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Institute Healthcare Improvement http://www.ihi.org / familiarize nursing quality indicators. How quality indicators reflect quality nursing practice? #2) Visit a website Institute Healthcare Improvement http://www.
Nursing quality indicators
How quality indicators reflect the quality of nursing practice
The link between quality of nursing practice and patient outcomes has been demonstrated through research. Over 1,000 facilities in the U.S. have contributed to the growing database on nursing quality indicators in order to help improve the quality of nursing care given to patients. A review of the history and evaluation of nursing care quality has shown that the nursing indicators have helped to strategize patient outcomes to become nursing-sensitive and to measure the value of care provided to patients. Nursing in its professional definition and guidelines requires the nurses to evaluate and improve their practice. This helps the nurses to recognize the sufficiency of their practice and improve their role in patient safety…
healthcare administration and governance is medical staff credentialing and "delineation of privileges." As a senior manager, you will be directly involved in making sure that physicians practicing in your organization are qualified for the services they offer and procedures they perform. You must protect patients' safety as highest priority in this regard. hat steps will you take in the process of physician credentialing and delineation of privileges for your hospital or clinic?
The delineation of privileges may be one of the most important aspects to healthcare management. If the professionals that are tasked with treating patients are not properly trained or qualified then it is likely that patient care will suffer. Therefore, credentials for the delineation of privileges must be designed individually based on the particular roles of the employees in the organization. They should also follow best practices and national standards. Each position in the hospital should be designed…
Haynes, D. (2008, September 13). What Nurses Want. Retrieved from The Washington Post: http://www.washingtonpost.com/wp-dyn/content/article/2008/09/12/AR2008091203367.html
MMC Case Study
Major Problems and Secondary Issues
Organizational Strengths and Weaknesses
Alternatives and ecommended Solution
In the early 1990's a new Medicaid managed care company, MMCC, set up shop in the neighborhood right across the street from a major medical center in downtown Baltimore that served many poor patients. The company seems to have embarked on a strategy to maximize its revenues without providing a value to their patients. They are compensated when they enroll new patients and thus they have an incentive to grow their client base. However, they are expected to provide services to the patients under their care. MMCC has taken steps to create bottlenecks for the patients to receive healthcare services so that they can maximize short-term profits.
Major Problems and Secondary Issues
All companies must have a strategy that creates a return on investment for their stakeholders. Some companies focus on maximizing profits…
Bass, B. (1985). Leadership and performance beyond expectations. New York: Free Press.
Bass, B. (1999). Two decasdes in research and development in transformational leadership. European Journal of Work and Organizational Psychology, 9-32.
Kilburg, R., & Donohue, M. (2011). Toward a "Grand Unifying Theory" of Leadership. Consulting Psychology Journal, 63(1), 6-25.
Healthcare Program Improvement
The purpose of the program or project.
The purpose of the quality program is to create a system that will better equip personnel in the workplace to identify barriers to patient flow, create pattern solutions to improve patient flow, and use measurement of data to evaluate the quality improvement plan and to support implementation of the improvement efforts. The patient flow improvement plan will be based on the proven methods of eal Time Demand-Capacity (TDC) management and planning.
The target population or audience.
The program is designed for the staff, practitioners, and clinicians who work within the environments that directly impact patient care and that require the movement of patients into and out of these contexts.
3.The benefits of the program or project
The patient flow quality improvement plan is based on learning outcomes and practices employed in other fields. A number of key concepts are found…
Sweeney, B., Meisner, H., Lovett, P.B., DeEugenio, L., Caliguri, D., DeAngelis, H., Johnston, M., and Premaza, M. (2013, February 26). Use of the Institute for Healthcare Improvement's (IHI) Real Time Demand Capacity model to promote organizational values and optimize patient flow. Philadelphia, PA: Thomas Jefferson University Hospital (TJUH). Retreived http://www.ache.org/PUBS/Research/mgmtinnovationsPDFs13/IHI-RTDC-OrganizationalValuesPatientFlow.pdf
Resar, R., Nolan, K., Kaczynski, D., and Jensen K. (2011, May). Using real-time demand capacity management to improve hospital-wide patient flow. Journal on Quality and Patient Safety, 37(5), 217-227.
Flow Seminar. Retrieved http://app.ihi.org/marketing/program_documents/Flow_Seminar_Oct2014_InfoCall_FINAL.pdf
We can compare the healthcare workplace to what is seen by a person when he/she looks through a kaleidoscope: since there are numerous different patterns that appear as the moments pass by. The shortage of nurses which has been publicized widely and the high turnover rates amongst the nurses are some of the unwanted patterns which have occurred. The dependence of healthcare institutions on the nurse-managers for the retention and recruitment of nurses is steadily increasing (Contino, 2004).
There are a number of routes through which the critical care nurses have become the leaders. Most of these routes don't have any educational or managerial training as a part of the process. There is a need for effective strategies for the care leaders who provide critical care in order to inspire the staff and manage the departmental operations in an effective manner to get positive results. One of the strategies…
Adams, J., Erickson, J., Jones, D., & Paulo, L. (2009). An evidence-based structure for transformative nurse executive practice, Nursing Administration Quarterly, 33(4), 280-87
Advisory Board Web site. (2004). Available at: http://www.advisory.com .
Ales, B.J. (1995). Mastering the art of delegation. Nurs Manage. August; 26: 32A, 32E.
American Organization of Nurse Executives (2005). AONE Nurse Executive Competencies. Nurse Leader, 3(1), 15-22.
Healthcare/Statistics/Human esources Leadership
Human esource Management in Healthcare
The article taken into consideration in this assignment is Home Care: The Fastest Growing Low-Wage Industry by Candace Howes. In accordance to Howes (2015), essentially all the growth and development in the Long-standing Services and Supports industry is encompassed in home and community-based services that are progressively being more subjugated by the fast-growing for-profit home care agency industry where charters are making considerable and noticeable progress (Howes, 2015). In contradiction of nurses' aides in hospitals and nursing homes, who are undertaking, in fact, similar jobs, home care workers employed by these agencies and by public entities are not covered under the FLSA (Fair Labor Standards Act). In turn, this makes it prohibitive for them to link with unions and repudiating them the right to minimum wage and overtime protection (Howes, 2015).
I agree that home-care health nurse aides ought to be eligible…
Casto, R. (2015). Why Are Statistics Important in the Health Care Field? Livestrong. Retrieved 11 January, 2016 from: http://www.livestrong.com/article/186334-why-are-statistics-important-in-the-health-care-field/
Curtis, E. A., de Vries, J., & Sheerin, F. K. (2011). Developing leadership in nursing: exploring core factors. British Journal of Nursing, 20(5), 306.
Giltinane, C. L. (2013). Leadership styles and theories. Nursing Standard,27(41), 35-39.
Howes, C. (2015). Home Care: The Fastest Growing Low-Wage Industry. New Labor Forum 2015, Vol. 24(2) 98-10.
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).
Identify the milestone you chose in the history of quality improvement in…
1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81
2) Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.
3) Kelly, D.L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press
4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1
Healthcare spending by the New York State persistently surpasses its earnings. That difference continues to be expanding and is also anticipated to broaden unless of course there happen to be severe, continuous modifications in spending budget actions. Lieutenant Governor ichard avitch, in "A 5-Year Strategy to Deal with the State of New York's Spending budget Deficit" released during March 2010, approximated this structural disproportion within the state's spending budget to become no less than $13 billion. The structural inequality isn't simply the consequence of the economic downturn that started during 2007, and a commonly strengthening economic climate is not going to get rid of it.
To help the State of New York in providing the solutions and dedication to quality that its residents rely on, structural modifications are needed. The aim of this paper is actually to summarize one particular realignment - solving an outright inequity involving the state as…
California Public Employees' Retirement System, "Facts at a Glance: Health," September 2010, http://www.calpers.ca.gov/eip-docs/about/facts/health.pdf .
Citizens Budget Commission, Out of Balance: A Comparison of Public and Private Employee Health Benefits in New York City, December 2009, http://www.cbcny.org/sites/default/files/REPORT_Survey_12162009.pdf .
