Manager of a Primary Care Clinic
A new primary care facility has been established approximately 25 miles outside of a small city that has a population of 50,000 people. This facility currently has five family physicians, two nurse practitioners, twenty clinical support staff, and two physician assistants. The main objective of this new primary care facility is to provide primary care services to an increasingly diverse community of people within and outside the city. Despites the tremendous growth opportunities in the city, most of the residents still struggle to make end meet. Since the central city comprises two huge acute care facilities and one tertiary care facility, the residents are forced to use the facilities' emergency departments for routine conditions and illnesses in cases where their private physicians are unavailable. Therefore, this new primary care facility will play a crucial role in enhancing the health and well-being of this population through…...

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References

Alvarez & Marsal Holdings. (2015, May 18). Retail Healthcare: Growing Trend for Healthcare Service Delivery. Retrieved November 3, 2015, from  http://www.alvarezandmarsal.com/retail-healthcare-growing-trend-healthcare-service-delivery 

Health Resources and Services Administration. (2011, April). Performance Management and Measurement. Retrieved from U.S. Department of Health and Human Services website: http://www.hrsa.gov/quality/toolbox/508pdfs/performancemanagementandmeasurement.pdf

Heidenreich, J. & Peterson, L. (2013, August 14). 4 Tips for Your Primary Care Strategy. Retrieved November 3, 2015, from  http://www.beckershospitalreview.com/hospital-physician-relationships/4-tips-for-your-primary-care-strategy.html

Halcomb, Peters, and Mclennes (2015) aims at examining pre-registration nurses' experiences in community clinic assignments as well as the effect such assignment has on their education. The authors have determined that clinical assignments to community facilities may offer nursing undergraduates important opportunities for learning. The research was conducted using a qualitative study design.
The research work attempts at examining pre-registration nurses' experiences in community clinic assignments as well as the effect such assignment has on their education.

Statement of Purpose

For promoting the profession of primary healthcare, comprehending pre-registration pupils' experiences within primary care contexts at the time of clinical assignment is vital.

In spite of the observable advantages such assignment have for pupils, poor supervisor-student relationships, work climates that do not foster a sense of belonging, and the absence of adequate guidance and monitoring are proven to have strong links to exacerbated anxiety and stress levels, greater pupil attrition and an inferior…...

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Reduced treatment mistakes and patient falls, together with patient perceptions of being better informed during shift change, was witnessed by researchers. The intervention incorporated a 3-hour nursing pupil handoff practicum, 2-hour clinical staff training, and a formative student assessment and feedback in the course of clinical experiences all through the 3rd semester. The pupil practicum was integrated into clinical orientation and clinical lab experience. Best practices in bedside hand-offs were addressed as well. All through the course of the practicum, emphasis was placed on the handoff receiver's active participation in safety communication (Avallone & Weideman, 2015). Numerous favorable results were recorded with regard to combined bedside nurse shift reporting practice, with a small number of downsides. Nursing outlook towards reporting during final data acquisition proved to be more favorable as compared to their outlook at the start of program implementation. If put into proper practice, bedside nurse reporting may improve patient safety results and nurse and patient satisfaction. But it is imperative to ensure nurse involvement in practice implementation and to continually check both report format uniformity and process support on nurses' and patients' part (Jecklin-Sand & Sherman, 2014).

Avallone, M., & Weideman, Y. (2015). Evaluation of a nursing handoff educational bundle to improve nursing student handoff communications: A Pilot Study. Journal of Nursing Education and Practice, 65 - 75.

Jecklin-Sand, K., & Sherman, J. (2014). A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation. Journal of Clinical Nursing, 2854 - 63.

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.
Conclusion

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 care,…...

Also, as care is prioritized, those individuals deemed to be in a less urgent need of care are given a lower priority, which results in a wait list. Finally, as physicians are compensated on the same level of salary, fewer people may be attracted to the profession for its financial rewards. In a public system, patients shop around less for providers because most providers charge the same fees. ithin a public system there is less 'siphoning' of middle-income people to higher-cost physicians with short waiting lists.
Visit: http://www.csc-surgery.com/contact.php.hatexactly is this hospital? hat would your policy response be?

According to its website, the Cambie Surgery Centre is a private healthcare clinic. The site notes that the "BC provincial government looks to private health care facilities like the Cambie Surgery Centre to help ease the long public wait lists." The hospital is a paying hospital that uses sophisticated technology to perform its services.…...

