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A. Description of total market
There are several markets we could consider given the nature of our activity, however, we can integrate our assisted care in the larger category of the nursing care industry. In the United States, this has come to reach a total of around 30,000 companies, with a combined annual revenue of close to $100 billion. These companies operate around 60,000 nursing facilities. It is estimated that the average nursing home has an average annual revenue of around $5 million.
One of the interesting characteristics of the market is the fact that it is highly labor intensive, with annual revenues per worker of less than $50,000. We have decided to compete with this in two manners: first, by increasing the average salary in our association to be included in the medium to high range, in order to stimulate and motivate our employees; and second, we…
Quality and Sustainability Paper
Quality and safety are paramount for patients experiencing illness and seeking treatment. The role of the nurse is complex, requiring effectiveness, efficiency, compassion, and understanding. Some aspects of nursing science involve research and use of evidence-based practice to provide the high quality and safety standards patients deserve. How are quality and safety measures adopted and implemented? This essays aims to look at the role quality and safety play in nursing science using a contemporary example, and seeing how real world strategies aim to test and assess standards of care to deliver the positive health outcomes patients need. By delving into real-world application of quality and safety measures, one can determine the process from cultivation of concepts, implementation, and assessment.
Quality measures in nursing science
Often a good way to understand if a patient is experiencing a high quality of care is through patient outcomes and…
Although there are several considerations one must weigh prior to defining medical care quality, one of the most effective definitions of this term is that care which ultimately achieves the greatest benefit while taking the lowest risk in doing so. In many ways, this notion is at the heart of the Affordable Care Act, for the simple fact that one of the principle components of this act is to emphasize preventative care since insured people's "policy will cover more than 60 preventive tests and treatments as required" (Glasserman and Hensel, 2013). Virtually no one can argue with the fact that there is a low risk associated with providing preventative care and, if implemented correctly in a safe care delivery model, it can also achieve the greatest benefit to individual health care patients, the system itself, and to the country as a whole. Thus, the prudent researchers of medical…
Centers for Disease Control and Prevention. (2013). Affordable Care Act helping prevent disease. www.cdc.gov. Retrieved from http://www.cdc.gov/features/AffordableCareAct/
Glasser, M. Hensel, B. (2013). Preventive care services and the Affordable Care Act. www.nbclosangeles.com. Retrieved from http://www.nbclosangeles.com/news/local/Preventive-Care-Services-and-the-Affordable-Care-Act-223984451.html
Furthermore, the VA hospitals are devoted to new research on Parkinson's disease in the development of surgical treatment for late-stage patients for whom medical therapy is no longer effective and development of new medications, which are more effective and have fewer side effects (Department of Veterans Affairs, 2001). In this way the VA's rehabilitation services structure assists in the transition of patients from one level to another level of care.
alanced Scorecard of the VA's Rehabilitation Services
The creation of a balanced scorecard for the rehabilitation services offered by the VA consists of developing metrics, collecting data and analyzing the data in relation to: 1) the learning and growth perspective, 2) the business process perspective, 3) the customer perspective, and 4) the financial perspective. The learning and growth perspective includes employee training and corporate cultural attitudes related to both individual and corporate self-improvement. In the current climate of rapid technological…
Department of Veterans Affairs. (2001, February). Parkinson's disease: VA Benefits and Programs. Office of Public Affairs Media Relations, p. 1.
Mitchell, S.L., Kiely, D.K., Kiel, D.P., & Lipsitz, L.A. (1996). The epidemiology, clinical characteristics, and natural history of older nursing home residents with a diagnosis of Parkinson's disease. J Am Geriatr Soc 44, 394-9.
Wilson, N. & Kizer, K. (1997). The VA Health Care System: An Unrecognized National
Safety Net. Health Affairs 16(4), 200-4.
Care Case Study
Slide 1 Footnotes
There have been enormous changes due to introduction of various cultural elements in the continuum of care. Before, when people were admitted to assisted living facilities or hospital settings, there were very little cultural elements outside of the majority culture which had sponsored the facility. For example, if a facility was associated with some sort of church or temple, there were elements of that religion present, but there was little alternatives for members of other cultures or religions.
Yet, today, there are now a much wider array of cultural elements available in assisted living homes and hospital facilities. Assisted living programs are regulated on the level of the state.
As such, different states have different types of programs and policies that impact the degree to which cultural characteristics are included or excluded within various assisted living facilities. Some programs encourage cultural elements of patients…
ALFA - Assisted Living Federation of America. (2009). Assisted Living Regulations and Licensing. Retrieved from http://www.alfa.org/State_Regulations_and_Licensing_Informat.asp
Medicare Payment Advisory Commission. (2011). Report to the Congress: Medicare Payment Policy. Retrieved from http://www.medpac.gov/documents/Mar11_EntireReport.pdf
National Caregivers Library. (2012). Independent Living Facilities. Retrieved from http://www.caregiverslibrary.org
Next Step in Care. (2012). Reducing the Stress of Hospitalization for Patients with Dementia and their Family Caregivers: A Guide. Family Caregiver Alliance. Retrieved from http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=2449#researchpractice
A quality assessment could turn up this problem and create the atmosphere for solving the problem creatively and effectively.
There is another aspect of the quality assessment program that directly affects all of the staff of any healthcare facility. Essentially, a quality assessment program can help make the facility more profitable, and that benefits everyone on the staff. Quality assessment can identify areas of waste and neglect that may have been overlooked before, and they can help staff members come up with solutions that are not only more viable for the patient, bust cost-effective, too. That means the fiscal health of the organization is managed and sound, and that means a more stable working environment for the staff. In a facility that is having money problems, the staff may be stressed or distracted, and that can lead to health concerns for the patients. In a fiscally sound institution, the staff…
Arling, G., Lewis, T., Kane, R.L, Mueller, C., and Flood, S. (2006). Improving quality assessment through multilevel modeling: The case of nursing home compare. Health Services Research, Volume 42 Issue 3. p. 1177-1199.
Editors. (2008). Nursing facility quality assessment. Retrieved 12 Nov. 2008 from the Lifespan Web site: http://www.lifespan-network.org/docs/10.01.20%20Procedures%20for%20Facility%20Quality%20Assessment.pdf
Wong, C.A., Cummings, G.G. (2007). The relationship between nursing leadership and patient outcomes: A systematic review. Journal of Nursing Management; Vol. 15 Issue 5, p. 508-521.
This is important, because it is showing how a lack of: following up and monitoring safety standards can increase the long-term financial problems facing a heath care facility. (Master, 2005, pp. 259 -- 285)
At the same time, there is also the possibility that the lack of focus on safety could expose the hospital to possible law suits. This is because the plaintiffs could use this information to show, how the staff is negligent in the quality care that they are providing to them. Once this occurs, it means that the costs for: medical malpractice insurance and other operating expenses will rise. While, the facility will have the negative publicity from: these lawsuits and there is the possibility of increased amounts of regulation (surrounding internal procedures). This is important, because it is showing how these kinds of issues will have an adverse effect on: the reputation and economic viability of…
Grol, R. (2008). On the Trail of Quality and Safety. British Journal of Medicine, 336, 74 -- 76.
Master, K. (2005). Role Development in Professional Nursing. Sudbury, MA: Jones and Bartlett.
Manser, T. (2009). Team Work and Patient Safety. Acta Anaesthesiologica Scandinavica, 53 (2), 143 -- 151.
Vincent, C. (2008). Is Health Care Getting Safer. British Journal of Medicine, 13, 337 -- 345.
