Use our essay title generator to get ideas and recommendations instantly
medical condition, delirium, and its relationship to the nursing profession. The paper is partially a literature review as well as a literary comparison. The Journal of Gerentologic Nursing defines delirium as "a syndrome characterized by the rapid onset and fluctuation of altered mental status, primarily involving the domains of attention and cognition." (Waszynski & Petrovic, 2008, 49) The material provided suggests that detection of delirium very early is important in the prognosis of the patient who experiences delirium. The American Journal of Critical Care (AJCC) states, "delirium is associated with higher mortality, prolonged ICU stay, and greater health care costs." (Devlin et al., 2008, 556) The articles to be examined make critical connections between the roles that nurses play in the diagnoses and treatments of delirium, but they each approach the subject from a different perspective. McCarthy, for example, focuses upon the various perspectives of nurses that impede the recognition…
Devlin, J.W., Fong, J.J., Howard, E.P., Skrobik, Y., McCoy, N., Yasuda, C., & Marshall, J. (2008). Assessment of the delirium in the intensive care unit: nursing practices and perceptions. American Journal of Critical Care, 17(6), 555-565.
Inouye, MD, S.K., Foreman, PhD, M.D., Mion, PhD, L.C., Katz, K.H., & Cooney, Jr., MD, L.M. (2001). Nurses' Recognition of Delirium and Its Symptoms. Arch Internal Medicine, 161, 2467 -- 2473.
McCarthy, M.C. (2003). Detecting Acute Confusion in Older Adults: Comparing Clinical Reasoning of Nurses Working in Acute, Long-Term, and Community Health Care Environments. Research in Nursing & Health, 26, 203 -- 212.
Ramaswamy, MD, R., Dix, PharmD, E.F., Drew, J.E., Diamond, PhD, J.J., Inouye, MD, S.K., Roehl, MD, B.J.O. (2010) Beyond Grand Rounds: A Comprehensive and Sequential Intervention to Improve Identification of Delirium. The Gerontologist, 51(1), 122 -- 131.
Treatment for Emergency Medical Conditions and Women in Labor
The objective of this study is to complete a policy analysis on examination and treatment for emergency medical conditions and women in labor. Arising from the policy analysis will be three to five options to present to the client, a representative in Congress. K
This study is challenging because it is necessary to identify some type of added value to the health care services provided at a medical facility that treats women in labor for emergency medical conditions while at the same time adhering to regulations and standards of treatment both legally and ethically speaking. The costs of treating patients with non-insurance are extremely high and there are regulations barring the transfer of individuals to other facilities until they have been stabilized. In the case of the women in labor treated at this facility, the span of time that the facility…
Mind, Body, Sprit Research Education (2013) Penny George Institute for Health and Healing. Overview and Outcomes Report, 2010. Retrieved from: http://www.allinahealth.org/ahs/anw.nsf/page/ANW_PGIHH_Outcomes_FNL-1.ForWeb.pdf/$FILE/ANW_PGIHH_Outcomes_FNL-1.ForWeb.pdf
Zastrocky, G. (2013) Healthcare Reform "No Birthday" For Holistic Medicine. Holistic Primary Care Vol 13 No. 4. Winter, 2013. Retrieved from: http://www.holisticprimarycare.net/topics/topics-h-n/news-policy-a-economics/1443-healthcare-reform-no-birthday-for-holistic-medicine
Overgaard, C. Fenger-Gron, M> and Sandall, J. (2011) Freestanding midwifery units vs. obstetric units: does the effect of place of birth differ with level of social disadvantage? International Journal for Equity in Health. Retrieved from: http://www.equityhealthj.com/
Medical Coding Ethics
Ethical Concerns in Health Care Delivery: Focus on Medical Coding and Billing Practices
The objective of this study is to examine ethical concerns medical coding and billing in the physician office. Medical coding and billing has become very complex in light of health care reform. Recently, Christopher Gregory ayne, reported to be "dubbed the Rock Doc" was arrested on a dozen charges of Medicare fraud" when he was accused of fraudulently billing for "physical therapy procedures, such as massages and electrical stimulation, that were not necessary or in some instances had been provided at his prior medical practice in Miami." (eaver, 2013, p.1) It appears that where this doctor failed is billing for physical therapy when his staff was not properly accredited for providing these treatments.
Health Care Coding and Billing Changes
It was reported by Gunderman (2013) that October 1, 2014 is the deadline on implementing…
American Health Information Management Association Standards of Ethical Coding. (2008) AHIMA House of Delegates. "AHIMA Standards of Ethical Coding. Sept 2008. Retrieved from: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok2_001166.hcsp?dDocName=bok2_001166
Know your ethical obligations regarding coding and documentation (2009) Association of Clinical Documentation Improvement Specialists, August 4, 2009 HCPro. Retrieved from: http://www.hcpro.com/HOM-236942-5728/know-your-ethical-obligations-regarding-coding-and-documentation
Weaver, J. (2013) Miami Beach's 'Rock Doc' busted on Medicare fraud charges. The Miami Herald. Retrieved from: http://www.miamiherald.com/2013/09/30/3660611/miami-beachs-rock-doc-busted-on.html#storylink=cpy
Sufficient documentation a major hurdle for ICD-10 (2013) APCs Insider. Retrieved from: http://www.hcpro.com/HIM-297687-859/Sufficient-documentation-a-major-hurdle-for-ICD10.html
The author of this report has been asked to assess the medical condition and prognosis for John Smith. John is a sixty-eight years old and has a pretty good array of medical problems. He has had psoriasis for more than a generation and the ointments he has been using to treat it have become ineffective. Beyond that, the psoriasis is spreading to parts of his body that have not been trouble areas before. His son Patrick asserts that he believes that the psoriasis is to the point that it is contagious. While John is facing some challenges, there are things that can be done and this includes properly education both John and Patrick.
Straight off the top, the assertion by Patrick that the psoriasis is "contagious" is patently and absolutely false. Psoriasis is never contagious and there is not a chance that anyone around John will "catch" it.…
WebMD. (2015). Adult Vaccines TOC. WebMD. Retrieved 8 October 2015, from http://www.webmd.com/vaccines/default.htm
WebMD. (2015). Causes of High Blood Pressure. WebMD. Retrieved 8 October 2015, from http://www.webmd.com/hypertension-high-blood-pressure/guide/blood-pressure-causes
WebMD. (2015). Heart Disease Health Center. WebMD. Retrieved 8 October 2015, from http://www.webmd.com/heart-disease/default.htm
WebMD. (2015). Lung Disease & Respiratory Health Health Center - Symptoms, Causes, Treatments. WebMD. Retrieved 8 October 2015, from http://www.webmd.com/lung/default.htm
Medical Home Model and Health Disparity
Nursing esearch Proposal
The Impact of the Medical Home Model on Health Disparities
The Impact of the Medical Home Model on Healthcare Disparity
Medical homes are primary care practices where a physician or NP establishes a long-term care relationship with patients and provide patient/family-centered, coordinated, and culturally-sensitive care (AANP, n.d.; Strickland, Jones, Ghandour, Kogan, & Newacheck, 2011). The benefits include improved healthcare access, quality, and safety. A number of states have enacted statutes supporting the medical home model after research findings revealed health disparities for racial and ethnic minorities were reduced (NCSL, 2013).
As a nurse practitioner I am interested in how effective a medical home model would be in reducing healthcare disparities, especially for racial and ethnic minority children residing in underserved communities. Nurse practitioners have traditionally practiced in underserved communities and will continue to do so; therefore, any strategy that could improve…
AANP (American Association of Nurse Practitioners). (n.d.). Medicare legislation: Fact sheet: The medical home -- What is it? How do nurse practitioners fit in? Retrieved from: http://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/349-the-medical-home .
Abrams, M., Nuzum, R., Mika, S., & Lawlor, G. (2011). Realizing health reform's potential: How the Affordable Care Act will strengthen primary care and benefit patients, providers, and payers. The Commonwealth Fund. Retrieved from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Jan/1466_Abrams_how_ACA_will_strengthen_primary_care_reform_brief_v3.pdf .
NCSL. (2013). Health disparities: State laws. Retrieved from: http://www.ncsl.org/research/health/health-disparities-laws.aspx .
Strickland, B.B., Jones, J.R., Ghandour, R.M., Kogan, M.D., & Newacheck, P.W. (2011). The medical home: Health care access and impact for children and youth in the United States. Pediatrics, 127(4), 604-11.
Medical Use of Marijuana
Increasing use of medical marijuana
Having looked at the various areas that medical marijuana has been brought into use and the various forms in which marijuana is administered, it is also important to take note of the various challenges that come with it. There have been various researches that have been conducted that covers the medical as well as the ethical side of the medicinal marijuana, and there have been a dilemma in the balance of the two sides on whether to institutionalize the drug or to stop it, and even on whether the medicinal use can be made to work without the proneness to abuse as is the case at the moment.
Medicinal marijuana has neither medical nor ethical standing within the contemporary society where drug abuse is one of the biggest worries of governments across the world and the alternative medicines that medical research…
In this case, that power dynamic was only exacerbated by the fact that the entire MSICU nursing team had never received training in management of the type of clinical issues presented and by the fact that they were excluded from any consultation in connection with a post-operative management plan.
