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Cost is one of the primary issues -- it is cheaper to go to an RN than a doctor, and walk-in clinics have lower overhead costs than physician's offices, which is of great concern to uninsured or minimally insured patients. ait time is another concern -- clinics provide immediate treatment, patients do not have to wait for appointments for a brief, routine procedure, which insured patients may balk at if they merely wish to get a routine culture for strep throat. Using the Internet to access information about insurance and care results in lowered administrative costs for providers, less need for phone operators to provide advice, and results in additional speed for the consumer, in accessing records.
For a patient without insurance, ordering drugs online and not having to pay for a 'live' consult may be more cost-efficient, despite the higher costs of the drugs. Healthcare companies' desire to make…
Kantor, Aileen. (Dec 1991). "New role for nurses." Business & Health. Retrieved 23 Jul
2007 at http://findarticles.com/p/articles/mi_m0903/is_n13_v9/ai_11673858
Wal-Mart to expand walk-in clinics in stores." (24 Apr 2007). AP Wire. Retrieved 23 Jul
2007 at MSN. http://www.msnbc.msn.com/id/18292564
Financial Environments Paper
Healthcare institutions: Nonprofit, for-profit, and government-administered
"Three types of entities -- nonprofit, for-profit, and government" exist within the American healthcare industry (Horowitz 2015). All available evidence indicates that this status affects the business model choice of all of these institutions. "In this econometric analysis of American Hospital Association data for every U.S. urban, acute care hospital (1988 -- 2000), more than thirty services were categorized as relatively profitable, unprofitable, or variable. For-profits are most likely to offer relatively profitable medical services; government hospitals are most likely to offer relatively unprofitable services; nonprofits often fall in the middle" (Horowitz 2015). Thus it is important to understand how these various organizations view profitability, given its material effect upon how they allocate resources and impact patient care.
Not-for-profit healthcare institutions like the Mayo Clinic are dependent upon donors, government funding, foundations, and also from revenue from activities. Unlike…
Aurora's role as a not-for-profit organization. (2015). Aurora Healthcare. Retrieved from:
About community benefit. (2015). Kaiser. Retrieved from:
Educational Mission and Nursing Practice Statements
Educational Mission Statement
The University of Iowa is known for its world-class academic programs, including the professional preparation and training that is provided through the College of Nursing. The formal mission statement for the College of Nursing University of Iowa is as follows:
"The mission of the College of Nursing is to prepare nurse leaders and to be forerunners in the discovery, dissemination and application of nursing knowledge. As a state supported higher degree program in nursing, the college is committed to preparing nurse clinicians, scholars, and educators to meet the health needs of the people of Iowa. As part of a research intensive university, the College of Nursing supports its research mission through national and international leadership in innovative educational and practice programs and the generation of new knowledge" ("UOI, Nursing," 2014).
State supported colleges and universities are somewhat unique in their missions…
____. (2014). Mission Statement. The University of Iowa, College of Nursing. Retreived from http://www.nursing.uiowa.edu/about-us/mission-statement
____. (2014). Kaiser Permanente Mission Statement, KP Promise, and Vision. Retreived from http://www.sdnsec.org/kaiserpermanente/forms/KPPromise.pdf
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/
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 Legal Issues
Discuss the impact Federalism has on the regulation of health care delivery; how do the different sources of law as they related to the federal and state governments matter, if at all?
In general, federal regulation of health care delivery would be much more appropriate and efficient than state or local law, at least in so far as major aspects of health care delivery are concerned. That is because state laws vary considerably; that makes it impossible to establish a consistent or uniform standard of health care delivery across state lines. Certainly, there are aspects of health care that are appropriate to regulate at the state or even the local level, but there are others that would be much better to regulate on a national or federal level.
One of the best examples of an aspect of health care delivery that should be regulated federally are elements…
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
The experiences of seniors within the healthcare delivery system will alter how all Americans view healthcare. The healthcare delivery systems and overall organizational structure in the United States has been slow to adjust but that rest of the world is currently in flux that will migrate into our system. Technological advances in communication have made telehealth and telemedicine vialbel solutions to our outdated healthcare industry orgainzational structre. While these types of advances are only in their infancy, "...there seemed to be broad acceptance that telehealth and telemedicine had provided positive benefits to the worlds healthcare delivery system." (Telehealth Applications) Our technoloically challenged seniors have actually discovered the trend within the healthcare system and telehealth and telemedicine seems to be an advance that will find worldwide support so we as a nation will be reqquired to jump on the bandwagon.
In conclusion, this article review focused on new Healthcare Delivery Systems…
Farnsworth, Chris. "The Truth About Fraud" Washington Monthly 01 May 1997.
Joshua-Amadi, Mabel. "Recommendations: A Study in Motivation: Recruitment and Retention in the NHS" Nursing Management. February (2003).
Soloye, Daniel J. "Privacy and Power: Computer Databases and Metaphors for Information Privacy" Stanford Law Review July (2001).
Telehealth Applications. (2004) "Current Telehealth Applications" Retrieved October 26, 2004, at http://www.startegis.com/epic/internet/inict-tic.nsf/PrintableE/it07545e.html
Centralization and decentralization of HM
Centralized HM operations are conducted within the HM department and they assume that all employee related actions be implemented by the human resources specialists. Such an endeavor creates a context in which the human resource actions are taken in an objective and professional manner. Specifically, the decisions are made based on the organizational benefits and the technical considerations at an overall organizational level. In the case of decentralization nonetheless, the human resource decisions are taken in a less formal manner and they are influenced by personal bias of the medical staff conducting the interviews. The benefit is nevertheless that of the staff decisions being made not on grounds of organizational benefits, but on skills and abilities at a medical level.
A centralized human resource department then supports organizational gains and objectives, whereas a decentralized human resources act supports professional and medical benefits. It is expected…
Connor, E.T., Educational tort liability and malpractice, University of Iowa, http://www.uiowa.edu/~c07p134/tort.htm last accessed on March 3, 2011
Salvador, F.A., Which is better? Formal authority or informal authority? Entrepreneur, http://www.entrepreneur.com.ph/features/article/which-is-better-formal-authority-or-informal-authority last accessed on March 3, 2011
Website of Medicare, http://www.medicare.gov last accessed on March 3, 2011
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://184.108.40.206/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://220.127.116.11/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
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 Communication
As the nation's health care resources become more and more strained, health care professionals are being asked to do more with less. They are being pressured to find cheaper ways to improve the quality of health care they deliver. Given the current circumstances, this sounds difficult and even unreasonable, but it may not be entirely impossible.