Anxiety, poor school performance and suicidal conduct have been among the frequent signs of sexual abuse. Excessive masturbation and other unusual sexual activities are also associated with sexual abuse. Symptoms of emotional abuse, on the other hand, are loss of self-esteem, sleep disturbances, headaches or stomach aches, refusal to go to school and running away from home. Neglect can be more visibly detected when the child's normal physical, social, emotional and mental development is hampered. Symptoms can be underweight, slower acquisition of language skills and emotional neediness. Child abuse inflicts lifelong consequences (aker 1999). These include poor school work, emotional problems, the formation of an antisocial personality, promiscuity, drug or alcohol abuse and suicide attempt. Abused children often find difficulty in establishing intimate relationships as adults (aker).
The economic, cultural, and social revolution 50 years ago changed the scenario for everyone. Young women joined the workforce even when they became…
Baker, H. (1999). Child abuse. 3 pages. Encyclopedia of Medicine: Gale Encyclopedia of Medicine.
Bower, B. (1996). Mom-child relations withstand day-care attachment behavior in infants. 3
Pages. Science News: Science News Service, Inc.
Grooms, a. (2007). Quality child care expensive. 2 pages. La Crosse Tribune: ProQuest
Nursing Quality Improvement Activities
Providing quality nursing care is the foundation of professional ethics for nurses. Nurses have a moral obligation to not only provide quality care, but to also to constantly strive for excellence in the quality of the care they furnish.
Non-medical prescribing is increasingly being seen as a cost-effective option, quality improvement option by both the U.S. government and professional nursing societies. The employment of potentially dangerous preparations in an array of clinical settings is not without risks, however.
There are other considerations for quality improvement in nursing -- including:
Nursing considerations for prescribed drugs.
Review of practice and practice outcomes.
New nursing standards, and guidelines.
Quality improvement is a formal approach to the analysis of performance and systematic efforts to improve it. There are numerous models used.
Providing quality nursing care is the foundation of professional ethics for nurses. Nurses have a…
decision models are used in your a major hospital organization? Does top management; make decisions by a management team, or does it all depends on the type of decision? hat method would be the most effective for different types of decisions?
In any large hospital environment, decision models and protocols are often challenged by necessity on a situational basis. In the field, the practitioner of health always faces a paradox of obedience and responsiveness. After all, certain hierarchies in the decision modeling process must be held to for legal and medical reasons. A competent patient's confidentiality must be respected, even if it is not in the patient's best interest -- for instance, a mother who wishes to keep her cancer secret from her adult children must be allowed to do so. Yet during an emergency, the primary goal is always to save a life, and one cannot ask for an…
Ashley, William C. And James L. Morrison. (1997) "Anticipatory Management." The Futurist, September/October 1997, 31(5), pp. 47-50.
Richard W. Scholl. (2 Oct 1999) "Decision Making Models." Retrieved from University of Rhode Island Website on 10 Feb 2005 at http://www.cba.uri.edu/scholl/Notes/Decision_Making_Models.htm
Family Nurse Practitioner
The expansion of healthcare coverage through the Affordable Care Act (ACA) is expected to create an enormous increase in the number of people seeking medical treatment and healthcare. A number of demographic issues exacerbate the situation: An aging population requiring more extensive treatment and care, a rising national population, and a shortage of primary care physicians (Iglehart, 2013). The shortage of primary care physicians is one of the most crucial for national medical care because of two substantive dynamics: 1) The number of graduates from medical school who plan to enter careers as primary career physicians is currently estimated at 25%; and 2) the care that advanced practice registered nurses (APN) can provide is constrained by the current scope-of-practice laws on the books in any states (Iglehart, 2013).
An enduring tension exists between the American Medical Association and nursing advocates regarding the scope of practice that should…
Iglehart, J.K. (2013, May). Expanding the role of advanced nurse practitioners: Risks and rewards: Health policy report. New England Journal of Medicine, 368(20), 1935-1941.
National Organization of Nurse Practitioner Faculties (NONPF) (2002). Family nurse practitioner primary care competencies in specialty areas: Adult, family, gerontological, pediatric, and women's health. Pp. 21-24. U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/primarycarecomps02.pdf
Naylor, M.D. And Kurtzman, E.T. (2010, May). The role of nurse practitioners in reinventing primary care. Health Affairs, 29(5), 893-899. DOI: 10.1377/hithaff.2010.0440.
Savrin, C. (2008). Growth and development of the nurse practitioner role around the globe. Journal of Pediatric Health Care, 23(5), 310-314. DOI: 10.10.1016/j.pedhc.2008.10.005.
Caring for the Old
The End of Life Care
End of life care refers to the total care of a person that has an advanced illness that is incurable and does not equate with death. This end of life care can last for a number of weeks, months or even years depending on the state an individual is.it is usually the care which helps those that have advanced, progressive and illnesses that can not be cured to live life as well as possible until they meet their death. End of life care makes it possible for the patient and their family to get supportive and palliative care needs identified and met throughout the last phase when they are living and into the bereavement period. Supportive care is care which helps a patient and the family to cope with the condition and the treatment of that condition right from the pre-diagnosis…
Boswell, Kahana & Worth-anderson, 2006). Spirituality and Healthy Lifestyle Behaviors: Stress Counter-balancing Effects on the Well-being of Older Adults. Retrieved April 30, 2014 from http://www.case.edu/artsci/soci/documents/Spiritualityandhealthylifestylebehaviors.pdf
U.S. Department of State, (2012).Legal & Financial Issues In Caregiving for Older Adults. Retrieved April 30, 2014 from http://www.state.gov/m/dghr/flo/142266.htm
American Society of Clinical Oncology (ASCO), (2014). Caregiving Considerations. Retrieved April 30, 2014 from http://www.cancer.net/navigating-cancer-care/older-adults/caregiving-considerations
The Joanna Briggs Institute, (2011). Age-friendly nursing interventions in the management of older people in emergency departments. Retrieved April 30, 2014 from http://connect.jbiconnectplus.org/ViewSourceFile.aspx?0=7127
Quality Improvements in Emergency Services
Consumers in the form of patients and other stakeholders are increasingly demanding for proof that the care being delivered or rendered to them is of high quality. In general, the public is cognizant of, demand quality from the medical sector or industry, and anticipates action and improvements to be undertaken when quality is not existent. There are very clear expectations and anticipations for improved health, improved efficiency and in overall improved quality. It is important for an Emergency Medical Services agency or organization to have programs and agendas in place that not only analyze, evaluate and assess the manner in which the organization and its employees are operating. The purpose of this paper is to analyze the aspect of quality improvement in Emergency Medical Services. The paper will take a look into the background of quality improvement and advancement in the emergency medical services sector.…
Angelini, K., Klein, S. (1989). The QA guarantee. Emergency, 20-23.
Bingaman, D. (1994). Continuous quality improvement in emergency service: what and why. Dallas: American College of Emergency Physicians.
El Sayed, M. J. (2011). Measuring quality in emergency medical services: a review of clinical performance indicators. Emergency medicine international.
Estepp, M., Crabtree, S. (1988). Quality assurance in EMS. Fire Command, 20-23.
Quality Measurement Proposal
The focus of quality measurements is, generally, care processes or structures having an established relationship with positive healthcare outcomes, and being under the healthcare system's control. The technical definition of quality measures provided by the Agency for Healthcare Research and Quality (AHRQ) is: a mechanism for assigning quantity to care quality through comparison to some criterion. One can apply quality measures to the evaluation of managed care organizations, healthcare providers, health programs/plans, and hospitals (U.S. Department of Health and Human Services, 2012).
Healthcare quality measurement denotes a process of utilizing data for the purpose of performance assessment of healthcare professionals and health plans against accepted quality standards. There are many forms a quality measure may assume. These measures assess healthcare across the entire array of care settings, right from hospital systems to physician offices and imaging facilities (Families USA, 2014).