Therefore, it is recommended that the institution immediately implement a policy of "see something, say something" according to which all members of healthcare teams are encouraged to speak up irrespective of power differentials. Furthermore, that protocol must include a statement of policy insulating any member of a healthcare team who does voice a legitimate concern in good faith from any retaliation or other negative response that could conceivably deter such diligence. Finally, the record of this case also indicates the immediate need for protocols requiring all members of the healthcare team to identify themselves to other members of the team, especially…
Bosk, Charles L. (2003). Forgive and Remember: Managing Medical Failure.
Gawande, Atul. (2008). Better: A Surgeon's Notes on Performance.
Groopman, Jerome. (2008). How Doctors Think.
Timmermans, Stefan. (2003). The Gold Standard: The Challenge of Evidence-Based
Medical Case Study
Florence (F) is a 43-year-old woman who is two days post-operative, following an appendectomy. She has a history of arthritis, and currently takes 10mg of prednisone daily. She is allergic to penicillin. She weighs 46 kg (101.5 lbs.) and is 168cm tall (5'6"). This puts her slightly underweight for her age and height, at least 18-25 pounds (Height and Weight Chart, 2010). While doing a route in dressing change, nurse notice a yellow discharge emanating from the wound.
Identify and discuss the importance of obtaining information during a nursing admission in relation to post- operative assessment. In modern healthcare, a nurse must first and foremost try to understand and utilize a systematic and synergistic model of data collection and assessment. Human beings are complex creatures, and the more data one has, the easier it will be to ensure that a proper diagnosis is made. A systematic assessment…
Height and Weight Chart. (2010). HealthCheck Systems. Retrieved from:
Prednisone and Other Corticosteroids: Balance the Risks and Benefits. (2011). The Mayo
Clinic. Retrieved from: http://www.mayoclinic.com/health/steroids/HQ01431
These examples highlight that technology is always a tool, a way of enhancing human judgment -- we must not mistake it as a replacement for good nursing practice.
After all, the use of a computer is no substitute for a medical education. Anyone who works in a hospital can see this -- the increased accessibility of information through the Internet also means that patients often come in, convinced that they are suffering from a serious illness, allergy, or condition, based more upon a diagnosis Googled on WebMD, rather than upon the fact that they saw a doctor! If a computer alone was required to diagnose, everyone would have a degree!
Don't get me wrong -- I use technology every day in my life, and thank my lucky stars, and my patient's lucky stars, that it is so ubiquitous. When health care providers wish to communicate, the use of cell phones…
Initial Patient Analysis
Discomfort in lower back.
Patient is a 78-year-old woman presented as disheveled, with bug bites throughout her body, and exuding a foul odor. Cognitively, she orients only to her name with a BMI of 30 and a minimal understanding of the English language. She is able to nod "yes" or "no" to questions, but calls the nurse "Mother." She is unsteady on her feet, and has a fine "pill-rolling "tremor in her left hand. He legs are quite cool to the touch, hairless, and toe capillary refill is greater than 2 seconds.
Past Medical History
Unknown, but patient appears to be in distress both physically and psychologically.
Poor, disheveled, may not be receiving adequate care or living in an environment with enough food or warmth. BMI of 30 is technically obese, which also may indicate the patient is not…
Hypoglycemia. (2012). Web MD. Retrieved from: http://symptoms.webmd.com/#./conditionView
Michael, K. And Shaughnessy, M. (2006). Stroke Prevention and Management in Older
Adults. Journal of Cardiovascular Nursing. 21 (55): 521-26.
Mohr, J., et al. (2004). Stroke: Pathopshyciology, Diagnosis and Management. New York: Churchill Livingstone.
Nurses are required to make many immediate decisions in their assigned duties. Unfortunately, in recent years, patient care has often been compromised as a nursing shortage crisis has escalated to epic proportions. Increased patient loads have resulted in often hasty nursing decisions as responsibilities and hours worked have increased. Although precious time must be spread thin to accommodate higher numbers of patients, nurses must exercise their morals through consistency in ethical behaviors. According to Peggy Chinn (1), "Many ethical issues, such as end-of-life decision making, have increased in complexity. Other issues, such as advocacy and choice, have changed in certain respects but are more clearly centrally situated within nursing's ethical domain."
As a result, nurses are held accountable for a variety of decisions in nursing practice and in many instances, a patient's life depends on such decisions to survive. Gastmans (496) states that "Generally, the goal of nursing…
Chinn, P. (2001). Nursing and ethics: the maturing of a discipline. Advances in Nursing Science
Erlen, J. (2001). Moral distress: a persuasive problem. Orthopaedic Nursing 20(2): 76-80.
Erlen, J. (2001). The nursing shortage, patient care, and ethics. Orthopaedic Nursing 20(6):
Gastmans, C. (2002). A fundamental ethical approach to nursing: some proposals for ethics education. Nursing Ethics 9(5): 494-507.
As mentioned earlier, the desired outcome of nursing care is comfort and there are many articles in which the researchers have talked about the needs of the patients and the things that alter the comfort of the patients. Kolcaba suggested that the cancer patients who are terminally ill can benefit from comfort care as it pays attention to the perspective and needs of the patients. Through such kind of care, the patient is not only provided with pain relief, but the depression of the patient is also addressed adequately. As she said that patients who are not in pain but are depressed seek comfort in the transcendental sense as well as in the psycho-spiritual sense (Kolcaba, 1992 p 4). In some of her works, she has explained the use of the instruments and their application by the nurses. Kolcaba reckons that the instruments presented by her to evaluate the comfort…
Kolcaba K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(10): 1178-1184.
Kolkaba, K. (1992). Holistic comfort: Operationalizing the construct as a nurse-sensitive outcome..Advances in Nursing Science, 15 (1), pp. 1-10.
Kolkaba, K. (1997). The primary holisms in nursing..Journal of Advanced Nursing, 25 pp. 290-296.
Kolkaba, K. And Fisher, E. (1996). A holistic perspective on comfort care as an advance directive..Critical Care Nursing Quarterly, 18 pp. 66-76.
Above all it has followed the delibeate maketing of health cae (in association with touism) as medical cae has gadually moved away fom the public secto to the pivate secto, ensuing that a gowing majoity of people, especially in the ichest counties, and paticulaly in the United States, must pay -- often consideably -- fo health cae. Finally, gowing inteest in cosmetic sugey, involving such elective pocedues as hinoplasty, liposuction, beast enhancement o eduction, LASIK eye sugey and so on, o moe simply the emoval of tattoos, have ceated new demands. Vaious foms of dental sugey, especially cosmetic dental sugey, ae not coveed by insuance in counties like the UK and Austalia; hence dental touism has become paticulaly common. In Asia these tends ae 'the unlikely child of new global ealities: the fallout of teoism, the Asian economic downtun, intenet access to pice infomation, and the globalisation of health sevices'…
references because the family vetoes it, in part because they were never made known. For a grieving and bereft family, a request for organ donation is difficult to agree to because they can only guess at the wishes of the deceased and if there were any doubt at all, would not the natural answer be a rejection? If relatives had severe objections, they should be taken into account for to do otherwise raises the spectre of the swastika, but the point remains that by changing the default position of organ donation it is a veto clearly against the deceased's wishes, which would be rather more unlikely to take place than the current veto due to a simple lack of information. It is not that the PC system is ethically unsound (Hatfield and Walker 1998).
It can be argued that presumed consent is superior to the opt-in system because it truly ensures autonomy by giving effect to choices each person makes. It gives legal effect to individual autonomy and it ensures truly informed consent when accompanied by public education and information, instead of intuitive responses to organ donation. But one has to question how comfortable the deceased family will be when they come to realise that their relatives' kidney is being placed into someone who is HIV positive. This is likely to be an ethical and morale matter rather than a discriminatory one (Williams, 1999).
Nonetheless, some problems with presumed consent have been pointed out. Patient autonomy lies at the very heart of modern medicine and medical research. This is partly a reaction against medical paternalism and an increasing awareness of the integrity of the individual. It may be argued that a presumed consent (PC) system is paternalistic - but it concomitantly reinforces individual autonomy and preserves the dignity and integrity of the individual especially in comparison to, for example, an organs market. (Brooks).
McLean points out that underpinning the system of organ donation is the fundamental view that organ transplantation should be a gift relationship and should not be based on the type of disease a person has. This underlines that HIV sufferers are just as entitled to a kidney transplant as those who are looking for a heart transplant. John Morris doubts that proposals to change legislation to allow presumed consent to be introduced are likely to be publicly accepted. However, why is presumed consent any less a gift? It does not mean widespread harvesting of major organs. It means greater public awareness and individual choice that is made concrete.
In today's modern, the reality is that HIV / AIDS is at a crossroads where the economic and political niches of the contemporary modern condition provide both the possibility to raise scientific research in order to create a means of effective pandemic or the new religion of globalize capital may only serve as to extend HIV / AIDS to become the biggest social issue of all history. There is a huge issue with regards to donor transplantation and especially kidney transplantation. Unfortunately, some patients with Human Immunodeficiency Disease are denied equal access to kidney transplantation and the same priorities of other people who are suffering from other serious diseases. Therefore, in this research, evidence will be provided to proof HIV patients have the same rights as others to get a kidney transplant regardless if they appear completely diseased.