One simple way for medical professionals to improve the quality of health care they provide is by improving their health care communication skills. Health care communication is "The art and technique of informing, influencing, and motivating individual, institutional, and public audiences about important health issues. The scope of health communication includes disease prevention, health promotion, health care policy, and the business of health care as well as enhancement of the quality of life and health of individuals within the community." (U.S.D.S.H.S., 2000, p.11-20).
In health care, as in all aspects of…
U.S. Department of Health and Human Services. (2000). Healthy People 2010: Volume I, Focus Area 11: Health Communication (second edition) Washington, DC: U.S. Government Printing Office.
Zachariae, R. et. al. (2003). The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management. British Journal of Cancer, 88(5), 658-65.
Heisler, M. et. al. (2002). The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management. Journal of General Internal Medicine, 17(4), 243-52.
Safran, D.G. et. al. (1998). Linking primary care performance to outcomes of care. Journal of Family Practice, 47(3), 213-20.
But due to the ineffective allocation of resources, while money was spent on his care when his blood sugar was 'out of control,' and when he began to develop blindness and other symptoms of uncontrolled diabetes, he did not receive the consistent but relatively low-care necessary to reduce the causes of his inability to manage his condition. Conclusion Healthcare operates within the market system, and is subject to opportunity costs like any other good or service. However, overall the healthcare system does not operate upon the principles of efficiency, often due to the bureaucracy of the healthcare system and its methods of reimbursement and prioritizing acute over primary care.
Gawande, Atul. (2009, June 1). The cost conundrum: What a Texas town can teach us about health care. The New Yorker. etrieved February 2, 2011 at http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande#ixzz1CpZ4jbV
Gawande, Atul. (2011, January 24). The hot spotters. The New Yorker. etrieved February…
Gawande, Atul. (2009, June 1). The cost conundrum: What a Texas town can teach us about health care. The New Yorker. Retrieved February 2, 2011 at http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande#ixzz1CpZ4jbVR
Gawande, Atul. (2011, January 24). The hot spotters. The New Yorker. Retrieved February 2,
2011 at http://www.newyorker.com/magazine/bios/atul_gawande/search?contributorName=atul%20gawande
Gibson, Jennifer, Douglas K. Martin, & Peter a Singer (2004). Setting priorities in health
Health Care Finance
One of the things people should know is that the landscape for health care is not good at present, especially in the not-for-profit sector. We are definitely running a not-for-profit health care institution here at VGH. Consider the Moody's Outlook for 2012, which is currently negative. There are a number of challenges that institutions like ours face, and will be explained in this article.
Hospital revenue growth for the next 18 months is forecast to be modest, but there are further issues that complicate the situation. For example, the expectations for the economy in the coming months remain poor. There will also be operating pressures resulting from regulatory changes and these will also include balance sheet challenges. The ultra-low interest rates on our debt are especially challenging to our ability to invest for the future.
Some would argue that there are opportunities in the market, for example…
Moody's. (2012). Moody's U.S. not-for-profit healthcare outlook remains negative for 2012. Moody's. Retrieved March 28, 2014 from https://www.moodys.com/research/Moodys-U.S.-not-for-profit-healthcare-outlook-remains-negative-for -- PR_236074
Healthcare Financing and Nursing
Healthcare is one of the most contentious subjects in the United States today, with the financing of the healthcare system the specific issue of concern in legal, ethical, and pragmatic spheres. The debate surrounding this industry has impacted all areas of the healthcare industry, including the nursing profession, in a variety of complex ways that are both direct and indirect. ising healthcare costs without a rising ability to pay has created a strain on many medical institutions, and a rising demand for are with the rapidly aging population of the United States (that is, with a much larger older generation(s) in the country, the overall demographic of the nation is shifting quickly towards more elderly and care-intensive individuals) has not been adequately met with a rising provision of services (Kovner et al. 2011). The following paragraphs will explore several implications of this situation on…
Cleverley, W., Cleverley, J. & Song, P. (2011). Essential of Healthcare Finance. Sudbury, MA: Jones & Bartlett.
Kovner, A., Knickman, J., Weisfield, G. & Jones, S. (2011). Jonas & Kovner's Health Care Delivery in the United States. New York: Springer.
Mason, D., Leavitt, J. & Chaffe, M. (2007). Policy & Politics in Nursing & Healthcare. New York: Elsevier.
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. .
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
Healthcare Delivery System Challenges
The American healthcare system has been criticized as favoring the middle and upper classes while ignoring the lower classes. Based on these speculations, the federal government has constantly tried to institute reforms in the healthcare sector though some of the proposals have failed to overhaul the industry. With rising insurance costs, the number of citizens barred from accessing quality healthcare has increased to more than 45 million uninsured Americans. On the same note, it is hypothesized that with time, the problems currently witnessed in the industry are likely to increase and finding solutions to them will be a tall order for the government (Stolberg & Pear, 2010). Despite the advent of new technology in the sector, which is likely to improve service delivery over the years, it is speculated that the cost of new tests and treatments will outweigh the savings. With the better technology, physicians…
Stolberg, S.G. & Pear, R. (March 24, 2010). Obama signs health care overhaul bill, with a flourish. The New York Times: p. A19. Retrieved March 1, 2013.
Woolhandler, S. & Himmelstein, D.U. (1997). Costs of care and administration at for-profit and other hospitals in the United States. The New England Journal of Medicine 336 (11): 769-774.
Swanson, E. (July 30, 2009). Health Care Plan: Favor / Oppose. Huffington Post.
Blumberg, L.J. & Holahan, J. (2009). The Individual Mandate: an Affordable and Fair Approach
healthcare issues country. How solve ongoing problem Medicare Fraud Abuse government sufficient effective regulation enforce. If, resolve problem? recommendation ? It Economics Healthcare economically sound.
Economics of healthcare
The population of the modern day society is faced with incremental pressures, but also incremental challenges, and these new issues impact all aspects of life, including the provision of healthcare services. For instance, the more and more technological developments made within the medical and pharmaceutical industries improve the quality of the medical services and as such the life expectancy of the patients. Then, the sustained academic research conducted also improves the quality of the services and the overall quality of the medical act.