City of New York Office of Labor Relations, "New York City Summary Program Description, Health Benefit Program," 2010, http://www.nyc.gov/html/olr/downloads/pdf/healthb/full_spd.pdf.
Government Finance Officers Association, "Recommended Practices, Health Care Cost Containment 2004," http://www.gfoa.org/downloads/corbaHealthCareCostContainment.pdf .
Health Care Reimbursement and Billing
Both Mrs. Zwick and Mr. Davis face significant issues in the presented scenarios. Mrs. Zwick has multiple considerations under Medicare Parts A, B and D, in addition to her hospital-acquired urinary tract infection. Meanwhile, Mr. Davis must address the severe time constraints and costs of COBRA in light of his job termination. These two scenarios underscore current difficulties and complexities of current health care in the United States.
Discussion of Mrs. Zwick's coverage under Medicare Parts A, B and C
Medicare Part A (often called "hospital insurance") (U.S. Department of Health and Human Services, 2011, p. 15) assists in covering inpatient hospitalization and skilled nursing facilities, hospice and home health care (U.S. Department of Health and Human Services, 2011, p. 14). There is usually no monthly premium if you and/or your spouse paid Medicare taxes while employed (U.S. Department of Health and Human Services, 2011,…
Ethical implications of Mrs. Zwick's incurring costs related to her hospital-acquired condition are applicable despite the rehabilitation facility's exemption from POA/HAC Medicare laws. Having no first-hand knowledge of the cause of the urinary tract infection, no clear indication that I work at the rehabilitation facility and neither the privilege nor the duty of diagnosis, it would be unethical for me to tell Mrs. Zwick about my suspicions. Rather, a nurse is required to maintain his/her professional boundaries (American Nurses Association, 2001, p. 6). Simultaneously, a nurse is supposed to assure "responsible disclosure of errors" to patients and act to stop bad practices and promote best practices (American Nurses Association, 2001, p. 6). Consequently, a nurse in my position faces a dilemma: lack of personal knowledge and authority vs. my concern for the patient's well-being and constant improvement of the profession. In the face of this dilemma, I would: contact the rehabilitation facility's newly-hired nurse and advise/remind him/her of the duty to report to the appropriate supervisor and responsible disclosure to Mrs. Zwick; contact Mrs. Zwick's personal physician and explain the entire situation; direct Mrs. Zwick to discuss her health issues with her personal physician, who can review, diagnose and discuss the ramifications of her medical records, including but not limited to the urinary tract infection (American Nurses Association, 2001, p. 7). The desired outcomes would be: the rehabilitation center's absorption of Mrs. Zwick's costs related to her hospital-acquired infection through pressure exerted by its own nursing staff and Mrs. Zwick's personal physician; Mrs. Zwick's awareness of the true cause of her infection by health care providers who are directly responsible and capable.
Explain how the COBRA will allow Mr. Davis to continue his insurance coverage while he is out of work.
Due to Mr. Davis' termination from an employer of more than 20 employees, he can obtain coverage for himself, his spouse and his dependent children for up to 18 months (U.S. Department of Labor, 2012). In addition, due to his chronic cycle cell anemia, he may be entitled to an additional 11 months' extension for disability (U.S. Department of Labor, 2012). His employer is required to give a qualifying event notice to COBRA; then, COBRA sends a notice of the right to elect to continue coverage and an explanation of the steps that must be taken to continue coverage; Mr. Davis, his spouse and either or both of them in behalf of dependent children may elect for continuation of coverage
The idea with this part of the strategy is to be able to form some kind of a partnership with these individuals. This will help to push for a transformation inside the organization. As, these people will help to provide everyone with: a reason for adapting and pushing others to do so (indirectly). (Turner, 1999, pp. 162 -- 163)
Once this occurs, you could then have these individuals become a part of a committee. They will have the responsibility for making specific recommendations about how this can be implemented. This is important, because this will help everyone to realize that some kind of change is occurring inside the facility. Over the course of time, this will lead to shifts in the operating environment by giving people reason for embracing these changes. (Turner, 1999, pp. 162 -- 163)
The Effectiveness of the Plan
To determine the effectiveness of the plan the…
Nationwide Medical Errors Cost $19.5 Billion. (2010). The Society of Actuaries. Retrieved from: http://www.qualitydigest.com/inside/health-care-news/study-nationwide-medical-errors-cost-195-billion-annually.html
Kovnar, A. (2008). Jonas and Kovnar's Health Care Delivery in the United States. New York, NY: Springer Publishing.
Turner, S. (1999). Essential Readings in Managed Nursing Care. Gaithersburg, MD: Aspen Publishing.
The expectations for these kinds of changes will be to see gradual shifts at first. Where, it may not seem like anything is changing at the facility. However, over the course of time, these kinds of changes will be obvious in the quality of treatment that is being provided will improve. As a result, the strategy will take approximately one year to fully implement a change in the atmosphere of the operating environment.
To ensure that these improvements can continue to be built upon a new system will be introduced of monitoring for shifts that are occurring. In this case, the committee that was established to implement these changes will become way of: monitoring the kinds of treatment that is being provided and the challenges that are facing the facility. This will be accomplished by having outside consultants conduct anonymous surveys of patients, staff members and within the community. They…
Online Customer Surveys. (2011). Key Survey. Retrieved from: http://www.keysurvey.com/solutions/healthcare-surveys.jsp
SWOT Analysis. (2010). Quick MBA. Retrieved from: http://www.quickmba.com/strategy/SWOT/
Badrick, T. (2002). Role of External Management. Clinical Leadership, 16 (5), 281 -- 286.
Bennis, W. (1969). Organizational Development. New York, NY: Addison Wesley.
Are healthcare inequalities UK
Defining Health Inequality
The term healthcare disparity or healthcare differences have been defined in a number of ways. Healthcare inequality can be defined as the difference of the health levels of any tow comparable demographic groups within a certain country or a region even when proper healthcare facilities are available. The inclusive incidences include higher rates of mortality as well as morbidity within the people who belong to lower occupational classes and are poorer. These rates are higher as compared to the mortality rates in the people who belong to better occupational classes being richer and more privileged. Second important aspect that has been highlighted in the definitions of healthcare inequality includes increased rates of occurrence of mental healthcare-based issues in people from poor classes.
A number of countries have been highlighted with healthcare inequalities including Canada and UK. Since 1980, the documentation of…
Asthana, S, and Dr. Halliday, J 2006, What works in tackling health inequalities?: pathways, policies and practice through the life course, Studies in poverty, inequality, and social exclusion, The Policy Press.
Barron K. 2009, Health inequalities: written evidence; Volume 422 of HC SeriesPaper (Great Britain. Parliament. (Session 2007-08). House of Commons)) Written evidence, The Stationery Office.
Davies P. 2007, The NHS in the UK 2007/08, 9th edn, The NHS Confederation.
Dowler E. 2007, Challenging health inequalities: from Acheson to choosing health, Health and Society Series, The Policy Press.
isk Involved in Poor Chart Documentation: An Overview in Total Quality Management
Poor chart documentation in the behavioral health field is a concern for risk management and a critical area for total quality improvement. Poor chart documentation can lead to an audit by accrediting bodies and in severe circumstances lead to discharge. There are many legal ramifications associated with poor chart documentation. This paper will highlight the importance of poor chart documentation, the consequences of poor documentation, and suggest possible tools for resolving documentation errors. The best tool for eliminating chart documentation risk is developing a risk management system appropriate to the health care setting.
Poor chart documentation costs behavioral health providers thousands of dollars in malpractice costs every year. Errors related to chart documentation can be severe; a patient can suffer an untimely death for example. In fact, statistical evidence suggests that each year thousands of patients…
Aron, DC. & Headrick, L.A. (2002). Educating physicians prepared to improve care and safety is no accident: It requires a systematic approach. Quality and Safety in Health Care, 11, 168-173.
Burke, M., Boal, J., & Mitchell, R. (2004). Communicating for better care. American Journal of Nursing. 104(12), 40-47.