Measurement of healthcare quality is an essential…
Aligning Forces for Quality. (n.d.). The Case for Measuring Patient Experience of Care. Retrieved from Good for Health: Good for Business: http://forces4quality.org/case-patient-experience
Families USA. (2014). TheVoice for Health Care Consumers. Measuring Health care Quality: An Overview of Quality Measures. Retrieved from www.familiesusa.org
National Academies of Sciences. (1999). Measuring the Quality of Health Care. In Institute of Medicine. Washington DC: The National Academy Press. Retrieved from www.nap.edu/read/6418/chapter/2
US Department of Health and Human Services. (2012, September). Advancing Excellence in Health Care. Retrieved September 2012, from www.ahrq.gov/professionals/quality/patient-safety/quality-resources/toolschtoolbox/understand
Quality of Work Life of Health Care Providers in Saudi Arabia
In iyadh, the quality of work life of health care providers is not as high as it should or could be, according to researchers (Alhousaini, 2006; Almalki, FitzGerald, Clark, 2012). Almalki et al. (2012) have shown that "30.3% of nurses in iyadh were not offered any training courses or continuing education programs and 65.9% were offered very short courses (1 to 5 days per year)" (p. 30). Overall, health care providers have expressed dissatisfaction with their work life (Almalki et al., 2012). Likewise, Abu-Zinadah (2006) has indicated that work life in conditions in iyadh are sub-par for health care providers and could be improved considerably through attention to work hours and other variables. In iyadh as well as in other regions throughout the Kingdom, a lack of clinical experience can negatively impact a health care providers' quality of work…
Abu-Zinadah, S. (2006). Nursing situation in Saudi Arabia. Riyadh: Saudi Nursing
Board, Saudi Commission for Health Specialties.
Al-Ahmadi, H., Roland, M. (2005). Quality of primary health care in Saudi Arabia: a comprehensive review.
Alhusaini, H. A. (2006). Obstacles to the efficiency and performance of Saudi nurses at the Ministry of Health, Riyadh Region: analytical field study. Riyadh, Saudi Arabia, Ministry of Health.
Quality Improvement in Healthcare
Nearly all healthcare organizations today are aware of the Quality Improvement (QI) movement and seek to actively instill their businesses with such elements. In fact, the past few decades have shown the QI movement to be the main approach for healthcare organizations to measure performance and engage in lasting changes (Colton, 2000). The foundations of QI reside with its origins which come from multiple arenas: "in systems engineering, as a way of defining production processes; in quantitative analysis, as a methodological approach for collecting and analyzing data; and in organizational behavior, as a way of understanding how QI fits with an organization's structure and management philosophy" (Colton, 2000). QI fundamentally stands as a mode for a healthcare organization to better itself through enhancing the way in which it delivers service and by improving patient outcomes (Colton, 2000). "The U.S. Agency for Healthcare esearch and Quality defines…
Colton, D. (2000). Quality improvement in health care. Conceptual and historical foundations. Eval Health Prof., 7-42.
Familydoctor.org. (n.d.). Medical Errors: Tips to Help Prevent Them. Retrieved from Familydoctor.org: http://familydoctor.org/familydoctor/en/healthcare-management/self-care/medical-errors-tips-to-help-prevent-them.html
Varkey, P., Reller, K., & Resar, R. (2007). Basics of Quality Improvement in Health Care. Mayo Clin Proc., 735-739.
Healthcare Quality Indicators
ith the adoption of the Affordable Care Act, also now commonly referred to as Obamacare, the array of quality indicators used to assess healthcare facility performance has expanded. The addition of a number of quality indicators with direct connections to penalties and other punitive measures has created a great deal of pressure for hospitals and other healthcare facilities. Many of these quality indicators are designed to heighten accountability among hospitals and other acute healthcare treatment cites or systems. Among them, penalties for preventable readmissions has become an exceptionally prominent indicator of performance quality.
According to Brink (2013), the quality indicator of readmission rates has become an important issue for healthcare leaders and hospital administrators. Brink reports that roughly 12% of all Medicare patients will be readmitted to the hospital within the first 30 days of discharge for recurrent conditions that could be prevented…
Brink, S. (2013). Hospitals Seek to Avoid Penalties by Minimizing Readmissions. U.S. News and World Report.
Johnson, M. (2013). For Hospitals, Obamacare Rollout Makes Readmission Penalties a Top-of-Mind Priority. NJ Biz.
Rau, J. (2013). Medicare Revises Readmissions Penalties -- Again. Kaiser Health News.
114). ising medical costs and diminishing quality of care demand that something be done, however (IOM 2009).
The Quality Chasm documents and the research that went into producing them have been specifically requested and utilized by the Department on Health and Human Services to implement policy reform at state and local levels that his directly changed the way primary care is provided (IOM). Nursing education is also affected by these policy changes as expectations and standards of care change.
IOM. (2009). "Crossing the Quality Chasm: The IOM Health Care Quality Initiative." Accessed 18 September 2009. http://www.iom.edu/CMS/8089.aspx
Piper, S. (2008). Top Ten Myths of American Health Care and Crisis. Pacific esearch Institute. Accessed 18 September 2009. http://liberty.pacificresearch.org/docLib/20081020_Top_Ten_Myths.pdf
IOM. (2009). "Crossing the Quality Chasm: The IOM Health Care Quality Initiative." Accessed 18 September 2009. http://www.iom.edu/CMS/8089.aspx
Piper, S. (2008). Top Ten Myths of American Health Care and Crisis. Pacific Research Institute. Accessed 18 September 2009. http://liberty.pacificresearch.org/docLib/20081020_Top_Ten_Myths.pdf
10). While basically valid, this claim is disingenuous and actually self-defeating. While we might not have a "right" to any of these things, the government does provide food, shelter and clothing to those in need, and not just on an emergency basis (as is the case with health care). Health goes to basic security of life, and the government has an inherent duty to protect its citizen's lives.
The Qulity Chasm report has been used to change healthcare by advocating a shift in primary care to a more developed infrastructure via systems demonstrations. The report affected both policy and ethics in its finding on lowered safety levels due to insufficient staffing capabilities (IOM). Nursing education has changed due to the enhanced standards and new methodologies suggested by the report.
IOM. (2009). "Crossing the Quality Chasm: The IOM Health Care Quality Initiative." Accessed 18 September 2009. http://www.iom.edu/CMS/8089.aspx
Piper, S. (2008).…
IOM. (2009). "Crossing the Quality Chasm: The IOM Health Care Quality Initiative." Accessed 18 September 2009. http://www.iom.edu/CMS/8089.aspx
Piper, S. (2008). Top Ten Myths of American Health Care and Crisis. Pacific Research Institute. Accessed 18 September 2009. http://liberty.pacificresearch.org/docLib/20081020_Top_Ten_Myths.pdf
also emphasize the importance of education and communication to consumers in order to ensure that quality standards are met.
The Malcolm Baldrige National Quality Award was established during 1987, when businesses were slowly but increasingly becoming aware of the importance of quality service and goods to customers. The award program was then established in order to not only promote quality awareness, but also to recognize businesses providing the highest quality in comparison to others. This promotes competition, which in turn promotes higher quality goods and services.
In addition to the health care sector, the annual Baldrige Award is presented by the President to businesses in manufacturing, service, small business, education, and nonprofit organizations. The award, along with the Baldrige National Quality Program, is managed by the National Institute of tandards and Technology.
Businesses can apply for the award by submitting the details of their achievements and improvements in seven key…
Bethell, Christina, Carter, Kim, Lansky, David, Latzke, Brooke & Gowen, Kris. (2003, March). Across Culturally-Diverse Populations: A focus on Consumer-Reported Indicators of Health Care Quality. Foundation for Accountability.
