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Patient-focused healthcare has come to the forefront in recent discourse on care quality. Cited in the "quality chasm" paper of the Institute of Medicine as an aspect of superior-quality healthcare, the term 'patient-centered healthcare' is being currently incorporated into the lexicons of health planners, healthcare facilities, policymakers and the public relations personnel of healthcare organizations. Insurance companies are increasingly linking payments to patient-focused care delivery. But much discourse on the subject fails to take into account the vital, radical meaning of actual 'patient-focused' care. This concept's initiators were quite cognizant of their work's ethical consequences. Their services were founded upon profound regard for clients/patients as individuals with unique characteristics, expectations, and wants, and a duty to offer them health services on their individual terms. Therefore, a patient is recognized as an individual in relation to his/her respective social world, respected, paid attention to, kept updated, and allowed to…
Epstein, R., & Street, R. (2011). The Values and Value of Patient-Centered Care. Annals of Family Medicine, 100-103.
Rickert, J. (2012). Patient-Centered Care: What It Means And How To Get There. Retrieved from http://healthaffairs.org/blog/2012/01/24/patient-centered-care-what-it-means-and-how-to-get-there/
Extra Additions for Patient Centered Care Model
Within the rubric of 21st century medicine, it is often surprising that we need to be reminded that it is not the technology, the clinical expertise, or even the health care and institutional debates that should drive the paradigm of appropriate medical care -- it is the patient. Patient Centered Care is a model that focuses on the patient as the center of a multi-dimensional approach that considers patients' cultural traditions, their personal preferences and values, their unique family situations, and their lifestyles. The PCC model allows for families to become an integral part of the process of medical care, and the entire care team who assist the patient in making decisions and allowing the patient a modicum of responsibility for their own healing process. Indeed, PCC places the responsibility for important milestones of self-care and monitoring squarely in the patient's hands, yet…
General Overview: Patient Centered Care. (2010, January). Retrieved November 2010, from Institute for Healthcare Improvement: http://www.ihi.org/IHI/Topics/PatientCenteredCare/PatientCenteredCareGeneral/
McKerns, L. (2009, July). What is Patient Centered Care and How is it Better? Retrieved October 2010, from Selfgrowth.com: http://www.selfgrowth.com/articles/What_is_Patient_Centered_Care_and_how_is_it_Better.html
Parsons and Murdaugh. (1994). Patient-Centered Care - A Model for Restructiing. Gaithersburg, MD: Aspen Publications.
Stewart, Brown, Donner, McWhinney, Oates, Weston and Jordan. (2000, July 4). The Impact of Patient Centered Care on Outcomes. Retrieved November 2010, from The Journal of Family Practice: http://www.jfponline.com/Pages.asp?AID=2601&issue=September_2000&UID=
Emotional Intelligence and Patient-Centered Care" is a 2007 publication from the Journal of the Royal Society of Medicine which seeks to discover whether or not Emotional Intelligence (EI) can be of use in the health care industry. Emotional Intelligence is a personal characteristic that some have identified as linked to the successful ability to form interpersonal relationships with patients in order to benefit the patient's interaction in the health care system. This would not only include a patient's experience when visiting health care professionals, but also the patient's increased overall health benefits such as being healthier and living longer. The authors stated purpose is to examine whether Emotional Intelligence, when adapted to the idea of patient-centered care, can be of assistance in the health care system.
Emotional Intelligence is defined as "a set of abilities (verbal and non-verbal) that enable a person to generate, recognize, express, understand and evaluate their…
Birks, Yvonne, and Ian Watt. "Emotional Intelligence and Patient-Centered
Care." Journal of the Royal Society of Medicine 100.8 (August 2007):
Nelis, Delphine, et.al.. "Increasing Emotional Intelligence: (How) is it
Global Health Care Issues
The most significant healthcare issues that the countries surveyed are facing include care coordination and safety. Significantly, these issues were prevalent across international borders and throughout many of the countries surveyed. Care coordination in particular seems a salient issue, since it refers to the dissemination of conflicting information on the part of providers and an inability of patients to get further treatment because of a lack of prerequisites (such as authorization or tests) (Commonwealth, 2015). Such care coordination issues inherently lead to safety problems for geriatric patients. Other issues that were eminently revealed in this survey are that older patients have difficulty paying for the costs of their health care services. Subsequently, it is difficult for these patients (particularly in the United States) to obtain the care that they need. Other issues include a lack of ease with getting care the same day that a patient…
The Commonwealth Fund. (2015). International survey of older adults finds shortcomings in access, coordination, and patient-centered care. www.commonwealthfund.org Retrieved from http://www.commonwealthfund.org/publications/in-the-literature/2014/nov/international-survey-of-older-adults
Communication by Nurses in the ICU
What are the concepts of the study addressed in the Literature Review?
In this article, there are no discussions made on the previous studies that were conducted on the research concepts. Moreover, it does not have a literature review section. Recorded information on the document relates to what two nurses reported especially when working as translators and this showed they were able to communicate more or less in particular areas. The other report came from a nurse who focuses on the errors that come with the patient's inability to communicate with their families concerning their pertinent health issues. The interviews conducted showed precision because the participants answered questions that were aligned to their profession. They also had examples that show the validity aspect of research with regard to data collection. Furthermore, the study is feasible because the information obtained using interviews come from the…
Patient-centered care is the goal of many healthcare organizations, but the ability of an organization to deliver patient-centered care is influenced by a number of factors both internal and external. Business practices, regulatory requirements, and reimbursement all can impact patient-centered care in any healthcare organization. Promoting patient-centered care requires an organizational culture committed to this paradigm, which also needs to be embedded in the mission and values of the organization.
Executives and administrators create the organizational culture that promotes patient-centered care. All leaders in the organization are responsible for using patient-centered practices and communications styles in their interactions with patients and their families. Furthermore, administrators oversee the policies and procedures that directly impact the culture of care. Analyzing areas of weakness within the organizational structure and culture via established assessments like the Patient-and Family-Centered Care Organizational Self-Assessment Tool, it is possible to create multidisciplinary teams that promote the organization’s…
Patient Centered Medical Homes (PCMH) are often confused as being actual "homes" for patients to be admitted in and given medical treatment and care. PCMH is actually a health care model based on which health care is provided to patients, under the supervision of physicians. The PCMH model of health care provides patients with continuous, comprehensive medical care, in order to increase the chances of achieving the goal of benefitting the patient with as much attention and medical care in order to maximize his/her health outcomes.
Over the years the PCMH model of health care has become widely adopted and preferred. This is because of the philosophy and approach that the model adopts in organizing and delivering the health care initiatives. The PCMH model is based upon delivering medical care and attention to patients with team-based health and medical experts that are focused strongly on the quality and the safety…
109-432, P.L. (2006, December 20). TAX RELIEF AND HEALTH CARE ACT OF 2006. Public Law 109-432 (109th Congress) .
Backer, L.A. (2009). Building the Case for the Patient-Centered Medical Home. Family Practice Management 16 (1), 14-18.
De Geest, S., Moons, P., Callens, B., Gut, C., Lindpaintner, L., & Spirig, R. (2008). Introducing advanced practice nurses/nurse practitioners in health care systems: a framework for reflection and analysis. Swiss Medical Weekly (138), 621-628.
NASHP. (2013, April). Medical Home & Patient-Centered Care. Retrieved from The National Academy for State Health Policy: http://www.nashp.org/med-home-map
Patient-Centered Medical Home
How the Patient-Centered Medical-Home reducing cost and improving quality and safety for patients.
The patient centered medical home is a platform that fills a need in the current healthcare system. The U.S. healthcare system has been plagued for quite some time with a trend of substantially rising healthcare costs as well as another trend of slipping quality standards. These two trends are argued to be a phenomenon that has emerged at least partly from poor planning and ineffective use of resources. One solution to some of these issues can be found in the patient-centered medical home (PCMH) model of primary care. This model has been developed with the coordination of long-term physician-patient relationships in mind. Developing these relationships further can not only reduce costs in unnecessary procedures that are the result of the missed opportunity for preventive care, but also have been shown to improve…
Christensen, E., Dorrance, K., Ramchandiani, S., Lynch, S., Whitmeore, C., Borsky, A., . . . Bickett, T. (2013). Impact of a Patient-Centered Medical Home on Access, Quality, and Cost. Military Medicine, 135-141.
Ewing, M. (2013). The Patient-Centered Medical Home Solution to the Cost-Quality Conundrum. Journal of Healthcare Management, 258-266.