For example, because different etiologies require corresponding therapeutic designs and mechanisms (Spector, 2000; Steefel, 2002), specific support group makeup must consider the need to develop different strategies and methodologies for the following types of patients at a minimum if support groups are to provide equal benefit to all patients:
Elderly Patients and Lifelong Laborers - This group typically presents with psychological issues in the realm of a direct link between their sense of purpose and self-worth and their ability to continue to function productively in their community. Their need for acute medical and ancillary services, particularly in the Longview/East Texas community are often precipitated by chronic physical deterioration from a lifetime of relatively hard labor. Therefore, support group rehabilitation services must address the issues of self-esteem as a function of vocational productivity and lifestyle changes necessitated by medical conditions.
Prime-of-Life Victims of Traumatic Injury - This group typically presents with…
Clark, C., Robinson, T. (2000). "Multiculturalism as a Concept in Nursing" Journal of the Black Nurses Association, 11(2), 39-43.
Spector, R. (2000). Cultural Diversity in Health and Illness (5th ed.). New Jersey: Prentice Hall.
Stanhope, M., Lancaster, J. (2004). Community and Public Health Nursing (6th ed.)
St. Louis: Mosby.
Ethics for Medical Conditions
In the case study for this assignment about the 12-year-old girl Emma, Dr. Hamid's decision regarding her treatment is fairly clear. Since Emma is not of legal age to make decisions for herself, he should defer to the wishes of her parents. Doing so is in accordance with legal procedures as well as those commonly employed when important medical decisions involve minors. An examination of this decision and its ramifications, as well as that of the alternatives, demonstrates the prudence of this choice.
There certainly is no reason for the doctor to get a court order to perform this operation on Emma. In fact, taking such measures would contradict conventional protocol in such instances. That protocol typically involves having a parent or guardian who is of legal age making a decision on behalf of the child. From an ethical perspective, however, obtaining a court order is…
Butkus, Matthew A. (2015). "Free will and autonomous medical decision-making." Journal of Cognition and Neuroethics 3(1): 75-119.
Retrieved from http://www.cognethic.org/jcn/jcnv3i1_Butkus.pdf
Veatch, R.M., Gaylin, W., Steinbock, B. (1996). Can the moral commons survive autonomy? The Hastings Center Report. 26(6), Retrieved from https://www.questia.com/library/journal/1G1-18995185/can-the-moral-commons-survive-autonomy
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.
Professional Medical Transportation:
In order to prepare a Business Plan, it is worthwhile to note that professional medical transportation can be offered both as an emergency as well as non-emergency service. Services offered could be Priority Medical Dispatch, 911 Pre-arrival instructions, Emergency Ambulance Service, Wheelchair service and Scheduled Ambulance Service. Since Priority Medical dispatch will be taking the 911 calls, it has to be ensured that ambulance possessing the most sophisticated equipment and qualified medical experts reach during emergency situations. As regards 911 pre-arrival instructions, the dispatchers will be answering 911 callers, the information they require to tackle an emergency medical situation till arrival of the ambulance. (Services we offer)
Under Emergency Ambulance Service, paramedics and emergency medical specialist have to attend to emergency calls and deal with transfers among health care facilities, round the clock, all seven days in a week. Under Wheelchair service, non-emergency patients using…
Medicaid/Reach up Program. Vermont Public transport Association. Retrieved from http://www.vpta.net/publicservice_medical.html Accessed on 6 February, 2005
Medical Transportation. Prince William Health System. Retrieved from http://www.pwhs.org/patients/transportation / Accessed on 6 February, 2005
Services we offer. Allina Hospitals and clinics. 2004. Retrieved from http://www.allina.com/ahs/transport.nsf/page/AMT_services Accessed on 6 February, 2005
They have a great deal of responsibility for selecting the images during the scan that provide the most comprehensive picture for diagnostic purposes, as well as recording their own preliminary findings.
Why did you apply to this health program?
I have worked three years as a 401K plan analyst. I enjoy making the complex financial services industry comprehensible to clients, but I am seeking a job that is more meaningful and hands-on that still makes use of detail-oriented personality. The field of medical sonography is fascinating and likely to be more and more important in the future because of its ability to quickly provide a portrait of a patient's state of well-being. Working in the field will allow me to be in close contact with patients and to give them meaningful comfort, advice, and care during diagnostic procedures.
Donald then concluded that when a child is found suffering from genital irritation, it was best to have circumcision performed on him "during the first year of life, so that to a degree at least danger of future moral contamination may be avoided."
he obvious and well-documented benefits of circumcision led to a sudden increase in its popularity and by 1889, it was getting circumcised was in fashion. Circumcision gained even greater support when it was presented not as a cure but also as a prophylactic. Since the benefits were well-known and circumcision was widely advocated, people decided that it was better to get their children circumcised as soon as it was possible. hus, instead of waiting for diseases to develop or other signs of discomfort to emerge, it was thought best to have circumcision done before it was too late and thus neonatal circumcision became popular. By 1910 and…
Task Force on Circumcision (1999)
John Firman & Ann Gila, The Primal Wound: A Transpersonal View of Trauma, Addiction, and Growth (1997
Thomas Metcalf, et al., Circumcision: A Study of Current Practices, 22 Clinical Pediatrics 575, 576 (1983)
However, the screening of patients for these conditions necessitates the inclusion of brief screening questions into a health systems review at the medical visit because patients may be embarrassed or unwilling to show concerns or talk about their mental distress or health. The inclusion of the questions into the health systems review can help to facilitate early discovery and intervention and communicating to patients about concerns on their overall health. Many people with these mental conditions tend be unwilling to consult their care providers because of the stigma linked to the conditions and the lack of effective treatments available (Haddad, Buszewicz & Murphy, n.d.).
The other approach that can be taken to screen for these conditions is to administer validated screening measures in the waiting room. In this case, the screening measures even as brief scales have been identified to be effective in discovering the problems. The validated screen measures…
Bartels et. al. (2003). Evidence-based Practices in Geriatric Mental Health Care: An Overview of Systematic Reviews and Meta-analyses. Psychiatric Clinics of North America, 26, 971-990. Retrieved from http://amhd.org/About/ClinicalOperations/MISA/EBP%20geri%20meta-analysis.pdf
Haddad, M., Buszewicz, M. & Murphy, B. (n.d.). Supporting People with Depression and Anxiety. Retrieved November 23, 2012, from http://www.mind.org.uk/assets/0001/4765/MIND_ProCEED_Training_Pack.pdf
Katz, S. (2010, March 8). it's Not Just about the Gut: Managing Depression and Anxiety in Inflammatory Bowel Disease. Retrieved November 23, 2012, from http://www.practicalgastro.com/pdf/July10/GraffArticleRev.pdf
"Specific Mental Disorders." (n.d.). Mental Illness and Suicide. Retrieved November 23, 2012,
To demonize the concept of universal healthcare with the word 'rationing' "buys into the myth that we don't have rationing of medical services now. But we do. It takes many different forms. It is commonplace for health insurance companies and HMOs to deny patients beneficial treatment. They find a variety of excuses for doing so, and may not openly admit it, but we all know that it happens. Medicare rations drugs by requiring co-payments that many patients can't afford. Emergency rooms ration care by making people wait so long in line that some just give up and go away" (Singer 2011).
The recent decimation of many retirement funds means that more and more members of the elderly are eligible for both Medicare and Medicaid. The elderly on fixed incomes often struggle to afford medications not currently covered within the provisions of Medicare because of the "doughnut hole" in…
Kane, Robert, Rosalie Kane, Neva Kaye, Robert Mollica, Trish Riley, Paul Saucier, Kimberly
Irvin Snow & Louise Starr. (1996). Managed care.
Retrieved August 12, 2011 at http://aspe.hhs.gov/Progsys/Forum/basics.htm
Leonard. Sean. (2011). How to fix Medicare. Salon. Retrieved August 12, 2011 at http://www.salon.com/technology/how_the_world_works/2011/05/25/the_long_march_to_healthcare_reform/index.html
Technology in Medicine: Distant Medical Surveillance Technology for Diabetics in the Less Developed Area of Texas
An estimated 26 million Americans live with diabetes. When not properly treated, diabetes could be fatal as it occupies the seventh position on the list of major mortality causes and it is also a strong causative factor of renal failures, sight damage and clinical limb removals among Americans. Diabetes occurrences are approximately 17% higher in less developed areas. Ethnicity and race are also major factors in determining the risk of suffering from the disease as it affects the smaller factions more. Distant medical surveillance can be very helpful in acquiring daily data about a diabetic's sugar levels, dangerous signs, feeding habits and therapy devotion. This method could help patients take their medications appropriately. Even though certain patients could decide not to adhere to their treatments and thus render this technology useless, the group who…
Balamurugan, A., Hall-Barrow, J., Blevins, M. A., et al. (2009). A pilot study of diabetes education via telemedicine in a rural underserved community -- opportunities and challenges: A continuous quality improvement process. The Diabetes Educator, 35(1), 147 -- 154.
Greenwood, D. A., Young, H. M., & Quinn, C. C. (2014). Telehealth Remote Monitoring Systematic Review: Structured Self-monitoring of Blood Glucose and Impact on A1C. Journal of Diabetes Science and Technology, 8(2), 378 -- 389.
Hale, N. L., Bennett, K. J., &Probst, J. C. (2010). Diabetes care and outcomes: disparities across rural America. Journal of community health, 35(4), 365-374.