McKenna, Jeffrey, Pechacek, Terry F., Stroup, Donna F. (2003, May-June). Health Communication Ethics and CDC Quality-Control Guidelines for Information. Public Health Reports, Vol. 118.
In terms of communication within the hospice setting, this might occur by means of communicating with patients and their families to determine whether they experience their care setting in an optimal manner. If this is not the case, strategies are implemented to address the commonly experienced difficulties.
In conclusion, communication is a vitally important part of any care setting. Patients and their families must feel that they are the recipients of patient-centered care, and that they receive sufficient information to help them through difficult times. It is suggested that the PDSA model will be an effective way to accomplish this, along with process mapping. A logical sequence of steps must first address the underlying reasons behind the lack of effective communication among staff and patients. This can relate to the stress factors and harsh work schedules that practitioners often face. To work in such an emotionally eroding environment makes…
IHI.org. (2011). Improvement Methods. Retrieved from: http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/HowToImprove/
Leavitt, M.O. (2009). Report to Congress on the Evaluation of the Quality Improvement Organization (QIO) Program for Medicare Beneficiaries for Fiscal Year 2006. Retrieved from: http://www.cms.gov/QualityImprovementOrgs/downloads/2006RtCQIO.pdf
Melinkovich, P. (2011). Adoption of Rapid Cycle Improvement Process From Toyota Increases Efficiency and Productivity at Community Health Clinics. AHRQ. Retrieved from http://www.innovations.ahrq.gov/content.aspx?id=1807
Victorian Quality Council. (2007, June.) Process Mapping. Retrieved from: http://www.health.vic.gov.au/qualitycouncil/downloads/process_mapping.pdf
Quality and Data-ased Management
The purpose of this paper is to examine the organization of NewYork- Presbyterian Hospital in relation to the hospital's quality indicators and measures that are currently in place. Further to identify quality indicators and goal measurements used in the organization plan and also to review the mission statement and vision.
Rigorous standards are used in ranking healthcare institutions particularly when ranking is applied to hospitals. There are approximately 6,012 hospitals in the United States not including military and veteran facilities and out of all of those "only 177 or fewer than 1 in 30 were of high enough quality to be ranked in even a single specialty this year."(Souroujon, 2004)
The first category applied in consideration of a hospital's ranking is that of the hospital's "reputation." (Souroujon, 2004) The second category is that of "mortality ratio" (Souroujon, 2004) and the last is a miscellaneous…
Cornarow, Avery (2004) Methodology Behind the Rankings Best Hospitals 2004; U.S. News Online at: http://www.usnews.com/usnews/health/hosptl/methodology.htm
National Health Care Quality Report: High Quality Health Care Is Not Yet a Universal Reality www.qualitytools.ahrq.gov/qualityreport
Connor, Deni (2003) Healthcare Network Aims to Improve Patient Care Network World Fusion 2005 June 3.
Souroujon, Andre (2004) Best Hospitals 2004 U.S. News Report Online at: http://www.usnews.com / usnews/health / hosptl/tophosp.htm
By reducing stress levels, this could even have a direct medical benefit. It is essential that a healthcare professional be knowledgeable and efficient, but to make them truly excellent they need to have good people skills, too.
In essence, being an excellent healthcare provider simply means understanding people, and treating patients like human beings. It sounds simple, but remarkably few people in today's world seem to recognize other humans in day-to-day transactions. The healthcare professionals that exhibit this quality are the ones I consider truly excellent, and the ones that have inspired me to attend nursing school. I will keep in mind the level of service they provided, and try to emulate the same qualities in my career in healthcare.
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…
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
52, 53). Thus, in less than a month, Washington improvised an entirely new battle plan and seized the advantage offered to him by the British. Coupled with his relentless dedication to his cause, Washington's ability to react and improvise throughout the war is what allowed the relatively untrained and poorly supplied Continental Army to overcome the might of the British empire.
The third trait, a fatherly devotion to his men, is evident throughout Washington's military career. Though he was careful to maintain a certain distance between himself and his men in order to ensure a modicum of respect (or at least fear), he nevertheless care deeply about their well-being (Harvey, 2008, p. 39). For example, when he became the leader of the Continental Army, one of his first orders was for the men to be issued fresh bedding and food, and he organized colonial women to produce 14,000 new coats…
Harvey, R. (2008). Maverick military leaders, the extraordinary battles of washington, nelson, patton, rommel, and others. Skyhorse Pub Co Inc.
org 2010). These tools were selected for their simplicity and ease of use/interpretation, as well as for their established usefulness in similar situations (ihi.org 2010). The FOCUS PDCA method for implement quality improvement changes in the organization will be carried out in the manner that defines the methodology itself, with distinct stages being performed in a cyclical manner that identifies needed changes, makes those changes, evaluates the outcome, and identifies additional changes and refinements to processes as needed (ansom et al. 2008).
Comparisons and Performance Measures
There are a variety of methods that can be utilized to analyze the performance of the implemented changes, and several of them will be specifically implemented to ensure adequate performance by the proposed changes. Comparisons between the yearly annual reports available form the University of Kansas Hospital as well as other less long-term internal measures will be used to determine improvements in efficiency and…
The Institute for Healthcare Improvement. (2010). Tools. Accessed 25 October 2010. http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/Tools/
The National Coordinating Council for Medication Error Reporting and Prevention. (2010). About Medication Error. Accessed 25 October 2010. http://www.nccmerp.org/aboutMedErrors.html
Ransom, E. R, Joshi, M.S., Nash, D.B., & Ransom, S.B. (2008). The healthcare quality book: Vision, strategy, and tools. (2nd ed.). Health Administration Press: Chicago, IL.
The University of Kansas Hospital (2009). The Center for Advanced Heart Care Outcomes Report. Accessed 25 October 2010. http://www.kumed.com/default.aspx?id=4937
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. .
Poor dental health can be a portal that allows bacteria and other infectious organisms into blood stream. Poor dental health care can also lead to poor outcomes of dialysis. Heart disease patients have special needs when it comes to dental care. Spreading this knowledge would motivate patients with these diseases to visit Eastside clinic regularly.
If staffing of more employees is not able to attract more patients to the clinic then the clinic would make a greater loss than it is currently making.
Kool Smiles being a profit making organization might be more efficient and have a more cooperative and friendly staff which can attract Eastside clinic patients towards them.
Promotions through dental vehicles would lead to extra costs such as repairmen of vehicles and fuel costs for which the clinic might not have funds.
The clinic might not have enough funds to employee more people
Vissers, J. & Beech R. (2005). Health operations management: patient flow logistics in health care. USA: Routledge.
Pierce, S. (2010). Dynamic Capacity Management For Health Care. USA: Taylor & Francis.
Kovener, A. & Knickman J. (2005). Health care delivery in the United States. USA: Springer.
Wall, A. (1996). Health care systems in liberal democracies. USA: Routledge.
Quality TV generates interest about social problems
Quite often, fictional TV programs can raise national consciousness and awareness about social problems. Through fiction, viewers care about people far away because problems and issues are personalized and humanized. For example, the HBO program Oz about life in prison has generated compassion about the fate of incarcerated individuals and motivated calls for prison reform in a way that seeing someone in handcuffs on the nightly news cannot. The Sopranos was not simply a high-quality TV drama, its location in a suburban community also forced viewers to think more critically about their daily lives, like the lies, pain, and murder that lay behind the closed doors of affluent suburban New Jersey. The use of violence in these shows is designed to accurately depict life
Quality TV is cinematic
Violence has become part of the cinematic vocabulary, and modern television dramas with legitimate aspirations…
The author suggests that care for the individual is characteristic of small, personal enterprises like Gessler's shoe shop, unlike standardized, corporate places of trade. Gessler can recognize a manufactured boot from far away, and will not charge for poorly made goods. "If I can do noding wid dem, I dake dem off your bill" (4). He says of firms, "dey get id by adverdisement, nod by work" (5).