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Works Cited

Cambie Surgery Centre." Official website. 7 Apr 2008. http://www.csc-surgery.com/contact.php

Economies of scale." Investopedia. 7 Apr 2008.  http://www.investopedia.com/terms/e/economiesofscale.asp 

Economies of scope." Investopedia. 7 Apr 2008.  http://www.investopedia.com/terms/e/economiesofscope.asp 

Green, David G., Ben Irvine & Ben Cackett. "Health care in Germany." 2005.

As well as expanding patient's abilities to obtain primary care, virtually, telemedicine can enable patients in isolated locations to see specialists. When rural patients are connected to a hospital network such as the Grinnell egional Medical Center, they are able to access high-quality physicians through some of the more advanced healthcare technology available, although this is not always possible in a local healthcare system with fewer physicians and less access to high-level technology. Technology can still enable patients in a variety of settings to keep track of vital signs such as heart rate, blood pressure, and blood sugar, and to alert their physician immediately if their readings are abnormal.
While some surgeons have even performed procedures through virtual consults, certain aspects of medicine remain challenging to provide rural patients, such as physical rehabilitative services, which may require the patient to travel to receive the full benefit of the services. Patients…...

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References

Campbell, James D. (2001, May). Introducing telemedicine technology to rural physicians and settings. Journal of Family Practice. Retrieved January 27, 2011 at  http://findarticles.com/p/articles/mi_m0689/is_5_50/ai_75244766/ 

Spath, Patrice. (2011). Community Continuum of Care planning.

Brown-Spath & Associates. Retrieved January 27, 2011 at  http://www.brownspath.com/original_articles/cccplan.htm

Secondary Assessment
Tracy Folsom is a 28-year-old female who was brought to the Emergency Department by her neighbor. The neighbor stated that Miss Folsom was found lying semi-conscious in the shower. The patient was received in the ED by the on call nurse. The nurse's performance with Miss Folsom's management is reviewed in this article.

Emergency evaluation of a patient is supposed be in a systematic manner. A systemic approach prevents the examiner from missing out important clues that may point to a patient's diagnosis. This approach is divided into primary and secondary.

As part of the Primary Assessment, the patient's Airway, Breathing, Circulation and degree of Disability was evaluated, as per protocol. Miss. Folsom's airway was patent, breathing was shallow, and her skin color was pink, indicating good perfusion. She was obeying commands and pupils were equal in size and reactive to light. It is also helpful to state the capillary…...

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REFERENCES

Canadian Medical Association. (2007, July). Putting patients first ®: patient-centred collaborative care a discussion paper. Retrieved from http://fhs.mcmaster.ca/surgery/documents/CollaborativeCareBackgrounderRevised.pdf

Dean, R & Mulligan, J, 2009, 'Initial management of patients in an emergency situation', Nursing Standard, vol. 24, no. 5, pp. 35-41, (Academic Search Complete).

Gilbert, G., Souza, P., & Pletz, B. (2009). Patient assessment routine medical care primary and secondary survey. San Mateo County EMS Agency, 1-5. Retrieved from  http://smchealth.org/sites/default/files/docs/243322118Patient_Assessment.pdf 

Institute of Medicine. (2001) Crossing the quality chasm. Washington, DC: National Academy Press.

Primary Care
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 barriers.

Beckman,…...

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References

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.

Evolution of Health Care Information Systems
The objective of this study is to compare and contrast a contemporary healthcare facility or physician's office health care facility or physician's office operation of 20 years ago and to identify at least two major events and technological advantages that influenced current HCIS practices. The physician's office and health care facility of 20 years ago was a paper-based operation. All records were paper records, appointments were written on calendars and prescriptions were handwritten, notations on the patient's health records was done by writing on the physical paper record and all hospital orders were written by hand. During the 1970s hospital growth and expansion occurred and the expenditures for Medicare and Medicaid were on the rise. At this time mainframes were still in use and microcomputers became available and not only were they smaller but they were also less expensive. However, transformation did not come until…...