American Society of Healthcare Risk Management, American Hospital Association. (2004). The
growing role of the patient safety officer: Implications for risk manager. Chicago: American Hospital Association.
(Menzel, 1990, p. 3) Fisher, Berwick, & Davis alude to the idea of integration in health care, with providers linking as well as creating networks of electronic medical records and other cost improvement tactics.
The United States and other nations over the last twenty or so years, have begun a sweeping change in health care delivery, regarding the manner in which health information is input, stored and accessed. Computer use in the medical industry has greatly increased over the last thirty years the culmination of this is fully networked electronic medical record keeping. (Berner, Detmer, & Simborg, 2005, p. 3) the electronic medical record trend began in the largest institutions first, as hospitals and large care organizations attempted to reduce waste and improve patient care, while the adoption has been much slower among physician's practices and smaller medical institutions. (Hillestad, et al., 2005, pp. 1103-1104) Prior to this time medical…
Resources, and Utilization
Health Care Communication
Background- Within the modern nursing paradigm, there must be a clear link between a health outcome and the process that helps ensure those outcomes. Typically, outcomes are classified in terms of preventability, impact, severity and an overall holistic view of the client's safety issues. Positive behaviors that impact individuals either rescue or protect patients from potential or actual events. This is also part of the issue with modern communication and dissemination of information to patients, stakeholders, and the community (Burns and Grove, 2005).
At the heart of healthcare as an institution is, of course, the need to care for the sick and the injured. However, in the contemporary model of healthcare, effective communication during a crisis is not only important, but also vital. Communication by healthcare professionals takes the concern and worry out of the situation; offers a quicker resolution, makes better control of information possible, earns…
Alligood, et.al. (2002). Nursing Theorists and their Work. Philadelphia: Mosby.
Burns, N. And Grove, S. (2004). The Practice of Nursing Research. St. Louis:
D'Antonio, P., et al., eds., (2007). Nurses Work: Issues Across Time and Place. New York:
The result is that a multilayered system which is inherently designed to maintain and improve our public health standards has instead become almost entirely designed by its profitability. The best opportunity we have for reversing this trend is the applying of pressure that only the federal government can bring to bear. Greater regulation of pricing, coverage and standards of care will shift the focus back to quality health outcomes rather than strict improvement of the bottom line at all costs.
- Is there a solution?
How can (or can't) public policy shape health care in the U.S. hat do you predict for the next year?
Public policy absolutely has the capacity to bring improvement to a highly dysfunctional system. The Affordable Care Act and many of its related sub-initiatives such as the Readmissions Reduction Program are indicative of this opportunity. Indeed, the continuing pressure upon hospitals to focus on producing…
Krueger, a. (2013). As ACA Implementation Continues, Consumer Health Care Cost Growth Has Slowed. Whitehouse.gov.
Technology is one of the main drivers of change in healthcare, and it is up to healthcare organizations to join the rest of the world in adopting new technologies to run their industry better. In most industries, something like electronic record keeping has been done for decades and nobody was wringing their hands about it. It is absurd that this is even an issue for healthcare companies. The best thing is to stop talking about this as if it is an "issue" or a "challenge," and just get it done. If you were to design the health care system from scratch, of course everything would be electronic. The development and adoption of these technologies will improve the quality of healthcare immensely, so the only real question is not how will this challenge affect healthcare, but how quickly can healthcare get its act together and join the 21st century.…
Kumbroch, D. (2014). Affordable Care Act creates big demand locally for healthcare workers. WHNT. Retrieved November 17, 2014 from http://whnt.com/2014/09/17/aca-creates-big-demand-for-healthcare-workers/
Wister, A. (2009). The aging of the baby boomer generation: Catastrophe or catalyst for improvement? Health Innovation Forum. Retrieved November 17, 2014 from http://www.healthinnovationforum.org/article/the-aging-of-the-baby-boomer-generation-catastrophe-or-catalyst/
Changes to Healthcare Practice and Delivery: A Study of Two Detroit, MI Healthcare Facilities Separated by Twenty Years
Changes to technology and to the political and regulatory landscape have led to many changes in the ways that businesses in all manner of industries operate. Increased communications capabilities, the shrinking size and cost for advanced technologies, and a variety of other changes have provided many businesses with an opportunity to operate more efficiently, and in so doing have also made many industries and markets more competitive. An examination of some typical businesses operating in these industries today as compared to their counterparts that were in operation twenty years ago provides ample evidence of the changes that have occurred and the ways in which businesses have adapted.
The healthcare industry has by no means been immune from these changes, but in fact has changed more than many other industries due…
Anderson, J. & Aydin, C. (2005). Evaluating the organizational impact of health care information systems. New York: Springer.
Armoni, A. (2000). Healthcare information systems: challenges of the new millennium. Hershey, PA: Idea Group.
Wager, K., Lee, F. & Glaser, J. (2009). Health care information systems: a practical approach for health care management. New York: Wiley.
Healthcare Partnership in the Community
Discuss an example of healthcare partnership in your community and specifically cite examples that show how nurses, both individually and collectively, influenced the care provided. What obstacles were confronted and what strategies were employed in order to effectively overcome them.
One community healthcare partnership that is salient in my mind is Texas Department of State Health Services' program on tuberculosis or TB. This group of projects is specifically handled by the Office of Border Health, specifically because communicable diseases transmitted over the Texas-Mexico border will inadvertently affect the state of community health of both countries (i.e., the U.S. And Mexico). Under the program, two projects have been successful and known for its accomplishment in helping decrease TB prevalence in communities near the Texas-Mexico border: Proyecto Juntos and TBNet.
Proyecto Juntos specifically centers on "bilateral TB control," centering its efforts to curbing TB prevalence by monitoring…
Texas Department of Health Services, Office of Border Health. Available at: http://www.dshs.state.tx.us/borderhealth/
Texas Organization of Nurse Executives. Available at: http://www.texasnurse.org/
Health Care Finance
Financial analyst Eric Feigenbaum (2009) notes that while we like to think of hospitals in terms of compassion, patient care and dedication to altruistic aims, they are businesses concerned with revenues and expenses like any other business (Feigenbaum 2009, p.2). In today's hectic world of economic downturn and financial struggles felt from individuals of every demographic and social status, revenue and expense accounting are issues that must be addressed carefully by nearly every business in every market. The same holds true for the health care industry and health care providers. With financial uncertainty come threats for health care providers in managing revenue and expenses during the upcoming years. However, with these threats remain certain opportunities for health care providers to take on in order to combat the uncertainty that comes with managing revenue and expenses when the amount of each is not ideal.
With the appropriate management…
Bristow, W. (2009). How to thrive during a recession. Doctor's Digest. 81(1): p.16.
Retrieved from: LexisNexis Database.
Feigenbaum, E. (2009). Categories of expenses and revenues in the hospital business setting. Demand Media, 2(1), pp. 2-5. Retrieved from: ProQuest Database.
Johnson, N., McNichol, E. And Oliff, P. (2011). Feeling the recession's impact on health care. Handbook of Health Economics 3(2), pp. 54. Retrieved from: ProQuest Database.
Hadley, Jack, John Holahan, Teresa Coughlin, & Dawn Miller. (2008). Covering the uninsured in 2008: Current costs, sources of payment, and incremental costs. Health Affairs, Web
According to Hadley (et al. 2008), "the cost of expanding coverage to the 16% of Americans who are uninsured would add 5% to national health spending" (Hadley 2008: 399). This cost is considerable, yet the cost of allowing the status quo to remain is far greater. In the article, "Covering the uninsured" the authors use quantitative analysis to determine how much care uninsured persons currently receive, how much of it remains uncompensated because of an inability to pay, and how much more coverage would be consumed if all Americans did have health insurance (Hadley 2008: 399). Their data encompasses interviews of 102,000 people who were part of the Medical Expenditure Panel Surveys; data from government budgets and health care providers; surveys…
Hadley, Jack, John Holahan, Teresa Coughlin, & Dawn Miller. (2008). Covering the uninsured in 2008: Current costs, sources of payment, and incremental costs. Health Affairs, Web
Healthcare Budgetary Decision Making
With resources becoming increasingly limited in the healthcare industry, managers are continually challenged with devising effective strategies for dealing with budgetary concerns. The most prominent challenge comes in the form of decision making that results in striking a balance between cost reduction and the maintenance of high quality care and safety for patients. The following discussion outlines approaches that can be utilized by managers to effectively deal with budgetary concerns in healthcare settings, with an emphasis on the advantages of group decision making strategies.