For Gessler, the quality of his work is the only advertisement that is legitimate as he equates his own value with the quality and value of his work. He even looks like his handiwork: "Himself, he was a little as if made from leather" (2). But this belief impoverishes and ultimately kills Gessler. Eventually, the narrator learns that Gessler prioritizes his own life over his shoes, and funnels all of the profits back into the rent of the shop and the leather…
Galsworthy, John. "Quality." E-text from Project Guttenberg. 25 Sept 2004.
23 Mar 2007. http://www.gutenberg.org/catalog/world/readfile-fk_files=101658&pageno=1
Quality Management in Sports Tourism
It should surprise no one that "travel and tourism [are] the world's largest industry" (Moli). Most people have not wanted to travel far outside the bounds of a resort or a prescribed tourist destination, but that is not necessarily the case anymore. Since people from wealthier countries are now able to travel easily to even the most remote spot n the world, it has become vogue to visit out-of-the-way spots. The benefits of this can be seen in the fact that nations which have not previously been able to provide jobs for their people to any extent whatsoever are now employing large numbers in these two industries. Travel and tourism are a global market and they scene is set for more adventurous and exotic types of travel.
One of the fastest growing segments of this market is sports tourism. More people are seeing the benefits…
Bowman, James S. "At Last, an Alternative to Performance Appraisal: Total Quality Management." Public Administration Review, 54.2 (1994): 129-136.
Devine, Adrian, and Frances Devine. "Sports Tourism: Marketing Ireland's Best Kept Secret - the Gaelic Athletic Association." Irish Journal of Management, (2005): 7- 16.
Gibson, Heather J. "Sport Tourism: the Rules of the Game." Parks & Recreation, 34.6 (1999): 36-42.
Hackman, J. Richard, and Ruth Wageman. "Total Quality Management: Empirical, Conceptual, and Practical Issues." Administrative Science Quarterly, 40.2 (1995): 309-325.
Social Determinants of Health
Quality Improvement and isk Management in Health Care
A health care system is an institution or organization of people using resources to deliver health care services to meet the target population's health needs. There are many health systems worldwide with many organizational structures and histories. Different countries have various systems that support their health system planning such as trade unions, governments, market participants, charities and religious co-ordinate bodies who deliver health care services that are planned and evolutionary. isk management entails the proper strategies that reduce possibilities of specific losses in health organizations (Spath, 2009).
The systematic utilization and gathering of data are very important to the practice and concept. The programs of risk management consist of both reactive and proactive components. The reactive components include the actions, which are in response to adverse occurrences while proactive components include those activities done to prevent adverse occurrences…
Barry, R. (2002). The six sigma book for healthcare: Improving outcomes by reducing errors. Chicago: Health Administration Publisher
Cook, R. (2006). Awareness and influence in health and social care: How you can really make a difference. San Diego, C.A: Radcliffe Publishing
Kavaler, F. (2003). Risk management in health care institutions: A strategic approach. Sudbury, U.S.A: Jones and Bartlett Publishers
Marco, W. (2011). Performance-Based medicine: Creating the high performance network to optimize managed care relationships. New York: Productivity Press
Improving Local Health Care:
Quality health care is an important aspect in the modern health care system because of the necessity for quality and safety improvement measures. This concept is described as the extent in which health care services for patients and populations enhance the possibility of desired health outcomes. These services also need to be consistent with the existing professional knowledge in the field. Consequently, quality and improved care services are determined through evaluating the impact of these services on desired outcomes and the extent they adhere to procedures based on scientific and professional knowledge. As part of improving health care services, health care systems should adopt several process-improvement strategies. These strategies should recognize ineffective care, inefficiencies, and avoidable errors and then effect changes on the system to result in improved care.
Incorporating Unapplied Telecommunications Concepts:
Based on the last visit to the local health care system in the…
Angst, C.M., Devaraj, S. & D'Arcy, J. (2012). Dual Role of IT-Assisted Communication in Patient Care: A Validated Structure-Process-Outcome Framework. Journal of Management Information Systems, 29(2), 257-292.
Hughes, R.G. (2008). Tools and strategies for quality improvement and patient safety. In Patient safety and quality: an evidence-based handbook for nurses (chap. 44). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK2682/
eports from medical center services and committees concerning patient incidents are used to develop appropriate interventions.
Trended data of patient incidents can point to shift and date where most incidents occur.
A 50% reduction in the number medication errors of all types over the next 12 months.
Goals and Objectives to Facilitate Outcome
The overarching goal of this program would be to reduce the number of medication errors in general and among those wards/shifts with the highest numbers of medication errors over the past 12 months. The objectives in support of this goal include:
1. Developing awareness campaign materials such as locally prepared newsletter articles, posters and brochures concerning the goal to reduce medication errors.
2. Conduct a medication error theme seminar that provides basic guidelines for avoiding medication errors (the "5 Ps").
Translation of Goals and Objectives into Policies and Procedures
The above-described goals and objectives would…
Jorm, C.M. & Dunbar, N. (2009, August). Should patient safety be more patient centered?
Australian Health Review, 33(3), 390-395.
Tillman, P. (2013, January 7). U.S. Department of Veterans Affairs. Retrieved from http://www.
Flows in Health Care
Since the government had started the practice of handing over major departments to private sector like health care and education, these areas are now more focused on employing techniques that can draw major profit flow. On examining the three crucial aspects of profit earning such as the number of patients, quality of staff and management, we come to a conclusion that all three areas go side by side and need to be checked upon regularly (Michael, 2006 ).
The numbers of patients are important, to a hospital; patients are the customers who are taking advantage of the health care services provided by that respective hospital. Another item that is associated to the number of patients is the type of patients coming in which is directly associated with the services that a hospital is providing at that particular time. In order to earn more profit in this…
Del. Donna M., Christensen M.D. (Oct 2003). Women on the Cutting Edge of Health Care and Research. Ebony, 82.
Funtleyder, L. (2008). Healthcare Investing: Profiting from the New World of Pharma, Biotech, and Health Care Services. McGraw-Hill Professional.
Harry A. Sultz, Kristina M. Young. (2010). Health Care USA. New York: Jones & Bartlett Learning.
Leiyu Shi, Douglas A. Singh. (2011). Delivering Health Care in America. Jones & Bartlett Publishers.
Strategic human resource management:
Applications in a healthcare organization
It has been said that one of the great ironies of healthcare is that despite the fact it is an industry where the 'human' dimension is so important, the H department is often one of the most-overlooked aspects of healthcare organizations. "There is arguably no other labor-intensive industry that is so reliant upon a highly skilled, highly educated, high-cost, and high-in-demand workforce that literally makes life-or-death decisions every day. And yet, in many hospitals and health systems H remains an afterthought in the C-suite" (Commins 2013:1). However, the need for change is constant, and many organizations are finding they must 'adapt or die,' given the new realities they are facing. "by the federal healthcare law, the inevitable and growing shortages of skilled healthcare professionals, and the newfound and measurable importance of patient satisfaction scores for reimbursements will prompt…
Commins, J. (2013). Ready or not healthcare HR is going strategic. Health Leaders Media.