In spite of the developments made, it must also be noted that the provision of healthcare services in the United States is a complex situation, with numerous ramifications and challenges. On a first note, it is revealed that the…
Angell, M.,2002, The forgotten domestic crisis, The New York Times, http://www.nytimes.com/2002/10/13/opinion/the-forgotten-domestic-crisis.html last accessed on August 8, 2011
Cunningham, W., 2003, The development of the U.S. health care system and its problems, UCLA Schools of Medicine / Public Health, http://www.ph.ucla.edu/hs/hs_100_4_02_lecture_cunningham.pdf last accessed on August 8, 2011
Garson, A., 2000, The U.S. healthcare system 2010, Current Perspectives, http://circ.ahajournals.org/content/101/16/2015.full last accessed on August 8, 2011
Gratzer, D., Why isn't government healthcare the answer? Free Market Cure, http://freemarketcure.com/whynotgovhc.php last accessed on August 8, 2011
Human Resources planning and strategy will be 'key' in enabling the organization to deal with pandemic situations. This leads to another primary challenge that the health care industry faces which is the shortage of nursing staff in today's health care organizations and institutions. Nursing staff in the healthcare industry re under great stresses on staffing due to an inadequate supply of individuals pursuing their nursing degree with an."..unprecedented demand for nursing services" however, colleges and universities as well as health care institutions have failed to develop effective workforce supply. The work of leich and Hewlett (2004) entitled: "Dissipating the Perfect Storm - Responses from Nursing and the Health Care Industry to Protect the Public's Health" published by the Journal of Issues in Nursing states: "In spite of the progress in nurse recruitment, the prognosis for balancing supply with demand is still precarious, at best. Sadly, AACN (2003a) reports that more…
Bleich, Michael R. And Hewlett, Peggy O. (2004) Dissipating the Perfect Storm - Reponses to Nursing and the Health Care Industry to Protect the Public's Health. Online Journal of Issues in Nursing. Vol. 9 No.2, May 2004. Online available at http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume92004/No2May04/DissipatingthePerfectStorm.aspx
Bureau of Labor Statistics, U.S. Department of Labor, Career Guide to Industries, 2008-09 Edition, Health Care, on the Internet at http://www.bls.gov/oco/cg/cgs035.htm (visited March 11, 2008).
Business Continuity Planning for the Global Healthcare Industry (2007) International Federal of Pharmaceutical Manufacturers and Associations. Jan 2007 IFPMA.
" (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
Success in several high-profile areas, such as stroke prevention, acute coronary intervention, or nosocomial infection have the benefits of focusing the organization on a task which can bring tangible results, measured in clinically-relevant ways.
Specific Program for our Institution
This memo recommends that we choose five treatment areas, and implement specific quality improvement programs for each one. The focus on each should include procedures which are important to the overall quality of this institution's morbidity and mortality results. Given the hospital's focus on acute care, the following procedures might be candidates for quality improvement programs:
Ischemic stroke treatment
ACS treatment (acute coronary syndrome).
Trauma in the ER related to gunshot wounds.
Maternal ward delivery performance
Nosocomial infection reduction.
In each case, the procedures should proceed as outlined above: (1) an identification of the problem, (2) identification of best practices as demonstrated in peer-reviewed clinical trials, (3) adoption of the best…
CancerCenter. (2007). Cancer Treatment Centers of America. Retrieved November 23, 2007, from CCA: www.cancercenter.com
Civitarese, L.A. (1999). Congestive Heart Failure Clinical Outcomes Study in a Private Community Medical Group. Journal of American Board of Family Practice, 467-472.
Dana Farber. (2005). Dana-Farber attains nation's highest honor for nursing excellence; first cancer center in New England to earn Magnet recognition. Boston: Dana Farber Cancer Institute.
Katzan, I.L. (2003). Quality Improvement and Tissue-Type Plasminogen Activator for Acute Ischemic Stroke. JAHA, 799-800.
educe Patient Falls in a Hospital Environment
Method of Obtaining Necessary Approval(s)
Description of Current Problem
Explanation of Proposed Solution
esources equired for Implementation
isk and quality management is a fundamental and important aspect to many health care organizations and patient lives are often at stake. This is especially true in nursing facilities or hospitals that house elderly patients because of the level of direct patient interactions that occur on a daily basis and the specific needs of this population. There are many potential risks that can emerge from this population. Three common risks were identified from a literature review based on evidence-based practices. One common risk deals medication error and making sure patients receive the right dosage of the correct medication at the right time. Another risk that is becoming increasingly common is the risk of the spread of infection and in severe cases infections that are…
Colon-Emeric, C., Schenck, A., Gorospe, J., McArdle, J., Dobson, L., Deporter, C., & McConnell, E. (2006). Translating Evidence-Based Falls Prevention into Clinical Practice in Nursing Facilities: Results and Lessons from a Quality Improvement Collaborative. Journal of the American Geriatrics Society, 1414-1418.
Renteln-Kruse, W., Krause, T., & Georgr, D. (2007). Incidence of In-Hospital Falls in Geriatric Patients Before andAfter the Introduction of an Interdisciplinary Team -- BasedFall-Prevention Intervention. The American Geriatric Society, 2068-2076.
This work will first provide a synopsis of a more detailed review of literature developing the case of transformational leadership model in healthcare, exploring some of the claims of the model as it is observed in practice. (Edmonstone & Western, 2002) the work will then provide a qualitative review of 50 healthcare professionals, from leadership to trade. Ultimately the work will attempt to focus on a single hospital organization setting and review all departments, through a questionnaire regarding the leadership model (based on characteristics of the TrLM) and attempt to determine first if the literature is accurate in its assessment of TrLM being the most common and i.e. popular model in health care and then determine if this leadership model is reflective of better health outcomes for the community served than were provided prior to implementation of the TrLM. Lastly I will determine if some of the…
Aarons, G.A. (2006). Transformational and Transactional Leadership: Association With Attitudes Toward Evidence-Based Practice. Psychiatric Services, 57, 1162-1169.
Bass, B. (1985). Leadership and Performance Beyond Expectation. New York, NY: Free Press.
Bowles, a., & Bowles, N. (2000). A comparative study of transformational leadership in nursing development units and conventional clinical settings. Journal of Nursing Management, 8 (2), 69-76.