It is evident that there is often a struggle in the healthcare industry for managers to continually and effectively manage depleting resources, address the ever-changing needs of patients, and all the while provide a high level of patient care (Sibbald et al., 2010). This struggle has at its core a need for improvement in regards to the processes in which priorities are…
Burleson, G. (1984). Management, budgeting and the use of resources -- a private sector review. Hospital and Health Services Review, 80(3), 124-5.
Sibbald, S.L., Gibson, J.L., Singer, P.A., Upshur, R., Martin, D.K. (2010). Evaluating priority setting success in healthcare: a pilot study. BMC Health Services Research, 10, 131.
Xie, H., Chaussalet, T., Toffa, S., Crowther, P. (2005). A software tool to aid budget planning for long-term care at local authority level. Studies in Health Technology and Informatics, 114, 284-90.
Healthcare spending and GDP
With the renewed comprehensive healthcare system, the obvious challenge that came with it is how to finance it. The huge projections of the financial inputs needed to efficiently run the program portends a challenge to the government and is likely to spin out of control and be unaffordable in the long run after a few decades from now. This is informed by accompanying supplies and services increasing in cost like the essential original drugs that have been noted to have increased in prices among other services within the healthcare. In many countries people are expected to pay for their own health care. Therefore the ability of people to pay for their health care or the affordability of the healthcare has become a policy issue in many countries and especially an issue of urgency. The issue of healthcare spending has been a topic for debate over the…
Rise in healthcare spending can also be attributed to the use of improved technology, vaccine improvement, antibiotics, introduction of disease care as well as advances in surgery. There have also been improved medical devices like CT scanners, MRI, ultrasounds and defibrillators that can be implanted. At the same time there are developments in pharmaceuticals and administration costs have also contributed to the rise in costs of healthcare. Mostly the heath care costs are due to medical technology which is approximately over 200 billion per year (Wayne, 2012).
The Americans lifestyles also impact the health care industry in significant measures, almost sixty percent of the population is overweight and childhood obesity is rampant. Other factors that have an impact on the healthcare spending are; poor diets, high blood pressure, smoking, lack of exercise, drugs and drinking. It is the people themselves who have pushed the costs of health care up. The high healthcare spending ahs effects not only to families but also to businesses and public budgets. Expenditure on healthcare is seen to rise at a rate that is fast even faster than the state of the economy entirely and the wages of the working people.
In 2011 spending on medications, hospital visits as well as other medical care went up with an estimated percentage of 3.9 this consumed about 17.9% of the GDP. This is more than three times the deficit. Much of the money is considered to be spent appropriately which is keeping people alive and healthy but of
Healthcare in Sweden
The healthcare system in Sweden is used as one of the model systems in the world. hen Johan Hjertoqvist from the Timbro Policy Group spoke before the Montreal Economic Institute in 2002, he said, "...you refuse to accept the consumer as an equal partner, you still look upon the client, the patient, as an inferior partner in the relation" and "you deny the need for good working condition when it comes to the staff, etc." (http://www.iedm.org/conference5_en.html).Moreover, he stressed the need to move interests and priorities away from the processes and production organization to "the quality of the outcome for the consumer" (http://www.iedm.org/conference5_en.html).Quality seems to be synonymous with healthcare in Sweden.
Two important characteristics of the Swedish healthcare system are that it is "decentralized and it is run on democratic principles" (http://www.si.se/docs/infosweden/engelska/fs76.pdf).All residents of Sweden are covered by the national health insurance system which covers medical care, pharmaceuticals,…
Fact Sheets on Sweden: The Health Care System in Sweden. Swedish Institute. May 1999. http://www.si.se/docs/infosweden/engelska/fs76.pdf .(accessed 06-27-2003).
Gennser, Margit. "Sweden's Health Care System." http://oldfraser.lexi.net/publications/books/health_reform/sweden.html.
A accessed 06-27-2003).
Hadenius, Stig; Lindgren, Ann. "Sweden: On Sweden Health care." Countries of the World. January 01, 1991.
On the other hand, the industry will most likely insist on the service quality segment rather than on the price transparency. A constant improvement of the services provided within the healthcare facility will not only produce the appropriate competition on the market, but it will also provide the incentives for the other healthcare organizations, thus rising overall quality levels in the market. This will rather change the way hospitals price their services rather than price transparency.
Nevertheless, price transparency will change ridiculous situations in which the client is charged $35,000 to change a battery in a pacemaker. It will drive such prices lower, encouraging price competition.
1. A Call for Transparency in Healthcare Cost and Quality. On the Internet at http://blogs.msdn.com/healthblog/archive/2006/05/16/599064.aspx.Last retrieved on June 30, 2007
2. Feld, Stanley. What Is Real Price Transparency? Medicine: Healthcare System. May 2007. On the Internet at http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2007/05/what_is_real_pr.html.Last retrieved on June 30, 2007…
1. A Call for Transparency in Healthcare Cost and Quality. On the Internet at http://blogs.msdn.com/healthblog/archive/2006/05/16/599064.aspx.Last retrieved on June 30, 2007
2. Feld, Stanley. What Is Real Price Transparency? Medicine: Healthcare System. May 2007. On the Internet at http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2007/05/what_is_real_pr.html.Last retrieved on June 30, 2007
Call for Transparency in Healthcare Cost and Quality. On the Internet at
Healthcare Finance: hat is the break-Even analysis approach and its application in health care organizations?
Unfortunately, hospital and health care budgeting of resources has become increasingly important in this cost-conscious era of health care. The last decades of cost-controlled medicine have required fiscally conscious approaches to the healthcare for many organizations, often at the expense of patient services. A financial analyst must strive to minimize this, yet still keep the organization afloat. A segment that does not make money or at least break even for the health care provider may have to be eliminated.
Health care facilities may take longer to break even on their initial investment than other forms of businesses. Also, the break-even period for primary care is different compared to tertiary care. Still, developing any break-even action plan begins with a clear understanding of any significant shortfalls against benchmark, with a special focus on provider productivity in…
Halley, Marc D. & Lloyd. (Nov 2000) "How to Break Even on an Acquired Primary Care Network." Healthcare Financial Management. Retrived 17 Apr 2005 at http://www.findarticles.com/p/articles/mi_m3257/is_11_54/ai_66936335/pg_2
Healthcare Plan eview
The author of this report is to answer three general questions relating to healthcare program evaluation. The first question asks the author of this report to examine the overall purpose of healthcare program evaluation. The second question asks the author to identify at least five different types of common healthcare program evaluation techniques. Finally, one of those methods in particular will be selected and there will be a drilling down into more detail on that single type. While the purpose and method of operations is quite similar with all program evaluation types, there are some subtle to major differences from type to type.
At its core, the purpose of healthcare program evaluation is to analyze and improve the operations and performance of a healthcare program based on a systematic and full review of what is going right, what is going wrong and what needs to be changed.…
Fink, A. (1992, October 15). Formats:. National Center for Biotechnology Information.
Retrieved September 16, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/
MUSC. (2014, September 16). Program Evaluation 101. Program Evaluation 101. Retrieved
Lastly, the sixth issue is that the hospital has no relationship with an HMO. They have not been able to come to an agreement with Kaiser Permanente. This reduces revenues, reduces traffic flow and creates a problem where Kaiser is building a new hospital in the area that will directly compete with EMC.
3. Perform a financial analysis of EMC. Based on the analysis, where is the company strong and where is it weak?
EMC's financial position is weak. The company is faced with a steep decline in its cash position, which makes it difficult to invest in the future. The company is also relying on its investments for cash flow, and the current investment climate makes this a challenge. EMC has seen a strong increase in net patient revenue in 2002, reversing a flatlining trend. However, operating expenses have been a long-term increasing trend, and ballooned in 2002. Salaries…
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.