Retrieved from: http://www.healthleadersmedia.com/content/HR-266470/Ready-or-Not-Healthcare-HR-is-Going-Strategic
Kabene, S. (et al. 2006). The importance of human resources management in health care: A
global context. Human Resources Health, 4: 20. Retrieved from:
Healthcare: Clinical Integration
What is clinical integration
History of clinical integration
Goals of clinical integration
Importance of clinical integration
New payment models
Barriers to clinical integration
Lack of practitioner alignment
Lack of interoperability
How to achieve success in clinical integration
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…
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/
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:
Healthcare and Economics:
Health care costs have continued to increase in the past few decades despite of the numerous health reform initiatives. Currently, these expenditures account for more than 18% of GDP in the United States, a percentage that is expected to continue rising significantly. Actually, it's projected that the share will rise to 34% of GDP by 2040 if health care costs continue to increase at historical rates. The increased health care costs have considerable impacts on households, insurance companies, and government budgets. For instance, households with employer-financed health insurance will have a progressively minimal portion of their total compensation in the form of take-home pay. On the other hand, a progressively larger fraction of compensation will be in the form of employer-provided health insurance. Governments will be forced to cater for more than 50% of health care expenditures if they continue to increase at historical rates. Therefore, the…
Harrington, L. (2011, May). Career Scope: Balancing Quality and Costs During Economic
Downturns. Nursing Management, 42(5), 46-48. Retrieved from http://www.nursingcenter.com/lnc/JournalArticle?Article_ID=1163319&Journal_ID=54013&Issue_ID=1163211
Philipson, T. (2013, October 31). Obamacare or Not, Healthcare Costs are Set to Soar. Forbes.
Retrieved December 3, 2013, from http://www.forbes.com/sites/tomasphilipson/2013/10/31/obamacare-or-not-healthcare-costs-are-set-to-soar/
Patient Protection and Affordable Care Act
On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care
Act (PPACA). This is more commonly referred among United States Citizens as Health Care eform.
This revolutionary law offers three main guarantees: First, health insurance for all American's, not just those who can afford it; Second, cost reduction in the insurance premiums for individuals and businesses; Lastly, higher quality care. On the surface, the PPACA seems all around beneficial for all
American's, but there are some aspects that need to be further analyzed. There is no doubt, this law will give those who are uninsured or under-insured, better coverage and ensure better quality health care, but there is one factor that may have been overlooked; the PPACA comes at great financial cost for citizens, will take a decade to fully implement and will be not be sustainable for generations to…
Blumberg, L. (2010, July 6). How Will the PPACA Impact Individual and Small Group
Premiums in the Short- and Long-Term? Retrieved May 5, 2012, from Urban Institute: Health Policy Center: http://www.urban.org/health_policy/url.cfm?ID=412128
FLAHEC. (2007). Health Services Administrative and Clerical Staff . Retrieved May 6, 2012, from Florida Area Health Education Centers: http://www.flahec.org/hlthcareers/HCADMIN.htm
Owcharenko, N. (2005, June 21). A Road Map for Medicaid Reform. Retrieved May 6, 2012, from The Heritage Foundation: http://www.heritage.org/Research/Reports/2005/06/A-Road-Map-for-Medicaid-Reform
Technology and Healthcare
Demographics of the global community are rapidly changing so that each year there are more and more seniors within the population base. This has a profound implication on the healthcare system of many regions since a large number of elderly citizens will be spending their lives in the confines of their home, and some may have chronic illness that require continuous monitoring. Clinical telemedicine is one way to offer greater services to rural or homebound populations. Indeed, a variety of technological advances have made it possible to change the paradigm of healthcare. Clinical information systems, for instance, have expanded in scope and depth. Increased processor speeds and data storage devices have made it possible to collect more data than ever on the detailed encounters that make up the provider-patient care delivery process, and present it more effectively to a wider range of users. Healthcare monitoring is part…
Luppicini, R. And R. Adell, eds., (2008). Handbook of Research on Technoethics. New York: Information Science Publishing Company.
Teo, T., et.al. (2008). "Wireless Healthcare Monitoring Systems. World Academy Of Science, Engineering, and Technology. 42 (1: Retrieved from:
Toward that same end, the new strategic plan must also include provisions for a comprehensive centralized governance system.
The second most important reason that MUSC requires a new strategic plan relates to the impact of managed care, HMO insurance, and the healthcare crisis that accounts for many uninsured patients.. Evolving legislation delineating the respective funding responsibilities of federal and state government programs may place additional financial burden on healthcare institutions, particularly those that are engaged in providing education services, those that maintain research programs, and those that furnish medical services to a large proportion of patients who cannot afford to pay for their share of those services. Therefore, a comprehensive plan must allow for subsequent change within its formulation, because MUSC maintains educational programs and research programs, in addition to serving a large needy and/or uninsured constituency.
Finally, the new plan must address the formulation and integration of comprehensive communications…
As South Carolina's only comprehensive academic, research and point-of-service health center, the Medical University of South Carolina provides a full range of programs and services in the biomedical sciences that would otherwise be unavailable to many South
Carolinians. The Medical University of South Carolina is dedicated to serving the community by ensuring that all patients get the treatment they need irrespective of their ability to pay. Located on more than 50 acres in the city of Charleston, the MUSC campus serves more than 2000 healthcare students from six colleges and MUSC programs provide essential residency training for more than 500 post graduate healthcare professionals. The MUSC program faculty includes a teaching staff of approximately
850 full-time and 1600 part-time faculty members. Our dedicated staff and faculty are committed to providing the best and most up-to-date programs and to continually adapting to changes in both the science and the need for our services to enable us to achieve the ultimate goal of modern medicine: patient care, health, happiness, and well- being.
The last few decades have seen the healthcare environment change from one that was dictated by physicians to one that is dictated more by big business and government entities. That is particularly problematic, because that puts healthcare into the hands of people who are not really focused on helping people, and are, instead, focused on the financial aspects of ensuring that people get care. While healthcare should be about taking care of people who are ailing, injured, or sick, it becomes who has the most money or the best insurance provider. There are a number of segments to the healthcare environment, as well, and they all play roles in the mission that involves caring for the health and well-being of the greater society. Among these segments is the pharmaceutical industry, which has provided medicines for more than 100 years so that people with disease and health conditions could…
Galloway, S.J., (2009). Simulation techniques to bridge the gap between novice and competent healthcare professionals. OJIN: The Online Journal of Issues in Nursing, 14(2), manuscript 3. doi:10.3912/OJIN.Vol14No02Man03
Hagler, D., & Wilson, R. (2013). Designing nursing staff competency assessment using simulation. Journal of Radiology Nursing, 32(4), 165-169. doi:10.1016/j.jradnu.2013.10.001
Iacono, M. (2013). The culture of accountability. Journal of PeriAnesthesia Nursing, 28(2), 107-109. doi:10.1016/j.jopan.2013.01.002
Muller, L. (2013). Integrity and accountability the omnibus final rule: Part 1. Professional Case Management, 18(4), 204-207. doi:10.1097/NCM.0b013e3182950694
Success in several high-profile areas, such as stroke prevention, acute coronary intervention, or nosocomial infection have the benefits of focusing the organization on a task which can bring tangible results, measured in clinically-relevant ways.
Specific Program for our Institution
This memo recommends that we choose five treatment areas, and implement specific quality improvement programs for each one. The focus on each should include procedures which are important to the overall quality of this institution's morbidity and mortality results. Given the hospital's focus on acute care, the following procedures might be candidates for quality improvement programs:
Ischemic stroke treatment
ACS treatment (acute coronary syndrome).
Trauma in the ER related to gunshot wounds.
Maternal ward delivery performance
Nosocomial infection reduction.