Kern, L., Dhopeshwarker, R., Edwards, A., & Kaushal, R. (2013). Patient Experience Over Time in Patient-Centered Medical Homes. American Journal of Managed Care, 403-410.
Nielsen, M., Olayiwola, J., Grundy, P., & Grumbach, K. (2014). The Patient-Centered Medical Home's Impact on Cost & Quality. Patient-Centered Primary Care Collaborative, 1-38.
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.
It is felt that an important part of this process is the family since that is where the child spends the majority of their time. The family situation and the experiences that are provided to the child within this situation are critical to a child's development (Bruder, 2000).
Physical Therapy is one type of early intervention that is often used with disabled children. The idea of family-centered care brings many wonderful things to the practice of pediatric physical therapy. Physical therapy is the profession of developing, maintaining and restoring maximum movement and function to a patient. Treatments often focus on improving gross and fine motor skills, balance and coordination, strength and endurance as well as cognitive and sensory processing. For a child with a disability all of these practices are things that they need to work on and improve in order to be able to grow up and care for…
Bruder, Mary Beth. (2000). Family-Centered Early Intervention: Clarifying Our Values for the New Millennium. Topics in Early Childhood Special Education. 20(2). p.105-115.
****Johnson, Beverly H. (1999). Family-Centered Care: Creating Partnerships in Health. Group Practice Journal. p. 18-21.
****- This citation needs the journal number and volume number in order to be complete…..it wasn't on the article itself and I couldn't locate it anywhere.
Perhaps the most fundamental tenet of my nursing philosophy is the administration of care in an intrinsically empathetic manner which benefits the patient. I unequivocally believe in patient-centered care and that nurses who are able to maintain this component of their practice as their primary goal are able to produce the greatest efficacy in administering to patients. Moreover, with all of the concerns of the contemporary healthcare market, including various facets of financial and technological concern, the shortage of various practitioners, and innovations in precision medicine, it is easy to forget that the most vital component of the health care industry is the patients themselves. Quite simply, patients have the most to gain and lose from the health care system. Therefore, I readily believe that keeping those patients as the center of the care delivered by me and others within my profession is the best way we can…
Andrist, C., Nicholas, P. and Wolf, K. (2006). The Evolution of the Environment Paradigm in Nursing. A history of nursing ideas (pp. 97- 108). Sudbury, MA: Jones and Bartlett.
Bourdeau, M. Auguste Comte. The Stanford Encyclopedia of Philosophy. https://plato.stanford.edu/archives/win2015/entries/comte/
McEvoy, L., Duffy, A. (2008). Holistic practice -- a concept analysis. Nurse Education in Practice. 8, 412-419.
Zborowsky, T. (2014). The legacy of Florence Nightingale's environmental theory: nursing research focusing on the impact of healthcare environments. Health Environments Research & Design Journal. 7(4), 19-34.
Patient Centered Medical Home
PCMH model leads to reduced cost of care, improved population health" is a medical report authored by Katie Sullivan Published on FierceHealthcare. The report is a summary of the general findings of a report carried out by the Patient-Centered Primary Care Collaborative. According to the research report, the Patient Centered Medical Home has resulted in reduced unnecessary emergency room (ER) and hospital visits, costs of care, and improved population health.
The research methodology employed is the review of literature released between August 2012 and December 2013. This means that a panel of experts reviews all the articles before they accepted for publication. The report achieves quality and merit by restricting the literature to peer review articles that can be relied for scholarly and official use. However, there is no indication of the section process used in identifying the literature to be used. August 2012 to…
Inter and Intraprofessional Communication
Patient-centered practice is designed to address issues that usually appear as a consequence of nurses having a limited understanding of their role and as a result of patients not being provided with the opportunity to learn more about the attitudes they need to take in order to make the experience less painful for all individuals involved. One of the principal ideas related to this type of thinking is the fact that there is always room for innovation and nurses thus need to be proactive in their line of work. Considering that conventional strategies are likely to be ineffective in certain situations, nurses need to be able to adapt to stressing conditions and to get actively involved in trying to provide patients with the best service possible.
Through concentrating on intraprofessional and interprofessional practices, nurses can contribute to their understanding of their line of work in general…
Norgaard, B. "Communication with patients and colleagues," Retrieved May 29, 2015, from http://www.danmedj.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=8390873.PDF
"Interprofessional Education, Team, Intraprofessional Communication" Committee," Retrieved May 29, 2015, from http://symposium.medicine.dal.ca/documents/Team2ReportIPE_Team_IntraprofessionalCommunication.pdf
Evolution of Health Care Information Systems Physician's Office Operation
Filling in the hole of health care information technology will endorse safe, capable, patient-centered, and patient care that is fruitful in a timely way. In this essay, the theme is to look into two modern health
care organizations and then compare and contrast many characteristics that will involve the kind of evidence systems are using at the moment, investigate the transmission of information 20 years ago and how the substitute of data today. Furthermore, this essay will cover two major events and technology developments that have inclined present Health Care Informational Services practices.
Compare and Contrast Doctor's Workplace Operation
These day's doctor's office operation is familiarizing to the health care reform that was sanctioned in 2010 by the Obama organization. During sometime in October of 2013, the exchanges in health insurance was available on the market for customers on order to…
Burke, D., Wang, B., & Wan T.T.H. & Diana, M. (2009). Exploring Hospitals' Adoptionof IT. Journal of Medical Systems, 21(9), 349 -- 355.
Callen, J., & Braithwaite, J. & . (2008). Cultures in Hospitals and TheirInfluence on Attitudes to, and Satisfaction with, the Use of Clinical InformationSystems. Social Science and Medicine, 65(4), 635-639.
Finchman, R., & Kohli, R. & . (2011). Editorial Overview -- The role of IS inHealthcare. Information Systems Research, 22(3), 419-428.
Being ill is never a simple thing. Besides the physical tolls a medical condition can take on a person's body, there are also many mental and psychological costs that affect a sick person. Nor do these physical and mental effects only harm the person with the medical condition. Research shows that family members and close friends of ill people will also be seriously affected by the condition. Illness is a physical, mental, sociological, and financial drain and, in some family units, an illness can destroy the fabric of the family itself. A person who is involved in the medical profession must have a clear understanding not only of medicine and what they need to do to cure or treat an illness; they must also be aware of the psychological issues that a patient deals with, along with the pressures which are placed upon members of their family. Nurses…
Bruce, B. et al. (2002). A multisite study of health professional's perceptions and practices of family centered care. The Journal of Family Nursing. (8:4). 408-29.
Harrison, T. (2010). Family centered pediatric nursing care: state of the science. Journal of Pediatric Nursing. (25:5). 335-43.
Raoufian, D. (2003). The power of family-centered care. The Journal of Family Nursing. (9:3).
The author of this report has been asked to answer several questions relating to a survey that was taken and the conclusions or outcomes that can be drawn from the same. Within this report, the current practice setting will be describe as well as the patient- and family-centered nature (or lack thereof) of the organization. The gaps that exist will be described, there will be an analysis of how business practices and regulatory requirements can impact patient- and family-centered care and there will be a strategy created based on all of the above. While all businesses need to make a profit and while not all feedback is helpful or based on the most good for the most people, cutting out the feelings and feedback of families and patients is less than wise and should never be happening.
State of the Practice
The basic state of the practice at…
Ahmed, S.M., Lemkau, J.P., Nealeigh, N., & Mann, B. (2001). Barriers to healthcare access in a non-elderly urban poor American population. Health & Social Care In
The Community, 9(6), 445-453. doi:10.1046/j.1365-2524.2001.00318.x
Brown, B.P. (2014). Interpreting Medicine: Lessons From a Spanish-Language
Clinic. Annals Of Family Medicine, 12(5), 473-474. doi:10.1370/afm.1661
"Person-centred care is underpinned by values of respect for persons, individual right to self-determination, mutual respect, and understanding (McCormack, Dewing, & McCance, 2011). Sometimes providing person-centered care demands facilitating the independence of patients. At other times it may require the nurse or another caregiver to step in provide additional assistance. egardless, the ultimate intention of person-centered support is to maximize the autonomy of the individual. In contrast to the 'hotel model' of care in which everything is done for the patient (even actions he or he could conceivably perform) the person-centered model requires individualized knowledge of the capabilities of each person whom the nurse is trying to serve and invests a sense of competence and choice in the heart of patient.
The level of autonomy may differ from patient to patient, depending on psychological and physical limitations, but the emotional and social goals are always the same. In…
McCormack, B., Dewing. J., McCance, T. (2011). Developing person-centred care: Addressing contextual challenges through practice development. OJIN: The Online Journal of Issues
in Nursing, 16, 2: 3. Retrieved: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No2-May-2011/Developing-Person-Centred-Care.html
The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation.
