses the purpose of accreditations and related costs.
A summary of the purposes of accreditation and accreditation standards
Organizations duly accredited, are recognized as trustworthy and reliable entities committed to constant, long-term adherence to top quality standards. Accreditation is considered an important point of reference when it comes to…
Passion Home Health is a provider of home health care services in Camarillo, CA. The company`s challenge typically revolves around a shortage of care workers given the number of clients. There are two sides to this issue - one is the demand side. That challenge can be addressed in a different ways, but ultimately the goal of management is to have as many clients as possible for the capacity that it has. Thus for this task, the challenge will be on the supply side, for labor. It will be assumed that there will be sufficient demand for whatever the optimal labor configuration is going to be.
Care givers come in a number of different varieties, with different degrees of training. They typically visit the home site of the client. They perform a variety of duties for the client, including sometimes daily chores, for other care givers more of physiotherapy,…
Signature 410-Non-Profit Healthcare Organization-A Comprehensive Study
Catholic Health Initiatives (CHI) is a non-profit organization that consists of four separate national Catholic health systems that were combined under CHI over the past three decades. CHI offers assisted living services, nursing home services, memory care, rehabilitation care, hospital care, adult day care services, and many other health care services around the nation. It has recently merged with Dignity Health becoming one of the largest health services conglomerates in the U.S. This paper will discuss the marketing strategies employed by CHI, its financial situation, partnerships and strategic planning.
The marketing strategies used by CHI include TV, digital-marketing with content and social media, print ads and even outdoor advertising to help make CHI more popular among the different communities throughout the states in which it operates (CHI, 2018). As Doster (2013) and Jackson (2011) show, social media is one of the…
Financial Management in Healthcare
Medicare and Medicaid are programs run by the government and which provide medical services as well as services that are health care related to particular groups of individuals in the United States. It is imperative to note that these two programs are exceedingly dissimilar but are supervised and overseen by the Centers for Medicare and Medicaid Services which is a department that is found within the Department of Health and Human Services of the United States. The origin of these two programs dates back to the year 1965 when they were created after President Lyndon B. Johnson signed changes to the Social Security Act (Crosta, 2015) for the national health care program. This program was principally created at the time when individuals who were aged 65 years and above found it impossible to obtain private coverage for health insurance. In particular, this was a time when…
Wareham, T. (2014). Funding the Transformation: Three financial considerations will shape hospitals' transition success. Trustee.
Scamperie, K. (2013). The fee-for-service shift to bundled payments: financial considerations for hospitals. Journal of Health Care Finance 39(4):55-67.
Addicott, R., Buck, D., Goodwin, N., Harrison, T., Ross, S., Sonola, L., ... & Curry, N. (2013). Transforming our health care system. The King's Fund.
Often, these disparities take on a cultural, age, or gender role. When combined with the financial barriers that block health care (whether or not the individual has insurance or not), it is one of the most risky segments of 21st century healthcare. This is quite ironic because over the last century so many improvements have been made in the field of disease prevention, public health, and approaches to health care. Even in the last few decades the country has matured in its approach to STDs and the HIV epidemic. Yet still, while we recognize that the brain is the very locus of the human "being" and while we know more today about treating mental illness effectively, rapidly, and with typically positive results, we still tend to stigmatize this segment of society with inadequate care, difficult access to that care, or in some rural or smaller towns and cities, zero access…
Public Health and Aging. (2003, Febuary 14). Retrieved August 2011, from CDC Weekly: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5206a2.htm
Mahant, S., Peterson, R., & Campbell, M. (2008, May 1). Reducing Inappropriate Hospital Use on a General pediatric Inpatient Unit. Retrieved August 2011, from Pediatrics: http://pediatrics.aappublications.org/content/121/5/e1068.full
Neumann, R. (2010, April 8). Top 10 Reasons NOT to plan for retirement. Retrieved August 2011, from Northjersey.com: http://www.northjersey.com/news/business/business_opinion/90328449_Top_10_reasons_to__not__plan_for_retirement.html
Paul, J.S. (2006, March). New Measures of Ambulatory Care. Retrieved August 2011, from Hosptiral Report HRRC: http://hospitalreport.ca/downloads/otherreports/SNAPSHOT_REPORT_Amb_FINAL.pdf
