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Benjamins, M., Whitman, S. (2014). Relationships between discrimination in health
care and health care outcomes among four race/ethnic groups. Journal of Behavioral Medicine, 37: 402-413.
he researchers are based out of Sinai Urban Health Institute in Chicago, IL. heir study focuses on the ways in which discrimination impacts health care by providing a comparison of the discrimination levels (both ethnic and racial0 in health care in four different ethnic groups. he study then analyzes the relationship between the acts of discrimination and the consequences in health care services. An assessment is made of ways in which mediators and moderators might be utilized in order to mitigate the risk of discrimination and its impact on care. he method used by the researchers to conduct this study included the adoption of multivariate logistic regression models. he sample studied consisted of 1700 individuals of white, black, Mexican, and Puerto Rican descent. Of this…
This study examines the extent to which racial disparities in renal transplants in the U.S. It approaches the subject from the standpoint of the impact of socioeconomic conditions on racial groups in order to fill a gap in literature where this particular factor is undiscussed. The researchers thus examine the relationship between race and socioeconomic status in a population sample of patients under 21 years of age from 2000 to 2008. Nearly 8500 patients were included in this study and of that sample, 30% were black, 27% were white-Hispanic, 44% were female and 28% were from impoverished economic conditions and environments. Of this sample, over 60% were put on waiting lists for transplant surgery and just over 30% received a transplant. The study found that white individuals were most likely to receive a transplant. The study is, however, inconclusive in explaining the disparities among the different racial groups and affirms that socioeconomic status alone is not enough to understand or explain this phenomenon. Thus, while this study is helpful for contextualizing the issue, further research is required to explain the racial disparities involved in renal transplants among under 21 populaces.
Grubbs, V. (2007). Good for harvest, bad for planting. Narrative Matters: 232-237.
This narrative study focuses on a single case of why a transplant would be slow to occur when the kidney is evidently ready to be transferred. The physician at the center of this narrative case study finds that race plays pivotal factor in the slowness of the transfer. What the physician found was that a patient was being made to wait because the "median wait time for cadaveric (deceased donor) kidneys is nearly twice as long for blacks as for whites" (p. 236). Thus, there was no special policy in place predicating this outcome, it was simple mathematics (of a racialized sort). The physician thus decided to donate his own kidney to help the patient since he was not receiving the available kidney that matched his blood type. As the doctor was a match for the patient, he stepped up and provided his kidney. While this narrative analysis is more qualitative in nature, it is helpful in understanding the conditions in which doctors and patients must react, as racism pervades the system of health care at every level and has essentially been institutionalized.
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 Financial Management
To quote Jonathan Clark at the beginning of his article, "Improving the revenue cycle can be a daunting task due to the scope and complexity of the interdepartmental process." Of the suggestions offered by the authors, which concept(s) give you the greatest insight into creating an improved evenue Cycle process in the organization where you work (or one in which you are familiar)? Be sure to identify which article or author you are referencing.
In his comprehensive advisory article to improve the medical industry's revenue capturing capabilities, entitled Strengthening the evenue Cycle: A 4-Step Method for Optimizing Payment, Jonathan Clark provides a series of sensible solutions to the ongoing dilemma of payment optimization. David Hammer also provides guidance to healthcare finance professional in his article The Next Generation of evenue Cycle Management, by reminding them that the key performance indicators (KPIs) which dictated policy in previous years…
Clark, J. (2008). Strengthening the revenue cycle: a 4-step method for optimizing payment. Healthcare Financial Management, 62(10), 44.
Hammer, D.C. (2007). The next generation of revenue cycle management. Healthcare Financial Management, 61(7), 49.
Seddon, J. (2008). Think system. Management Services, 52(2), 10.
Wilson, D.B. et al. (2004). 3 steps to profitable managed care contracts. Healthcare Financial Management, 58(5), 34.
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.
"Studies of the relationship between managed care penetration in the health care market and expenditures for Medicare fee-for-service enrollees have demonstrated the existence of these types of spill over effects" (Bundorf et al., 2004).