Dunham-Taylor, J. (2000). Nurse Executive Transformational Leadership Found in Participative Organizations. Journal of Nursing Administration, 30 (5), 241-250.
equiring newly licensed registered professional nurse to attain a baccalaureate degree in nursing within 10 years seems to be a reasonable expectation, particularly given the greater demands put upon the profession in healthcare environments where nurses are often called upon to function in a similar fashion to doctors (Vitale, 2010, NJSNA).
School nursing: Scope and standards of Practice (2005). evised 2020. ANA. etrieved
Vitale S-620. NJSNA. etrieved http://www.njsna.org/displaycommon.cfm?an=4
Share any comments you would like to make on the Gordon's chapters 6-10.
One of the most depressing comments made by Gordon (2005) in Nursing against the odds is the statement that despite mounting evidence that "no matter how many warnings" they received about overcrowding, poor patient conditions, and overburdened staff, nursing academics did not address these challenges within their literature (Gordon 2005, p.249). Nursing is facing a twofold crisis at present: on one hand, there are…
Gordon, S. (2005). Nursing against the odds: How health care cost cutting, media stereotypes, and medical hubris undermine nurses and patient care. Ithaca, NY:
1. Nursing Theorist Overview
Theory guides nursing practice and provides a framework for nurse leadership and healthcare management (McKenna, Pajnikar & Murphy, 2014). All prominent nursing theorists like the individuals covered in the multimedia presentation have influenced nursing practice in some way or another, and all do resonate with me on a personal and professional level. I will incorporate elements of all theorists into my practice in terms of interpersonal communications and attitudes towards health and healing. Of the theorists covered in the presentation, those of Florence Nightingale resonate the most because of her inclusion of environmental factors implicated in patient care. Environmental factors like lighting or ventilation can have a profound impact on perceptions of quality of care, too, which has a strong bearing on the efficacy of the healthcare institution (Sabza & Pirani, 2016). The environmental factors that Nightingale identified as being important to patient care also have…
Drawbacks that exist within the structure of healthcare institutions include the lack of universal implementation of the electronic health records, and the lack of consistency in service quality and delivery. Moreover, there are different systems for different classifications of patients depending on their insurance coverage. For instance, seniors on Medicare use different products and services within the system and may be processed differently at different institutions. The nature of healthcare insurance is also overly complicated. Because each state also has different rules, regulations, and healthcare issues, there is a potential for service disruptions and inconsistencies. Patients living in more than one state or who travel often will frequently encounter the inconveniences of the American health care system.
Not all healthcare institutions have the same structure, but many hospitals and other large healthcare organizations are structured similarly. Lack of consistency in healthcare is especially apparent among the elder population, which…
The Greatest Challenge to US Healthcare
The role is played by the government
The role played by the government in healthcare is a divisive issue. Many healthcare organizations executives do support the idea of extending healthcare coverage to the uninsured, however, who this is implemented is the cause of concern. There are numerous changes that are taking place in the healthcare industry and the government needs to catch up quickly. Policy development is the role of government and there is a need to ensure that there are timely and applicable policies in place to govern the provision of healthcare services to the masses. As it stands, healthcare is moving from fee-for-service to value outcomes and there should be policies in place to support this advanced move. Providers have been moving towards value-driven care and the government policies should be able to mirror this movement. While not all providers will be…
Hand-held devices and portable digital assistants (PDAs) are being integrated into the health care setting in the United States. It is important to understand which devices are being used, how they are being used, what they are being used for, and why. Understanding the role that hand-held devices and other portable electronics play in health care can help to inform organizational policy, and help health care administrators better implement electronic medical records.
History of use
The first documented PDA was the Newton MessagePad, issued by Apple in 1993. It was described as being "revolutionary" (Wiggins, 2004, p. 5). Palm, Inc. developed the next big handheld device: the Palm Pilot, in 1996. By the late 1990s, PDAs were equipped for Internet access, and memory capacity and other features improved with each product release. Microsoft also entered the portable electronic devices marketplace in the 1990s. The devices were not yet being…
Alerndar, H. & Ersoy, C. (2010). Wireless sensor networks for healthcare. Computer Networks 54(15): 2688-2710.
Fornell, D. (2008). PDAs bring hand-held solutions to healthcare. Acuity Care Technology. Retrieved online: http://www.soti.net/PDF/PDAsBringHandHeldSolutionsToHealthcare_Article.pdf
Garritty, C. & El Emam, K. (2006). Who's using PDAs? Journal of Medical Internet Research 8(2).
Huang, V.W. (n.d.). PDAs in medicine. Power Point Presentation Retrieved online: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&ved=0CF4QFjAB&url=http%3A%2F%2Fwww.cs.princeton.edu%2Fcourses%2Farchive%2Fspr02%2Fcs495%2Fpda.ppt&ei=xxqAUsq_NtTFqQG25IHwAQ&usg=AFQjCNE4Wf4YrX7slTbcdYJwxujV3rwgog&sig2=Uee9rvdDYwY0uYM33n1ZBg&bvm=bv.56146854,d.aWM
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 in Canada: To Privatize or Not to Privatize
To Privatize or not to Privatize: Healthcare in Canada
Canada prides itself in one of the most generous healthcare systems in the world. Canadians do not have to rely on their employers for health insurance or to pay out-of-pocket for their medical procedures as the greater part of their healthcare bill is footed by the government. This has had the effect of making the country a rather healthy nation; however, its health comes at a cost. Canada currently spends over 9% of its GDP on healthcare -- the highest amount in the developed world. This proportion can be expected to rise over the coming years as the Baby Boomer population ages. Privatization has been proposed as a possible way of reducing the government's expenditure on healthcare. This text assesses the potential costs and benefits of healthcare privatization.
Open letter to the…
Commission on the Future of Healthcare in Canada. (2002). Sustainability of Canada's Healthcare System. Commission on the Future of Healthcare in Canada. Retrieved December 14, 2015 from http://www.cfhi-fcass.ca/sf-docs/default-source/romonow-commission-english/Discussion_Paper_Sustainability_of_Canada_s_healthcare_system.pdf?sfvrsn=0
Howard, W. J. (2011). Missing Links: the Effects of Healthcare Privatization on Women in Manitoba and Saskatchewan. Prairie Women's Health Center of Excellence. Retrieved December 14, 2015 from http://www.pwhce.ca/pdf/ml.pdf
Wilson, DF. (2000). Privatization of the Canadian Healthcare System: Not Yet and Hopefully Never. University of Alberta, Edmonton. Retrieved December 14, 2015 from https://www.uow.edu.au/~bmartin/dissent/documents/health/privat_canada.html
All spending includes state and federal expenditures. Growth figures reflect increases in benefit payments and disproportionate share hospital payments; growth figures do not include administrative costs, accounting adjustments, or costs for the U.S. Territories.