In an acute care setting, such Veterans Affairs, this objective is executed by educating patients about how to maintain a healthy diet and lifestyle after the leave the facility, while in a long-term care setting-such as Cobble Hill-this objective is executed on a daily basis by providing nutritious meals for elderly residents. And finally, in an ambulatory, out-patient care setting-such as Atlantic -- the clinical nutritionist works to support patients in maintaining a diet that addresses their personal healthcare needs, while still living independently within a larger community. Perhaps the most significant similarity between facilities is the notion of nutrition as merely one component of a comprehensive care program; hence the necessity of a clinical nutritional to work in conjunction with a full medical, administrative, and social support staff. The apparent goal of such an approach is to promote multiple aspects of health and well-being among patients, regardless setting or…
Cite Health. (2010). Long Island College Hospital. Retrieved December 19, 2010 from http://citehealth.com/dialysis-centers/new-york/cities/brooklyn/long-island-college-hospital
Cobble Hill Health Center. (2010). Resident Services. Retrieved December 19, 2010 from http://www.cobblehill.org/services
United States Department of Veterans Affairs. (2010). Patient Information. Retrieved December,
19, 2010 from http://www.brooklyn.va.gov/patients/index.asp
Ethical Issues Surrounding the Adoption of Electronic Health Records (EHR) by Health Care Organizations and Meaningful Use
The objective of this work in writing is to examine why health care organizations are hesitant to adopt electronic health records (HER) in light of the potential of HER to improve quality, increase access, and reduce costs. This issue will be examined from a legal, financial, and ethical standpoint and in relation to 'meaningful use'.
The use of information technology in the health care field shows a great deal of potential toward improving quality, efficiency, and safety in medical care. (DeRoches, Campbell, and Rao, 2008, paraphrased; Frisse & Holmes, 2007, paraphrased; and Walker, et al., 2005, paraphrased) The American Recovery and Reinvestment Act (ARRA) of 2009 is reflective of the unprecedented interest of the Federal government in the area of bringing about increases in the use of IT in health care for system…
A New Hospital EMR Adoption assessment Tool (2012) HIMSS Analytics. Retrieved from: http://www.himss.org/content/files/EMR053007.pdf
American Recovery and Reinvestment Act of 2009. Available athttp://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h1enr.pdf. Accessed 5 August2010.
Daniel, J. And Goldstein, MM (2010) Consumer Consent Options for Electronic Health Information Exchange: Policy Considerations and analysis. 23 Mar 2010.
DesRoches CM, Campbell EG, Rao SR, et al. Electronic health records in ambulatory care -- a national survey of physicians. N Engl J. Med 2008; 359:50 -- 60.
There are no deductibles and no user fees nor limits to contributions on the plan. There are also no restrictions on services to be used and no premiums to pay for basic care coverage other than taxes, a far cry from the high deductibles, co-pays and other fees associated with health care in the United States.
Key to this point is the idea that Canadian health care costs less because a large portion of it is publicly financed. The author's note that since Canada adopted their universal healthcare system the Canadian Health Act has implemented a policy of public administration which keeps the cost of health care spending lower and maintains the government's ability to provide health care services to the entire population. The authors argue that public administration is a more optimal choice for keeping health care expenditures down because administration is inexpensive.
U.S. hospitals keep more details of…
Armstrong, Hugh; Armstrong, Pat; Fegan, P. (1998). "The Best Solution: Questions and Answers on the Canadian Health Care System." Washington Monthly, Vol. 30, Issue 6, p. 8
Clark, Cal & Mceldowney, Rene. (2000). "The Performance of National Health Care Systems: A "Good News, Bad News" Finding for Reform Possibilities." Policy Studies Review, Vol. 17, Issue 4, p. 133
Grubaugh, S.G. & Santerre, R.E. (1994). "Comparing the Performance of Health Care Systems: An Alternative Approach." Southern Economic Journal, Vol. 60, Issue 4, p. 1030
Martens, Pim. (200). "Health Transitions in a Globalising World: Towards More Disease or Sustained Health?" Futures, Vol. 34, Issue 7, p. 635+
Schneck Medical Center
Provide a description of the company, its mission, and values
SMC (Schneck Medical Center) is a nonprofit healthcare organization that provides specialized and primary care services. The center was established in 1911 with a donation of five thousand dollars and a land from Mary Schneck (Jcr, 2007). It was established in memory of the founder's Husband to provide healthcare requirements to people of Jackson County. Initially, the center had a seventeen-bed capacity but it has now developed to ninety five-bed capacity. SMC celebrated its 100th centenary in 2011. This medical center is located in Jackson Country where it provides medical services to people of this area and the surrounding communities. Schneck Medical Center provides a full continuum of primary care services (Jcr, 2007). Particularly the medical center focuses on the health of women, noninvasive cardiac care, bariatric surgery, cancer care and joint replacement. Schneck Medical Center provides…
Biller, J. (2008). The interface of neurology & internal medicine. Philadelphia: Wolters Kluwer Health/Lippincott Wiliams & Wilkins.