Helseth, C. (2014). Diabetes Management in Rural Areas Takes Holistic, Community Approaches, Rural Health Information Hub. Retrieved from https://www.ruralhealthinfo.org/rural-monitor/rural-diabetes-management/ on February 18, 2017
It would then become incumbent on the experienced coder to be able to read through the injuries and determine the accurate code to use. Another issue Kramer, Barancik, and Thode, Jr. (1990) found was that certain areas of the body lacked a code when injured to a very specific area of the body.
The training and education one needs to be a successful medical coder, and in particular a remote medical coder, is extensive. If we examine Figure 1 below, we can understand why this is so:
AAT (alpha-1 antitrypsin) deficiency 273.4
AAV (disease) (illness) (infection) - see Human immunodeficiency virus (disease) (illness) (infection)
Abactio - see Abortion, induced
Abactus venter - see Abortion, induced
Abasia (-astasia) 307.9
Abderhalden-Kaufmann-Lignac syndrome (cystinosis) 270.0
Abdomen, abdominal - see also condition
Kramer, Barancik, and Thode, Jr. (1990) found
Abduction contracture, hip or other joint -…
American Health Information Management Association (AHIMA). (2011). Quality healthcare through quality information. Retrieved from http://www.ahima.org/Default.aspx/ .
Kramer, Caroline F., Jerome I. Barancik, and Henry C. Thode, Jr. (1990). Improving the sensitivity and specificity of the abbreviated injury scale coding system. Public Health Reports, Vol. 105, No. 4, pp. 334-40.
Rodecker, Kristy. (2010). Medical billing and coding. Retrieved from http://www.medicalbillingandmedicalcoding.com/ .
Taylor, JM. (2008). [Emergency Department] Management. Experienced coders help ED create excellence. The Monthly Update On Emergency Department Management, Vol. 20, No. 11, pp. 123-5.
Acute renal failure is a serious medical condition. The gravity of the condition is manifested itself in the fact that the survival rate for renal failure has not improved for more than forty years. It occurs in 5% of all hospitalized patients and dialysis treatment is required in approximately .5 of cases. Dialysis is required to sustain "fluid and electrolyte balances, minimize nitrogenous waste production and sustain nutrition Infection accounts for 75% of deaths in patients with acute renal failure, and cardiorespiratory complications are the second most common cause of death" (Agrawal & Swartz 2000). Pathophysiology can vary depending upon the type: "patients who develop AKI can be oliguric or nonoliguric, have a rapid or slow rise in creatinine levels, and may have qualitative differences in urine solute concentrations and cellular content.... Oliguria is defined as a daily urine volume of less than 400 mL/d and has a worse prognosis,…
Epstein, Murray. (1997). Alcohol's impact on kidney function. Alcohol Research and Health21. 1 (1997): 84-91.
Malay, Agrawal & Richard Swartz. (2000). Acute Renal Failure. American Family
Physician. Retrieved October 29, 2011 at http://www.aafp.org/afp/20000401/2077.html
Page, Timothy F. & Robert S. Woodward. (2009). Cost-effectiveness of Medicare's coverage of immunosuppression medications for kidney transplant recipients.
Medical marijuana has increasingly been in the news as a growing number of states throughout the U.S. have passed measures or at least put on the ballot an initiative to legalize either medicinal or recreational marijuana usage. The history of marijuana in the U.S. is one that goes back as far as the country itself: hemp (a type of marijuana plant) was used for rope, paper and a number of other purposes because of its strong fibrous tissue.1 It was not until the Prohibition Era of the 1920s that marijuana began to be prohibited by law in the U.S.—and within a decade, it was regulated among most states under the Uniform State Narcotic Act.2 Thus, from its very first days as a crop grown by the Virginia Company for exporting to England by decree of James I—and in fact from the days of the first President of the U.S.…
medical home concept and describe the principles (operational characteristics mentioned above) of the PC-MH as defined by these organizations. How does this concept differ from the gatekeeper concept of Managed Care Organizations?
According to the 'gatekeeper' philosophy of health management organizations (HMOs), physicians are intentionally given incentives to reduce access to care. This is based upon the assumption that patients will want to obtain as much care as they can receive and physicians will want to bestow that care to please patients and incur more revenue. HMOs encourage physicians to do the opposite and often financially reward physicians for cost reductions and limiting access of patients to specialists or heroic treatments. In the HMO model, physicians try to restrict access to specialists when they do not deem it necessary.
In contrast, the medical home concept is viewed as a partnership between "individual patients, and their personal physicians, and when appropriate,…
Case for change to the PC-MH Model (2011). American Dietetic Association.
Retrieved October 19, 2011 at http://www.eatright.org/HealthProfessionals/content.aspx?id=7059
Joint Principles of the Patient-Centered Medical Home. (2007). American Academy of Family
Physicians (AAFP). American Academy of Pediatrics (AAP). American College of Physicians (ACP). American Osteopathic Association (AOA)
medical and ethical dilemmas, even if the activities were deemed technically legal or not questioned at the time. The fact that the studies sought to gain information from human subjects under unfair and undesirable circumstances means their results cannot be condoned and the findings cannot be accepted or used as viable study data. Each study directly crosses the line into scientific unacceptability in different ways; and while their underlying approaches raise interesting historical and philosophical questions -- that did not need to be tested to be debated -- there is no way to weed out the biases that contaminate the data.
This being said, it is generally safe to say that all of the studies were improper (unethical and/or illegal) at the time that they were being undertaken. This can be seen in the fact that in every instance the medical professionals involved were either directly or indirectly punished for…
Consumer Reports (2007). "Off-Label" Drug Use, Shopper's Guide. Downloadable at http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/money-saving-guides/english/Off-Label-FINAL.pdf .
Pain Management of America (2011). Chronic Pain Treatment and Management with Medical Marijuana. Viewable at http://www.medicalmarijuana.net/uses-and-treatments/chronic-pain/.
SOURCES OF STUDIES
Jewish Chronic Disease: http://johnmueller.org/Problems/Cancer.html
According to A.J. Larner's book, "A Dictionary of Neurological signs," prosopagnosia is a neurological condition, "a form of visual agnosia characterized by an inability to recognize previously known human faces or equivalent stimuli (hence a retrograde defect) and to learn new ones (anterograde defect)" (Larner, 2010). Larner further distinguishes between two forms of prosopagnosia: apperceptive and associative agnosia. This "category-specific recognition disorder," as G, Neil Martin calls it in his "Human Neuropsychology" is often, but not always, associated with other forms of visual agnosia such as alexia or achromatopsia.
Prosopagnosia can be congenital or developmental, or a consequence of brain damage, following a stroke, a brain injury, or caused by a degenerative disease (Kinai, 2013) . There are two types of prosopagnosia: apperceptive prosopagnosia and associative prosopagnosia. This form of visual impairment has various degrees of manifestation, from mild to severe and can or cannot be associated with other…
Bowles, Devin C. McKone, Elinor. Dawel, Amy. Duchaine, Bradley. Palermo, Romina. Schmalzl, Laura. Rivolta. Davide. Wilson, Ellie. Yovel. Galit.
Cognitive Neuropsychology, "Diagnosing prosopagnosia: Effects of ageing, sex, and participant-stimulus ethnic match on the Cambridge Face Memory Test and Cambridge Face Perception Test." Available at: http://www.faceblind.org/social_perception/papers/Bowles%2009%20CN.pdf
Sperry, Roger Wolcott. Ed.Trevarthern, Colwyn B. 1990. Brain Circuits and Functions of the Mind: Essays in Honor of Roger Wolcott Sperry, Author. Cambridge University Press
Newman, Nancy J. Miller, Neil R. Biousse, Valerie. 2008. Walsh and Hoyt's Clinical Neuro-ophthalmology: The Essentials. Lippincott Williams & Wilkins
Ethical Dilemma: case study of clinical trial on a child
The field of medicine and research has been surrounded by issue of experiments in order to have the conclusive result of the effectiveness of a drug or otherwise. These results can only be obtained if the drugs are at times used on human beings with the real medical problem that the experiment seeks to find solution to. The problem of ethical dilemma often comes in at such stages on whether to go ahead to experiment on the effectiveness of the new drug or not.
Ethical dilemma refers to the situation that is deemed complex since it involves some element of mental conflict between moral imperatives that is one goes ahead and obeys one, it will mean the transgression of another (Braunack-Meyer A.J., 2001). The individual does not have a clear cut direction on which option to go for, despite there…
Braunack-Meyer A.J., (2001). What makes a problem an ethical problem? An empirical perspective on the nature of ethical problems in general practice. Retrieved November 29, 2014 from http://jme.bmj.com/content/27/2/98.full
Pier B.K., (2007). Children, Gillick Competency and Consent for Involvement in Research. Retrieved November 29, 2014 from http://jme.bmj.com/content/33/11/659.abstract
Spriggs M., (2010). Understanding Consent in Research Involving Children: The ethical Issues. Retrieved November 29, 2014 from http://www.mcri.edu.au/media/62539/handbook.pdf
against experimentation on animals, and some are more compelling than others. Some people suggest that the practice is immoral because choosing to experiment upon animals is directly analogous to racial or sexual discrimination; or more closely related to discrimination on the basis of mental capacity. Others contend that it is wrong because, by their estimations, no clear advances in medical research have been made through animal experimentation, and alternative modes of research are emerging. Doubtlessly, animal experimentation is a delicate moral issue, but asserting that animals should enjoy the same rights as humans within a society is a weak claim. Arguments have been formed differentiating animals from humans depending upon both their moral status and biological status. Yet, the most obvious line of reasoning is associated with the fact that granting animals the same rights as humans within society leads to many logical contradictions.