In each case, the procedures should proceed as outlined above: (1) an identification of the problem, (2) identification of best practices as demonstrated in peer-reviewed clinical trials, (3) adoption of the best…
CancerCenter. (2007). Cancer Treatment Centers of America. Retrieved November 23, 2007, from CCA: www.cancercenter.com
Civitarese, L.A. (1999). Congestive Heart Failure Clinical Outcomes Study in a Private Community Medical Group. Journal of American Board of Family Practice, 467-472.
Dana Farber. (2005). Dana-Farber attains nation's highest honor for nursing excellence; first cancer center in New England to earn Magnet recognition. Boston: Dana Farber Cancer Institute.
Katzan, I.L. (2003). Quality Improvement and Tissue-Type Plasminogen Activator for Acute Ischemic Stroke. JAHA, 799-800.
For example, and elder citizen may consider having the ability to sit and watch television or read all that is necessary to improve their quality of life, and thus demand healthcare services that would allow him or her to do just that.
There are no universal standards that are likely to be accepted by a majority of the population, or even by enough people to consider QALY assessments moral and ethical practices in healthcare (Drotar, 1998). Many also argue that healthcare authorities may favor certain populations including the young adult or pediatric population, based on the theory this group has the greatest chances for survival; this however is often not the case, as there are many older adults that have powerful enough beliefs and mature immune systems so that with proper treatment they might have just as much chance for survival than doctors may assess on first glance (Drotar, 1998).…
Bergner, M., Bobbitt, R.A., Carter, W.B., & Gilson, B.S. (1981) the sickness impact profile: Development and final revision of a health status measure. Medical Care, 19: 787-805.
Drotar, D. (1998) Measuring health-related quality of life in children and adolescents:
Implications for research and practice. Mahwah: Lawrence Erlbaum Associates.
Kaplan, R.M., Bush, J.W. & Berrgy, C.C. (1976) Health status: Types of validity and the index of well being. Health Services Research, 11(1): 478-507.
Clearly, since the focus of these articles are based on an institutional economics point-of-view of healthcare quality, a limitation of the study is that it does not take into consideration other variables that might influence the efficiency of nursing homes in providing quality healthcare. Among these unaccounted variables are the politics behind healthcare, specifically federal laws and policies related to the provision of healthcare. Apart from policies and laws, another variables unaccounted for in this study is a thorough look or analysis of the relational dynamics between patients and nurses, as well as other healthcare practitioners and professionals. This variable is vital in understanding the concept of quality healthcare because it provides an in-depth look at the 'experiential" dimension or perspective healthcare -- that is, healthcare quality as assessed by patients and healthcare professionals/practitioners.
In terms of socio-demographic characteristics, the literature collated regarding nursing home care does not…
(Menzel, 1990, p. 3) Fisher, Berwick, & Davis alude to the idea of integration in health care, with providers linking as well as creating networks of electronic medical records and other cost improvement tactics.
The United States and other nations over the last twenty or so years, have begun a sweeping change in health care delivery, regarding the manner in which health information is input, stored and accessed. Computer use in the medical industry has greatly increased over the last thirty years the culmination of this is fully networked electronic medical record keeping. (Berner, Detmer, & Simborg, 2005, p. 3) the electronic medical record trend began in the largest institutions first, as hospitals and large care organizations attempted to reduce waste and improve patient care, while the adoption has been much slower among physician's practices and smaller medical institutions. (Hillestad, et al., 2005, pp. 1103-1104) Prior to this time medical…
Resources, and Utilization
To analyze and compare the U.S. healthcare, internationally, it is important to know what really constitutes a good health care system. The U.S. Institute of Medicine describes this quality as, "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." This system, in its broad sense, should comprise of two main branches of preventative and curative medicine, both of which should cover different aspects of health, such as travel medicine, school health, occupational health, mental health, reproductive health and so on. Furthermore, a well established health care system does not act independently but in co-ordinance with other industries, such as the agricultural industry. Therefore, since a well developed nation has better access to proper sanitation, housing and adequate nutrition, it is more likely to have a better developed health care system. Other factors,…
Atrash, H.K., Alexander, S., & Breg, C. (1993, Feburary 05). Maternal mortality in developed countries: not just a concern of the past Obstetrics and Gynecology, 15(3), Retrieved from http://www.inamay.com/?page_id=86
Docteur, E. & Berenson, R.A. (2009, August). How does the quality of u.s. health care compare internationally?. Timely Analysis Of Health Policy Issues, Retrieved from http://www.urban.org/uploadedpdf/411947_ushealthcare_quality.pdf
Health care for all: a frameworkfor moving to a primary care-based health care system in the United States. (2011). American Academy Of Family Physicians, Retrieved from Kurt, H. (2008). A success story in american health care: eliminating infections and saving lives in michigan. Healthreform.gov
Mark A., S., McGlynn, E.A., & Brook, R.H. (1998). How good is the quality of health care in the United States? The Millibank Quarterly, 76(4), retrieved from http://www.milbank.org/760401.html
Social, Cultural, And Political Influence in Healthcare Delivery
Social, cultural, and political inequalities are detrimental to the health and healthcare system of the U.S. This is because the U.S. is one of the most multicultural, overpopulated, diverse and undergoing rapid economic growth. The federal government has embarked on efforts geared at addressing unsustainable costs of health care in the U.S. With the leadership of the current president, Barrack Obama, initiatives of containing health care costs will evaluate and explore strategies to contain the growing costs of health care based on a system-wide while enhancing the value and quality of health care (Ubokudom, 2012). The apparent system of health care is rife with opportunities of minimizing waste, delivering coordinated, effective care, and improving well-being and health of all Americans. The government in collaboration with care providers must prioritize cost effective containment strategies with the greatest possibility for political success and non-partisan…
Albrecht, G.L., Fitzpatrick, R., & Scrimshaw, S. (2013). Handbook of social studies in health and medicine. London: Sage Publications.
Armstrong, E.G. (2011). The health care dilemma: A comparison of health care systems in three European countries and the U.S. Singapore: World Scientific.
Bale, J.R., Stoll, B.J., & Lucas, A.O. (2013). Improving birth outcomes: Meeting the challenge in the developing world. Washington, DC: National academies press.
Buseh, A.G. (2008). Empowering resilience: Improving health care delivery in war-impacted African countries: a case study of Liberia. Lanham, Md: University Press of America.
The Foundation called specific attention to the prospect of institutional and policy-level strategies to increase the participation of under-represented minorities in the health professions. In response, the Institute Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Healthcare Workforce came out with a report, entitled "In the Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce." The Committee consisted mostly of academicians, two of whom represented the nursing profession.
In its report, the Committee recognized the importance of increasing racial diversity among health professionals in order to improve access to care, greater patient choice and satisfaction and better educational experiences for practitioners, among other benefits. It also recognized the lack of strategies in reducing institutional and policy-level barriers among health profession educational institutions or HPEIs. In response to the lack, the Committee recommended that health professions education make a clear stand and mission on the…
AHRQ (2007). The national healthcare disparities report, 2006. Agency for Healthcare
Quality and Research, Medscape. Retrieved on June 18, 2009 from http://www.medscape.com/viewarticle/552271
Alabama Nurse (2004). ANA Review: Institute of Medicine report on workforce diversity,
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
Barak concludes by suggesting that the issue and concept of diversity take on a "special urgency" in human service healthcare organizations among the organization as a whole and staff, and that the organization review its quality of service and commitment to the community in order to truly impact the lives of diverse populations.
Managing Diversity: Best Practices
H Management often works off of the ideals of 'best practices.' This concept is discussed in the next article, "Managing the Diversity evolution: Best Practices for the 21st Century Business." Aronson takes a more general approach to diversity but one that can be applied directly to the healthcare industry nonetheless. Aronson points out many of the trends previously identified with regard to diversity problems in the nation's business climate as a whole. In particular the author points out that diversity issues may stem from a number of causes including cultural differences and systematic…
Aronson, D. (2002). "Managing diversity revolution: Best practices for the 21st century."