Cribb, A. (2005). Health and the good society: Setting healthcare ethics in social context. Oxford: Clarendon Press.
Rahman, N., & de Feis, G.L. (2009). Strategic decision-making: models and methods in the face of complexity and time pressure. Journal Of General Management, 35(2), 43-59.
Johnson, K., Uecke, R., & Austin, R.(2006). The essentials of project management. New York: Harvard Business Press.
Martin Army Medical Center, Fort Benning, Georgia and St. Francis Medical, Columbus Georgia
Because resources are by definition scarce, it is important for tertiary healthcare providers to develop healthcare delivery structures that are efficient and effective. Since every healthcare organization is unique, though, these delivery structures can vary widely in scope and purpose. To gain some fresh insights into the healthcare delivery structures that are used by civilian and military health facilities, this paper provides a comparison of Martin Army Medical Center at Fort Benning, Georgia with St. Francis Medical in Columbus, Georgia, followed by a summary of the research and important findings in the conclusion.
eview and Comparison
Martin Army Medical Center, Fort Benning, Georgia
Health care delivery structure. Opened in 1958, this is a U.S. Department of Defense facility operated by the U.S. Army that offers inpatient, outpatient and emergency services. At present, Martin Army Medical Center 250-bed,…
About St. Francis Hospital. (2012). St. Francis Hospital. Retrieved from http://www.
About us. (2012). Martin Army Community Hospital. Retrieved from http://www.martin.
(3) Goal 13A states that the means for patients and their families should be defined and communicated in regards to reporting of concerning about safety and that encouragement should be provided for them to follow through on this.
(4) Goal 15 states that the organization "identifies safety risks inherent in its patient population; and (5) 15A states "The organization identifies patients at risk for suicide. [Applicable to psychiatric hospitals and patients being treated for emotional or behavioral disorders in general hospitals -- NOT APPLICALE to CRITICAL ACCESS HOSPITALS] (the Joint Commission, 2009)
Stated as the only change to the 2007 Disease-Specific Care National Patient Safety Goal is the noted change to 8 which adds that the complete list of medications is provided to the patient upon discharge from the health care facility. (the Joint Commission, 2009)
The work of Cooper (2009) entitled: "NYC Hospital to Educate Patients Using Opinionmeter Survey…
Stoessel, Kathleen B. (2009) the Joint Commissions' National Patient Safety Goals: Implications for Infection Preventionists. Virgo Publishing. 2009 July 08. Online available at: http://www.vpico.com/articlemanager/printerfriendly.aspx?article=252020
Powell, Stephen M. (2009) Can the Ambulatory Care Setting Learn Lessons from Other High Risk Domains. Advocate MD. Online available at: http://www.advocatemd.com/downloads/risk_management/CantheAmbulatoryCareSettingLearnLessons.pdf
2007 Home Care National Patient Safety Goals (2006) the Joint Commission 1 June 2006. Online available at: http://www.jointcommission.org/ PatientSafety/NationalPatientSafetyGoals/07_ome_npsgs.htm
2007 Disease-Specific Care National Patient Safety Goals (2006) the Joint Commission 1 June 2006. Online available at:
There are various applications of the FID technology in the healthcare. These are explored by a HIBCC,(2006 ) report that studies the application of the FID technology in the healthcare setting with emphasis on its benefits, limitations as well as recommendations The report categorically pointed out that that the applications of the FID technology in the health care settings are numerous. They range from being used in the management of the hospital's supply chain to the management of the patients themselves. In terms of the supply chain management, the FID technology can be used in the organizing the delivery of supplies such as pacemakers, artificial limbs as well as defibrillators. This is because the supply chain of these crucial items is very complicated and requires the timely delivery of the consignments. The high degree of traceability that is needed to track the shipments from the supplier up to the time…
Anonymous (2004), RFID in the hospital, in RFID Gazette. July 15,
Aarts, J., Doorewaard, H., and Berg, M.(2004), "Understanding implementation: the case of a computerized physician order entry system in a large Dutch university medical center," Journal of the American Medical Informatics Association, vol. 11, no. 3,
Chin-Yin,(2000)RFID-Enabled Analysis of Care Coordination and Patient Flow in Ambulatory Carpp. 207-216.