Managed care organizations generate these types of spillover effects by increasing competition in the health care market, altering the arrangement of the health care delivery system, and altering physician practice patterns. Studies have found that higher levels of managed care infiltration are linked with lower rates of hospital cost inflation and lower physician fees are consistent with competitive effects. "Other studies demonstrate the impact of managed care on delivery system structure including hospital capacity, hospital admission patterns, the size and composition of the physician workforce and the adoption and use of medical equipment and technologies. More recent evidence has linked market-level managed care activity to the process, but not the outcomes of care" (Bundorf et al.,…
Altman, D.E. And L. Levin. (2005). The Sad History of Health Care Cost Containment as
Told by One Client. Health Affairs, 24(1).
Bodenheimer, T. (2005). High and rising health care costs. part 1: Seeking an explanation.
Annals of Internal Medicine, 142(10), 847-54.
esearch has shown that good communication amid patients and health care providers is directly connected to a person's happiness, treatment adherence and affirmative health results (Cultural Competency for Health Care Providers, 2007).
The goal of a lot of provider-oriented health it tools is to make relevant patient information flawlessly and unmistakably accessible to providers at the point of care. In so doing, these tools can decrease clinical indecision related to blurred or mistaken patient information that may be found in a handwritten medical record. In the nonexistence of desired information or in the presence of blurred or uncertain data, providers may undervalue patient precise information while at the same time overweighting their own medical viewpoints, suppositions, prejudices, or stereotypes about certain kinds of patients. If apparent and precise patient information is accessible to the clinician, the utilization of this information should augment, getting rid of the need for relying on…
Cultural Competency for Health Care Providers. (2007). Retrieved March 13, 2011, from Web
Prejudice and ethical/leadership issues with healthcare are nothing new but the fight to keep those standards and ethics on an even keel and prevent racism, bigotry and predudice of any sort including based on class, money, political ideology, nationalism, and so forth should be stomped out and eviscerated whenever it can be. People are people and should treated with dignity and respect regardless of their race, gender, beliefs and so forth. Even convicted murderers and rapists should not be treated disdain due to their actions because doing otherwise lowers the ethics and standards of the healthcare community that can and should still apply at all times.
Callahan, M. (2008). Healthcare providers constricted by financial, legislative, and regulatory issues. The Journal of Medical Practice Management: MPM, 24(3),
Cobaugh, D., Angner, E., Kiefe, C., ay, M., Lacivita, C., Weissman, N., & ... Allison, J.
(2008). Effect of racial differences…
Callahan, M. (2008). Healthcare providers constricted by financial, legislative, and regulatory issues. The Journal of Medical Practice Management: MPM, 24(3),
Cobaugh, D., Angner, E., Kiefe, C., Ray, M., Lacivita, C., Weissman, N., & ... Allison, J.
(2008). Effect of racial differences on ability to afford prescription medications.
A target market is defined as recognizable segments that make up the market, and the target market consists of the groups the organization wants to focus on (Swayne, Duncan & Ginter, 2008). There are a number of ways that a target market can be understood. The main breakdowns in health care are geography, demographics, payer and specialty (Gandolf, 2010).
Geography is perhaps the simplest one. It reflects the service radius that the hospital wants to serve. In Emanuel's case, does it want to serve mainly Turlock, or does it consider its playing field to be broader. Is it competing for customers in the major towns in the area? In some respects, the other competitors in the market are defining for Emanuel what its geographic target market is, since they are winning customers away from Emanuel.
Demographics reflects the ways of describing the people in your target market. The…
Dranove, D. & Satterwaite, M. (2000). The industrial organization of health care markets. Handbook of Health Economics. Vol. 1 (B) 1093-1139.
Gandolf, S. (2010).
How to define your target audience -- a critical health care marketing success factor. Health Care Success Strategies. Retrieved November 24, 2014 from http://www.healthcaresuccess.com/blog/branding/define-target-audience.html
McQueen, M. (2007). Health insurers target the individual market. Wall Street Journal. Retrieved November 24, 2014 from http://online.wsj.com/articles/SB118765356072903507
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
(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
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 Access Ethical Dilemma
Access to health care services is not equitable in the United States. The 15% of Americans without health insurance coverage find it extremely difficult to access health care services (Trotochaud, 2006). This is an injustice that should be addressed. Patients going to rural health care facilities face myriad challenges that are occasioned by stigmatization. Stigmatization of illnesses that patients grapple with occasions ethical conflicts. In the process, patients' right to privacy and confidentiality are often violated. There are practical guidelines that can be used to minimize ethical conflicts. It is imperative that confidentiality and trust be made paramount under circumstances where healthcare professionals deal with patients with stigmatizing illnesses.