Federal Fiscal Year: Unless otherwise noted, years preceded by "FY" on statehealthfacts.org refer to the Federal Fiscal Year, which runs from October 1 through September 30. for example, FY 2009 refers to the period from October 1, 2008 through September 30, 2009.
Urban Institute estimates based on data from CMS (Form 64) (as of 12/21/11).
From this entire chart, the entire increase in expenditure of…
Clark, Cheryl et al. "State Medicaid Eligibility and Care Delayed Because of Cost." New England Journal of Medicine, 368 (2013): 1263-1265. Print.
Ellwood, Marilyn Rymer et al. An Exploratory Analysis of the Medicaid Expenditures of Substance Exposed Children Under 2 Years of Age in California. U.S. Department of Health and Human Services, 1993. Print.
Goodnough, Abby. "October 25th." The New York Times. 25th October. 2012. Web. 29th March 2013. [ http://www.nytimes.com/2012/10/26/us/spending-on-medicaid-has-slowed-survey-finds.html?_r=0 ].
Grannemann, Thomas W. And Mark V Pauly. Controlling Medicaid Costs: Federalism, Competition, and Choice. Washington DC: American Enterprise Institute, 1983. Print.
The reason why, is because this is a sign that the quality of care that is being provided in declining. What normally happens is staff members, will often become frustrated with: health care environments that are inefficient and where management has an attitude of indifference. This is problematic, because it can spread through the organization like cancer by: eating away at the fundamentals that made the facility great.
Once this occurs, it will have an impact on: the costs, efficiency and profitability of the hospital. This is the point that this could undermine the reputation of facility and it could have an impact on the brand. When this takes place, it is a sign that many hospitals are falling into a downward spiral of: declining quality of care and increasing costs. At which point, it only becomes a matter of time until: some kind of major restructuring must occur or…
Ableson, R. (2010). Employers Push Costs for Health Care on Workers. New York Times. Retrieved from: http://www.nytimes.com/2010/09/03/business/03insure.html
Palfry, C. (2004). Effective Health Care Management. Malden, MA: Blackwell.
Shortell, S. (2006). Health Care Management. New York, NY: Thomason.
Healthcare Legislative Bill
The expanded and improved Medicare for all Acts
The Expanded and mproved Medicare for All Act was introduced to the House of Representatives in 2009 and seeks to lobby for the implementation of a common single-payer health care system throughout the United States o0f America. The bill if enacted would require that all medical care costs be paid for automatically by the government instead of private insurances for the same. The move will significantly alter the role of private insurance companies as merely offering supplemental coverage especially when the kind of medical care sought is not all that essential (McCormick, 2009).
With the Expanded and mproved Medicare for All Bill, the country's national system will be paid for through taxes and the monies that will replace the regular insurance premiums. Proponents of the bill argue that by eliminating the need for private insurance companies in the national…
Institute of Medicine of the National Academies of Science, (2010), Insuring America's Health: Principles and Recommendations
The American Journal of Medical Practices, (2011), The Impact of single-payer Medicare
Program, New York
While it may not be just to hold an organization liable, absolutely, for every instance of employee negligence, there is a rationale for imposing such liability in many cases. For example, many types of industries entail potential danger to others that are inherent to the industry.
Individual workers are not likely to be capable of compensating victims of their negligence, but the employer benefits and profits financially by engaging in the particular industry. Therefore, the employer should not necessarily escape liability for compensating all harm caused by their activities, regardless of fault in particular instances.
10.A nurse is responsible for making an inquiry if there is uncertainty about the accuracy of a physician's medication order in a patient's record. Explain the process a nurse should use to evaluate whether or not to make an inquiry into the accuracy of the physician's medication order.
Like other highly trained professionals, experienced nurses…
Abrams, N., Buckner, M.D. (1989) Medical Ethics: A Clinical Textbook and Reference for the Health Care Professionals. Cambridge, MA: MIT Press
Caplan, a.L., Engelhardt, H.T., McCartney, J.J. Eds. (1981) Concepts of Health and Disease: Interdisciplinary Perspectives. Reading, MA: Addison-Wesley
Starr, P. (1984) the Social Transformation of American Medicine.
New York: Basic Books
(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
However, they contradict themselves trough supporting one's right to commit physician-assisted suicide, since this would virtually mean that the individual who is no longer willing to live is not provided with health care meant to prevent him or her from dying (Epstein, 1999, p. 1).
Among those opposed to the fact that health care is becoming increasingly better are those who are in their twenties and are obliged to work hard in order to pay for their own medical insurance and for that of the underprivileged (Bonner, 2010).
Contemporary health care is basically provided by groups forced to pay taxes in order for others to benefit out of the process. The fact that health care is a privilege and not a right was made obvious ever since the 1954 foundation of the Department of Health, Education, and elfare. The name contained the term welfare with the intention of highlighting how…
Bloche, M.G. ed., The Privatization of Health Care Reform: Legal and Regulatory Perspectives (New York: Oxford University Press, 2003)
Epstein, R.A. Mortal Peril: Our Inalienable Right to Health Care? (Cambridge, MA: Perseus Books, 1999)
Heirich, M. Rethinking Health Care: Innovation and Change in America (Boulder, CO: Westview Press, 1998)
Sanders, B. (2009). Retrieved from the Huffington Post Website: http://www.huffingtonpost.com/rep-bernie-sanders/health-care-is-a-right-no_b_212770.html
Health Care Past, Current, And Future
The health of any nation should be a top priority for leaders and elected political representatives, but in the United States it took several centuries for the nation to begin to come to terms with providing health care for its citizens. This paper covers the gradual implementation of health care services and doctor training facilities in the U.S., and also covers the recent attempt by President Barack Obama to reform a chaotic, poor-functional and expensive health care system. Thesis: It is a scandal of massive proportions that a well-functioning, citizen-friendly universal health care system cannot be instituted in America, the world's most democratic superpower. Until the divisive and toxic political climate can be reformed, there is no chance of major reforms -- or for universal health care coverage -- in these United States.