Civil Rights Journal, 6(1):46
Barak, M.E.M. (2000). "The inclusive workplace: An ecosystems approach to diversity
Management." Social Work, 45(4):339
Contracts with doctors often contain a clause which doesn't allow the doctors to discuss
Health care 7 with their patients financial incentives to deny treatment or about treatments not covered by the plan (Glazer, 1996). This has caused many consumers, especially those with chronic illnesses, to form organizations with the American Medical Association and physician specialty groups to promote legislation forbidding "gag rules" (Glazer, 1996). One group, Citizen Action, has 3 million members and "has been lobbying in state legislatures for laws that would require plans to disclose how they pay their doctors; give patients the right to choose specialists outside the plan; and provide appeals for patients who get turned down for expensive treatments" (Glazer, 1996).
The doctor-patient relationship is also affected if a patient must switch to a new doctor under managed care. Having a longterm relationship with a primary doctor is important because he or she is…
Bennett Clark, Jane (1996, July). What you should ask your HMO.
Kiplinger's Personal Finance Magazine. pp. 92-93.
Glazer, Sarah (1996, April 12). Managed Care. CQ Researcher, 6,
Koop, C. Everett (1996, Fall). Manage with care. Time. pp. 69.
It is true, healthcare is not free. Yet, in an environment where so many are uninsured, it is clear that the free market method of private insurance is not working. This is where the Patient Protection and Affordable Care Act comes into play. All tax payers will see an increase in tax rates in order to help provide quality healthcare for the millions of uninsured Americans in need. Still, "the wealthiest 2% of Americans will take the biggest hit," with the majority of average Americans seeing very little increases in their taxes (Cass, 2012). This ultimately means that individuals making more than $250,00 annually will take the brunt of the tax increases. Also, increased taxes on certain activities, like smoking and tanning, will also help allocate funding for the healthcare reform bill. Still, the government is also allowing for greater tax credits "that start in 2014 to help them pay…
Agency for Healthcare Research and Quality. (2010). Disparities in healthcare quality among racial and ethnic minority groups. National Healthcare Quality and Disparities Report. Web. http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr10/minority.pdf
Cass, Connie. (2012). PPACA's tac hikes are coming" Who pays? Life Health Pro. Web. http://www.lifehealthpro.com/2012/08/09/ppacas-tax-hikes-are-coming-who-pays
INTENET'S IMPACT ON HEALTH CAE INFOMATION
The Internet's Impact on Health Care Information
The Internet's Impact on Health Care Information
This paper explores some of the best and well-known cites and sites around the world for information and health care. Early in the 21st century, the World Health Organization made its first attempt to rank the quality of health care in approximately 200 countries. (NYT, 2007) The WHO ranked the countries' health care based on factors such as fairness, quality, access, insurance coverage, patient satisfaction, and use of information technology among other factors. (NYT, 2007) According to this research, some of countries in the world that provide the best health care overall are France, Italy, Malta, Japan, and Monaco, among others. (NYT, 2007) As much as the United States of America boasts at being the best in the world at nearly everything, United States health care was not in…
Global Health Council. (2012). Health Linkages. Web, Available from: http://www.globalhealth.org/Health_Linkages.html . 2012 August 26.
Mayo Foundation for Medical Research and Education. (2012). Mayo Clinic. Web, Available from: http://www.mayoclinic.com/ . 2012 August 26.
National Institutes of Health. (2012). Health Information. Web, Available from: http://health.nih.gov/ . 2012 August 26.
No listed author. (2007). Editorial -- World's best health care? The New York Times, Web, Available from: http://www.nytimes.com/2007/08/12/opinion/12sun1.html?pagewanted=all . 2012 August 26.
Pennsylvania Health Care
Pennsylvania is a Mid-Atlantic State and is the 6th most populous state of the Union. Its capital is Harrisburg, and its 2010 total gross product of almost $600 billion ranked 6th in the nation. Per capital, Pennsylvania's DSP of $39,830 ranks 29th among the 50 states. The largest employers in the state are Wal-Mart and the University of Pennsylvania. Much of the state is rural, but there are almost 20 Fortune 500 companies located in the state's urban areas. Pennsylvania's population shows a small level of growth, with the state being primarily Caucasian (79.5%), African-American, (10.8%), Native American (.2%), Asian (2.7%), Latino (5.7%), and mixed (1.9%). The state's unemployment rate as of July, 2011 was 7.4% (Pennsylvania, 2012).
Healthcare in Pennsylvania- In 1986, the State of Pennsylvania enacted legislation designed to mitigate the circumstances surrounding the health care crisis in the state. Costs were rising, according to…
House Bill 2053.(2009). General Assembly of Pennsylvania. 2829. Retrieved from:
Pennsylvania. (2012). Commonwealth of Pennsylvania. Retrieved from:
United States and National Healthcare Insurance:
A Winning Proposition?
Physical health and well-being are among the most basic needs and desires of human beings. We all hope that neither ourselves nor our families will ever be the victims of sickness, incapacitation, or any other malady. We hope too that if we ever do require the services of professional Healthcare providers we will not be bankrupted by the expense. Yet, it is a fact of life, that good Healthcare does not come cheaply. Especially in the United States, physicians hospitals, and other forms of medical care are extremely expensive. Like their counterparts in so many other fields, American medical practitioners are among the most highly paid in the world. A serious illness, especially one requiring hospitalization, can spell financial ruin. It is of course for these reasons that so many Americans have Healthcare insurance. Nevertheless even this insurance is very costly.…
1. Allen, Mike. (14 September 2004). "Bush Assails Kerry on Health Care; Democrat's Plan Would Mean More Taxes, He Says." The Washington Post.
2. Clark, C., & Mceldowney, R. (2000). The Performance of National Health Care Systems: A "Good News, Bad News" Finding for Reform Possibilities. Policy Studies Review, 17(4), 133.
3. Kaus, M. (1995). The End of Equality (2nd ed.). New York: Basic Books.
4. (1996). Living as Equals (P. Barker, Ed.). Oxford: Oxford University Press.
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).
U.S. & Norway Healthcare Systems
healthcare system has many advantages and disadvantages which are most revealing when compared to the other health care systems of the world. An analysis between the U.S. healthcare system and a government run healthcare system of Norway provides a deeper understanding of the similarities and differences in the two systems.
Almost every other developed nation in the world has some form of universal coverage which reduces this disparity in care. However, many of these systems are purportedly ridden with their own issues such as high cost and long waiting times. By comparing the U.S. system with the universal system like that of Norway, I can investigate the effectiveness of each in terms of the quality of care provided and the equality of distribution of that care.
A Comparison and Analysis of Healthcare Systems in the United States and Norway
A. United States
The healthcare system…
Goldman, Dana P. And Elizabeth A. McGlynn. (2005). U.S. Healthcare Facts About Cost, Access and Quality [Online]. Retrieved from http://www.rand.org/pubs/corporate_pubs/2005/RAND_CP484.1.pdf
Johnsen, Jan Roth. (2006). Health Systems in Transition: Norway. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0005/95144/E88821.pdf
Tanner, Michael D. (March, 18, 2008). Policy Analysis: The Grass is Not Always Greener: A Look at National Health Care Systems Around the World (policy number 613). Retrieved from http://lib.trinity.edu/research/citing/APAelectronicsources.pdf
The University of Maine. (2001). The U.S. Health Care System: Best in the World, or Just the Most Expensive? [Online]. Retrieved from http://dll.umaine.edu/ble/U.S.%20HCweb.pdf