A typical example of confidentiality, overlapping relationships and lack of willingness to seek care can be attested to in a situation where a woman working at a local store finds out that her partner is HIV-positive…
Trotochaud, K. (2006). Ethical Issues and Access to Healthcare. Journal of Infusion Nursing,
Tummala, A. & Roberts, L.W., (2009). Ethics Conflicts in Rural Communities: Stigma and Illness. Hanover, NH: University Press of New England.
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.
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.
On the contrary, a comprehensive medical care solution that tackles the main issues driving up health care costs in America is possible. The main problem experienced by the average American is that health insurance premiums are cost prohibitive for the middle-class, but being uninsured can bankrupt a family forced to deal with even a minor catastrophic illness. Therefore, a national health insurance program has to be part of the solution. However, one cannot overlook the role that unpaid medical bills and exorbitant malpractice premiums also play in the modern healthcare crises. As a result, the solution must include a way to reduce malpractice premiums through tort reform, and a way to reduce the percentage of medical bills that go unpaid. The proposed three-prong approach would tackle all of those issues, without forcing any unwilling person to participate in a nationalized healthcare program.
American Tort Reform Association. "Medical Liability…
American Tort Reform Association. "Medical Liability Reform." ATRA Issues. 2007.
American Tort Reform Association. 6 Nov. 2008 http://www.atra.org/show/7338.
Kershaw-Staley, Tracy. "Miami Valley Hospital Files Lawsuit Over Unpaid Medical Bills."
Dayton Business Journal. 2008. Dayton Business Journal. 6 Nov. 2008 http://dayton.bizjournals.com/dayton/stories/2008/01/07/story5.html .
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
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
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
Health Care Strategic Management
The deliberative model in healthcare is expected to meet quite a few of the needs of the American public regarding the general area of healthcare. Of the many areas that may decide to look at this problem, an attempt is made here to look at two specific problems. One is the need of patients taking medicine properly and the other is the needs of patient care among all Americans. The problems in taking medication have been taken up on the issue of individual needs of patients for education on medicine taking. The education needs of patients in this area are not being met by healthcare providers. It may be worthwhile to take up a study to develop medication taking instructions for patients which can be used by health care providers in the long run. The aim should be to reach an approach which will be based…
Bajcar, Jana. M. (2003) "Development of a Needs-Driven Theory-Based Model for Medication-
Taking Education with Plans for Implementation and Evaluation." An Applied Dissertation Presented to the Programs for Higher Education in Partial Fulfillment of the Requirements for the Degree of Doctor of Education. Nova South Eastern University. Retrieved from http://www.schoolofed.nova.edu/dhel/pdf/dissertations/bajcar_jana.pdf Accessed on 14 June, 2005
Goold, Susan Dorr; Green, Stephen A; Biddle, Andrea. K; et. al. "Will Insured Citizens Give Up
Benefit Coverage to Include the Uninsured?" Retrieved from http://www.bioethics.nih.gov/research/give_up.pdf Accessed on 14 June, 2005
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/
People still die because they cannot afford health care, and that simply is not right in the most powerful nation on earth. People should not have to go bankrupt or lose their home because they cannot afford health insurance, and health care should be more affordable for everyone. An Indiana Congress member notes, "Expenditures on health-care lobbying last year rose to $325 million, as health-care providers, insurers, drug makers, medical professionals and others all worked to make sure their interests were served as Congress took up their issues" (Hamilton). Americans need to stop listening to lobbyists and start taking health care reform into their own hands for real health care reform to occur in this country.