The research showed that many elderly patients who suffer from congestive heart failure also suffer from a wide range of comorbid conditions, including diabetes and hypertension. These patients can be reasonably expected to require periodic or even frequent treatment in emergency departments and/or hospitalizations for these conditions, making the need for effective and seamless post-discharge planning especially important. In this regard, the research also showed that there are some valuable evidence-based practice guidelines available, though, that can help clinicians better coordinate post-discharge…
DIAGNOSIS AND TREATMENT PLAN
Diagnosis and Disease Processes
Using an appropriate patient assessment form (Sample Forms, 2013), D.M. has been found to have uncontrolled Type 2 diabetes, hypercholesterolemia, uncontrolled hypertension, chronic anemia, and probable hypothyroidism (Sample Forms).
Diabetes Type 2
is most probably on a poorly controlled diet of high cholesterol and high simple sugars. Diabetes mellitus type 2 is a metabolic disease wherein the body is not able to properly use ingested food because of insulin resistance. If more simple or refined sugars are consumed, the less the body is able to process them as nutrients. These tend to stay and float in the blood stream, un-used, and in this condition, they cause trouble in the different parts of the body. These include the end organs, such as the brain, the eyes, the kidneys, the heart, and even the feet. A poorly controlled diet and the lack…
Glasgow, R.E., et al. (2005). Development and validation of the patient assessment of chronic illness care. Vol. 43 # 5, Medical Care: PuMed. Retrieved on October 15,
2014 from http://www.ncbi.nlm.nih.gov/pubmed/15838407
Sample Forms (2013). Patient assessment form. Sample Forms.org. Retrieved on October 15, 2014 from http://www.sampleforms.org/patient-assessmentform.html
Schneck Medical Center
Provide a description of the company, its mission, and values
SMC (Schneck Medical Center) is a nonprofit healthcare organization that provides specialized and primary care services. The center was established in 1911 with a donation of five thousand dollars and a land from Mary Schneck (Jcr, 2007). It was established in memory of the founder's Husband to provide healthcare requirements to people of Jackson County. Initially, the center had a seventeen-bed capacity but it has now developed to ninety five-bed capacity. SMC celebrated its 100th centenary in 2011. This medical center is located in Jackson Country where it provides medical services to people of this area and the surrounding communities. Schneck Medical Center provides a full continuum of primary care services (Jcr, 2007). Particularly the medical center focuses on the health of women, noninvasive cardiac care, bariatric surgery, cancer care and joint replacement. Schneck Medical Center provides…
Biller, J. (2008). The interface of neurology & internal medicine. Philadelphia: Wolters Kluwer Health/Lippincott Wiliams & Wilkins.
Cribb, A. (2005). Health and the good society: Setting healthcare ethics in social context. Oxford: Clarendon Press.
Rahman, N., & de Feis, G.L. (2009). Strategic decision-making: models and methods in the face of complexity and time pressure. Journal Of General Management, 35(2), 43-59.
Johnson, K., Uecke, R., & Austin, R.(2006). The essentials of project management. New York: Harvard Business Press.
Future of Healthcare as it Relates to the Geriatric Population
Description and Problem Statement
The geriatric population in the United States is growing and compared to the population of health care providers the geriatric population growth is advancing much more rapidly. This presents a problem in making provision of health care to the future geriatric population. While there is a growth in the demand for geriatric health care services, there is not a matching growth in the population of health care providers and in fact, a shortage presently exists.
The population of geriatric patients is experiencing rapid growth while the population of health care providers specifically trained in geriatric medicine is seriously lagging behind. In fact, of the approximately 650,000 medical doctors who are practicing, only a small percentage receives the training and education required to provide geriatric care. Exacerbating the problem is the fact that only three medical schools…
Bagel, LM (2011) Designs to Support Aging Acute Care Patients. Elder Care. Health Facilities Management. Retrieved from: http://www.hfmmagazine.com/hfmmagazine/jsp/articledisplay.jsp?dcrpath=HFMMAGAZINE/Article/data/04APR2012/0412HFM_FEA_interiors&domain=HFMMAGAZINE
Gottlieb, S. (2013) Medicare Has Stopped Paying Bills For Medical Diagnostic Tests. Patients Will Feel The Effects. Forbes 27 Mar 2013. Retrieved from: http://www.forbes.com/sites/scottgottlieb/2013/03/27/medicare-has-stopped-paying-bills-for-medical-diagnostic-tests-patients-will-feel-the-effects/2/
Graverholt, B., et al. (2011) Acute hospital admissions among nursing home residents: a population-based observational study. BMC Health Services Research 2011. Retrieved from: http://www.biomedcentral.com/1472-6963/11/126
Healthcare in America: Trends in Utilization (2004) U.S. Department of Health and Human Services. Retrieved from: http://www.cdc.gov/nchs/data/misc/healthcare.pdf
Beard, C., Weisberg, .B., & Primack, J. (2012). Socially anxious primary care patients' attitudes toward cognitive bias modification (CBM): a qualitative study. Behavioural and cognitive psychotherapy, 40(05), 618-633.
This study shows how traditional methods of approaching patients with information can cause confusion and thus create barriers to accessing patient knowledge in primary care settings. The study focused on working with primary care patients suffering from anxiety and how they reacted to cognitive bias modification (CBM) for that anxiety. Upon initial discussion of the treatment, most participants showed that they understood. However, it was clear by the end of the treatment that the program was not clarified enough to patients prior to treatment and that created a knowledge barrier that caused the treatment not to work as successfully as previously tested. Better methods for communicating the treatment within the primary care setting must be developed to bring down these…
Beard, C., Weisberg, R.B., & Primack, J. (2012). Socially anxious primary care patients' attitudes toward cognitive bias modification (CBM): a qualitative study. Behavioural and cognitive psychotherapy, 40(05), 618-633.
Beckman, H.B., Wendland, M., Mooney, C., Krasner, M.S., Quill, T.E., Suchman, A.L., & Epstein, R.M. (2012). The impact of a program in mindful communication on primary care physicians. Academic Medicine, 87(6), 815-819.
Cheung, P.T., Wiler, J.L., Lowe, R.A., & Ginde, A.A. (2012). National study of barriers to timely primary care and emergency department utilization among Medicaid beneficiaries. Annals of emergency medicine, 60(1), 4-10.
Crabtree, B.F., Nutting, P.A., Miller, W.L., McDaniel, R.R., Stange, K.C., Jaen, C.R., & Stewart, E. (2011). Primary care practice transformation is hard work: insights from a 15-year developmental program of research. Medical care, 49(Suppl), S28.
Community Dementia Care and the Chronic Care Model
nd-Stage Dementia valuation Proposal
Health Promotion Plan for Community nd-Stage Dementia Care: The Chronic Care Model
Health Promotion Plan for Community nd-Stage Dementia Care: The Chronic Care Model.
In 2013 an estimated 5.0 million Americans over the age of 65 suffered from Alzheimer's disease (Alzheimer's Association, 2013). Although the U.S. Centers for Disease Control and Prevention (CDC) considers dementia/Alzheimer's to be the fifth leading cause of death among adults 65-years of age or older, careful examination of Medicare claims data revealed that dementia is probably right behind cardiovascular disease as the second leading cause of death for this age group (Tinetti et al., 2012). Most of these patients would prefer to die at home, not only because of comfort concerns, but due to the higher quality of care that tends to be provided by informal and paid caregivers in this setting (reviewed…
Eloniemi-Sulkava and colleagues (2009) evaluated patients at baseline using the Barthel Index and Neuropsychiatric Inventory (NPI) (see Appendix). The Barthel Index (Stone, Ali, Auberleek, Thompsell, & Young, 1994; University of Iowa Healthcare, n.d.) and NPI (Cummings et al., 1994) were administered again at 6 and 12 months into the study and will be used in the current study to track ADL and BPSDs using the same intervals. PQOL will represent a composite score obtained using the Color Analog Scale for pain (Santos & Castanho, 2013) and the Quality at the End of Life Scale (QUAL-E) (National Palliative Care Research Center, 2005) (see Appendix). In cases of severe cognitive impairment, completion of the QUAL-E may depend on family caregivers. FCQOL will be evaluated using the Zarit Burden Scale (Regional Geriatric Program Central, 2014) (see Appendix). The success of the intervention, as perceived by family caregivers and providers, will be assessed using the questionnaires developed by Morita and colleagues (2013). The goal of these questionnaires will be to evaluate how effective the community palliative intervention was in improving the knowledge and skills of palliative care, increasing access to specialized services, coordinating care services, and increasing deaths at home. This evaluation will be performed following the death of the patient or the end of the study period, whichever comes first. The validity and reliability of the questionnaires developed by Morita et al. (2013) have not been evaluated, but should prove informative and provide context for the other findings.