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References

Costs and Benefits of Health Information Technology (nd) Evidence Report/Technology Assessment Number 132. Southern California Evidence-based Practice Center, Santa Monica, CA. Retrieved from:  http://www.ahrq.gov/research/findings/evidence-based-reports/hitsys-evidence-report.pdf 

Friedman, S. (nd) Facts About Health Care Information Systems. eHow Retrieved from: http://www.ehow.com/about_6117257_health-care-information-systems.html

History and Evolution of Health Care Information Systems (nd) Chapter 4. Retrieved from:  http://www.slideserve.com/paul/history-and-evolution-of-health-care-information-systems

Health Care
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).

Identify the milestone you chose in the history of quality improvement in the first…...

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References:

1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81

2) Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.

3) Kelly, D.L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press

4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1

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 model…...

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References

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:

Provide sustained technical assistance (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003)

Evaluation of the process in rural and small communities includes: (1) scope of the project; (2) goals; (3) critical success factors; and (4) technical assistance." (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Community grants have been focused on the provision of 'personal digital assistant (PDA) systems in assisting with the decision support role. The initiative is stated to include: (1) development of toolkits; (2) leveraging known tools; (3) developing capacity; and (4) disseminating best practices. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003)

Ormond, Wallin, and Goldenson report in the work entitled: "Supporting the Rural Health Care Safety Net" (2000) state: "The policy - and market-driven changes in the health care sector taking place across country are not confined to metropolitan areas. Rural communities are experiencing changes impelled by many of the same forces that are…...

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Bibliography

Healthcare and Healthcare Insurance Country Report: India (2004) Tata Consultancy Services and Microsoft. WebHealthCentre.com. 2004 August. Online available at http://download.microsoft.com/documents/customerevidence/7144_WebHealth_CS.doc

Expert Panel Meeting: Health Information Technology (2003) Agency for Healthcare Research and Quality (AHRQ) 23-24 July 2003. Online available at  http://www.ahrq.gov/data/hitmeet.htm 

Silberman, P. And Slifkin, R. (nd) Innovative Primary Case Management Programs Operating in Rural Communities: Case Studies of Three States. Working Paper No. 76 North Carolina Rural Health Research and Policy Analysis Program.

Ormond, Barbara a.; Wallin, Susan Wall; and Goldenson, Susan M. (2000) Supporting the Rural Health Care Net. 15 May 2000 Urban Institute

Strategic Management of a Healthcare Facility in St. Louis
In the late 1800's and early 1900's St. Louis was a major center for automotive and other heavy manufacturing but the industrial restructuring of the Midwest during the latter half of the century has resulted in consistent economic decline of the St. Louis region. Today however as the rest of the country faces a slowing economy this region is showing new signs of growth. [Kotkin, 2002] Due to changing socio-demographics, the demand for health care and advanced medical technologies is growing consistently with a concomitant rise in health expenditure. [Zhou 2001] Health expenditure in the U.S. has risen from 7.4% of the GNP in 1970 to 15% of the GNP in 1995.[Zhou, 2001] The Health care sector deals with not only the clinical medical services, but also include methods which finance them, for e.g. insurance, benefit schemes, Medicare and Medicaid. eforms have…...

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References:

1. Kotkin, J, 2002 St. Louis: On the Way to Somewhere? Rebuz Inc.

2. Author not available, 1997, Economic Report of the President. Government Printing Office, Washington, D.C. [accessed on 4/4/03]:  http://www.umsl.edu/services/govdocs/erp/1997/chap3.htm 

3.Author not available, 1996, Focus... Non-Elderly Missourians without Health Insurance, March 1996, Vol. 30, No. 1 [accessed on 4/4/03]: http://www.dhss.state.mo.us/MonthlyVitalStatistics/March96Vol30No1.html

4. Author not available, January 1999, Focus... Managed Care (MC+) in Medicaid Population, January 1999 Vol. 32, No. 11[accessed on 4/4/03] at http://www.dhss.state.mo.us/MonthlyVitalStatistics/Jan99Vol32No11.html

Terrace Hospital Marketing Plan
Marketing trategy -- Terrace Community Hospital

ummary- Terrace Hospital is a smaller, community hospital, located in a suburb of a major city. There are a number of large urban hospitals within 45-60 minutes of Terrace, but the focus for Terrace is as an expanded clinic that provides basic services for urgent care, seniors, obstetrics, general practice, counseling and education programs, radiology, complete blood work, and an osteo-care unit for citizens of the outlying communities that are 45-60 minutes from Terrace, and thus quite a distance from the urban hospitals. The hospital is reviewing its marketing plan in order to focus more on profitable and complete care, knowing that more complicated specializations are more available in the urban center.