Past Health Care Services -- Early America
Health care in colonial…
Daly, John. (2005). Professional Nursing: Concepts, Issues, and Challenges. New York:
Springer Publishing Company.
Gorsky, Martin. (2010). Good Health for America? History Today, 60(2), 1-6.
McCarthy, Robert L., and Schafermeyer, Kenneth W. (2007). Introduction to Health Care
A patchwork of laws provided narrow privacy protections for selected health data and certain keepers of that data." (Administrative Simplification in the Health Care Industry) Therefore, new technologies such as relational databases have simplified the data gathering and maintenance processes of all types of healthcare related data like the physician information process. It is not unheard of today for healthcare and insurance providers matching or 'sinking data' on a monthly or quarterly basis because of the availability of better communication capabilities as well as compatible database comparison processes.
Even the doctors themselves have access to providers' systems and databases today. Through automatic telephone systems, business to business Internet portals, and tape or disk delivery processes, all of a physician's personal, office and patient information can be updated easily. In many cases, the entire process including security and confirmation is a completely hands free operation. In other words, without human intervention,…
Administrative Simplification in the Health Care Industry. Ed. HIPAA. Health and Human Services. 23 Oct. 2004 http://www.hipaa.com/.
HMO Patients Can Contact Their Doctors Electronically as Blue Shield of California Expands Online Communication Services. Ed. Unknown. October 29, 2003. Relay Health. 23 Oct. 2004 http://www.relayhealth.com/rh/general/news/newsRecent/news49.aspx .
Hoffer, Prescott, and McFadden. Modern Database Management. 7th ed. Add City: Add Publisher, Add Year.
The American Public Health Association (APHA) is founded. This organization is concerned with the social and economic aspects of health problems.
The National Quarantine Act is signed into law. This legislation is designed to prevent entry into the country of persons with communicable diseases.
1899 the National Hospital Superintendent's Association is created. It later becomes the American Hospital Association.
Patel & ushefsky, 1995, p. xvii)
The seeds of health care legislation and centralization began before 1875 but began to take hold as the most accepted manner in which to ensure safe and scientifically founded health care for many and to begin to ensure that diseases that commonly plagued a newly urbanized and highly stressful environment of mass immigration could be dealt with, in a more centralized and practical manner. Founded earlier in 1847, the American Medical Association began to have a concrete and centralized role in the health care decisions…
When considering the ever-changing and highly competitive economic landscape of the modern world; governments, businesses and institutions must remain diligent in their care and compassion for their citizens and staff members. With the current exponential growth and advancement of technology and the computerization of business and learning, voters, workers and consumers have become much more connected to the organizations they patronize (Kurzweil). Accordingly, these important groups are faced with the continuous task of finding new ways to understand and subsequently accommodate the needs of their followers, while simultaneously securing lucrative business models and job environments. One of the most important needs presented in all demographics is reliable healthcare. Thus, with the inelasticity in the demand for healthcare, countries need to determine an applicable system, whereby citizens can have access to the medical services they will inevitably need. Collective access to healthcare represents the main problem in field of…
Blumenschein, K. And M. Johannesson. "Economic Evaluation in Healthcare. A Brief History and Future Directions." Journal of Pharmacoeconomics 10.2 (1996): 114-122.
Cox, Malcolm, et al. "Health Care Economics, Financing, Organization and Delivery." Family Medicine January 2004: 20-30.
Hamburger, Tom and Kim Geiger. "Healthcare Insurers Get Upper Hand." The Los Angeles Times 24 August 2009.
Jeremiah Hurley. "An Overview of the Normative Economics of the Health Sector." Journal of Health Economics 1.1 (2000): 55-118.
Healthcare in the United States: Where We Have Been, Where We Are Going
The current healthcare crisis in America is not one that happened over night. It is one that has been building for more than a quarter century. There was a time in America when healthcare was a stellar institution: research, cures, technological advances, and treatments. The focus of healthcare was maintaining and improving the quality of life. Then, during the early 1980s, managed care became an entity between the physician, the patient, and the healthcare provider of hospital services. It began subtly, but has, today, become one of the most aggressive and successful business ventures of our time; and it has been the unmaking of a once stellar and progressive American institution.
Managed care is a "distinctly American" product (Birenbaum, 1997). It was legislation introduced by the Nixon Administration with the intent to regulate healthcare and to maintain…
Bernstein, A.B., Hing, E., Moss, A.J., Allen, K., Siller, A., and Tiggle, R. (2003). Health Care in America: Trends in Utilization. Hyattsville, MD: National Center for Health Statistics.
Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care. Westport, CT: Praeger.
Birenbaum, A. (1997). Managed Care: Made in America. Westport, CT: Praeger.
Committee on Health Care Access and Economics Task Force on Mental Health (2009). Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration. The Official Journal of the American Academy of Pediatrics, March, 30, 2009, pp. 1248-1251.
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:
Polls examining public support of the bill and specifically the public healthcare option vary significantly. ith regard to physicians, the New England Journal of Medicine surveyed over six thousand medical doctors and found there was a majority in favor of federally provided public healthcare insurance (Keyhani & Federman). Other polls have suggested an opposition to the public option (Marmor).
The public option would provide an affordable alternative to the current private health insurance options and would provide impetus for competition and positive change. hether "America's Affordable Health Choices Act of 2009" will be passed is currently uncertain. hat is certain is that the healthcare and health insurance system is currently not sufficient to provide healthcare support for nearly 48 million uninsured Americans. Alterations need to be made to increase access and affordability for those individuals who desire health insurance.
The healthcare and health insurance system in the United States…
Harrington, Charlene, Carroll L. Estes, and Cassandra Crawford. Health policy. Jones & Bartlett Publishers, 2004.
Keyhani, Salomeh, and Alex Federman. "Doctors on Coverage -- Physicians' Views on a New Public Insurance Option and Medicare Expansion." N. Engl J. Med 361.14 (2009): e24.
Kotlikoff, Laurence J. The healthcare fix. MIT Press, 2007.
Marmor, T. "The Obama Administration's Options for Health Care Cost Control: Hope vs. Reality." 7 Apr 2009. 1 Nov 2009 .
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.
Day treatment programs can provide services at less cost because the patient goes home at night after being treated during the day, which often is used for rehabilitating chronically ill patients (Sharfstein, Stoline, & Koran, 1995, p. 249). The mere fact of having more choice benefits some patients by giving them more say in their care.