One question that needs to be…
1. Dunbar, Daniel. "The Confinement and Use of Non-Human Animals in Scientific and Medical Experiments is Morally Unacceptable." Ithaca University, 2005. Available: http://www.ithaca.edu/faculty/cduncan/250/ddunbar.doc .
2. Mitchell, Graham. "Guarding the Middle Ground: the Ethics of Experiments on Animals." African Journal of Science, Issue 85, May 1989. Available: http://www.garfield.library.upenn.edu/essays/v13p114y1990.pdf .
Cross Cultural elations
Cultural influences perceptions about gender roles in a number of ways. The first is through socialization. Being in a culture one sees how gender roles are typically manifested in that culture, and one thus will tend to adopt similar views. The structure of the culture is therefore highly influential simply because being in a culture leads one to adopt the gender roles in that culture (no author, 2015).
The second method is through enforcement. People in a culture will learn gender roles when those roles are enforced. People in positions of authority (parents, teachers, etc.) will specifically enforce gender roles on children in a society in the sense that when somebody steps out of the norms for that society, there will typically be negative consequences. Similarly, there are usually positive consequences for people who follow gender norms in a society most closely. Enforcement is not only through…
No author (2015). Gender and sociology. Boundless.com. Retrieved November 1, 2015 from https://www.boundless.com/psychology/textbooks/boundless-psychology-textbook/gender-and-sexuality-15/gender-414/gender-and-sociology-296-12831/
Federal Trade Commission ruled on charges of anti-trust leveled against the Wisconsin Chiropractic Association. The WCA and its executive director, Russell A. Leonard, had been charged with organizing a conspiracy among members of the WCA, which represent 90% of the chiropractors in Wisconsin, of conspiring to force health care providers to pay higher rates for chiropractic services than they had previously paid.
According to the proceeding records (FTC, 2003) and published statements by the FTC (FTC, 2000a), the plan began when the federal government as well as many insurance companies adopted new billing codes to cover chiropractic treatments. In addition, two other chiropractors, Michael T. erkley, D.C., and Mark A. Cassellius, D.C., settled with the FTC on similar charges (FTC, 2000a).
The final settlement included about 2,800 words of restrictions on the WCA and Leonard, some of them extending to the year 2020 (FTC, 2003).
The FTC alleged that the…
Brookings Institution. 2002. "The Effect of Antitrust Policy on Consumer Welfare: Assembling the Empirical Evidence." June. Accessed via the Internet 2/27/03. http://www.ftc.gov/be/seminardocs/antitrustpolicy-consumerwelfare.pdf
Federal Trade Commission (FTC). 2000. "Wisconsin Chiropractic Association and Its Director Agree to Settle FTC Charges of Price-Fixing." March 7. Accessed via the Internet 2/27/03. http://www.ftc.gov/opa/2000/03/wischiro.htm .
Federal Trade Commission (FTC). 2000. Docket No. C-3943 Decision and Order.May 18, 2000. Accessed via the Internet 2/27/03. http://www.ftc.gov/os/2000/05/wisconsin.do.htm
Federal Trade Commission (FTC). 2003. "HEARINGS ON7 HEALTH CARE and COMPETITION, LAW, AND POLICY." October 1. Accessed via the Internet 2/27/03. http://www.ftc.gov/ogc/healthcarehearings/031001ftctrans.pdf
Patient Centered Medical Homes
In the 1960s, the medical home concept referred to as patient centered medical home was developed.In order to reform the healthcare in the U.S.; the patient centered medical homes are evolving as a centerpiece of efforts (Bates, 2010). Basically, PCMH can be defines as a primary care model that offers coordinated and comprehensive care to the patients in order to improve health outcomes. PCMH is also recognized by the National Committee for Quality Assurance (NCQA). Patient centered medical homes can be portrayed as a team of people working together in form of a community. The purpose is to improve the health as well as healing of the people in that community. In comparison with the primary care, PCMH is more responsive towards the needs of local patients.
PCMH offers a number of benefits including complementary nutrition as well as wellness counseling along with providing prevention education…
Aysola, J., E.J. Orav, and J.Z. Ayanian. 2011. "Neighborhood Characteristics Associated With Access To Patient-Centered Medical Homes For Children." Health Affairs no. 30 (11):2080-2089.
Bates, D.W., and A. Bitton. 2010. "The Future Of Health Information Technology In The Patient-Centered Medical Home." Health Affairs no. 29 (4):614-621.
Nutting, Paul A., William L. Miller, Benjamin F. Crabtree, Carlos Roberto Jaen, Elizabeth E. Stewart, and Kurt C. Stange. 2009. "Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home." Ann Fam Med no. 7 (3):254-260.
Montefiore Medical Center
easons for Developing New Strategy
Designing the new strategy involved several meetings by the Medical Center's employees to assist in the development of a balanced scorecard and initiating nation-level measures. In this regard, the firm developed a new strategy to represent the cause-and-effect linkages among the environment, strategy, and operating plan that could deliver the required financial results. The new system proposed by the strategy was initiated to ensure that financials made up a 10-percent of the measures on the balanced scoreboard. Montefiore additionally, developed the new strategy to measure patient satisfaction, the cost, health care quality as well as cycle times of clinical and administrative processes. It was realized by the institution that the strategic measures were essential in positioning Montefiore for future innovation while encouraging organizational growth. The GIP strategy was initiated by the medical provider to help in increasing market penetration while assisting in…
Barney, J.B. (1986). Organizational Culture: Can It be a Source of Sustained Competitive Advantage? Academy of Management Review, 11(3), 656-665.
Barney, J.B. (1991). Firm Resources and Sustained Competitive Advantage. Journal of Management, 17(1), 99-120.
Collis, D.J., & Montgomery, C.A. (1995). Competing on Resources: Strategy in the 1990s. Harvard Business Review.
Engestrom, Y., Miettinen, R., & Punamaki, R.-L. (1999). Perspectives on Activity Theory. Cambridge University Press.
Market growth in wheelchairs is favorable for a few reasons. The growth in the industry is concentrated in higher-priced segments, with 12-15% each. This means that the relevance of the standard wheelchair is declining, despite that segment remaining the highest volume wheelchair at around 208,000 units or 61.3% by volume and 31.4% of dollar sales. Projecting current growth rates out five years, the industry will looks as follows:
1998 Wheelchair Market
1998 unit share
1998 $ share
Standard wheelchairs are going to lose unit share and are going to decline significantly in dollar share as well. The other three categories are going to increase in importance, so it is important for firms to capture a share of these markets. ight now, the power market is not served by Sunrise, so the company is essentially competing for what will be 38-39% of the total…
QuickMBA. (2010). Porter's five forces. QuickMBA. Retrieved February 22, 2012 from http://www.quickmba.com/strategy/porter.shtml
Blank, S. (2010). Here's why the first-mover advantage is extremely overrated. Business Insider. Retrieved February 22, 2012 from http://articles.businessinsider.com/2010-10-19/tech/30027432_1_market-bad-idea-failure-rate
McGahan, A. (1993). Sunrise Medical's wheelchair products. Harvard Business School 9-794-069
Nationmaster. (2012) Age distribution tables: United States. Retrieved February 22, 2012 from http://www.nationmaster.com/country/us/Age_distribution
Schneck Medical Center: The Baldrige Award
Schneck Medical Center: Overview
The Schneck Medical Center according to the National Institute of Standards and Technology -- NIST (2011) "is a 93-bed nonprofit hospital providing primary and specialized services to the residents of Jackson County, Ind., and surrounding communities." The facility as NIST (2011) further points out, offers a variety of primary care services including but not limited to cancer care, noninvasive cardiac care, and joint replacement.
Established in 1911, the facility was amongst four organizations selected by the President and the Commerce Secretary in 2011 to be awarded the Malcolm Baldrige Quality Award. This particular award in the words of NIST (2011) is "the nation's highest Presidential honor for performance excellence through innovation, improvement and visionary leadership." It is important to note that apart from the Baldrige Award, Schneck Medical Center has been a recipient of several other awards including the Outstanding…
Greene, A.H. (2012). HIPAA Compliance for Clinician Texting. Retrieved May 28, 2013, from: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_049460.hcsp?dDocName=bok1_049460
Hester, D.M. & Schonfeld, T., (Eds.). (2012). Guidance for Healthcare Ethics Committees. New York: Cambridge University Press.
Hernandez, S.R. & O'Connor, S.J. (2009). Strategic Human Resources Management in Health Services Organizations (3rd ed.). Clifton Park, NY: Cengage Learning.
Lyer, P.W., Levin, B.J. & Shea, M.A. (2006). Medical Legal Aspects of Medical Records. Tucson, AZ: Lawyers & Judges Publishing Company.
ithin the profession itself, there are many ethical debates, pertaining to medications, such as prescribing psychotropic drugs like antidepressants to adolescents, the correct times to use palliative care at the end of a patient's life, the ethics of emergency contraception and giving 'the morning after pill' and contraception to adolescents without parental consent. For pharmacists engaged in research, the appropriate use of animals in research and whom to include or exclude in clinical trials may be another issue of personal concern (Applelbe 2008). In all cases, to dispense medication means one must dispense good judgment, not simply pills and potions.