Prior to Launching Technology Initiatives
Over the past seven years, many healthcare organizations, like OUUCH, have begun to transition from the traditional paper-based systems to EH systems. esearch has shown that over a period of time. EH systems can improve quality of care for patients, provide more accurate information, and overall improve safety issues relating to reducing mistakes with patients. In the exploratory study, "Change factors affecting the transition to an… [EH] system in a private physicians' practice: An exploratory study," Aaron D. Spratt, Social Security Administration and Kevin E. Dickson (2008), Southeast Missouri State University, report that the U.S. health care industry reportedly ranks among the world's leading inefficient information enterprises. Although the system needs major changes, the transition process however, creates a high change in the business aspect of an organization. Spratt and Dickson (2008) explain that for an EH system to be successful, doctors must be involved…
Amatayakul, M. (2009). EHR vs. EMR: what's in a name? Healthcare Financial
Management. Healthcare Financial Management Association. Retrieved May 13, 2010
from HighBeam Research: http://www.highbeam.com/doc/1G1-202487730.html
Bennett, D. (2009). EMR market includes small and large system vendors. Managed Healthcare
" (MediLexicon International, Ltd., 2006).
The PCIP was formed from the recognition that high costs and low quality inherent in the Healthcare system of the U.S. is largely due to a system that is antiquated and fragmented (DOHMH, 2006a). The inability to properly collect and use health information is one of the primary problems associated with proper health care maintenance. The PCIP. was formed in response to this need. The primary care physician acts as the conduit between the patient and the healthcare system. However, the physician often has no means to effectively transmit the information that they collect to other entities within the system. The PCIP grew out of a need for the primary health care Physician to be able to transmit the needed information to others in the Healthcare system.
There are three essential parts to the PCIP. The first is the Primary Care Health Information Consortium (PCHIC).…
Department of Health and Mental Hygiene. (DOHMH) 2006. PCIP. Retrieved August 30 at http://www.nyc.gov/html/doh/html/pcip/pcip.shtml
DOHMH 2006b. Primary Care Health Information Consortium (PCHIC). Retrieved August 30 at http://www.nyc.gov/html/doh/html/pcip/pcip-pchic.shtml.
MediLexicon International, Ltd. (2006). 1,000 New York City Doctors Will Get Electronic Health Records Systems. Retrieved August 30 at http://www.medicalnewstoday.com/medicalnews.php?newsid=42483
The American Health Quality Foundation (AHQF)(2006). Quality Improvement Organizations and Health Information Exchange. March 6, 2006. Retrieved August 30 at http://www.ehealthinitiative.org/assets/documents/QIOHIEFinalReportMarch62006.pdf#search=%22Health%20care%20information%20management%20PCIP%22
Effective communications between doctors and nurses has always been a high priority in the medical field, especially in an arena such as a hospital, health clinic or hospice. Communicating effectively between the nurses and the doctors is especially important in a hospice setting due to the fact that the patient is usually suffering the most; both with the physical and the emotional pain and suffering that is being experienced as the patient nears death.