Patient-focused care involves a method for containing in-patient costs for hospitals and for improving quality by "restructuring services so that more of them take place on nursing units rather than in specialized units in other hospital locations, and by cross-training staff on the nursing units so that they can do several 'jobs' for the same small group of patients rather then one 'job' for a large number of patients" (Kovner, 1995, p. 186). Kovner notes a number of barriers to this type of care. One reason has been that hospitals have not had to…
Doctors Say Managed Care Strains Patient Relationships (1997, June 9). Westchester County Business Journal 36(23), p. 24.
Kovner, a.R. (1995). Hospitals. In Jonas's Health Care Delivery in the United States, a.R. Kovner (ed.), pp. 162-193. New York: springer Publishing.
Moore, G.T. (1991,
April 24). Let's provide primary care to all uninsured Americans ? now! JAMA, pp. 2108-2109.
Health Care Situation: Medical Error Due to Doctors' Bad Handwriting
Identify a health care news situation that affects a health care organization such as a hospital, clinic or insurance company.
I have identified the following health care news situation as the topic of my paper: "Poor Handwriting of Doctors and its implied risks for the Patient, Hospital and Medical Malpractice Insurance." Poor handwriting of physicians resulting in poor legibility of entries into patients' medical records carries very dramatic risks for all above-mentioned interest bearers. It can result in severe health danger for the patient and - in extreme situations - even cause a patient's death. Doctors' bad penmanship has long been seen a problem within organized medicine and the patient safety movement. Three American Medical Association (AMA) policies dating back to 1992, urge doctors to "improve the legibility of handwritten orders for medications" and review all orders for accuracy and…
Berwick, Donald M. & Winickoff, David E. (1996). The truth about doctors' handwriting: a prospective study. BMJ Vol. 313 (21-28 December 1996). 1657-1658. www.bmj.com/content/313/7072/1657.full, accessed 21 August 2011.
Bruner, Anne & Kasdan, Morton.L. Handwriting Errors: Harmful, Wasteful and Preventable.
1-4. www.kyma.org/uploads/file/.../Harmful_wasteful_and_preventable.pdfSimilar, accessed 22 August 2011.
Gallant, Al. (22 November 2009). For a secure electronic health record implementation, user authentication is key. 1-2). searchhealthit.techtarget.com/.../User-authentication-is-critical-for-pl.., accessed 24 August 2011.
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.
The health care industry is heavily regulated and has several special risk areas that need to be looked out for. An effective compliance program is necessary in order to mitigate these risks. In addition to the challenges that are associated with taking care of patients, health care providers are subject to huge and sometimes intricate sets of rules that govern the coverage and reimbursement of medical services. Because federal and state sponsored health care programs play such a big role in paying for health care, compliance with these rules are necessary in order to avoid penalties that can occur. These penalties can include such things as recoupment of improper payments, along with sanctions imposed by Medicare and Medicaid against health care businesses that engage in abuse or fraudulent practices (Corporate esponsibility and Corporate Compliance: A esource for Health Care Boards of Directors, (n.d.).
A good health care administrator will…
Corporate Responsibility and Corporate Compliance: A Resource for Health Care Boards of Directors. (n.d.) Retrieved April 3, 2009, from Office of the Inspector General Web site:
Health Administration. (n.d.). Retrieved April 3, 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.
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.
there are three parts. PAT A EQUIES 4 DIFFEENT ANSWES
"ICD-10-PCS is intended to replace ICD-9 volume 3 for facility reporting of inpatient procedures….ICD-10-PCS is a totally new coding system designed to better accommodate the rapidly changing world of procedures. The code system was developed in the 1990s, but use of the continually updated codes will start almost 20 years later." (Dimick 2011). This new standard is supposed to be more accurate and reflective of current healthcare realities than standards of the past, but it is uncertain if in its implementation this promise will be realized.
Current status of implementation
This standard has yet to be fully implemented. "On October 1, 2013, healthcare providers must begin reporting HIPAA claims using the ICD-10 counterparts to the current ICD-9 code sets" and full implementation will be a 20-year process (Dimick 2011).
Three major issues related to implementation status…
About ASC X12. (2013). ASC X12. Retrieved: http://www.x12.org/about/index.cfm
Dimick, Chris. (2011). Learning and using ICD-10-PCS. Journal of AHIMA. Retrieved:
Health Level 7 International. (2013). HL7. Retrieved: http://www.hl7.org/implement/index.cfm
Many of the chapters relate to medical research as well as medical procedures, with the informed consent issue in particular affecting both human beings involved in medical research and those facing a medical crisis and wanting to now what their treatment will entail.
Throughout, the authors present ways of thinking about these ethical issues and also encourage medical personnel to consider these matters and to have a means for making decisions in mind at all times and to follow certain procedures in analyzing a situation and making a determination as to what behavior is acceptable and what is not. Some of the issues discussed are more controversial than others, with abortion being perhaps the most controversial and so the most in need of an ethical structure to decide between competing interests. The death and dying issue is another with two clear positions polarizing the argument and with a range of…
Garrett, Thomas M., Harold W. Baillie, and Rosellen M. Garrett.
Health Care Ethics: Principles and Problems. Upper Saddle River, New Jersey: Prentice-Hall, 2001.
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
Healthcae Regulation Reseach
Regulation is a key aspect in the health cae industy. Regulation is necessay to safeguad the public inteest. In paticula, egulation in the health cae industy is all the moe significant as it diectly impacts the life and health of consumes (Field, 2006). The vaious egulatoy institutions implement health cae egulations to safeguad the geneal public fom vaious health isks and augment public health and well-being. Health cae egulations and standads ae impeative and fundamental to make cetain that thee is compliance and to povide safe health cae to evey peson that has accessibility to the healthcae system. They ae established and executed at the local, fedeal and state levels (Field, 2006).
Selected Health Cae Regulation
The selected health cae egulation is the HIPAA Pivacy Rule. The HIPAA Pivacy Rule was allotted by the United States Depatment of Health and Human Sevices to limit the usage and…
Pritts, J. (2008). The importance and value of protecting the privacy of health information: Roles of HIPAA Privacy Rule and the Common Rule in health research. National Academies.