As a result, millions of Americans remain unable to bear the heavy financial toll of medical expenses. Indeed, the problem of a lack of insurance for many is related to the problem of the cost of healthcare. So confirms the article by Consumer Reports (CR) (2008), which finds that "health-insurance premiums have grown faster than inflation or workers' earnings over the past decade, in parallel with the equally rapid rise in overall health costs. Industry spending on administrative and marketing costs, plus profits, consumes 12% of private-insurance premiums." (CR, 1) This reiterates the case that the undue imposition of costs by the healthcare industry -- a reflection of a free-market industry with little to no regulatory oversight -- has negatively impacted the accessibility and quality of healthcare for many of the poorest users.
Moreover, these users are most vulnerable to the long-term economic damages provoked by unexpected healthcare costs. So…
Bureau of Labor Education (BLE). (2001). The U.S. Health Care System: Best in the World, or Just the Most Expensive? The University of Maine.
Childress, M. (2010). Poverty is on the Upswing, but Metric is Out of Date. The Washington Independent.
Cockerham, W.C. (2004). Medical Sociology and Sociological Theory. The Backwell Companion to Medical Sociology.
Consumer Reports (CR). (2008). High Health Care Costs. Consumer Reports Health.org.
The Joint Commission on Accreditation of Healthcare Organizations -JCAHO is among the leading health-care benchmarks setting and accrediting bodies in the world today. To provide for continuous improvement to the safety and quality of health care provided to the general public through the provision of health care accreditation and the related services, which enable performance improvement in organizations that provide healthcare is the mission of JCAHO. The Joint Commission assesses and accredits almost 20,000 health care organizations and programs in the United States. It is an independent and non-profit organization. JCAHO has developed modern and professionally-based benchmarks. The Joint Commission assesses the compliance healthcare organizations using these standards. JCAHO services are provided to the full range of organizations involved or assisting in healthcare in any form. An organization accredited by the Joint Commission is acknowledged all around the country as meeting the performance standards of JCAHO, which…
"Health Facility Quality Assurance" Retrieved from http://22.214.171.124/search?q=cache:slYBAH_cu48J:www.doh.wa.gov/HWS/doc/HS/HS_FSL.doc+DOH+regulates+hospitals& hl=hi& ie=UTF-8 Accessed on 18 November, 2004
"HHS: What We Do" Retrieved from http://www.hhs.gov/about/whatwedo.html/
Accessed on 18 November, 2004
"JCAHO: Joint Commission on Accreditation of Healthcare Organizations" Retrieved from http://www.qmsonline.com/jcaho.htm. Accessed on 18 November, 2004
Health Policies Medicare
hen everyone in our country finally starts to reach the age of 65 years of age or older, then every person will become eligible for Medicare. It is clear that there are some elderly that are having minimum health concerns while others recurrently are dealing with medical issues for which they will have to seek out treatment by the doctor. However, research is starting to display that there are at least five top conditions that are enhancing on medical and drug spending. It is obvious that Heart disease circumstances are the number one medical issue that the those that are considered elderly are facing and that is becoming very costly to them. Most are unaware that the second one is the disease cancer and it could be internal or external for various elderly patients. Other issues such as joint ailments a lot of the times can cost…
Wenzlow, Audra T., et al. "Effects of a Discharge Planning Program on Medicaid Coverage of State Prisoners with Serious Mental Illness." Psychiatric Services 62.1 (2011): 73-8.
Sommers, Benjamin D. "Loss of Health Insurance among Non-Elderly Adults in Medicaid." Journal of General Internal Medicine 24.1 (2009): 1-7.
Verdier, James, and Allison Barrett. "How Medicaid Agencies Administer Mental Health Services: Results from a 50-State Survey." Psychiatric Services 59.10 (2008): 1203-6.
Harman, Jeffrey S., Allyson G. Hall, and Jianyi Zhang. "Changes in Health Care use and Costs After a Break in Medicaid Coverage among Persons with Depression." Psychiatric Services 58.1 (2007): 49-54.
The relationship between the doctor and a possible patient is established when the physician asks the person for the first time as how he could be of possible help. This direct and simple enquiry is the beginning of the trust of the patient that has to be put in the physician for any treatment to proceed. The patient is in need of help at that time, and has to trust the professional for getting the help and the patients want to do it. They need a person to take care of them during their period of suffering from illness. This relationship between the patient and the physician in the financial sphere also involves the same amount of reliance, confidence and trust, as otherwise, not treatment can be undertaken. This makes it essential that the physicians clearly mention to the patients when there is any conflict of interest in…
"Changes in Health Care Financing and Organization: Deriving Best Practice Models for the U.S. Health Care Safety Net: A Cross-State Meta Analysis of Finance, Organization and Outcomes" Retrieved from http://126.96.36.199/search?q=cache:h3F83ojarhYJ:depts.washington.edu/eprc/areas/proposalnarrative%2520web.pdf+Changes+in+Health+Care+Financing+and+Organization+& ; hl=en Accessed on 7 June, 2005
'Health Administration Press" (March/April 2003) Journal of Health Care Management.
Volume 48, Number 2. Retrieved from http://188.8.131.52/search?q=cache:p36ZB3H0T4AJ:www.ache.org/pubs/jhm482.cfm+healthcare+finance+relationship+centered& ; hl=en Accessed on 7 June, 2005
"The Core Program: Trust and the Patient -- Professional Relationship" (September, 2000) The
The issue of grey and black markets often arose as a result of the shortages of experienced health care personnel. The system could not adapt to a flexible environment as it was led by rigid official procedures and the mentality of the people who controlled it was commanding, their vision short-sighted and hardly beneficial in such a situation (Barr and Mark, 1996).
The breaking up of Soviet Union which brought crippling economic and political problems to the countries also aggravated the health care situation making it reach an all-time low. The collapse of the health care system ran by the government led to the belief that turning towards a market economy or more capitalistic notions and perceptions would have been a better idea. The competition in the private sector would have had improved efficiency and averted an inevitable collapse of the health care system in the Soviet Union. This transformation,…
Balabanova, D., Haerpfer, C., McKee, M., Pomerleau, J., Rose, R. (2004). Health service utilization in the former Soviet Union: evidence from eight countries. Health Services Research
Barr, D.A. And Mark G. (1996). The Current State of Health Care in the Former Soviet Union: Implications for Health Care Policy and Reform. American Journal of Public Health. 86, 3.
Lewis, M. (2002). Informal Health Payments in Central and Eastern Europe and the Former Soviet Union: Issues, Trends and Policy Implications. In Funding Health Care, European Observatory on Health Care Systems Series, edited by E. Mossialos, a. Dixon, J. Figueras, and J. Kutzin, pp. 184-205. Buckingham: Open University Press.
Mikesell, J.L. And Mullins, D.R. (2001), Reforming Budget Systems in Countries of the Former Soviet Union. Public Administration Review. 61. 5.
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.
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:
In United States the Congress had passed the Medicare Prescription Drug, Improvement and Modernization Act of 2003 or MMA and with this imposed a stoppage for 18 months on the starting of new physician owned specialty hospitals. At the same time, they also wanted to know the position regarding certain matters of physician owned heart, orthopedic and surgical specialty hospitals through MedPAC. The team visited sites, made legal analysis and met the share owners in these hospitals and finally presented a report to the Congress. It had also gone through the cost reports received from Medicare and inpatient claims of 2002, which was the most recent at that time. This will naturally form the basis of such hospitals being permitted or not. (Physician-owned specialty hospitals)
Findings of MedPAC:
The findings of this committee showed that:-
Physician owned hospitals generally treated patients who had less severe problems…
"Healing Ministry of the Madras Diocesan Medical Board" Retrieved from http://www.csimadrasdiocese.org/hospital.htm Accessed 21 August, 2005
Kamath, Gauri. "Doctors in arms" Retrieved from http://www.businessworldindia.com/Nov1003/indepth01.asp
Accessed 21 August, 2005
"Parkwest Medical Center" (October 25, 2004) Retrieved from http://www.covenanthealth.com/coldfusionapplication/covhlthwhatsnew/Detail.cfm?Post_ID=12027 Accessed 21 August, 2005
Stated to be barriers in the current environment and responsible for the reporting that is inadequate in relation to medical errors are:
Lack of a common understanding about errors among health care professionals
Physicians generally think of errors as individual that resulted from patient morbidity or mortality.