One recent study determined that "doctors and nurses have different but complementary roles in what, when and how treatment choices are negotiated with patients" (Mccullough, Mckinlay, Barthow, Moss, Wise, 2010, p. 482) and the treatment choices when facing death are decisions that should not be taken lightly, either by the involved nurses or the doctors. The decisions taking place in the hospice setting will often determine how much pain and suffering the patient will endure…
Basch, E.; (2010) The missing voice of patients in drug-safety reporting, New England Journal of Medicine, Vol. 362, Issue 10, pp. 865-869
Bezzina, A.J.; (2009) Prevalence of advance care directives in aged care facilities of the Northern Illawarra, Emergency Medicine Australia, Vol. 21, Issue 5, pp. 379 -- 385
Byrnes, J.; Braden, J.; James, G.; Broadus, T.; Owen, R.; (2011) Implementing an electronic medical record (EMR) in an integrated delivery system Sharp Healthcare (SHC) San Diego, California, accessed on September 25, 2011 at http://proceedings.amia.org/1alo2n/
David, S.E.; Ahmed, Z.; Salek, M.S.; Finlay, A.Y.; (2005) Does enough quality of life related discussion occur during dermatology outpatient consultations? The Journal of Dermatology, Vol. 153, pp. 997 -- 1000
Early Detection and Management of Diabetic Neuropathy in a Clinical and Homecare Setting
The objective of this study is to examine early detection and management of diabetic neuropathy in a clinical and homecare setting and specifically through examination of articles published after 2002. The information from each source will be summarized listing the strengths and weaknesses of each article in separate paragraphs. As well, this work will utilize table or graphs to present the findings.
O'eilly, Caryl Ann (2005) Managing the Care of Patients with Diabetes in the Home Care Setting, Diabetes Spectrum, July 2005. Vol. 18. No. 3. etrieved from: http://spectrum.diabetesjournals.org/content/18/3/162.full
The work of O'eilly (2005) reports that more patients than ever before are released earlier from hospitals and rehabilitation center and that those with diabetes are included in this trend. Diabetes is reported to be ranked second following congestive heart failure as the primary diagnosis at…
Zieger, Anne (2009) Studies Offer Mixed Grades for Remote Diabetes Care. 6 July 2009 Retrieved from FierceHealthIT at: http://www.fiercehealthit.com/story/studies-offer-mixed-grades-remote-diabetes-care/2009-07-06
O'Reilly, Caryl Ann (2005) Managing the Care of Patients with Diabetes in the Home Care Setting, Diabetes Spectrum, July 2005. Vol. 18. No. 3. Retrieved from: http://spectrum.diabetesjournals.org/content/18/3/162.full
McLaughlin, Sue (2005) From Research to Practice/Diabetes Care in Special Settings: Meeting the Challenges: Diabetes Care in Special Settings Diabetes Spectrum July 2005 18:143-145. Retrieved from: http://www.vnsny.org/research/projects/1_implemetation.html
Sunrise Clinical System Version 6.1
The Emergency Room: Hybrid System
Meetings and Collaborative Care Councils
orkflow of the EMR
The KBC ( Knowledge Bas Charting) 3.4 Upgrade 6
The Role of the Nurse Informaticist
Comprehensive Analysis of my Clinical Experience
After completing 100 hours of practicum in informatics, the following will show the time at the site with my preceptor. The practicum took place at Franklin Hospital - North Shore Long Island. North Shore-LIJ which is an award-winning health system that consist of world-class tertiary hospitals, a nationally well-known children's hospital, a notorious mental facility and an assortment of community hospitals, in addition to a range of wellness and health programs. North Shore-LIJ Health System consist of 16 award-winning hospitals and approximately 400 physician practice locations all through New York, as well as Long Island, Manhattan, Queens and Staten Island. North Shore-LIJ Proudly serving an area of seven…
North Shore-LIJ Health System. (2014, April 29). Retrieved from North Shore LLJ: http://www.northshorelij.com/hospitals/services-and-programs/bariatric-surgery
Russell, C.L. (2010). A clinical nurse specialist -- led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement. Clinical Nurse Specialist, 24(2), 69-75. doi:10.1097/NUR.0b013e3181cf554d
Seidl, K. L. And Newhouse, R.P. (2012). The Intersection of evidence-based practice with 5 quality improvement methodologies. JONA, 42(6), 299-304. doi: 10.1097/NNA.0b013e31824ccdc9
Smith, K., Tremblay, M.L., Richer, M.C., and Lanctot, S. (2010). Exploring nurses perceptions of organizational factors of collaborative relationships. The Health Care Manager, 29(3), 271-278. Doi:10.1097/HCM.0b013e3181e9351a
Community/Organization of Interest:
Health and medical services in Bella Vista, PA, a South Philadelphia neighborhood
The cultural perspective
Bella Vista, PA, a South Philadelphia neighborhood, is a largely Italian-American ethnic enclave dominated by white, working-class residents. Although recent scholarly literature has focused upon the deficit of healthcare knowledge and services in lower-income nonwhite populations, deficits in knowledge and willingness and ability to access vital resources to improve their health still persist across population groups. For example, one study of non-Hispanic and Hispanics found that there were high levels of systemic barriers to obtain colorectal screening, including: scheduling and financial barriers; fear of diagnosis and pain; and lack of motivation amongst all study participants (Green et al. 2008). Culturally and psychologically in many communities, there is often an unwillingness to seek medical treatment in the form of screening. Even though Bella Vista is not a poor community cultural attitudes towards healthcare…
Breen, T. (2013). Overview of the 2013-2014 Medicaid payment increase for primary care services. The Advisory Board Company. Retrieved:
Brown, E.R. (et al2004). Effects of community factors on access to ambulatory care for lower-
income adults in large urban communities. Inquiry - Excellus Health Plan, 41(1), 39-56.