Pharmacy Ethics and Decision Making. (2008). Foreword by Gordon E. Appelbe. First edition.…
Pharmacy Ethics and Decision Making. (2008). Foreword by Gordon E. Appelbe. First edition.
London: Pharma Press.
Conditions Associated ith a Lack of Exercise/Physical Activity
Health is one of the most important things in people's lives, but individuals often fail to focus on this aspect because they concentrate on diverse tasks that they wrongly consider to be more important. As a consequence, many end up suffering greatly as a result of their irresponsible behavior. In addition to causing significant health problems in people's lives, sedentary living is also responsible for costing society billions of dollars every year. The fact that the masses often trick themselves into thinking that they are eventually going to start exercising is extremely worrying and leads to numerous health problems.
Figures associated with sedentary living are alarming, but this is still not enough to influence some people in changing their attitudes concerning the concept. On a yearly basis, "approximately 250,000 people die prematurely because they are inactive" (Corbin & Lindsay 43). Even with…
Corbin, Charles B., and Lindsay, Ruth, "Fitness For Life," (Human Kinetics, 01.06.2006)
Evans, Lisa, "Obesity in England: why is it increasing?," Retrieved October 30, 2012, from the Guardian Website: http://www.guardian.co.uk/news/datablog/2012/feb/23/obesity-problem-increasing
Genuis, Stephen J., and Genuis Shelagh K., "Managing the sexually transmitted disease pandemic: A time for reevaluation," American Journal of Obstetrics and Gynecology (2004) 191, 1103-12
"Half of UK obese by 2030'," Retrieved October 30, 2012, from the NHS Website: http://www.nhs.uk/news/2011/08August/Pages/half-of-uk-predicted-to-be-obese-by-2030.aspx
Medical Research Funding - Government vs. Private
Most research funding comes from two major sources: corporations and government. Some small amounts of scientific research are carried out by charitable foundations, especially in relation to developing cures for chronic diseases.
Government funding for medical research amounts to approximately 36% in the U.S. he government funding proportion in certain industries is higher, and it dominates research in social science and humanities. Similarly, with some exceptions government provides the bulk of the funds for basic scientific research. In commercial research and development, all but the most research-oriented corporations focus more heavily on near-term commercialization possibilities rather than ideas or technologies.
Government-funded research can either be carried out by the government itself, or through grants to academic and other researchers otside the government. Critics of basic research are concerned that research funding for the sake of knowledge itself does not contribute to a great…
The various members of HHMI that are filling key staff positions include: Robert Tjian (President), Craig Alexander (Vice President / General Council), and Sean Carroll (Vice President for Science Education). Robert Tjian has formal training as a biochemist and has been the President of HHMI since 2009. He received a Bachelor Degree from Berkeley and a PHD from Harvard University. The greatest contribution that Tjian has made to medical research is through his groundbreaking work, regarding how genes are turned on and off. Craig Alexander has acted as legal counsel for HHMI since 1994 and has been the Vice President since 2006. He has a Law Degree from the Georgetown University Law Center. Sean Carroll is in charge of Science Education for HHMI. He has been working as an HHMI investigator at the University of Wisconsin Madison, where he is a world famous biologist.
Partnerships and cooperating agencies include: 18 Nobel Prize winners, the National Academy of Sciences, and 335 HHMI investigators around the world. The various board members include: James Baker, Garnett Keith, Fred Lummis and Paul Nurse. All of the different individuals made annual contributions to the foundation.
HHMI Personnel Budget
The condition of hypothyroidism is caused by a thyroid gland that does not produce the proper amount of certain important hormones.
The gland is located in the center of the neck and is described by ebMD (2012) as being butterfly shaped. The gland's hormone production is an important dimension of the metabolic process. Therefore, when its functionality is impaired, the body's capacity to digest, metabolize and utilize the nutrients and proteins yielded by food is also impaired. According to ebMD, "having a low level of thyroid hormone affects your whole body. It can make you feel tired and weak. If hypothyroidism is not treated, it can raise your cholesterol levels and make you more likely to have a heart attack or stroke." (ebMD, p. 1) In the vast majority of cases, the condition is produced by an inflammation called Hashimoto's thyroiditis. (ebMD, p. 1) ith this condition, the…
Mathur, R. (2011). Hypothyroidism. Medicinenet.com.
Mayo Clinic Staff. (2012). Hypothyroidism. Mayoclinic.com.
WebMD. (2012). Hypothyroidism. Webmd.com.
Improving Customer Service on a Medical Surgical Nursing Unit
Quality Improvment Project-Customer service on the nursing unit
The hospital medical-surgical nursing unit is usually referred to as the "catch-all" department for different types of patients. This is because it includes renal patients, cancer patients, cardiac and surgical patient. It also includes other patients who do not particularly fall into any of these specialized units. The medical-surgical nursing unit is a conglomeration of all kinds of adults with all sorts of health problems and thus the nurses in this unit need to be dynamic, quick to respond and are almost on their toes at all times. Patients in the medical-surgical nursing unit are likely to develop changes in their condition quite rapidly and therefore they become more unstable even though they may have been admitted in a stable condition. This is because most patients in the medical-surgical nursing unit have unpredictable…
Amba-Rao, S.C. (1994). Human Resource Management Practices in India: An Exploratory Study. Indian Journal of Industrial Relations, 30(2), 190-202.
Dirks, K.T., & Ferrin, D.L. (2002). Trust in leadership: Meta-analytic findings and implications for research and practice. Journal of Applied Psychology, 87(1), 611-628.
Glickman, S.W., Baggett, K.A., Krubert, C.G., Peterson, E.D., & Schulman, K.A. (2007). Promoting quality: the health-care organization from a management perspective. International Journal for Quality in Health Care, 19(6), 341-348. doi: 10.1093/intqhc/mzm047
Judge, T.A., & Piccolo, R.F. (2004). Transformational and transactional leadership: A meta-analytic test of their relative validity. Journal of Applied Psychology, 89(1), 755-768.
Terrible oads Houston Medical Center
Unfortunately, not all is well within the context of the Houston Medical Center. esidents and workers alike are being plagued with poor quality roads that are creating a situation where many are at a disadvantage in their own everyday lives. Potholes and poor roads throughout the Houston Medical Center facility are creating many residents and faculty alike to have to put up with poorly constructed roads, and thus potential damage to their own vehicles when driving on roads within the region. It is ridiculous in an era where public funds are being spent across the country for the residents of the Houston Medical Center region to have to continuously put up with such horrible road conditions. This can essentially create a situation where there is damage undertaken by vehicles driving on the premises. Vehicles of all types are being damaged while driving in the region.…
Dwight D. Eisenhower Presidential Library. "The Interstate Highway System." 2006. Available at www.eisenhower .utexas.edu/highway.htm.
Kuemmel, D. (1994, April). Accident study validates benefits of preventive maintenance. American City & County, 109, 52.
Takle, E.S. (1990, August). Bridge and roadway frost: occurrence and prediction by use of an expert system. Journal of Applied Meteorology, 29, 727-734.
Schnormeir, Russell H. "Asphalt Analysis, Sulfur Mixes, and Seal Coats," Transportation Research Record #1096. Washington D.C.: Transportation Research Board -- National Research Council, 1986.
HHS Initiative on Multiple Chronic Conditions
Multiple chronic conditions (MCC) are significant challenges and obstacles to the health practitioners and citizens of the United States. The aim of the programs by the HHS includes prevention and management of multiple chronic conditions in the context of the United States. In the execution of its duties in accordance to the programs, HHS also offers an essential component in relation to leadership for the improvement of the health of the citizens of the United States with multiple chronic conditions.
Brief overview of the mission of the program
Multiple chronic conditions (MCC) are significant challenges and obstacles to the health practitioners and citizens of the United States. This relates to the role of the multiple chronic conditions on the health and development of the economy. In order to reduce the burden and suffering in relation to the aspect of multiple chronic conditions, the government…
Anand K. Parekh et al. (2011). Managing Multiple Chronic Conditions: A Strategic
Framework for Improving Health Outcomes and Quality of Life. Public Health Rep.
2011 Jul-Aug; 126(4): 460 -- 471.
How is HHS addressing Multiple Chronic Conditions?
A new health care policy must make it mandatory for insurance companies to offer coverage to every individual who otherwise qualifies for insurance. Pre-existing condition must not be an excuse for denial. The new policy would prohibit companies from denying coverage to people with medical history or a chronic health problem. All existing policies would also be updated to accommodate the new changes. This means that people who already are suffering from a condition and have not been covered by their insurance companies will now be given coverage as long as they pay their premium on time and in full.
Similarly companies will not be allowed to leave people high and dry when they are found with an illness that is likely to affect them for some time. Benefits will not be watered down after diagnosis.
We strongly need these changes because millions of people are going without coverage every…
1 American Heart Association. Heart Disease and Stroke Statistics 2009 Update-at-a-Glance. http://www.americanheart.org/downloadable/heart/1240250946756LS-1982%20Heart%20and%20Stroke%20
2 Doty MM, Collins SR, Nicholson JL et al. Failure to Protect: Why the Individual Insurance Market is not a Viable Option for Most U.S. Families. The Commonwealth Fund, July 2009.