A review of interventions designed to improve the quality of community palliative care has revealed mixed findings, but the trend is in the desired direction of reducing the number of patients dying in hospital wards, ICUs, and hospice facilities. CCM has garnered the interest of researchers interested in improving palliative care outcomes for patients, family caregivers, and providers alike, and have begun to study the efficacy and quality of interventions, including CCM. This proposal provides justification for implementing CCM for end-stage dementia patients residing at home and details an evaluation strategy that can be implemented to determine the efficacy, effectiveness, and quality of the care provided. In contrast to many other studies, however, this proposal places equal value on the experiences of patients, family caregivers, and providers alike, in addition to the more common outcome measures of BPSDs and institutional admissions. The methods of data gathering will involve the review of patient records and several instruments designed
Health Care Cost and Quality
The objective of this study is to examine the relationship between health care cost and quality. This study will select one public agency and one private agency and differentiate their roles and major activities in addressing cost and quality in health care and analyze current and projected initiatives to improve quality while simultaneously controlling costs. This study will additionally conduct a synthesis of indications for staff nurses and advanced practice nurses, including evidence-based practice, relative to cost and quality.
There are many initiatives presently underway to meet the growing need of health care for a population that is greatly under-insured and many that are uninsured.
U.S. Department of Health and Human Services eport
According to the U.S. Department of Health and Human Services (2014) "Medicare is improving the way it pays for physician services. The Center for Medicare and Medicaid Innovation (Innovation Center) is exploring…
Advanced Practice Nursing: A New Age in Health Care (nd) American Nurses Association. Retrieved from: http://www.nursingworld.org/functionalmenucategories/mediaresources/mediabackgrounders/aprn-a-new-age-in-health-care.pdf
Health Care Costs (2014) Agency for Healthcare Research and Quality. Retrieved from: http://www.ahrq.gov/research/findings/factsheets/costs/health-care/index.html
A 21st Century Health Care Workforce for the Nation (2014) U.S. Department of Health and Human Services. Retrieved from: http://aspe.hhs.gov/health/reports/2014/HealthCare_Workforce/rpt_healthcareworkforce.pdf
Education in Healthcare:
The health care system has been characterized with several issues in the recent past including increased costs, poor patient outcomes, shortage in the number of health workers across every category, and under-utilization of health workers. While lack of access to care and increased demand for health care choices are also major issues in this sector, workforce issues will continue to have tremendous impacts on health care delivery. According to the findings of a recent report, dysfunction in private and public health workforce policy and infrastructure contributes to vulnerabilities for health workers and puts the health of the nation at risk (Kreitzer, Kligler & Meeker, 2009). In addition, the current health care system consist inequities and misrepresentations that have continued to affect health workforce.
Health workforce is mainly influenced by the current system of healthcare education, which is characterized with certain challenges. The modern education in healthcare deters…
Kreitzer, M.J., Kligler, B. & Meeker, W.C. (2009, February). Health Professions Education and Integrative Health Care. Retrieved from Institute of Medicine of the National Academies website: http://www.iom.edu/~/media/Files/Activity%20Files/Quality/IntegrativeMed/Health%20Professions%20Education%20and%20Integrative%20HealthCare.pdf
Morganti, N. (2013, September 13). What Does it Take to Ready a Healthcare Workforce for Transformation to a Patient Centered Team-based Care Model? Retrieved from Health IT website: http://www.healthit.gov/buzz-blog/meaningful-use/ready-healthcare-workforce-transformation-patient-centered-teambased-care-model/
Leadership and Management in Healthcare
Models of management and leadership in health care contexts
As when it comes to modern company structures, management and leadership play a main function in health care as well, specifically focusing on reform motions, kinds of services offered, quality of services and capital use. As we specified earlier, there is no universal dish for effective management and leadership, contextual aspects like political system and socio-economic elements play a substantial part in the results.
In basic terms, a health care system has to complete 2 standard things (adjusted from Dorros, 2006):
Enhance the wellness condition of the population (according to specific requirements and targets);
Provide services in the most reliable method possible in order to achieve the first objective.
Furthermore despite the condition of the economy and nation, when attempting to reform health care systems, governments have to ask themselves 3 standard concerns: Who spends for…
Collins, J.C. (2001). Good to Great. New York, NY: HarperCollins: 17 -- 40.
Collins, J.C. And Porras, J.I. (1997). Built to Last. New York, NY: HarperCollins; 173 -- 174.
Contino, D.S. (2001). Budget training: it's overdue. Nurs Manage; 32:16 -- 17.
Contino, D.S. (2004). Leadership Competencies: Knowledge, Skills, and Aptitudes Nurses Need to Lead Organizations Effectively. Critical Care Nurse; 24: 52-64.
Among the most important aspects to the health promotion plan will be the benefits associated with a care manager, who can ensure that all six core elements of CCM are implemented fully. If this is accomplished, there should be a significant reduction in health disparities for patient and caregiver outcomes across generations.
AHQ. (2012). National Healthcare Disparities eport, 2011. No. 12-0006. ockville, MD: Agency for Healthcare esearch and Quality. etrieved 16 Apr. 2014 from http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf.
Braveman, P.A., Kumanyika, S., Fielding, J., Laveist, T., Borrell, L.N., Manderscheid, . et al. (2011). Health disparities and health equity: The issue is justice. American Journal of Public Health, 101(Suppl. 1), S149-55.
Brodaty, H. & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11, 217-28.
Castro, A. & uiz, E. (2009). The effects of nurse practitioner cultural competence on Latina patient satisfaction. Journal of the American Academy of Nurse…
AHRQ. (2012). National Healthcare Disparities Report, 2011. No. 12-0006. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved 16 Apr. 2014 from http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf .
Braveman, P.A., Kumanyika, S., Fielding, J., Laveist, T., Borrell, L.N., Manderscheid, R. et al. (2011). Health disparities and health equity: The issue is justice. American Journal of Public Health, 101(Suppl. 1), S149-55.
Brodaty, H. & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11, 217-28.
Castro, A. & Ruiz, E. (2009). The effects of nurse practitioner cultural competence on Latina patient satisfaction. Journal of the American Academy of Nurse Practitioners, 21(5), 278-86.
Quality & Safety
The quality and safety of health care services has been a major issue in the recent past because of the significance of these factors in the improvement of patient outcomes and enhancing the effectiveness of the health care system. Health care professionals and practitioners have increasingly focused on the need to improve the quality and safety of their services given the constant increase in patient population. As a result, various measures have been developed and implemented in attempts to enhance the quality and safety of care services and improvement of practices. These measures include delivery of patient-centered care, safety initiatives, teamwork and collaboration, informatics, quality improvement, and evidence-based practice. There are several ways with which incidents or interactions in each of these components are handled and can be improved based on leadership/management theory content.
Patient Centered Care -- Interaction
A bedside report was not done at bedside…
Evanoff, Bradley, Patricia Potter, Laurie Wolf, Deborah Grayson, Clay Dunagan, and Stuart Boxerman. "Can We Talk? Priorities for Patient Care Differed Among Health Care Providers." Advances in Patient Safety 1 (n.d.): 5-14. AHRQ -- Agency for Healthcare Research and Quality: Advancing Excellence in Health Care. Hhs-logoU.S. Department of Health & Human Services. Web. 20 Apr. 2015. .
"How Fast Is Too Fast For IV Push Medications." ISMP Medication Safety Alert. Institute for Safe Medication Practices, 15 May 2003. Web. 20 Apr. 2015. .
Laws, Dawn, and Shelly Amato. "Incorporating Bedside Reporting into Change-of-Shift Report." Rehabilitation Nursing 35.2 (2010): 70-74. Rehabilitation NURSING. Rehabilitation NURSING, Mar.-Apr. 2010. Web. 20 Apr. 2015. .
Blueprint for Evaluating Patient Safety Competency in Nursing Students
Ever since the report To Err is Human was published in 2000 by Kohn and colleagues, healthcare stakeholders in Western countries have intensified reform efforts designed to increase patient safety. The report revealed that nearly 100,000 patients were dying annually from medical errors in the 1990s, a statistic that caught the attention of legislators, healthcare policymakers, clinicians, patients, and the general public. Additional research revealed that nurses were considered to be the source of most medical errors and also the best defense against errors, but nurses had little, if any, control over patient care planning (Lachman, 2007). Systems were therefore a major determinant of patient safety.