Major Health Concerns -- Quality pediatric care, childhood obesity and Type-II diabetes, alcohol and cigarettes, substance abuse, TDs, geriatric care, obesity and cardio-renal issues.

Target Patients- The community of Terrace, as well…...

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Sources Consulted

Buckley, P. (2009). The Complete Guide to Hospital Marketing. Marblehead, MA: HCPro, Inc.

City University of New York. (2011). Marketing Planning, Strategic Planning and the Marketing Process. Retrieved from: http://academic.brooklyn.cuny.edu/economic/friedman/mmmarketingplanning.htm

Eckrich, D.; Schlessinger, W. (2011). An Application of the marketing concept in health-care services planning. Journal of Marketing Research. Retrieved online from: http://www.www.aabri.com/manuscripts/10571.pdf

HR Council. (2012). HR Planning. Retrieved from: http://hrcouncil.ca/hr-toolkit/planning-strategic.cfm

Access to Health Care in USA
This research paper focuses on the degree of accessibility to the health care services in the U.S.A. Accessibility refers to the ability of an individual to meet health care needs and to acquire the needed medical services on time. It then discusses the findings of the research. The suggestions for the elimination of the prevailing problems in the health care system are also given in the preceding paper.

Health Care: Access to Health Care in United States of America

To achieve a long-lasting life and to save oneself from major diseases it is important that people have an easy access to the medical and health care services. Access to the health care services means that individual gets timely health services to attain the best heath results. In other words it refers to the ability of an individual to meet health needs and to acquire the needed medical…...

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References

Albert, R. (2009). The U.S. Health Care Rip-Off. Retrieved May 16, 2013, from  http://rendezvous.blogs.nytimes.com/2013/03/03/the-u-s-health-care-rip-off/ 

Alex, E. (2012). Health Care Access Worsened For Americans Since 2000: Report. Retrieved May 16, 2013, from  http://www.huffingtonpost.com/2012/05/07/health-care-access-urban-institute_n_1497658.html 

Maria, E. (2012). Benefits of the United States Health Care System. Retrieved May 17, 2013, from http://www.ehow.com/list_7411670_benefits-states-health-care-system_.html

Maryann, B (2011). Health Care Systems: Three International Comparisons. Retrieved May 17, 2013, from  http://www.stanford.edu/class/e297c/poverty_prejudice/soc_sec/health.htm

Healthcare: Clinical Integration
Item Page

What is clinical integration

History of clinical integration

Goals of clinical integration

Importance of clinical integration

Health reform

New payment models

IT advancement

Barriers to clinical integration

Legal barriers

Lack of practitioner alignment

Lack of interoperability

How to achieve success in clinical integration

Incentive alignment

Knowledge alignment

Behavioral alignment

The future of health care systems

Physician acquisitions vs. clinical integration

HIEs -- solution to clinical integration?

Policy makers are beginning to appreciate the fact that only systemic change can effectively change, for the better, the manner of health care delivery in the U.S.; and that anything less would only alter the system's edges - with little or no substantial effect on cost-control, innovation-promotion, effectiveness of reward incentive schemes, coordination and coverage (AHA, 2010). Clinical integration has been found to be crucial to the change needed for the achievement of the aforementioned goals (AHA, 2010). Despite the challenges (legal and otherwise) clinical integration faces, it still is key to health sector reforms.

What is Clinical Integration?

Clinical integration…...

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References

AHA. Clinical Integration -- the Key to Real Reform. Trend Watch. Retrieved from [HIDDEN]

Athena Health. (2014). History of the Clinical Integration Model. Athena Health. Retrieved from https://www.athenahealth.com/knowledge-hub/clinical-integration/clinical-integration-model.php

eHealth Initiative. (2012). The Rise of the Private Health Information Exchange and Changing Role of Public Exchanges. eHealth Initiative. Retrieved from [HIDDEN]

Fridsma, D. (2013). Interoperability Vs Health Information Exchange: Setting the Record Straight. Health IT Buzz. Retrieved from  http://www.healthit.gov/buzz-blog/meaningful-use/interoperability-health-information-exchange-setting-record-straight/