Healthcare: A focus on Leadership, Culture, and Systems
HEALHCARE: A FOCUS ON LEADERSHIP
As organizations are growing progressively competitive, it is very clear that the need to even extend to other entry modes really does vary considerably in positions of not only price experienced by companies but likewise benefits and drawbacks. his capstone will discuss the relevance of how a more holistic change management approach will be needed to include new leadership models, organizational transformation, and driving towards a "system-ness culture. In today's changing healthcare environment, cost pressures are at an all time high. oo often, most health systems are focused on reducing costs via improving operational efficiencies, which is extremely important.
It is also becoming more and more obvious that all organizations are out their facing challenges that come from within the business; for instance, an establishment's internal environment may be affected by inadequacies, changes in the workforce, or…
Taylor HA, G.B. (2013). A conceptual model for transformational clinical leadership withinprimary care group practice. Journal of Ambulatory Care Management, 89(56), 345-356.
Uding, N.K. (2009). Parent and community participation in program design. Clinical Nursing Research, 18(4), 68-79.
Zarubi, K.L. (2012). Putting patients and families at the center of care. Journal of Nursing, 38(6), 275-281.
Smart Card Health Role in Rational Use of Medicines
The objective of this study is to examine the role of smart cared in health and their role in the rational use of medicines. Smart cards are very small and very secure and serve to protect patient privacy. Smart cards contain digital logs with location, date, time, and the individual's stamp to record every transaction. Smart cards also may contain digital prescriptions therefore mistakes made with prescriptions that are handwritten are eliminated and specifically as to the "quantity or quality of medications." (HealthOne, 2011)
How the Smart Card Works
The smart card uses technology that stores a patient's personal health information on a microprocessor chip embedded in the card that is the size of a credit card but that has a "small metal contact plate on the front which is how the reader accesses the medical information stored on the chip"…
Benjamin, DM (2003) Reducing Medication Errors and Increasing Patient Safety: Case Studies in Clinical Pharmacology. J Clin Pharmacol 2003 Jul;43(7):768-83.
Hsu, MH (2011) Online detection of potential duplicate medications and changes of physician behavior for outpatients visiting multiple hospitals using national health insurance smart cards in Taiwan. Int J. Med Inform. 2011 Mar;80(3):181-9. Epub 2010 Dec 22.
Hsu, MH, Li, YC, and Liu, CT (2006) ADRs and Smart Health Cards. CMAJ Aug 15, 2006 Vol. 175 No. 4. Retrieved from: http://www.cmaj.ca/content/175/4/385.1.full
Runciman, WB et al. (2003) Adverse Drug Events and Medication Errors in Australia. Int J. Qual Health Care 2003, Dec;15 Suppl 1:i49-59.