Physicians report errors in medical records that have in turn been ignored by researchers.
Interestingly errors in medication occur in almost 1 of every 5 doses provided to patients in hospitals. It was stated by Kaushal, et al., (2001) that "the rate of medication errors per 100 admission was 55 in pediatric inpatients. Using their figure, we estimated that the sensitivity of using a keyword search on explicit error reports to detect medication errors in inpatients is about 0.7%. They also reported the 37.4% of medication errors were caused by wrong dose or frequency, which is not far away from our result of…
Discussion Paper on Adverse Event and Error Reporting In Healthcare: Institute for Safe Medication Practices Jan 24, 2000
Patient Safety/Medical Errors Online at the Premiere Inc. page located at: http://www.premierinc.com/all/safety/resources/patient_safety/downloads/patient_safety_policy_position_2001.doc
Medstat / Shortell, S. Assessing the Impact of Continuous Quality Improvement on Clinical Practice: What It Will Take to Accelerate Progress.
Health Policy Monitor (2001) A Publication of the Council of State Governments Vol. 6, No. 1 Winter/Spring 2001 PO18-0101
Health Care -- Lean Philosophy on Cost Reduction and Quality Improvement
Lean Philosophy is initially traced back to Henry Ford's innovative assembly line, revolutionizing manufacturing while failing to provide true variety. Building on Ford's concepts Toyota management established a Lean Philosophy in the 1930's and 1940's that focused on production flow and waste elimination, resulting in rapid, low cost and high quality processes, along with simpler and more accurate management. These concepts were further elucidated by authors including James omack, who established the Lean Enterprise Institute in 1997.
The essential elements of Lean Philosophy are 5 principles including: defining the value sought by the customer; specifying the value stream of the product satisfying that value while challenging wasted steps; making a continuous flow of product through refined steps; creating "pull" (essentially meaning "customer demand/expectation") from step-to-step for continuous flow wherever possible; continually improve and refine the process to cut the…
Berk & Associates. (2011). Idea: Lean government. Seattle, WA: Washington State Auditor's Office.
Jimmerson, C. (2010). Value stream mapping for healthcare made easy. New York, NY: Productivity Press.
Lean Enterprise Institute. (2009). 5S - Visual workplace. Retrieved October 5, 2012 from www.lean.org Web site: http://www.lean.org/Workshops/WorkshopDescription.cfm?WorkshopId=39
Lean Enterprise Institute. (2009). Lean timeline. Retrieved October 5, 2012 from www.lean.org Web site: http://www.lean.org/WhatsLean/Timeline.cfm
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
Improved confidence, communication and collaboration: If these transformations are embraced, there will be enhanced practices and ideas that are utilized. This is because everyone must learn the proper techniques for communicating and working with each other. These concepts are used to create a change in the environment and how different individuals are interacting with each other. When this happens, there is a change in attitudes and ideas among the various stakeholders. (Wilkinson, 2008)
Part III: Critique. You are to provide your reaction (insightful, critical, and logical) to the points that the author tried to make, or an overall critique of the entire article. A simple statement of agreement or disagreement is not enough. While you may make such a statement by way of introduction to your reaction, you must clearly and logically state the reasons for the post that you have taken. If you are summarizing a case,…
Farrell, M. (2001). Breaking Bad News. Journal of Advanced Nursing, 36 (6), 765 -- 775.
Wilkinson, S. (2008). Effectiveness of a Three Day Communication Skills Course in Changing Nurses Communication Skills. Palliate Medicine, 22 (4), 365 -- 375.
Unless the physicians can succinctly argue their case for care and services, the managed care entity will, for reasons of medical necessity, deny access to care and services.
What Cost-Added atio Based on Illegal Immigrant Population?
The argument by opponents that loopholes exist that would allow illegal immigrants to access Obama's proposed legislation on healthcare services is rendered moot in lieu of the fact that those illegal immigrants are currently receiving healthcare services Medicaid and through Immigration and Naturalization Services (INS). The Federal eimbursement of Emergency Health Services Furnished to Undocumented Aliens states:
"Section 1011 of the (Medicare Prescription Drug, Improvement, and Modernization Act (MMA) (P.L. 108-173)) MMA appropriated $250 million dollars in FY 2005 through 2008 for payments to eligible providers for emergency health services provided to undocumented aliens and other non-specified citizens who are not eligible for Medicaid (Centers for Medicare and Medicaid Services, 2009, found online, p.…
Birenbaum, A. (1997). Managed Care: Made in America, Praeger Publishers, Westport,
Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care, Praeger Publishers, Westport, CT.
Centers for Disease Control and Prevention (2009). Uninsured Americans: Newly
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:
The research thus concludes the essence of having quality and effective legislation addressing the aspects of overall oral health of the people.
Additionally, the Canadian Dental Association also relates several issues of the overall body health to the oral health of the individual. In view of the article on the relation "oral health -- good life," the article gives information on the essence of good oral health, indicating some of the illnesses of ill oral health (Chattopadhyay, 2011). In this article, the relation between the ill oral health and the overall health of the body is that the mouth is the ingress to the body. Therefore, an individual with ill oral health is at the highest risk of having infection that affects the whole body system severely. According to this article, it emphasizes the need for dentists-patient relation as the dentists is the only person with the skill, expertise and…
Chattopadhyay, a. (2011). Oral health epidemiology: Principles and practice. Sudbury, Mass:
Jones and Bartlett Publishers.
Ramseier, C.A., & Suvan, J.E. (2010). Health behavior change in the dental practice. Ames,
edu). While this example just discusses one manner in which a given policy can empower a healthcare marketing strategy, social marketing is currently so engrained in our culture that its powers are truly widespread. Social marketing allows products and brands to have more flexible and sensitive pricing as their prices can be changed at any minutes and consumers alerted, given the instantaneous nature of social marketing. The same goes for service as well -- any changes or enhancements that are made to services can be alerted to the public immediately. Likewise, social marketing is a two-way process: it allows consumers to chat their thoughts, ideas and concerns to marketers, giving them immediate and constant feedback. Social marketing can impact large groups of people at once, as readily seen by campaigns used by the AHA or the FDA (Kotler et al., 2008).
Social networking can also be a means of social…
Berkowitz, E. (2011). Essentials of Health Care Marketing. Sudbury: Jones and Bartlett.
Brown, M. (1992). Healthcare Marketing Management. Gaithersburg: Apsen Publishers.
Hma, e. (n.d.). Stakeholders. Retrieved from Hma.eu: http://www.hma.eu/fileadmin/dateien/HMA_joint/02-_HMA_Topics/02-HMA_Strategy_Paper/Index/Section_III_01_Stakeholders.pdf
Kotler, P., Shalowitz, J., & Stevens, R. (2011). Strategic Marketing for Health Care Organizations: Building a Customer. San Francisco: Jossey-Bass.
Shuttling the results from an outside provider, because the health insurance agency will only reimburse outside screening, forces the patient to wait and possibly incurs more costs, if the delays in obtaining diagnostic information worsen the patient's condition. This can ultimately result in more prolonged treatment. Many patients may also be put at risk because of the logistics of being transported to outpatient facilities for essential screening and rehabilitative services, while they are still convalescing.
Being able to conduct all necessary tests in-house results in great efficiency, swifter screening, and improves coordination between the different providers involved in the case. Our hospital has extensive resources for patients, and can provide a wide range of treatment options, particularly in its specializations of cardiac and orthopedic care. And improvements in technology that are keeping extremely sick patients alive for longer periods of time also mean that, quite often, patients require attention from…
Mertens, Maggie. (2010, October 4). More Medicaid payment for some doctors. But will it last?