Hamilton, Lee. "Who Lobbies for the est of Us?" Indiana University. 2004. 22 Jan. 2008. http://congress.indiana.edu/radio_commentaries/who_lobbies_for_the_rest_of_us.php
Montanaro, Domenico. "Kucinich Details Health-Care Policy." Firstead.MSNBC.com. 2007. 22 Jan. 2008. http://firstread.msnbc.msn.com/archive/2007/10/25/430486.aspx
Hamilton, Lee. "Who Lobbies for the Rest of Us?" Indiana University. 2004. 22 Jan. 2008. http://congress.indiana.edu/radio_commentaries/who_lobbies_for_the_rest_of_us.php
Montanaro, Domenico. "Kucinich Details Health-Care Policy." FirstRead.MSNBC.com. 2007. 22 Jan. 2008. http://firstread.msnbc.msn.com/archive/2007/10/25/430486.aspx
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
Health Care oles in Communication
Communication is a fundamental piece of health care education and has been shown to improve health outcomes, patient compliance, and patient satisfaction. Quality health care emphasizes knowledge and utilization of communication skills. Health care professionals often express anxiety and lack of confidence and are deficient in a creating a situations that are conducive to open and candid communication with patients (Kameg et. al., 2009).
Effective communication involves gathering information, establishing a relationship or connection with a patient, and supporting the person through words and other non-verbal forms of interactions. Effective communication involves not only the interactions between the staff and the patient but also the interactions between staff and the interactions between the staff in front of the patient. Many times the high demand for services in a health care facility cause the staff to overlook the importance of good communication skills and enables situations…
Beer, J.E. (2003). Nonverbal Communication: Communicating across cultures. Cultures at work. Retrieved May 29, 2011 from http://www.culture-at-work.com/nonverbal.html
Coiera, E. (2006, May). Communication systems in healthcarre. Clinical Biochemist Reviews. nursing.Vol. 27, Issue 2, 89-98. Retrieved May 28, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1579411/
Gamble, T.K. & Gamble, M. (2006). Communication works. Burr Ridge, IL: McGraw-Hill.
Health Communication. (2010). Health communication. Healthy people 2010: Objectives for improving reproductive health. Office of Disease Prevention and Health Promotion. Retrieved May 29, 2011 from http://www.hhs.gov /opa/pubs/hp2010/hp2010rh_sec2_healthcomm.pdf
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.
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
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…
Healthcare Delivery Systems Annotated
Parnaby, J., & Towill, D.R. (2008). Seamless healthcare delivery systems. International Journal of Health Care Quality Assurance, 21(3), 249-73.
Towill, D.R., & Christopher, M. (2005). An evolutionary approach to the architecture of effective healthcare delivery systems. Journal of Health Organization and Management, 19(2), 130-47.
While the study had a number of scientific limitations; the two most significant were: 1) although the response rate of interns that volunteered to participate was 80%, those that did participate may not have been representative; and 2) the case-crossover analysis cannot account for the contribution of within-person factors that may have been co-variables with exposure status.
As a result of the related research, hospitals will be using medical resident interns as a means of making up for the lack of doctors caused by financing concerns. The redistribution of medical interns was expected to be completed before the next residency training year starts July 1, 2005, however, it remains currently underway. The Association of American Medical Colleges has stated that the health care system would be better off if the cap were lifted so hospitals could respond to the needs of their communities, such as adding a new cardiology…
Barger, L., Cade, E., Ayas, N., Cronin, J., Rosner, B., Speizer, F. & Czeisler, C. (2005).
Extended Work Shifts and the Risk of Motor Vehicle Crashes among Interns. NEJM
Cauchon, D. (2004). Medical Miscalculation Creates Doctor Shortage. USA Today,
Croasdale, M. (2004). Residency Slots Reallocated to Relieve Doctor Shortages.
Health Care & Faith Diversity
It is quite obvious how different religions hold different philosophical views on various aspects and even when it comes to healing. Each religion highly upholds their spiritual values hence the need for health practitioners to be cautious while handling varied clientele whether they hold the same religious sentiments or not. In this research we will major on the views held by the Sikh, Buddhist and Judaist religions in comparison to the Christian belief on healing.