Veteran/Purple Heart Recipient
Highly qualified and well-rounded healthcare administrator that has a strong and diverse background in healthcare, operations, facility management, strategic planning, Lean, healthcare development and redesign background. This includes sixteen years of hands-on patient care experience as well as over ten years' experience successfully providing executive level leadership in clinical, administrative, facility planning and overall hospital disciplines. Highly skilled with implementing and managing complex issues at all levels in order to plan, develop, organize, decipher and perfect policy. Able to evaluate hospital-wide operational management programs and needs. Sixteen years of in-depth management experience with healthcare-related development projects for both ambulatory and non-ambulatory settings throughout all disciplines of healthcare. Active security clearance.
PROFESSIONAL STRENGTHs & CERTIFICATIONS
• BLS certified
• HIPAA-Trained & Certified
• Certified in Food Protection and Safety
• Advanced skills with Microsoft Office, Defense Medical Logistics Standard Support Automated Information System, Armed Forces Health…
CQI is often seen as more forward- or futures-based compared to TQM, which is more of a series of techniques and initiatives to unify an organization around a common theme of quality and performance to customers' expectations (Lonial, Menezes, Tarim, Tatoglu, Zaim, 2010).
Unique Contributions To Quality Each Provides
TQM is ideally used for enterprise-wide shifts in strategy to be more quality and customer-driven while CQI is more oriented toward a specific process or strategy area where statistical analysis can be used to define parameters and predict an outcome based on improving quality. Of the two, CQI can deliver more immediate impact within a healthcare organization as it defines a specific strategy within a given process area. TQM on the other hand is better for redefining an entire corporate culture and making it more quality-based (Talib, ahman, Azam, 2011).
Implications for the Quality of Health Care
CQI is best suited…
Lonial, S., Menezes, D., Tarim, M., Tatoglu, E., & Zaim, S.. (2010). An evaluation of SERVQUAL and patient loyalty in an emerging country context. Total Quality Management & Business Excellence, 21(8), 813.
Suchy, K.. (2010). A Lack of Standardization: The Basis for the Ethical Issues Surrounding Quality and Performance Reports. Journal of Healthcare Management, 55(4), 241-51.
Talib, F., Rahman, Z., & Azam, M.. (2011). Best Practices of Total Quality Management Implementation in Health Care Settings. Health Marketing Quarterly, 28(3), 232.
Mosad Zineldin, Hatice Camgoz-Akdag, & Valiantsina Vasicheva. (2011). Measuring, evaluating and improving hospital quality parameters/dimensions - an integrated healthcare quality approach. International Journal of Health Care Quality Assurance, 24(8), 654-662.
Each standardized nursing language is designed for use in a number of clinical settings, including home care, ambulatory care, and inpatient treatment, with certain languages providing decided advantages within particular circumstances. Although it is true that "improved communication with other nurses, health care professionals, and administrators of the institutions in which nurses work is a key benefit of using a standardized nursing language" (utherford, 2008), the proliferation of several nursing languages throughout the years has inevitably resulted in discrepancies, wherein the personal preferences of nurses, the policy of a hospital's corporate ownership, or other factors determine when, where, and why a specific language is used.
To address the growing concern over the inability of nurse's to communicate through a single standardized language system, the International Council of Nurses (ICN) commissioned a comprehensive study which resulted in the International Classification for Nursing Practice (ICNP) being selected as the most advantageous option.…
Cho, I., & Park, H. (2006). Evaluation of the expressiveness of an ICNP-based nursing data dictionary in a computerized nursing record system. Journal of the American Medical Informatics Association, 13(4), 456-464. Retrieved from http://22.214.171.124/content/13/4/456.full
Rutherford, M. (2008). Standardized nursing language: What does it mean for nursing practice?. OJIN: The Online Journal of Issues in Nursing, 13(1), 57-69. Retrieved from http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/H ealth-it/StandardizedNursingLanguage.html
While the internal and general environments are pretty clear in this case and have previously been discussed, primarily through the necessary balance between the organization's resources and its projected initiatives, the task environment considers some of the external factors that may have an influence, in this case potential legislative acts that can award more funding to hospitals etc.
There is probably another very important part of the analysis of these strategic initiatives: sustainability. Besides correlating the vision and strategic objectives with the strategic initiatives here presented, the decision makers will also need to analyze the existing resources and decide on whether the hospital has the capacity and resource to develop some of these initiatives. If not, the decision makers can also analyze whether some of these initiatives could still be supported from third parties. Different fundraisers could be used to gather funds for developing the perinatal center, for example, as…