Shots. NPR Blog. Retrieved November 24, 2010 at http://www.npr.org/blogs/health/2010/04/will_medicaid_payment_follow_u.html
The infant mortality rate is of 8.97 deaths per 1,000 live births. This rate places Kuwait on the 160th position on the chart of the CIA. The adult prevalence rate of HIV / AIDS is of 0.1 per cent.
In terms of economy, Kuwait is a relatively open, small and wealthy economy. It relies extensively on oil exports -- petroleum exports for instance account for 95 per cent of the total export revenues as well as for 95 per cent of the federal income. The Kuwaiti representatives have recently set the goal of increasing the oil production per day. Currently, Kuwait is facing the pressures of the internationalized economic crisis -- which however, due to recent economic surpluses in Kuwait, affects the economy to a lower extent.
Simultaneously with the increase in oil production, the Kuwaiti authorities are also focusing on diversifying the economic activities in the sense of supporting…
Agency, Kuwait News. "Blair's "Kuwait Vision." 15 March 2010. Zawya.com. .
Al-Ansari, H. And S. AL-Enezi. "Health Sciences Libraries in Kuwait." Bulletin of the Medical Library Association 89.3 (2001): 287-93.
Al-Awadhi, Olusi, Al-Saeid, Moussa, et.al. "Incidence of Musculoskeletal Pain in Adult Kuwaitis." Annals of Saudi Medicine 25.6 (2005): 459=62.
Al-Baho, A. "Resident's Guide to the Curriculum for Training in Family Medicine." December 2008. Kuwait Institute for Medical Specialization. .
There are however existing organizations such as the Healthcare Communications Association which was also formed in 2001, however, this organization was formed primarily for pharmaceutical companies and practitioners. The 'Coalition for Healthcare Communication" organization when searched with keywords 'skilled nursing staff' returned a 'sorry no pages found with your keyword' indicating a gap in the communication network for skilled nursing staff in the communication network for health care issues under debate and analysis. The work of Thornby (2006) entitled: "eginning the Journey to Skilled Communication" states that often skilled nursing staff were found to be avoiding communication with physicians who were known to be aggressive or abrasive instead of becoming competent in skilled communication. It is additionally noted in Thornby (2006) that skills development is needed among today's skilled nursing staff in order to enable competent skilled communication among skilled nursing staff and other practitioners and physicians.
SUMMARY & CONCLUSION…
Thornby, Denise (2006) Beginning the Journey to Skilled Communication. Advanced Critical Care. Vol. 17, No. 3, 2006 AACN. Online available at http://www.aacn.org/WD/HWE/Docs/AACN17_3_266-271_HWE.pdf
Coalition for Healthcare Communication (2009) Current Issues. Online available at http://www.cohealthcom.org/content/current.htm
Sorry no pages found matching your keywords' (2009) Coalition for Healthcare Communication. Online available at http://cohealthcom.org/cgi-bin/search.cgi
Healthcare Communications Association (2009) Online available at http://www.hca-uk.org/Join-the-HCA
Although the Medicare prescription drug program has provided access to medications for seniors at a lower cost to the government than was originally expected and has lowered the out of pocket costs for the consumers, there is talk about needing to overhaul the program. Critics contend that the government should be able to negotiate lower costs for prescription drugs than private insurances can. It is also felt that the entire program is too confusing for the elderly beneficiaries and needs to be made more understandable (Wechsler, 2008). All of these proposed changes come with Medicare still trying to uphold there objectives of providing affordable prescription drugs to seniors.
It is believed that even with these proposed changes taking place there is still a need for greater education about the program as a whole. It is hoped that with increased education that consumers will be more informed about the choices that…
Hsu, John, Fung, Vicki, Price, Mary, Huang, Jie, Brand, Richard, PharmD, Rita Hui,
Fireman, Bruce and Newhouse, Joseph. (2008). Medicare Beneficiaries' Knowledge of Part D Prescription Drug Program Benefits and Responses to Drug Costs. Journal of the American Medical Association, 299(16), 1929-1939. doi: 10.1001/jama.299.16.1929)
Lichtenberg, Frank R. And Sun, Shawn X. (2007). The Impact of Medicare Part D on Prescription Drug Use by the Elderly.
Health Affairs, 26(6), 1735-1744. doi:
One instance where the doctor had influenced governance in the community hospital's organization plan was when the hospital had been unable to accommodate the increasing number of patients. Because most of the health care staffs in the hospital are similarly providing their medical service in other hospitals, as with the doctor, there was not enough time for the organization to plan to work on the improvement of the management planning. But, for our doctor interviewee who has a commitment in the delivery of good health care service, he volunteered to organize the management planning and improvement of the organization's structure. However, the doctor did not just individually govern the management planning. Instead, he promoted shared governance within the organization wherein everyone was able to contribute in the improvement of the framework and structure of the community hospital. A body of model employees and staffs were formed to exercise the authority…
The Role of the General Practitioner/Family Physician in Health Care Systems: A Statement From Wonca. Retrieved on Sept 3, 2005, from Online. http://www.globalfamilydoctor.com/publications/Role_GP.pdf.
2004). Shared Governance: Hartford Hospital's Experience.
Retrieved on Sept 03, 2005 from Online. http://www.nursingworld.org/ojin/topic23/tpc23_2.htm
Leadership and Management in Healthcare
Effective Leadership and Management
Leadership is much like communications in regards to the complexity inherent in these concepts. There are many different perspectives that are used to examine these issues and researchers study leadership and management from such disciplines includes Industrial and Organizational Psychology, Social Psychology, Business, and Sociology. There have been somewhere in the neighborhood of six to eight major approaches, depending on the vantage point, to leadership theory produced in the scientific literature over the last sixty years and even more have emerged from outside academia (Kilburg & Donohue, 2011). Competing theories include such perspectives as trait theory, situational theory, behavioral theory, competencies theory, network theory of leadership and many more.
Much of the work that a nurse-leader engages in on a daily basis rests in their ability to communicate with others; including clients, colleagues, superiors, and subordinates. Therefore, since this…
Judge, J., & Bono, J. (2000). Five factor model of personality and transformational leadership. Journal of Applied Psychology, 751-765.
Kilburg, R., & Donohue, M. (2011). Toward a "Grand Unifying Theory" of Leadership. Consulting Psychology Journal, 6-25.
Marquis, B., & Huston, C. (2011). Leadership Roles and Management Functions in Nursing: Theory and Application. Lippincott Williams & Wilkins.
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1993). Within medical settings in particular, physicians and supervisors are often too over-burdened with their myriad formal responsibilities to take note of minor irregularities in protocols and procedures. Because coworkers are often in the best possible situation to notice inadequacies, it is important for all levels of employees to be equally involved in the overall CQI process.
Optimal implementation of an effective CQI process also requires a culture of openness to suggestion and confidentiality with respect to reporting more serious issues such as those that result from negligence or willful misconduct on the part of co-workers.
11. The textbook states that "an organization's most vital component in costly resource is its staff." With this being the case, the human resource function plays a very important role. Should the human resource function be part of the senior management team?
In terms of policy implementation and organizational philosophy, the human resources function…
Horine, P.D., Pohiala, E.D., Luecke, R.W. (1993) Healthcare Financial Managers and CQI: Implementing Continuous Quality Improvement; Healthcare Financial Management.
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Other ways to celebrate achievements would be to send thank-you cards, congratulatory notes, make phone calls, and send emails.
4. Being able to set challenging goals - people often strive to achieve what is expected of them, but if they are presented with a set of challenging goals they will work even harder to accomplish them.
5. Being able to provide the necessary tools to succeed - no team will stay motivated if they do not have the necessary tools that are required to do their job. This includes: equipment, internal support, inventory, marketing materials, and training among other things.
6. Performance management - teams expect their leader to manage individuals who do not perform up to standard. Many managers often ignore these situations because they are afraid to deal with them. They hope instead that the situation will resolve itself. This is never the case; bad situations that are…
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4. What is the advantage of a "patch"?