The Sikh hold the belief that when one is sick it is the will of God and that He is merciful to heal; however one has to consider medical treatment in order to get well. During illness: Sikh patients engage in prayers to seek God for help, seek to obtain peace by remembering Gods name, recite sacred hymns (Gurbani) which are words from the holy scriptures (Guru Granth…
Dharma Haven, (2005).Tools for Healing Relaxing and Awakening. Retrieved March 30,
2012 from http://www.dharma-haven.org/tibetan/healing.htm
Manitoba, (2006). Core Competencies for Spiritual health care Practitioners. Retrieved March 30, 2012 from http://ahpcc.org.uk/pdf/compaudittool.pdf
Marinell & James (2009). Jewish Views of Illness and Healing. Retrieved March 30, 2012
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…
Meanwhile, without any competition, such as n the form of a public healthcare insurance system, the private healthcare insurance industry also continually increases premium fees virtually at will (Kennedy, 2006; eid, 2009). Furthermore, by refusing policies to high-risk patients, private health insurers essentially "cherry pick" the lowest risk patients while leaving the most expensive medical services to be furnished at the public's expense by public funds available to provide healthcare for low-income individuals (Kennedy, 2006; eid, 2009). That is why, at the very least. The future of American healthcare insurance must include a public option (Kennedy, 2006).
The Issue of Government Healthcare Insurance Lobbying
The principal way that the private healthcare insurance industry maintains its control over American healthcare is through political lobbying of government representatives (Kennedy, 2006). In fact, there are approximately six healthcare industry lobbyists in Washington for every publicly elected representative. Throughout the 2009 negotiations in Washington…
Kennedy, E. (2006). America: Back on Track. Viking: New York.
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
Drug costs have gone from 26% of health care spending by private insurance companies in 1990 to 44% in 2006 (Kaiser Foundation, 2008). This issue has not been adequately addressed by health care reform. Instead, a deal appears to be made for $80 billion in concessions from the pharmaceutical industry in exchange for its support of health care reform (Kirkpatrick, 2009).
The underlying trend in each of these major issues in health care reform is controlling the rising cost. Malpractice reform seeks to control the cost of insurance to health care providers, so that they can pass those savings along to consumers. The public option provides a plan for affordable health care coverage for uninsured and underinsured Americans. This is deemed necessary because private insurers will not offer insurance to those it feels will demand too much in terms of health care costs going forward. Reducing the cost of health…
Carey, Nick. (2009). Uninsured Americans hope reform brings health coverage. Reuters. Retrieved October 7, 2009 from http://www.reuters.com/article/topNews/idUSTRE58F0NO20090916
The White House. (2009). The Obama Plan: Stability and Security for All Americans. Retrieved October 7, 2009 from http://www.whitehouse.gov/assets/documents/obama_plan_card.PDF
New York Times. (2009). Malpractice and Health Care Reform. New York Times. Retrieved October 7, 2009 from http://www.nytimes.com/2009/06/17/opinion/17wed2.html
Kaiser Family Foundation. (2008). Prescription Drug Trends. Kaiser Family Foundation. Retrieved October 7, 2009 fromhttp://www.kff.org/rxdrugs/upload/3057_07.pdf
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:
The government should provide health care, because the economic characteristics of health care make it ripe for abuse in a market environment. Government should provide as a service to its population those goods that, for one reason or another, are open for abuse in a normal market economy. Normally, the main condition is natural monopoly, which makes the case for government involvement in commodities like electricity, water, or policing. Health care is not a natural monopoly in that there can reasonably be a number of different providers, but it has other characteristics that make it a strong candidate for government intervention.
In even the freest capitalist economies, there are public goods that the government provides. The government provision of certain services is accepted by populations because the alternative -- total anarchy -- results is a severely degraded quality of life. No government services at all is a failed…
Besley and Gouveia write about different modes of health care provision. They discuss in particular some of the cost drivers in the American system, and evaluate some other systems in order to come to some conclusions about what other options exist. They note that insurance is a key issue for a private health care system, and because of this most countries opt for public health care systems, typically with mandatory insurance.
Gupta and Davoodi seek to understand how corruption affects the provision of government services, including health care. Unfortunately, their analysis has significant bias, as they begin with the assumption that government-run programs are inherently corrupt.
Transparency International is an organization that measures the level of government corruption in all the countries of the world. This source was required to examine the claims of Gupta and Davoodi. It was found that in the West there is very little government corruption. While the U.S. has more than most Western nations, it remains a spurious claim on the part of Gupta and Davoodi that corruption is inherent in government programs. Further, the line between corruption (accepting payment in return for favors) and capitalism (accepting payment to provide a service) is not explored.