Healthcare System Practice Guideline
Introduce an overview of one healthcare system practice guideline
There are numerous areas within health care that demand change in everyday healthcare practice. More often than not, irrespective of the healthcare setting, an inventive group is required to conduct research and facilitate change. There are numerous practices that require change or upgrading. This is facilitated through the establishment and advancement of clinical practice guidelines. The selected healthcare system practice guideline is Management of Diabetes Mellitus in Primary Care (2017). This particular guideline delineates the important decision points in the Management of Diabetes Mellitus (DM) and provides well-outlines and wide-ranging evidence based recommendations assimilating prevailing information and practices for practitioners throughout Department of Defense (DoD) and Veretan Affairs (VA) Health Care Systems. Diabetes mellitus is an illness that is caused either by an absolute or relative deficiency in insulin giving rise to hyperglycemia. Type 1 DM (T1DM)…
Health Care Payment Reform
Buerhaus, Welton, and Rosenthal wrote and spoke about the way changes are hoped to be made in terms of the health care system and the way providers are paid, particularly hospitals and physicians. The hope is that changes in the payment system will produce greater output without being unfair to staff, reducing the quality of care and access to the people.
The disadvantages between the current system and proposed system are that currently, nurses aren't paid outright and there's a standard fee for care. This means there is an imbalance of work load, despite the amount of care needed in a variety of patient rooms and diagnosis. Currently, hospitals generate more profit and makes a fixed payment per patient that walks in those doors, and a daily room rate. The payment system now pays for the amount of help needed for each procedure, the time spent,…
Health care, and that too, a quality health care is one of the most basic needs of any human being. In current times, where the fast paced lives are getting faster each day, work stresses are increasing, streets are being storm with junk foods and fast foods, and pollution and congestion is increasing, human lives are getting more and more prone to physical and mental diseases. As a result, the importance of health care systems and health care facilities increases. While, surgeons and doctors are generally seen as the captain of the ship as far as health sector is concerned, very important personnel of the health sector are the nurses. Once quite ignored, the importance of the nursing profession was highlighted by Florence Nightingale, one of the nursing pioneers. Florence Nightingale broke the conventional perceptions associated with the profession of nursing and took it to a new level, explored various…
Lee, H. & Winters, C. (2006). Rural nursing: concepts, theories and practice. New York:
Joel, A. & Kelly, L. (2002). The nursing experience: trends, challenges and transitions. New York: Mc Graw Hill.
Lumby, J. & Picone, D. (2000). Clinical Challenges: focus on nursing. St. Leonards, N.S.W: Allen and Unwin.
Health Care udgeting
Larry Scanlan, in his article about hospital budgeting, presents seven keys to a successful budget. These "reality keys," as he calls them, are designed to help insure that the CFO and CEO are able to navigate through a difficult process.
The first of these is accountability. He recommends communicating about the status of financial performance in all areas, and instituting a compliance plan that monitors and responds quickly to problems. Teamwork and a high sence of management integrity are essential. The budget is everyone's responsibilty, not just management.
The second key is to know your market. The budget process should mesh seamlessly with the strategic plan. Management should have a clear enough understandfing of their market, so that they can respond to changes quickly and accurately.
The third key is to know how the institution's revenue is generated. Physicians are the key to revenue, and management should…
Larry Scanlan. (January 2005). "Budget Reality: It's Up to You." Healthcare Financial Management. Retrieved June 24, 2005 from http://www.findarticles.com/p/articles/mi_m3257/is_1_59/ai_n8706920 .
Larry Scanlan. (January 2005). "Budget Reality: It's Up to You." Healthcare Financial Management. Retrieved June 24, 2005 from
Healthcare for Mentally Impaired Patients
Probing what information is available about the current status of placement or accommodation and level of personal healthcare available to mentally impaired and emotionally disturbed individuals, it is clear that the analysis is as diverse as there are different mental illnesses. While statistics on managed care treatment for people with severe and disabling mental illnesses are sparse, it is evident that the financial responsibility to care for and house these patients is enormous.
According to Dr. David Satcher, the Surgeon General (1999), approximately 20% of the U.S. adult population has a mental illness. He says, "These illnesses include anxiety disorders, mood disorders, anorexia nervosa, and severe cognitive impairment. More serious mental illnesses include ipolar disorder and schizophrenia. Mental illness accounts for 15% of overall burden of disease -- more than malignant cancer and respiratory diseases -- and as far back as 1996 the direct cost…
Boulard, G. (2000, April). Forgotten Patients the Mentally Ill. State Legislatures, 26, 12. Retrieved February 13, 2004, from Questia database, http://www.questia.com .
Callahan, D. (1993, October) Minds and hearts: priorities in mental health services.
The Hastings Center Report.
Fox, M. & Kim, K. (2004, January) Evaluating a Medicaid Home and Community-based Physical Disability Waiver. Family and Community Health. Vol 27: 37.
Some hospitals create a "contingency" budget, which can be offset by a few of these patients.
The percentage of non-paying patients can vary a good deal, particularly in a city- or county-owned hospital. This number may not vary, and typically in a budget the hospital CEO and/or CFO negotiates with the governmental bodies for regular subsidies to cover.
The billing cycles can be difficult to predict, particularly for Medicare and Medicaid patients, where there are famous irregular delays on payment. It is possible, as noted above, to go to outside banks or other bodies to get a/R funding to cover these contingencies
Particularly in older hospitals, the amount in the depreciation account may not be enough to cover unforeseen expenses, such as asbestos removal or deterioration. Hospitals can address this by auditing their depreciation accounts and making a better assessment of what might be needed in coming budgets.
MedCath. "MedCath Corporation." 2006. medcath.com. 15 November 2007 www.medcath.com.
Mullins, D.W. "Financial Leverage, the Capital Asset Pricing Model and the Cost of Equity Capital." Harvard Business Review (1980): n.p.
Schneider, EC, Zaslavsky, AM and Epstein, AM. "Use of High-Cost Operative Procedures by Medicare Beneficiaries Enrolled in for-Profit and Not-for-Profit Health Plans." NEJM (2004): 143-150.
Shah, BR, Glickman, SW, Lian, L, Gibler, WB, Ohman, EM, Pollack, CV, Roe, MT and Peterson, ED. "The Impact of for-Profit Hospital Status on the Care and Outcomes of Patients With Non-ST-Segment Elevation Myocardial Infarction." JACC (2007): 1462-1468.