Patient safety and nursing ethics are also inseparable (Lachman, 2007, p. 401). While avoiding specific recommendations, provision three in the American Nurses Association Code of Ethics states that nursing professionals must protect the safety of…
AACN (American Association of Colleges of Nursing). (2012). Graduate-level QSEN competencies knowledge, skills, and attitudes. Retrieved from http://www.aacn.nche.edu/faculty/qsen/competencies.pdf .
Clark, C.C. (2008). Classroom Skills for Nurse Educators. Sudbury, MA: Jones and Bartlett Publishers.
IAR (Instructional Assessment Resources). (2011). Assess Students: Multiple-choice questions. Retrieved from https://www.utexas.edu/academic/ctl/assessment/iar/students/plan/method/exams-mchoice-bloom.php.
Institute of Medicine. (2010). The future of nursing: Focus on education. Retrieved from https://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Nursing%20Education%202010%20Brief.pdf.
Describe how health care is organized and financed, including the implications of business principles, such as patient and systems cost factor while examining the roles and responsibilities of regulatory agencies and their effect on patient care, workplace safety, and the scope of practice.
egardless of the country or situation, healthcare is generally some sort of blend of public and private sourcing and personnel. Depending on who is asking or answering the question, one or both can be seen as a pariah and one or both can be seen as saint. Publicly funded healthcare is financed by taxpayer dollars in large part (if not entirely) and thus is subject to oversight and regulation on a level that is much higher than in the private sector. Even so, government agencies and groups are often seen as being inept and lumbering and funding cuts and mismanagement are often seen as issues…
Basu, S., Andrews, J., Kishore, S., Panjabi, R., & Stuckler, D. (2012). Comparative Performance of Private
and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review. PLOS Medicine, 9(6), e1001244. http://dx.doi.org/10.1371/journal.pmed.1001244
Planned change in the eldercare advocacy organization
In the coming years, many countries will experience a dramatic shift in healthcare infrastructure due to an expanding elderly population size. However, the changes may vary across countries depending on many factors such as the kind of social welfare available in each country, the political environment which determine policies, the level of healthcare available and individual expectations in each country. Due to this wide variance, the innovations within this space will also vary greatly. What this means to the healthcare manager is that managing innovations becomes very hard (Shlutz, Andre & Sjovold, 2015 p 42). This also impacts on performance management which is fast gaining popularity in the public sector as a means to improve on accountability. Unfortunately, it has been cumbered by a series of challenges in its implementation; this is in spite of the frameworks developed over the last couple of…
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)…
With the ever-changing health care sector, reimbursement has increasingly been tied to care quality and health care outcomes. The Centers for Medicare and Medicaid Services (CMS) have particularly been changing the way hospitals are reimbursed, with hospitals that deliver high quality care and report better health outcomes getting higher reimbursements than those that perform poorly. This has led to increasing prominence of the pay-for-performance approach. Under this approach, hospitals that report greater patient satisfaction, reduced error rates, lower readmission rates, and higher recovery rates for chronic illness get higher reimbursements than their poorly-performing counterparts. The implication is that health care organizations must pay greater attention to performance, especially in terms of quality, safety, and individual performance. Measurement and models used in the commercial world for these three aspects are considerably relevant to the health care sector. This paper discusses the usefulness of the total quality management (TQM) model, the Organization…
Nursing Health Care Informatics
"…At the beginning of the 21st century, nursing informatics has become a part of our professional activities…[and has] advanced the field of nursing by bridging the gap from nursing as an art to nursing as a science…" (Saba, 2001, 177).
Nursing Health Care informatics relate to and address technology and other cutting edge issues of great interest in the healthcare field. According to the AMIA, Nursing Informatics is the "…science and practice (that) integrates nursing, its information and knowledge, with management of information and communication technologies to promote the health of people, families, and communities worldwide." New and relevant knowledge presented in the genre of informatics helps to empower nurses and other healthcare practitioners to deliver the most effective patient-center care possible. This paper presents several informatics in the belief that applying healthcare technologies and practices that are genuinely progressive and helpful to today's nurse is…
AMIA (2009) Working Group Nursing Informatics. Retrieved March 9, 2014, from http://www.amia.org .
An, J.Y., Hayman, L.L., Panniers, T., and Carty, B. (2007). Theory Development in Nursing
And Healthcare Informatics. A Model explaining and Predicting Information and Communication Technology Acceptance by Healthcare Consumers. Advances in Nursing Science, 30(3), E37-E49.
Cipriano, P.F. (2011). The Future of Nursing and Health IT. Nursing Economics, 29(5).
While most hospitals seem to be well-run and most situations and scenarios are planned for in advance when it comes to what nurses should be doing, should not be doing and why, this is not always the case. Just one example of this would be situations where palliative care is probably or definitely called for in a given situation but there is not a defined or clear protocol as to when the palliative path should be started and what criteria should be used. Indeed, patients that are facing such a situation are typically terminal or they at least cannot be treated for what is ailing them. An easy example to point to would be a cancer patient whose disease is beyond what medicine can do for them. When there is an absence of leadership when it comes to palliative care protocols, it falls to nurses to collaborate, work…
Engel, J., & Prentice, D. (2013). The ethics of inter-professional collaboration. Nursing Ethics,
20(4), 426-435. http://dx.doi.org/10.1177/0969733012468466
Ewashen, C., McInnis-Perry, G., & Murphy, N. (2013). Inter-professional collaboration-in-practice: The contested place of ethics. Nursing Ethics, 20(3), 325-335.
IOM Future of Nursing eport
The obert Wood Johnson Foundation (WJF), which is located in Princeton, New Jersey and was founded from the Johnson & Johnson fortunes, is the largest health-focused philanthropy in the United States. The foundation provides grant money to successful applicants seeking to improve the health of U.S. citizens and to improve the provision of American health care. Grants offered by the obert Wood Johnson Foundation are sizable, collectively amounting to approximately $400,000 million annually, and address a variety of health issues including these major categories: access to care, obesity in children, and training for doctors and nurses. Grants are often awarded for topics tangential to healthcare, such as access to fresh food, poverty and housing quality, and violence. esearch conducted at the Institute of Medicine has contributed to the efforts of the Institute and WJF to design, articulate, and implement nurse-led models of innovative practice with…
Nevidjon, B., Erickson, J. (January 31, 2001). "The Nursing Shortage: Solutions for the Short- and Long-Term." Online Journal of Issues in Nursing. 6(1), Manuscript 4. Retrieved from www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume62001/No1Jan01/NursingShortageSolutions.aspx
Potera, C. (2009, January). The nursing shortage. AJN, American Journal of Nursing, 109(1), 22. doi: 10.1097/01.NAJ.0000344026.43038.9b
The interest in palliative care, or counseling for bereavement comes to different people in different ways, and one doctor came into it through home care as long ago as 1975. The doctor had just finished working as a house staff in the University of California in San Francisco. Then he got a job at Massachusetts General Hospital as a physician. The doctor was placed at Chelsea Memorial health Center. This was a neighborhood health center in a poor multi-ethnic community, yet not a great distance away from MGH. The doctor had come to replace a person who had come from Britain for a working experience of a year in United States and had gone to the houses of a few elderly patients. In the beginning itself, it was suggested to the doctor by the senior that he visit two patients who were being cared by relatives at home. This…
A Compendium of Hospital-Based Palliative Care Practices. Retrieved from http://www.haponline.org/downloads/PPCN_Compendium_2004.pdf Accessed on 31 May, 2005
Austenfeld, Jennifer L. Stanton
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1467-6494.2004.00299.x;jsessionid=iVt_UOAe61_b?journalCode=jopy Accessed on 31 May, 2005
Bloomington School District. 20 November, 2002. Retrieved from http://www.shfsc.org/reports/BL2002.pdf Accessed on 31 May, 2005
Quality Improvement Project
Diabetes -- Chronic Condition Background
Type 1 and Type 2 Diabetes
isk factors for type 1 diabetes
isk factors for prediabetes and type 2 diabetes
isk factors for gestational diabetes
The ationale for Selection
The Target Population
It has been estimated that in New York there is roughly two million people, or over twelve percent of the population, that have diabetes; furthermore, of this population, over half a million people have the condition but are not aware that they have it (American Diabetes Association, N.d.). It is further estimated that nearly five and a half million people, or over a third of the population, have prediabetes. Diabetes and diabetes-associated cardiovascular diseases have become the leading cause of death in the region accounting for roughly two-thirds of the deaths and the rates of diabetes has lead this trend to be referred to as the…
American Diabetes Association. (N.d.). Health Disparities. Retrieved from American Diabetes Association: http://www.diabetes.org/advocacy/advocacy-priorities/health-disparities.html
American Diabetes Association. (N.d.). New York, New York. Retrieved from American Diabetes Association: http://www.diabetes.org/in-my-community/local-offices/new-york-new-york/
CDC. (2013). Diagnosed Diabetes, Age Adjusted Rate (per 100) Adults - Total 2013. Retrieved from Center for Disease Control: http://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html
Department of Health. (N.d.). Diabetes. Retrieved from New York State: https://www.health.ny.gov/diseases/conditions/diabetes/
The progressive care unit (PCU) is a practice setting in which the researcher’s health care team is often failing to meet quality care objectives according to patient reporting on the hospital consumer assessment of healthcare providers and systems (HCAHPS). Opportunities for growth in quality care based on the HCAHPS of the PCU include topic areas related to patient inclusion as well as communication skills of the members of the healthcare team. Patient perception of quality is that the healthcare team in the PCU is unable to explain the care process in a way that the patient and family members feel comfortable with or that allows them to understand the care that is being provided to them. The researcher has first-hand experience with this challenge in the PCU and has heard first-hand from patients there that the care seems disjointed, that continuity is lacking, and how problematic it is for…
The emphasis is on normal, everyday activities provided for residents. According to the authors, however, little research has been conducted to investigate the actual effect of such activities and settings upon residents. The assumption is that such settings have a better effect that traditional institutions, but there is little empirical research to support this.