3 USA Today/Kaiser Family Foundation/Harvard School of Public Health. National Survey of Households Affected by Cancer. November 2006. http://www.kff.org/kaiserpolls/upload/7591.pdf
Sociology -- Medical Dominance on the Profession of Nursing and How is the Profession of Nursing Challenging Medical Dominance in Australia
In the context of medical practice, the contemporary medical society is representing a change in the increasing issues of domination between medical professions. The focus of each practice's attention is on exploring its goals in providing integral contributions and impact to the framework of health care services. Each dimension of medical interest, specifically the doctors and nurses, are developing their respective paradigm and uniqueness to establish skills and authority in the field of health service.
This paper aims to do an informative research on medical dominance over the profession of nursing in Australia. As the industry of medicine progresses, the issue of domination among medical doctors and nurses in health care institutions are associated with competencies and authority over the other. The power and privileges of the profession is…
Andrews, I., Hale, A. (2000). The Division of Labour in Health Care Delivery.
Retrieved Sept 23, 2003, from Faculty of Health Sciences. The University of Sydney.
Web site: http://www2.fhs.usyd.edu.au/bach/1107/topic9.htm
Duffy, E. Evolving Role and Practice Issues: Nurse Practitioners in Australia.
eport on Conditions at Brighton and Sussex University Hospitals NHS Trust
The following report is based on extensive observation of the conditions for patients living at the Brighton and Sussex University Hospitals NHS Trust. While some patients received moderate care, overall, the quality of care in this facility was appalling. All patients -- all people -- deserve to be treated with dignity, and this was far from the case. The conditions were especially distressing given that in general they could be fixed or at least ameliorated relatively easily. Not all of the ills of old age or disability can be remedied, of course. Pain and fear will be present even with the best possible care. Given that this is true, all possible efforts must be made to reduce fear, anxiety, and pain to the greatest degree possible.
The facts that this report is based on were documented by…
Grant, P. (2010). Ethical lessons from the 'undercover nurse': implications for practice and leadership. Medical Ethics 36: 469-472.
Margaret Haywood's diary. Retrieved from http://news.bbc.co.uk/2/hi/programmes/panorama/4701651.stm .
Online bulletin. Retrieved from http://www.southerneditorial.co.uk/bulletin/july05/breaknews.htm.
Reasons for the substantive hearing of the Conduct and Competence. Retrieved from http://www.nursingtimes.net/Journals/1/Files/2009/4/17/haywood_NMCruling.pdf
But by removing the ability of insurance companies to discriminate in their selection of who to ensure, buying insurance -- and insurance premiums overall -- will inevitably increase. Why? "If insurers are forced to sell coverage to everyone at any time, many people will buy insurance only when they need medical care. This raises the cost of insurance for everyone else, in particular those who are responsible enough to buy insurance before they need it; they end up paying even higher premiums. And the more expensive the insurance, the less likely people will buy it before they need it" (the truth about health insurance, 2009, the Wall Street Journal).
Prohibiting discrimination, in other words, will create a vicious cycle. Individuals who feel they are immortal -- like healthy young people starting new careers pinching every penny -- will not buy health insurance. More of the sick and the elderly, who…
Freelancer's Union. (2010). Retrieved February 13, 2010 at http://www.freelancersunion.org/insurance/how.html
Preexisting conditions. (2010). How Stuff Works. Retrieved February 13, 2010 at http://health.howstuffworks.com/pre-existing-condition.htm
Seeyle, Katherine Q. (2010, February 12). Administration rejects health insurer's defense of huge rate increases. The New York Times. Retrieved February 13, 2010 at http://www.nytimes.com/2010/02/12/health/policy/12insure.html
The truth about health insurance. (2009, August 12). The Wall Street Journal. Retrieved February 13, 2010 at http://online.wsj.com/article/SB10001424052970204908604574332293172846168.html
(Illicit Drugs or Nutritional Supplements?) It is more likely that some illegal gratification was sought and not received and that led to this action. Since this was also a case for medicines, one should also be careful of the problems that may come up.
What has been stated earlier is that it would be better to leave the enterprise to operations by South Africans and in that case, they will determine most of the staffing. It is not advisable clearly that many ozambicans be depended on for operations at least due to their ability. An example of this has just been stated.
2. Training and Development
When we are talking about a business and a possible collaboration with an existing business owner, they would have completed the training in an operating business. This would be helpful as the culture of South Africa and ozambique would be similar.…
Mozambique- people and society. Retrieved at http://www.oxfam.org.uk/coolplanet/kidsweb/world/mozambique/mozpeop.htm . Accessed 11 October, 2005
Mozambique-South Africa - Investment climate generally favorable, new report. 2 June 2004.
Retrieved at http://www.irinnews.org/report.asp?ReportID=41385 . Accessed 11 October, 2005
Alcohol abuse is a condition that is characterized by a pattern of excessive drinking in spite of negative effects resulting from the use of alcohol on an individual's occupational, legal, educational, medical, and/or social life. Alcoholism results from this destructive pattern of alcohol abuse after a period of time and includes a number of other symptoms including: increased tolerance to alcohol over time; alcohol withdrawal; a pattern of using more alcohol and/or use for a longer time than planned; destructive patterns health, social, and occupational functioning as a result of alcohol use; and failed attempts at reducing its use (APA, 2000). Alcoholism is also known as alcohol dependence or alcohol addiction as the terms are used interchangeably in the medical and treatment literature. These terms describe a destructive pattern of chronic alcohol use that results in the development of tolerance to alcohol, needing more alcohol to achieve the same effects…
American Psychiatric Association (APA, 2000). Diagnostic and statistical manual of mental disorders (4th Ed.). Arlington, VA: Author.
Boorse, C. (1997). A rebuttal on health. In J.F Humber and R.F. Almeder (Eds.), What is disease? Totowa: Humana Press.
CDC (Centers for Disease Control, 2001) Chronic disease prevention: about chronic disease [Online]. Available: Internet: http://www.cdc.gov/nccdphp/about.htm .
Dick, D.M. And Bierut, L.J. (2006). The genetics of alcohol dependency. Current Psychiatric Reports, 8, 151-157.
On the other hand, when doctors prescribe inappropriate drugs, the cost is very high and it is a total loss. In 2001, the cost of non-compliance in prescription standards in United States was nearly $1.2 billion. (Can Costs Be Controlled While Preserving Quality?) These are the areas in which the experts have to tell the doctors. The aim of the sessions is not to reflect on the quality of existing doctors, or tell them that they are out of date and now need advice from others, but to advise them about methods through which costs can be reduced.
The total aim of the exercise is to maintain quality that exists and continue on the same path of excellence. At the same time, there are some problems in future that are being viewed, and action has to be taken before the real problems come.
Amish, Nan Andrews. "Healthcare Trends for…
Amish, Nan Andrews. "Healthcare Trends for Financial Executives" Retrieved at http://www.bigpicturehealthcare.com/HealthcareArticles/FinancialHealthcareManagement.html. Accessed on 23 July, 2005
Bodenheimer, Thomas; Fernandez, Alicia. "Can Costs Be Controlled While Preserving
Quality?" Annals of Internal Medicine. Vol: 143; Issue 1; pp: 26-31. Retrieved at http://www.annals.org/cgi/content/full/143/1/26Accessed on 23 July, 2005
Harrington, Cynthia. (May, 2003) "Health Care Costs on the Rise" Journal of Accountancy.
Torticollis is a condition which can be either temporary and of a minor inconvenience or it can be chronic and physically debilitating. The implications of the condition can run the gamut of severity and susceptibility to treatment. Torticollis, or a twisting of the neck, can be extremely common but its causes and impact exist across a wide range of variations. The discussion here will offer a concise overview of the condition with consideration of its various suspected causes, its most salient symptoms, strategies for its treatment and existing technologies or adaptive strategies aimed at helping individuals live with the condition.
Torticollis is not an altogether uncommon presence at the time of birth. hen the condition is present at the time of birth, it is referred to as congenital or inherited torticollis. According to the research provided by the Baby Center Medical Advisory Board (BMAB) (2012) "about…
Baby Center Medical Advisory Board (BCMAB). (2012). Torticollis. Babycenter.com.
Cunha, J.P. (2009). Torticollis Overview. EMedicine Health.
Mayo Clinic Staff. (2008). Cervical Dystonia. Mayo Clinic.com.
Medline Plus. (2011). Torticollis. NLM.NIH.gov.
Factors related to hospitals and the patient population influence incidents of discharge Against Medical Advice, also known as AMA (Karimi et al., 2014). There is a high rate of discharges against the doctor’s advice after admission into emergency units. There is a need to probe the reasons behind such a trend (Shirani et al., 2010). It should be noted with concern that AMA is a healthcare institutions’ problem across the world because, in cases where children are discharged in such a manner, the blame cannot fall on these children. Children do not contribute to such decisions (Mohseni et al., 2013). Figures show that out of every 65 to 120 discharges from general hospitals across the world, one is a case of AMA. Such action is prone to dire consequences including litigation (Devitt et al., 2000). The scenario is a challenge to physicians across the globe (Taqueti, 2007). It is…
Society at large does not and would not permit risking harm to humans in order to avoid using animals for research (Animals pp).