Lloyd and Sreedhar wrote about Hobbes' moral and political philosophy. Hobbes' seminal discussion about the state of nature is relevant because societies have evolved different forms of governance specifically to avoid the state of nature; an argument that government should not be involved in health care must consider the implications of having such a weak government -- these range from the state of nature to poor health outcomes and quality of life measures.
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
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.
hat are the dynamics of patient accounts receivable? hat are some of the factors affecting patients accounts receivable?
Facing the challenge of how to address the hospital's unpaid accounts receivable can be one of the most emotionally draining issues for a patient accounts receivable department. In addition to people simply reigining on their payments, the department must face patients who cannot pay, who did not understand that their insurance would not cover a procedure, or patients who simply refuse to pay because they fault the hosptial for inapprorpriate care.
Such a combination of patient's financial, insurance, legal, and emotional complaints often drives some hospitals to explore the option of moving their accounts receivable from a primary collecting agency within the hosptial to a secondary agency. But once a hosptial has written an accounts recievable off to bad debt and sends it somewhere else, it can be very cumbersome…
"Bad debt rising: when to sell your accounts receivable." (Aug 2004)
Healthcare Financial Management. Retrived 21 Apr 2005 athttp://www.findarticles.com/p/articles/mi_m3257/is_8_58/ai_n6154194
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
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
NPV and IBN
Net present value analysis can be used with respect to IBN in a real life investment situation where healthcare organizations are looking to decide where to invest revenues or capital for future expenditures. It may help healthcare organizations calculate the value of cash flows within the organization over varying time periods. Net present value analysis allows organizations to consider the difference in future cash flow values compared with the cost of raising capital for future investments. Organizations can use this analysis to decide whether or not to incorporate certain expenses into IBN.
A healthcare organization can use net present value analysis for example to pick between varying investment projects for example. A hospital could for example decide whether to invest more of its resources in improved technology and security measures or whether to invest more resources in research geared to finding new treatments for cancer patients that…
McLean, Robert A. Financial Management in Health Care Organizations. Canada:
Thompson Delmar Learning, 2002.
Ryan, Bruce and Clay, Scott B. "An Overview of IBNR - Incurred But Not Recorded
Expenses and Liabilities." Healthcare Financial Management, November 1994. 8, October 2005:
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 -- 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
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)…
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 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.
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.
Humphry, D. (1991) Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. Secaucus: Carol Publishing
Russell-Walling, E. (2005) Fifty Management Ideas You Really Need to Know. London: Quercus
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
As a woman enters her geriatric years, many unique problems are also faced. Her post-menopausal period leaves a woman with increased risk of osteoporosis, and hormone-replacement therapy may need to be considered or dismissed depending upon the needs and wellness of the individual women. Additionally, increased risk for obesity begins nearly at the adolescent period, when women's hormone loads change and often activity of childhood decreases. The incidence of obesity and overweight among women perpetually increases with every year of life. ("Overweight, Obesity Threaten U.S.," 2002, p. 8)Obesity and overweight, as one of the most significant conditions associated with several chronic diseases, such as type 2 diabetes, heart disease, increased risk of stroke and hypertension should be developed as a lifespan issue, as the needs of intervention and prevention change as women age and go through various stages of life.
While women have functional characteristics that require specialized health care,…
Blackwell, Daria, 2002. Women in the Healthcare Industry Reaching for the Top. Medical Marketing & Media, Dec2002, Vol. 37 Issue 12, p44, 8p.
Fleming, Carl, 2004. Healthcare Access: Conflicts of Interest Presented by Managed Care Icu Bedside Rationing and Their Impact on Minorities and Women. Georgetown Journal of Gender & the Law, Spring2004, Vol. 5 Issue 1, p663-676.
Heyman, B., & Henriksen, M. (2001). Risk, Age and Pregnancy: A Case Study of Prenatal Genetic Screening and Testing / . New York: Palgrave.
Lueck, T.L., & Chang, H. (2002). Tribune's 'WomanNews' Gives Voice to Women's Issues. Newspaper Research Journal, 23(1), 59.
It may be most appropriate when there is a question of adding a new service or getting rid of a current service, but makes less sense for a department which is expected to continue in service.