Hence, Verbeek et al. (2010) conducted a study to compare small-scale living with regular care in nursing homes in the Netherlands. Interestingly, they found no significant difference between the quality of life experienced by residents in traditional institutional settings and those in small-scale living facilities. Furthermore, there was also no significant difference in the job satisfaction levels of nursing staff between both types of institution was found. Another important aspect, namely neuropsychiatric symptoms and agitation were also significantly similar for both institution types. According to the authors, a difference was found in the satisfaction level of…
Gaugler, J.E. (2005, Mar.). Family Involvement in Residential Long-Term Care: A Synthesis and Critical Review. Aging and Mental health, Iss. 9, vol. 2. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2247412/
Lyness, J.M., Yu, Q., Tang, W., Tu, X., and Conwell, Y. (2009, Dec.). Risks for Depression Onset in Primary Care Elderly Patients: Potential Targets for Preventive Interventions. American Journal of Psychiatry. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2982671/
Simonazzi, a. (2009, Jun). Home care and cash transfers. Effects on the elderly care-female employment trade-off. Retrieved from: http://www.aiel.it/bacheca/SASSARI/papers/simonazzi.pdf
Verbeek, H., Zwakhalen, S.M.G., Van Rossum, E., Ambergen, T, Kempen, G.I.J.M., and Hamers, J.P.H. (2010, Nov.). Dementia Care Redesigned: Effects of Small-Scale Living Facilities on Residents, their Family Caregivers, and Staff. American Medical directors Association. Retrieved from: http://www.unimaas.nl/hcns/websiteVW/publications/Publication%20scans/Verbeek.%20Dementia%20care%20redesigned.pdf
Caring for ody and Soul
Critiquing Research Report
Modern nursing practice has focused more and more on treating the whole person, through four domains (Chan, 2009). These are physical, mental, social, and spiritual. Of the four, the spiritual domain is the most neglected. A retrospective study recently found that nurses with religious beliefs are more likely to extend spiritual care. The greater their spiritual perceptions, the more frequently they include a spiritual dimension to their care of patients (Chan). However, not many nurses are able to extend care in this domain.
Jean Watson's Theory of caring is applied as theoretical framework. Her concept sees caring as a process of transpersonal caring. It is something exceeding the self and recognizing the relationship as "mutual and reciprocal (Goliath, 2008)." It is in this environment that the nurse connects with the patient under his specific circumstances. Watson uses 10 carative factors in applying…
Chan, MF. (2009). Factors affecting nursing staff in practicing spiritual care. Vol 19
Journal of Clinical Nursing: Blackwell Publishing Ltd.
Deal, B. (2010). A pilot study of nurses' experience of giving spiritual care. Vol 15 # 4
The Qualitative Report: Nova Southeastern University. Retrieved on May 18, 2011
The cases of Todd vs. Mr. Gomez
When dealing with a situation in which communications between a patient and a physician is difficult -- for example, if the patient has limited English proficiency or is deaf -- inevitably barriers are created which prevent a fully patient-centered communications process. Physicians often cite limited time as a reason for being insufficiently patient-focused. In the case study of Todd, the interaction was challenging because of the lack of the presence of an ASL interpreter. This was a lose-lose situation for both the patient and the physician. The physician was frustrated because of the extra time needed to complete the interaction by writing everything down; the patient was frustrated because of the fact the physician often misunderstood him and tried to lip-read as a shortcut or ask him yes and no questions which did not sufficiently address his concerns.
Perhaps the area…
To wit, power is a huge influence in any social interaction, and in a study reported by the University of California Press (est, 2008, p. 87), men often interrupt women during conversations because men are generally viewed as the power in any male-female interaction. "Physicians interrupt patients disproportionately" in doctor-patient interactions, est writes, "except when the doctor is a 'lady'; then, "patients interrupt as much or more than physicians, and their interruptions seem to subvert physicians' authority" (est, p. 87). In other words, the stratification of male doctors having the power to interrupt is reversed when a woman is the doctor.
Blumer, Herbert. (1986). Symbolic Interactionism: Perspective and Method. Berkeley:
Breen, Catherine M., Abernethy, Amy P., Abbott, Katherine H., and Tulsky, James a. (2007).
Conflict Associated with Decisions to Limit Life-Sustaining Treatment in Intensive Care
Units. Journal of General Internal Medicine, 16(5), 283-289.
Donovan, Jenny L., and Blake,…
Blumer, Herbert. (1986). Symbolic Interactionism: Perspective and Method. Berkeley:
Breen, Catherine M., Abernethy, Amy P., Abbott, Katherine H., and Tulsky, James a. (2007).
Conflict Associated with Decisions to Limit Life-Sustaining Treatment in Intensive Care
Units. Journal of General Internal Medicine, 16(5), 283-289.
In addition the effect of bill has changed the documentation awarded through the state as of a certificate toward a license and authorizes a doctor to pass on duties to a PA with the purpose of managing physician's scope of performance however Another effect of bill has enabled Indiana's doctor assistants to widen their area of the health care services and also provided an innovative average of patient care (Stephanie, Matlock (27 April, 2007). Health care bills gives right to patient to know what health care should be known by the plan as well as several limits on care, kinds of health care be not enclosed, any treatment diagram required to endorse in advance. Yearly planning about on disburse to physician and health providers, file a complaint regarding any, disagreement between patient and the plan, and also procedure to make complaint, allowance to access emergency room twenty four hours a…
American-Speech Language Hearing Association. (2007) Characteristics of Licensure Law. Retrieved on November 29, 2007 from www.asha.org
New York State. (April 2007) Managed Care Bill of Rights. Retrieved on November 29, 2007 from www.health.state.ny.us
Federal Trade Commission. (October 21, 2002) FTC staff opposes Ohio Bill to Allow Physician Collective Bargaining. Retrieved on November 29, 2007 at http://www.ftc.gov/opa/2002/10/physicians.shtm
Girardin, Pierre. Internet Health Services: A Case Study. Retrieved on November 29, 2007 from https://www.isoc.org/inet96/proceedings/h5/h5_2.htm
The author also explains that the data stored in the system can be used to help public health officials identify medical issues facing the community as well as track various trends from the community and public health perspectives.
(How does this article relate to you as doctor?)
As a physician, I recognize that my time will be in very short supply. Therefore, any system or resource capable of saving time and increasing the efficiency of the healthcare services that I provide will be greatly appreciated. Similarly, patient safety, elimination of medical errors, and patient outcome are always paramount concerns for any physician. Therefore, I would welcome the opportunity to use EHR systems to the extent they address those issues positively. Moreover, as a physician, I am always interested in any approach that might be beneficial to human welfare and community and public health issues. According to the article,…
Patient Guide to the Worldwide Web
Mr. Atkins, 64, arrives at the hospital with his wife complaining that he has not had a bowel movement in over a week, and that he has significant pain in his abdomen. Mr. Atkins has an MI which shows a significant blockage in his colon. Surgery is suggested and when this is completed Mr. Atkins is told that he has colon cancer and a mass was removed from his colon along with eight inches of the diseased organ. It is then relayed that the cancer has also metastasized to his liver. The Atkins are farmers who have very little to do with computers other than checking weather reports. They both want to learn about the diagnosis and what can be done, but with their limited knowledge of the internet ask a nurse for help.