The pharmaceutical industry uses animals only when research cannot be accomplished in other ways, and always with care (Animals pp). If society wants to relieve conditions such as epilepsy, asthma, multiple sclerosis, and heart disease, then animals will continue to be need for research (Animals pp).
Although it is important and morally right to minimize the use of animals for research, it would be morally wrong to place the concern for animals above the concerns and needs of people who are dying from and/or living with incurable and untreatable conditions that could benefit from such research (Animals pp).
Animals in Medicines Research Information Centre - AMRIC. http://www.abpi.org.uk/amric/introduction.asp
Animals in Medicines Research Information Centre - AMRIC. http://www.abpi.org.uk/amric/introduction.asp
Medical Administration Service for File
ationale in Support of Selection of Heart Transplant ecipient
Because time was of the essence in formulating this decision, this memorandum for the record sets forth the decision-making process and that was used to select the most appropriate candidate for a heart transplantation procedure. It was my responsibility as lead surgeon to select the most appropriate heart transplant recipient from a pool of three candidates, each of whom had suffered from several health-related issues that adversely affected their suitability for the transplant procedure. Therefore, in order to formulate as subjective an analysis as possible in a timely fashion, a utilitarian ethical analytical approach was used to identify the candidate that held the most promise of using the gift of additional life from the heart donor to its maximum advantage. The utilitarian ethical analysis showed that of the three potential heart transplant candidates, the 12-year-old…
Andre, C. & Velasquez, M. (1989, Winter). Calculating consequences: The utilitarian approach to ethics. Issues in Ethics, 2(1), 37.
Hollingsworth, J.A., Hall, E.H. & Trinkaus, R.J. (1991). Utilitarianism: An ethical framework for compensation decision making. Review of Business, 13(3), 17-19.
Rosen, F. (2003). Classical utilitarianism from Hume to Mill. London: Routledge.
Experiential Exercise: Observing and Reporting Surroundings at a VA Medical Center
To satisfy the requirements of this assignment, the author recently volunteered at a local Department of Veterans Affairs medical center (VAMC) and the results of this experience are related below.
Date and address of where the experience took place
October XYZ, 20XX, in Anytown, Ohio.
Length of time you were there
Four hours (including lunch).
Brief description of the setting
The VAMC visited for this assignment is a major tertiary healthcare facility that provides medical, surgical, dental and mental health services to eligible veterans in its catchment area. The volunteer services department is located on the VAMC's first floor, immediately inside the main entrance. A young female receptionist behind a glass window greets volunteers with and without appointments, but a sign below the window recommends making an appointment to ensure volunteers' services are needed on a specific date. Besides…
The first level of the NHS - health centers and health costs produce a considerable part of the total volume of health services in the nation and comprise the first and only point of contact with the health system for the major part of the Mozambican population. The present approach while delivering primary level health services in Mozambique has been very successful. (Expenditure Tracking and Service Delivery Survey: The Basic Concept) iv) Profitability: Prices of medicines often has no relation to costs, as included in the cost of research and development -- &D and production, are added a portion of the mixture of marketing costs, profit margins, subsidies, tariffs, and tax requirements that vary across nations. The outcome is great price variations both between and within the nations. Since the patent for lamivudine/zidovudine taken on 1996 is valid for 20 years and low cost generic copies cannot be sold prior…
About Our Work: Antiretroviral Therapy. Retrieved at http://www.cdc.gov/nchstp/od/gap/pa_art.htm . Accessed 23 September, 2005
Dare to Lead: public health and company wealth. Oxfam Briefing paper on GlaxoSmithKline.
Retrieved at http://www.oxfam.org.uk/what_we_do/issues/health/dare_to_lead.htm . Accessed 23 September, 2005
Expenditure Tracking and Service Delivery Survey: The Health Sector in Mozambique. Survey Information and Status Report. August, 2002. Retrieved at http://www.worldbank.org/research/projects/publicspending/tools/Mozambique%20PETS/mozambique.ETSDS.lindelow.statusreport.sep4.2002.pdf . Accessed 23 September, 2005
Working egulations & Conditions
The Working Tine egulations of 1998 established a variety of legal provisions impacting the working hours and rest periods of employees. egulation 12 establishes the right to an uninterrupted break of 20 minutes for a daily work period in excess of six hours. egulation 10 establishes an entitlement to a daily rest period of 11 consecutive hours for each 24 hours during which the employee works, although there are a host of exceptions to this provision. egulation 11 establishes the right of adult workers to one day off a week, averaged over a two-week period (National Archives 2012).
There are a variety of provisions, and rights, available to mothers, fathers, and adult caretakers that impact the terms and conditions of an employee's employment. Using women as an example, it is clear that there are many provisions intended to protect, and enhance, the employment conditions and opportunities…
Citizens Advice Bureau, 2012. Advice Guide: Parental Rights at Work. [online] Available at: http://www.adviceguide.org.uk/england/work_e/work_rights_at_work_e/parental_rights_at_work.htm
Directgov, 2012. Employment: Discrimination at Work. UK Government. [online] Available at: http://www.direct.gov.uk/en/employment/resolvingworkplacedisputes/discriminationatwork/index.htm
Education International. Pay Equity: Training and Awareness Raising. Pay Equity Now! Campaign. [online] Available at http://download.ei-ie.org/Docs/WebDepot/feature5%20-%20100519%20-%20training%20and%20awareness%20-%20final%20EN.pdf
The National Archives. Working Time Regulations 1998. UK Government. [online] Available at http://www.legislation.gov.uk/uksi/1998/1833/contents/made
This would likely have resulted in a long delay in raising suitable support to those health care professionals already at the disaster site.
Duties of the DMAT
The initial duties of the DMAT were to assist the nursing team at Charlotte egional Medical Centre as most nurses there had been on duty for around 40 hours. This was due to the problems which relief staff had in getting to the facility and also the problems which had been caused at the hospital due to the power failures and the structural damage that had been inflicted on the hospital (Cohen and Mulvaney). This initial aid that the DMAT provided was invaluable, as if they had not been so well prepared and arrived so early there would have been far greater pressure on the staff at the hospital, which would have greatly reduced the quality of care which the patients received.
Cohen, Sharon S. And Karen Mulvaney. "Field observations: Disaster Medical Assistance Team response for Hurricane Charley, Punta Gorda, Florida, August 2004." Disaster Management and Response 3.1 (2005): 22-27.
Mace, Sharon E., Jaszmine T. Jones and Andrew I. Bern. "An analysis of Disaster Medical Assistance Team (DMAT) deployments in the United States." Prehospital Emergency Care 11 (2007): 30-35.
McEntire, David a. Disaster Response and Recovery: Strategies and Tactics for Resilience. Indianapolis: Wiley, 2007. 156-157.
South Florida Regional DMAT FL 5 / IMSuRT South. 2007. South Florida Regional DMAT FL5. 31 October 2007 http://www.fl5dmat.com/ .
Arthritic conditions found within the joints of the body: their causes, treatment, current research, and what effect they have on athletic participation.
Types of Arthritis
Causes of Arthritis
Arthritis and Athletic Activities
Arthritis is said to be the number one cause of disability in the United States, with more individuals disabled with arthritis than by both heart disease and strokes (Lewis 2000).
Arthritis is also a disease that is plagued with misunderstanding. The Center for Disease Control warns that it is these misunderstandings that result in the disease doing so much harm (Lewis 2000).
Some of the common misunderstandings involve recognizing that there are different types of arthritis and that arthritis is not only a disease of the aged. Arthritis is also often not taken seriously enough in its early stages, preventing individuals from seeking medical help that could…
AAOS: American Academy of Orthopaedic Surgeons. (2000). Arthritis. American Academy of Orthopaedic Surgeons.
The Arthritis & Glucosamine Resource Center. (2002). Treating and Preventing Sports Injuries & Secondary Arthritis. http://www.arthritis-glucosamine.net/arthritis/sports-injuries-arthritis.html
Arthritis Foundation. (2002). Progress and Opportunities in Rheumatoid Arthritis. http://www.arthritis.org/research/research_program/RA/default.asp
Lewis, C. (May-June 2000). Arthritis: Timely Treatments for an Ageless Disease. FDA Consumer, 34:3.
Performance Measures for (50,000 call per year) EMS
EMS ORGANIZATIONAL PERFORMANCE MEASUREMENT
That the organization implements additional clinical performance measures, including those to evaluate the quality of the EMS.
That the organization uses survey data to evaluate and analyze customer and employee satisfaction and that a proper feedback and control mechanism is in place to use this data to implement required changes.
This report starts from the premise that Emergency Medical Services will be treated as any other service. As a consequence, this type of service reflects the relationship between the service recipient (in this case the patients) and the service provider (in this case the medium-sized organization being analyzed in this report).
This means that this report will use many of the existing research and business literature and apply business principles such as customer and employee satisfaction in presenting and analyzing a comprehensive set of recommended performance measures for…
1. Balridge National Quality Program (2002). Criteria for performance excellence. Gaithesburg: National Institute for Standards and Technology
2. The Customer Communicator (TCC) (2005). Alexander Communications Group, 28 (1) 2.
3. National Highway Traffic Safety Administration (2009). Emergency Medical Services: Performance Measures, Recommended Attributes and Indicators for System and Service performance.
4. Bruce, J. (2004). Application of EMS Customer Satisfaction Survey Data to Improve Service Delivery at Rialto Fire Department.