Incremental budgeting is a part of the rolling forecast system. If there is a sudden spike in revenue, for example, it may make sense to do an incremental budget to take into account the new variable.
-down budgeting means that the CEO or CFO dictates how much money is present, and allocates it to each department. This has the benefit of control of expenditures, but the drawback that the department managers feel no responsibility to hew to a budget in which they had little or no input.
A s-up: This method starts at the department level and builds to an overall picture. While each department may want to have its needs fulfilled, there needs…
Economist. (2007, January 18). The Ivory Trade. Economist, p. n.p.
Fleisher, C.S. (1991). Using an Agency-Based Approach to Analyze Collaborative Federated Interorganizational Relationships. Journal of Applied Behavioral Science, 116-130.
Malkiel, B. (1996). A Random Walk Down Wall Street. New York: WW Norton.
Robinson, J.C. (1997). Physician-Hospital Integration and the Economic Theory of the Firm. Medical Care Research and Review, 3-24.
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
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
The topic on "Social Marketing in Healthcare" advances how social marketing tool predominantly used in marketing consumer items can be effectively applied in the healthcare field. In addition, the development of social marketing research is an effective means by which information can be collected from consumers. This adds weight on this subject. In today's age, all activities are caught up in the information technology web. This is possible through the creation of systems of collecting, analyzing, and sharing information. This opportunity is now available to the healthcare workers because they can conduct consumer research through social marketing avenues. The information collected will then be used to develop efficient healthcare programs for consumers (Aras, 2011).
The key Points
The key points in the article include the need for health workers to use social marketing tools in conducting consumer research prior to developing and implementing healthcare programs. In this case, the article…
Aras R.Y. (2011). Social Marketing in Healthcare. Australasian Medical Journal, vol. 4(8): 418
Leslie, a. (2004). The Rising Cost of Health Care, Strategic and Societal. HR Magazine, vol.
Diversity of Aging Population -- Innovative Healthcare
Over the past several decades there has been an avalanche of research and scholarly narratives focusing on the aging of millions of Americans -- among them the "baby boomers" that were born between 1946 and 1964 -- including their numbers and their health vis-a-vis the impact on the sometimes struggling healthcare system. But there has been a dearth of research on how American healthcare services will respond -- and is currently responding -- to an increasingly diverse older population when it comes to racial, cultural and ethnic identities. This paper points to the numerous issues and challenges that not only face an increasingly diverse older American population when it comes to healthcare, but also the challenges that the healthcare system itself faces as these Americans move into the twilight of their lives.
hat should be the Vision and Mission of Healthcare Professionals in…
Administration on Aging. (2010). A Statistical Profile of Black Older Americans Aged 65+.
Retrieved April 2, 2014, from http://www.aoa.gov .
Bookman, A. (2008). Innovative models of aging in place: Transforming our communities for an aging population. Community, Work & Family, 11(4), 419-438.
Centers for Disease Control and Prevention. (2007). The State of Aging and Health in America
health care for the disabled. The writer explores the health care stages that are available for the disabled in every stage of life. The writer uses published works from various sources to illustrate and underscore the need for solid health care access for all disabled individuals in the nation. There were six sources used to complete this paper.
"Different stages of available health care for people with disabilities"
The issue of health care has been a hot topic of debate in this country for many years. Health care costs are skyrocketing, available services are dwindling and the public is screaming with outrage and demand for improvements to the entire health care system. While those who can speak for themselves are having no trouble voicing their upset about the current state of the nation's health care system, there is a population that cannot always speak up. The disabled in this country…
HEALTH CARE DECISIONS FOR THOSE WHO CANNOT CARE FOR:DIANE COLEMAN THEMSELVES. Congressional Testimony; 4/19/2005
Congressional Testimony. 04-19-2005
LONG-TERM HEALTH CARE:MARK R. MEINERS
Congressional Testimony; 4/19/2005
Health Care and Nursing
As the medical profession gains a greater understanding of the various approaches to healthcare delivery, the concept of segmenting the services proscribed to a patient into primary, secondary, and tertiary care has emerged as one of the most useful advancements in the field. The preventative measures advocated by proponents of primary health care (PHC) are designed to improve a patient's quality of life in such a way as to reduce or eliminate their prospects of becoming ill or injured. Among the fundamental precepts of PHC are the administration of immunizations to guard against viruses and other contagious infections, the development of a nutritious daily diet to improve the body's natural immune defenses, and advisements to refrain from smoking tobacco or drinking alcohol to excess. As it pertains to the nursing profession, PHC involves "the delivery of comprehensive coordinated, continuous and individualized total patient care through the…
Canadian Nurses Association. (2005). Primary health care: A summary of the issue. CNA Backgrounder, 1-5.