The patient is very motivated to learn how to…
Johns Hopkins. (n.d.). Colorectal cancer that has spread to the liver. Retrieved from http://www.hopkinsmedicine.org/liver_tumor_center/conditions/cancerous_liver_t umors/colorectal_liver_metastases.html
Joy, K. (n. d.). Liver metastasis from colon cancer treatments. Retrieved from http://www.ehow.com/about_6618908_liver-metastasis-colon-cancer- treatments.html
National Center for Complementary and Alternative Medicine (NCCAM). (2006). Evaluating web-based health resources. Retrieved from http://nccam.nih.gov/health/webresources
There is also relevant information for specific sectors of society such as women and seniors. The MedlinePlus Magazine includes several links to asthma information. The bottom of the page includes links that contain information such as disclaimers, copyright, and privacy information. It also contains links that provide information on the contributors of information to the Website. The privacy statement clearly provides visitors and subscribers with the assurance that their information will not be shared. All the information on the site is therefore provided on the basis of full disclosure, both of the information itself and on information providers.
This Website is therefore very reliable, and also includes information on a myriad of other health topics, which will be helpful for Amy if she wants more information on her other conditions as well.
Suspicious Website: http://www.asthmaanswersonline.com/cures-asthma/
This Website indicates that asthma can in fact be cured. Prominently displayed at the top…
" (Morris & Woodcock, 2004)
V. Murakami et al. (2003)
In the work entitled: "Deep Venous Thrombosis Prophylaxis in Trauma: Improved Compliance With a Novel Miniaturized Pneumatic Compression Device" the authors state that: "Intermittent pneumatic compression (IPC) devices prevent lower-extremity deep venous thrombosis (LEDVT) when used properly, but compliance remains an issue." (Murakami et al., 2003) the study conducted by Murakami et al. (2003) is stated to be a."..prospective trial in which trauma patients (mean age, 46 years; revised trauma score, 11.7) were randomized to DVT prophylaxis with a standard calf-length sequential IPC device (SCD group) or a miniaturized sequential device (continuous enhanced-circulation therapy [CECT] group). Compliance rates for all subjects were averaged in each location: emergency department, operating room, intensive care unit, and nursing ward." (Murakami et al., 2004) the study results state that: "Total compliance rate in the CECT group was significantly higher than in the SCD group…
Kehl-Preutt, Wendy (2006) Deep Vein Thrombosis in Hospitalized Patients: A Review of Evidence-based Guidelines for Prevention. Dimensions of Critical Care Nursing March/April 2006. Vol. 25 No.2. Online available at http://www.nursingcenter.com/prodev/cearticleprint.asp?CE_ID=636024 .
Chang, David et al. (2002) Compliance with sequential compression device prophylaxis in at-risk trauma patients: a prospective analysis. Am Surg. 2002 May;68:470-3 Online available at http://lib.bioinfo.pl/auid:1350109.
Practice Alert: Deep Vein Thrombosis Prevention" (2006 American Association of Critical-Care Nurses Journal " Vol. 23 No. 1 January 2006.
Morris, Rhys J. & Woodcock, John P. (2004) Evidence-Based Compression: Prevention of Stasis and Deep Vein Thrombosis. Ann. Surg. 2004 February 239(2): 162-171.
However...generally a vast difference exists between what healthcare providers understand and what laypersons are able to comprehend. This immeasurability of knowledge was evident in the participants' narratives and was exacerbated by the conveying of "false hope" or "false optimism" to patients and patients' family members.
Seconding Robichaux's argument is ackstrand's (2006) findings that hospital-based EOL programs are not the "ideal" form of healthcare that elderly patients should receive, according to a survey of nurses. For the nurses, "no patient should face death alone," which ultimately happens when patients are confined in a hospital facility receiving palliative care. Comparing ICU EOL care against the hospice and nursing home care programs, 'dying with dignity' is remote in this kind of program, since "[t]he ICU is no place to die. It would be nice to have a comfortable, quiet, spacious room for those who are dying. Let everyone in and let the rest…
Anderson, R. (2003). "Nursing home quality, chain affiliation, profit status, and performance." Journal of Real Estate Research, Vol. 25, Issue 1.
Backstrand, R. (2006). "Providing a "good death": critical care nurses' suggestions for improving end-of-life care." American Journal of Critical Care, Vol. 15, Issue 1.
Elliot, D. (2006). "Determining the financial impact of hospice." Healthcare Financial Management, Vol. 60, Issue 7.
Imhof, S. (2005). "What do we owe the dying? Strategies to strengthen end-of-life care." Journal of Healthcare Management, Vol. 50, Issue 3.
health care profession is undergoing fundamental change due in part to new laws and regulations. These laws and regulations, although well intended may result in unintended consequences for the nursing profession overall. In the future, the role of a nurse will be fundamentally altered. For one, regulation such as the Affordable Care Act will result in an entire population of insured patients needing care. As such, the role of a nurse will ultimately be predicated on a more individualized basis with specialization in certain aspects. Caring for diabetes is no different in this regard. The public is particularly prone to diabetes primarily due to dietary and lifestyle considerations. As such, the topic of proper care and prevention of this issue is paramount to community health. The population at risk, due in part to regulation, is now society as a whole. This presents interesting challenges and opportunities for the overall health…
1) Mahan LK, Escott-Stump S (2000). Krause's Food, Nutrition & Diet Therapy. 10th Ed., WB Saunders Co. Philadelphia; Reuters (2010)
2) Polonsky, K.S. (2012). "The Past 200 Years in Diabetes." New England Journal of Medicine 367 (14): 1332 -- 1340
3) Stewart WF, Ricci JA, Chee E, Hirsch AG, Brandenburg NA (June 2007). "Lost productive time and costs due to diabetes and diabetic neuropathic pain in the U.S. workforce." J. Occup. Environ. Med. 49 (6): 672 -- 9
This ensures each data entry point has a very clear purpose in the overarching development of the enterprise-wide IT systems throughout a healthcare provider (Tan, Payton, 2010). By taking this top-down governance and process management approach to defining an IT structure with data points, a healthcare organization can also ensure a much higher level of security to their entire network as well (Dwyer, einer, Siegel, 2004). Aligning IT spending to processes and governance frameworks ensures a higher level of performance.
3. Describe a situation where you would use a CHIN or HINO system to provide care. How would you utilize cloud computing?
The Community Health Information Network (CHIN) and egional Health Information Network Organizations (HINO) are best suited to serving a broad base of patients across a wide geographic and socioeconomic area. The CHIN platform has been specifically tailored to the development of metro and urban requirements, with success in…
Dwyer, S.J., Reiner, B.I., Siegel, E.L. (2004). Security
Hickman, G.T., Smaltz, DH (2008). The Healthcare Information Technology Planning Field book: Tactics, Tools and Templates for Building your IT Plan. Chicago: HIMSS. ISBN 978-0-9800697-1-6.
Tan, J., Payton, F.C. (2010). Adaptive Health Management Information Systems: Concepts Cases and Practical Applications (3rd ed.). Boston: Jones and Bartlett. ISBN 13: 978-0-7637-5691-8.
com). A certain amount of errors is to be expected, but there should not be so many that it demonstrates a certain level of skewedness about the model in its entirety. Thus, if the NHI model is the one which is selected, then it needs to be tested against a range of different scenarios. The following demonstrate some truly relevant what-ifs: what if the doctors only move half the projected volume; what if medicare slashes rates; what if competitors open a comparable program (dgapartners.com).
There are a range of factors which can change or adjust once a healthcare facility opens their doors for business. And as much as this facility is attempting to engage in a solid humanitarian effort, at the end of the day, it's still a business and people need to get paid. Thus, before engaging in further developmental activities, one needs to determine in what ways the…
Brakatu Ofori-Adjei, a. (2007). Microfinance: An Alternative Means of Healthcare Financing for the Poor. Ghana Medical Journal, 193-194.