Evidently, the drug rivastigmine causes gastrointestinal side effects, but the patch allows only a small amount to be steadily absorbed into the bloodstream and thus creates fewer negative reactions to the drug. The Novartis website makes the case for a patch over a pill by saying "On average, an older American takes 5 prescription medicines. These medicines may need to be taken at different times and managing them all may seem overwhelming" (Novartis, para. 1). In this case, a patch eliminates having to remember several doses each day of one of the medications.
5. What is "moderate" dementia? What is dementia?
Dementia affects brain function. There is no known cure for dementia. It refers to several illnesses (Alzheimer's disease, Lewy or DLB) involving behavior, memory, communication and learning problems. There are other conditions in the brain which damage nerves or blood…
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Healthcare Organization Case Study
Health Care Organization Case Study
Health Care Organization Case Study
Banner Healthcare represents a set of diverse healthcare related facilities that provide healthcare services to societies in USA and beyond. Banner seeks to establish a healthier life for communities through developing a healthy environment. Banner Healthcare is arguably the largest healthcare provider in the country. The organization spans seven states, including Arizona, California, Colorado, Nevada, Alaska, Nebraska and Wyoming. The organization operates 20 hospitals, including healthcare facilities. The organization offers such services as hospice care, home care and physician services. Banner Healthcare also provided $130 million as their contribution to charity. The organization is a healthcare leader in all the communities it offers its services. The agency has shown tremendous growth in the past years. They admit over 190 000 patients every year and have a workforce in excess of 29-000. The emergency departments…
Banner Health, (2008). Here Now: Making a Difference. Retrieved from http://www.bannerhealth.com/_communityupdate/Banner_Health_Community_Update.pdf on 18 May 2016
Harrington, C. & Estes, C. (2008). Health Policy: Crisis & Reform in the U.S. Health Care Delivery System, 5th Ed. Jones & Bartlett Publishers
Wolf, J., Hanson, H. & Moir, M. (Eds.) (2011). Organization Development in Health Care: High Impact Practices for a Complex and Changing Environment. IAP
This is done by emphasizing organizations and systems as a whole rather than focusing on individual;s only. CQI is a management philosophy that cost containment on the once hand and customer service on the other hand to deliver service withing budget. CQI applies a the scientific method applied to everyday tasks to meet the above criteria ("Continuous quality improvement," 2011) .
Discuss the legal and ethical implication of end of life issues in the facility.
No one likes to admit it, but managed health care means medical rationing. There are only so many goods and services available and these have to be delivered fairly throughout a population in general and in a facility in particular. Secondly, there is the technology factor. Modern techniques, equipment, etc. allows the continuation of life support for a person almost indefinitely. For this reason, ethical decisions have to made concerning the types of care that…
Continuous quality improvement (cqi). (2011). Retrieved from http://www.fpm.iastate.edu/worldclass/cqi.asp
Runde, M. (2007, January). End of life decision making. Retrieved from www.health.gov.on.ca/english/providers/../ccs../sah_eol_learn.pdf
Singh, D.A. (2010). Effective management of long-term care facilities . (2 ed.). Sudbury, MA: Jones
and Bartlett Publishers.
More area is dealt by Human esource Management than people originally thought of. Some may explain it as the exchanges between boss and worker in the time period between which a worker is employed, until they are eliminated. It is true human resources management starts even before this, with the strategies that are formed by the institution, and the laws that govern workplace institutions. Human esource Management is the procedure of working with people so that they and their organizations attain full potential even when change accelerates the necessity to get new talents, take up new tasks, and develop new relationships, as per an article by L. Dobb abd P. Dick of 1993. (Blessinger, Human esource Management)
Human esource Management is projected as that part of management, which deals with plans, decisions, issues, ethics, process, routines, work, performance and system associated with the management of people as workers…
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Guide to Managing Human Resources: Chapter 14: Team Building" Available from http://hrweb.berkeley.edu/guide/teams.htm [Accessed 2 February 2003]
In order to be successful in the present complex and frequently unfavorable business settings, a healthcare organization's strategic direction should be estimated, focused, and financially sustainable. Strategic business planning is an indispensable instrument to aid organizations focus strategic choices within the financial actualities of their environment. An efficient strategic business planning cycle includes making an evaluation, identification of business objectives, making strategies, performing an impact analysis and developing an execution plan. The important steps in strategic business planning comprises of conducting an assessment, identifying business objectives, making a strategy, carrying out an impact analysis, and developing an implementation plan. This procedure could include a one-to-three-year sequence and can be applied at the clinical service line or at the level of business unit level for a greater focused planning. The only certainty in the present healthcare environment is a constantly changing set of hypothesis regarding the future. (Bachrodt; Symth,…
'A New Look Into Strategic Financial Planning." Retrieved from http://www.hospitalconnect.com/aha/fsi/monitor / Accessed on 4 May, 2005
Bachrodt, Andrew. K; Symth, Patrick. J. (November, 2004) "Strategic business planning linking strategy with financial reality" Health Care Financial Management. Retrieved from http://www.findarticles.com/p/articles/mi_m3257/is_11_58/ai_n6359509 Accessed on 4 May, 2005
Brown, Judith. (2005) "Ten Strategies to Manage Employee-Healthcare Costs." Career
Journal. Retrieved from http://www.careerjournal.com/hrcenter/ipma/20041207-ipma.html Accessed on 4 May, 2005
, 2007, p. 13). The effective use of it resources requires an organization to define and manage its client base (Hayles, Jr., 2007, p. 14), its products (Hayles, Jr., 2007, p. 15), its human resources (Hayles, Jr., 2007, p. 16), and its delivery of both the products and supporting services (Hayles, Jr., 2007, pp. 17-8). Clearly, concentration on the optimum use of it resources forces an organization to reexamine and "tweak" itself in major business aspects, thereby significantly improving the organization.
Arguments against the extensive use of database analysis and other it resources for basic strategy concentrate on the flip sides of previously stated advantages. For example, some organizations might prefer a more loosely-structured decision-making process that utilizes bottom-up decision-making in some aspects but top-down decision-making in other aspects; however, even if this mixed approach is preferred, a high degree of database analysis and use of other it resources can…
Hayles, Jr., R.A. (2007, September/October). Planning and executing it strategy. Retrieved June 17, 2013 from search.proquest.com Web site: http://search.proquest.com.ezproxy.trident.edu:2048/docview/206314543/13EB3D5768942456278/1?accountid=28844
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Nobel, C. (2010, November 1). How it shapes top-down and bottom-up decision making. Retrieved June 17, 2013 from hbswk.hbs.edu Web site: http://hbswk.hbs.edu/item/6504.html?wknews=110110
Webster, J. (2011). Understanding big data analytics. Retrieved June 17, 2013 from searchstorage.techtarget.com Web site: http://searchstorage.techtarget.com/feature/Understanding-Big-Data-analytics
Quality Improvement in Healthcare
Nearly all healthcare organizations today are aware of the Quality Improvement (QI) movement and seek to actively instill their businesses with such elements. In fact, the past few decades have shown the QI movement to be the main approach for healthcare organizations to measure performance and engage in lasting changes (Colton, 2000). The foundations of QI reside with its origins which come from multiple arenas: "in systems engineering, as a way of defining production processes; in quantitative analysis, as a methodological approach for collecting and analyzing data; and in organizational behavior, as a way of understanding how QI fits with an organization's structure and management philosophy" (Colton, 2000). QI fundamentally stands as a mode for a healthcare organization to better itself through enhancing the way in which it delivers service and by improving patient outcomes (Colton, 2000). "The U.S. Agency for Healthcare esearch and Quality defines…
Colton, D. (2000). Quality improvement in health care. Conceptual and historical foundations. Eval Health Prof., 7-42.
Familydoctor.org. (n.d.). Medical Errors: Tips to Help Prevent Them. Retrieved from Familydoctor.org: http://familydoctor.org/familydoctor/en/healthcare-management/self-care/medical-errors-tips-to-help-prevent-them.html
Varkey, P., Reller, K., & Resar, R. (2007). Basics of Quality Improvement in Health Care. Mayo Clin Proc., 735-739.