Hodgkinson, K. (1990). What primary nursing means. Australian Nurses Journal, 19(9), 16-19.
Tholl, B., & Grimes, K. Canadian Ministry of Health, Minister of Health of Alberta. (2012). Strengthening primary health care in alberta through family care clinics: From concept to reality. Edmonton, Alberta, Canada.
American History: Discussion
Today, the existence of America is often assumed to be obviously good because of the existence of American democracy and positive American democratic values exported all over the world. However, that was not always the case. The American colonists did not find untouched, virgin land but land that was already occupied by native peoples with unique cultural worldviews. Because the Indians did not 'own' land in a manner that was comprehensible to the Europeans the colonists viewed the territory as effectively 'up for grabs.'
The initial motivation of many of the early colonists was purely mercenary such as in Jamestown: "The colony was sponsored by the Virginia Company of London, a group of investors who hoped to profit from the venture. Chartered in 1606 by King James I, the company also supported English national goals of counterbalancing the expansion of other European nations abroad, seeking a northwest…
What is quality improvement? (2014). Duke University. Retrieved from:
" (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
overwhelming connections between healthcare costs and the macroeconomic performance of the U.S. economy. The impact of healthcare industry on the macroeconomic performance is evident from the fact that in 2009 healthcare expenditure of the U.S. was 18% of the gross domestic product (GDP) of the country. It was also estimated that should the healthcare costs continue to grow at historical rates, 34% of the U.S. GDP will compose of healthcare spending by 2040 (Whitehouse, 2009). The major sources of funding the healthcare costs are the Federal, State, and local governments of the U.S. Medicare is a healthcare program that subsidizes healthcare for citizens above 65 years of age. Medicaid subsidizes healthcare delivery for people below a certain income level. Approximately 50% of the healthcare expenditure is bore by governments at the federal, state and local level. It is also estimated that Medicare and Medicaid spending of Federal and State governments…
CMS. (2013, Nov). National Health Expenditure Projections 2012-2022. Centers for Medicare & Medicaid Services. Retrieved from: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsProjected.html
Kolstad, J.T., & Kowalski, A.E. (2012). Mandate-based health reform and the labor market: Evidence from the Massachusetts reform (No. w17933). National Bureau of Economic Research.
The Whitehouse. (2009). Deficit-Reducing Health Care Reform. The Whitehouse. Retrieved from: http://www.whitehouse.gov/economy/reform/deficit-reducing-health-care-reform
CBO. (2011, March). The Economic Case for the Health Care Reform. Congressional Budget Office: Executive Office of the President Council of Economic Advisers. Retrieved from: http://www.cbo.gov/publication/22077
Americans healthcare delivery in the United States has been via a market driven system, 1 usually through purchase of health insurance, participation in HOs or other types of collective agencies. For those who qualify enrollment in edicare and edicaid programs will cover or defray costs of healthcare.2 For a growing number of people in the U.S. medical care costs are not covered by insurance or government programs, for them out of pocket and indigent services are their only options.3 This paper will look at the how financing healthcare affects both costs and use of healthcare services.
Private Health insurance.
Private health insurance in the United States developed around the 1930's during the Depression4 and grew during the economic expansion of the post-WWII years. "Under most private insurance and Blue Cross -- Blue Shield plans, fee-for-service, with physicians determining the economic value of their own services, became the established method of…
Martin Ruef, "Social Ontology and the Dynamics of Organizational Forms: Creating Market Actors in the Healthcare Field, 1966-1994,"
Journal article by; University of North Carolina Press, 1999
Zelman W., and McLaughlin C. (1990). "Product Lines in a Complex Marketplace: Matching Organizational Strategy to Buyer Behavior." Health Care Management Review 15:2 (Spring),