Burnstein, L., Harris, R., & Love, L. (2012, August 30). Top Four Legal Issues to Consider When Opening an Urgent Care Center. Retrieved from Mondaq.com: http://www.mondaq.com/unitedstates/x/194082/Healthcare/Estate+planning+is+important+step
Burnstein, M., Harris, R.L., & Love, L. (2012, August 20). Top Four Legal Issues to Consider When Opening an Urgent Care Center. Retrieved from Mondaq.com:
RFP in Healthcare Industry
Request for proposal in health care industry
Request for Proposal (RFP) in Healthcare Industry
In order to continually provide adequate Medicare to patients, a review of the electronic health record options reveal that the appropriate strategy is to procure Electronic Medical Record software. The primary objective of this RFP is to implore bids from system integrators or commercial off the shelf software merchants to devise, install, construct and implement integrated EMR software solution. The health care system, Future Correctional Center seeks to procure a software solution including licenses, hardware (as recommend by the bidder), execution, and maintenance and support services. In addition, the software configuration should present a core set of EMR attributes that meet particular requirements such as order entry, outcome review, nursing and physician documentation, registration.
Something significant to note; Future Correctional Center will not consider proposals from bidders offering software as a service…
Health Information Technology has significant impacts on nursing policy and practice including the role of these professionals in patient education. Actually, the Information Technology development process in healthcare is based on the nurses' ability to understand the community and provide distinctive insights about patient education among other factors (Effken & Abbott, 2009). Since nurses are important elements of the healthcare system, they are critical in ensuring that the confidence of patients in the health providers is maintained even as technology mediates interactions.
The main impact of the emergence of Health Information Technology on the role of a nurse in patient education is that technology mediates interactions between patients and their care providers. As a result, nurses are required to ensure that the role technology plays in mediating these interactions does not affect the insights provided in the process or the delivery of improved patient care. Moreover, through Health Information Technology,…
Adams, K., Greiner, a.C. & Corrigan, J.M. (2012). Chapter 5 -- Patient Self-Management
Support. Retrieved from the National Academies Press website: http://www.nap.edu/openbook.php?record_id=11085&page=57
Bastable, S.B. (2008). Nurse as educator: principles of teaching and learning for nursing practice (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers.
Effken, J.A. & Abbott, P. (2009, August). Health it-enabled Care for Underserved Rural
Day treatment programs can provide services at less cost because the patient goes home at night after being treated during the day, which often is used for rehabilitating chronically ill patients (Sharfstein, Stoline, & Koran, 1995, p. 249). The mere fact of having more choice benefits some patients by giving them more say in their care.
Patient-focused care involves a method for containing in-patient costs for hospitals and for improving quality by "restructuring services so that more of them take place on nursing units rather than in specialized units in other hospital locations, and by cross-training staff on the nursing units so that they can do several 'jobs' for the same small group of patients rather then one 'job' for a large number of patients" (Kovner, 1995, p. 186). Kovner notes a number of barriers to this type of care. One reason has been that hospitals have not had to…
Doctors Say Managed Care Strains Patient Relationships (1997, June 9). Westchester County Business Journal 36(23), p. 24.
Kovner, a.R. (1995). Hospitals. In Jonas's Health Care Delivery in the United States, a.R. Kovner (ed.), pp. 162-193. New York: springer Publishing.
Moore, G.T. (1991,
April 24). Let's provide primary care to all uninsured Americans ? now! JAMA, pp. 2108-2109.
In spite of the struggling economy throughout the country, United Healthcare industries ascended in development and improved their year over year incomes by 9% in 2010. They had found a way to widen their customer foundation by 1.5 million people. The economy disorder was an important motive for the development in Medicaid program contribution increasing nearly to 16% from one year to the next one. Furthermore, the aging "baby boomer" age group supported in the point of 17% in Medicare Advantage customers in 2010 (Quinn, 2009). After travailing 1.8 million association damage in 2009; the commercial market had underwent an experienced an affected improvement that stemmed in a net gain of 185,000 individuals aided in 2010. "The developments were determined by fresher, more reasonable products, better client retaining, better service, and lesser employee abrasion trends that are among our customers" (CEO, 2011). ith that said, this essay will…
Quinn, G.P., Jacobsen, P.B., Albrecht, T.L., Ellison, B.A., Newman, N.W., Bell, M., & . "Real-time patient satisfaction survey and improvement process." Hospital Topics 18, no. 3 (2009): 26-32.
Safavi, K. "Patient-centered pay for performance: Are we missing the target?" Journal of 51, no. 4 (2006): 23-45.
Shi, L. & Singh, D. Essentials of the U.S. health care system. Sudbury, M.A.: Barlett Publishers, 2007.
Government Regulations and Hospice
Government Regulations Affecting Health Care in Hospice
Regulations Affecting Health Care in Hospice
Impact of rules on Hospice services
This paper focuses on how government regulations impact hospice. The paper starts off with an introduction to the hospice system that was revived by a nurse, Cecily Saunders, who then went on to become a physician, establishing one of the first modern hospices. The concept of total pain is explained in some detail. The body of the paper then includes the studies that have been conducted on patients and caregivers in hospice systems as well as on people who died after they were diagnosed with terminal illness resulting in death in six months following the prognosis. The overall conclusion that can be drawn here is that while in Japan there is a marked need for improving the Day hospice system, the American hospice industry…
American Medical Directors Association. (n.d.). White Paper on Palliative Care And Hospice In Long-Term Care. Retrieved March 10, 2012, from American Medical Directors Association: http://www.amda.com/governance/whitepapers/palliative_care.cfm
Carlson, M.D., Morrison, R.S., Holford, T.R., & Bradley, E.H. (2007). Hospice Care: What Services Do Patients and Their Families Receive? Health Services Research, 42(4), 1672-1690.
Centers for Medicare & Medicaid Services. (2008). Medicare and Medicaid Programs: Hospice Conditions of Participation; Final Rule. Federal Register, 73(109), 32088-32220.
Christakis, N.A., & Escarce, J. j. (1996). Survival of Medicare patients after enrollment In hospice programs . The New England Journal of Medicine, 172-179.
business plan provides a process change for bedside patient handoffs at Samaritan Medical Center, Watertown, New York. An overview of the medical center is followed by its mission and vision statements, and organizational values. A discussion of the assumptions involved together with a breakdown of associated costs involved in the business plan are followed by a discussion of the importance of timely patient handoffs and a description of the proposed bedside handoff protocols for Samaritan Medical Center.
Overview of Samaritan Medical Center:
"Samaritan Medical Center (Watertown, New York) is a 294-bed not-for-profit community medical center, offering a full spectrum of inpatient and outpatient healthcare services. From primary and emergency care to highly specialized medical and surgical services, such as cancer treatment, neonatal intensive care, behavioural health and addiction services, and imaging services, Samaritan Medical Centre and its team of healthcare professionals proudly serves the medical needs of our civilian and…
Centers for Medicare & Medicaid Services. (2008). Facts sheet: HCAHP facts. Retrieved from http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2008-Fact-sheets-items/2008-03-28.html?DLPage=4&DLSort=0&DLSortDir=descending
Centers for Medicare & Medicaid Services. (2013). HCAHPS facts sheet (CAHPS hospital survey). Retrieved from http://www.hcahpsonline.org/Facts.aspx
Friesen, M.A., White, S.V., & Byers, J.F. (2008). Handoffs: Implications for nurses. In Hughes, R.G. (Ed.). Patient safety and quality: An evidence-based handbook for nurses,
(pp. 2-285 -- 2-332). Rockville, MD: Agency for Healthcare Research and Quality.
" (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
What direction is the quality of health care and delivery of health care moving in; it is not moving in a direction at all. Like the pendulum, the direction of health care remains suspended to the far side - right or left, depending upon which side of the political isle one is on. The pendulum remains frozen in time, and it reflects chaos in the delivery of health care and the quality of patient care. Health care remains the captive audience to managed care company stockholders and executives whose business focused decision making on what benefits can access, when, and where remain guided by an archaic DG system that was implemented more than twenty-five years ago.
If there is a direction for American health care access and quality of care, it is that direction of circling the drain before it falls into the black abyss of the unknown, and…
Altman, S.H., Reinhardt, U.E., & Shactman, D. (Eds.). (1999). Regulating Managed Care: Theory, Practice, and Future Options. San Francisco: Jossey-Bass. Retrieved October 14, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=109671238
Birenbaum, a. (1997). Managed Care: Made in America. Westport, CT: Praeger Publishers. Retrieved October 14, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=27467039
Nickelson, Daniel J., and Saksena, Sanjeev (1994). The Pendulum Swings: Reappraising Prepaid Health Care Systems. Placing and Clinical Electrophysiology, 17/10, pp. 1676-1677. http://www.questia.com/PM.qst?a=o&d=6966140