Raymond is a 54-year-old man who lives in a rural part of Mississippi. He is a skilled worker, but his job does not provide health insurance



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HE003: Delivery of Services

 

Instructions

Write your responses where it reads “Enter your response here.” Write as much as needed to satisfy the requirements indicated. Each item contains the Rubric which will be used to evaluate your responses.

 

 

 

  1. Raymond is a 54-year-old man who lives in a rural part of Mississippi. He is a skilled worker, but his job does not provide health insurance. Raymond does not qualify for Medicaid, and he cannot pay for health insurance. He has not received consistent or coordinated healthcare for most of his life. The closest clinic is over 30 miles away, and he does not have the money for both the co-pays and gas. Raymond has been diagnosed with hypertension, and his family history includes pulmonary embolisms and heart disease.

Emmanuel is 55-year-old man who lives in Jackson, Mississippi. He is an office manager and receives insurance from his employer. Emmanuel has had annual medical and dental exams from the same providers for several years. Emmanuel has a family history of Type 2 diabetes, and he was recently diagnosed as pre-diabetic and obese. Emmanuel received referrals to an endocrinologist and a registered dietitian, and he was instructed to increase his physical activity.

  • Describe the challenges and barriers to access; affordability; and availability for Raymond and Emmanuel. (1–2 pages)
  • Describe the potential social, economic, and health outcomes for Raymond and Emmanuel if prevention had a higher priority in the US. (1 page)

Your Response

Barbara Barton, Irim Azam; 2017

The two individuals discussed have varying barriers and challenges regarding access, availability, and affordability of healthcare and healthcare services. The company that he works for do not provide healthcare insurance.

Raymond cannot afford to pay for healthcare insurance premiums on his own, considering low salary that he receives from the job he is doing. Considering where he lives in, and the distance between him and the closest clinic, this means Raymond cannot access quick and prompt medical case in case of an emergency.  There is no healthcare service provider within the acceptable range.   The fact that he does not have money for gas and co-pays mean that he cannot access the relevant medical assistance.

Residents in of rural arears often experience limited access to the healthcare they need. In order to have sufficient healthcare access, different but necessary services should be available and obtainable for residents in a timely fashion. In Raymond’s case, his different health conditions put his mortality rate at a higher number and his inability to get to a healthcare facility is even more detrimental to his health. Apart from suitable and accessible supply of healthcare services for his community, other provisions such as financial means, transportation abilities and quality healthcare must also be available for Raymond to feel completely safe and healthy. Another barrier for people in rural areas could be their lack of confidence in their ability to communicate and express their health issues with healthcare providers, particularly if the patient is not fluent in English or has poor health literacy.

Barriers to healthcare result in unmet healthcare needs including lack of preventive and screening services, treatment of illnesses, and preventing patients from needing costly hospital care (MacKinney, 2014). I believe his diabetes could have been prevented if he had access to preventative care.

Having access to healthcare is very important as it can be the difference between life and death. The closest hospital to Ray is 30 miles away which mean that he could be in grave danger if he has a heart attack especially with a diagnosis of hypertension. Rural places have lower population densities, resulting in rural residents having to travel greater distances to access health care and in health care providers being less proximate to the people they serve. Health care system redesign policies should include accessibility as a fundamental focus, preserving access to health care when populations are served well and improving access when they are not.” (Mackinney, 2014)

 

Emmanuel, on the other hand, is better off as compared to Raymond. Since Emanuel is insured, he can access healthcare services at any place without any limitation. Having annual medical exams make his health to be easily checked. Emmanuel has been having same medical examiners for many year. This enables him to be served well, as his health can be monitored for better decision making. Considering his family history regarding diabetes, he was diagnosed with pre-diabetic obese, and referred to specialists and given recommendations on physical activity. Healthcare insurance will affect the life expectancy of the two differently. If all things are held constant, Emmanuel will live life longer than Raymond (Ward & Martinez, 2014).

If prevention were considered a priority in the US, all people, regardless of social or economic status would be almost homogeneous. In this context, Raymond and Emmanuel are in different economic and health status. Raymond is unable for medical insurance program, and even his employer could not insure him. If prevention were a priority, everyone, irrespective of financial status would be given free insurance cover for preventive care services. This would provide screening services for blood pressure, obesity, cancer and heart diseases. This would ensure that these diseases are noticed earlier, or rather prevented before they become life threatening. All people irrespective of social and economic status, would live healthier and probably longer. An example of such program is vaccine programs. Imagining that there were no vaccines, or was not available to everyone. Diseases would not be managed. The poor would have been crippled by polio, while those of social ass would be polio free because of vaccination.

Most rural areas have little to no anonymity which creates privacy concerns. Social stigma and confidentiality concerns are more likely to act as barriers to healthcare. If everyone within his community is directed to the same clinic for healthcare, Raymond might have a hard time trusting that his health status is in confidentiality and might be weary of going to the doctor if he felt he would be the ridicule of his town. Although, there is a saying that one cannot put a price on health, Raymond has to work twice as hard to get money and access to transportation so if he feels he is making all of these trips and payments only for him to be the talk of the town he might be discouraged. Also, since he would have to work overtime to be able to afford his medical bills, this might affect his family and put further strain on his health.  Both social economic and health outcomes are intertwined especially in Raymond’s situation. If Raymond has access to a healthcare facility in his environment, he would not have to work as hard to pay for transportation, he would also be able to reach out to his physician should an emergency arise. He would also have access to preventative care which would have reduced his risk for diabetes and hypertension (since he would have been aware of his genetic traits and worked to prevent any major changes that would cause him to go in the same path as his family).

“Medical care is a bit like vitamins when it comes to health… essential, but not adequate alone for good health. You need the whole package… smoking cessation, exercise, weight control, substance abuse prevention and treatment, safe water, housing and so on–the things doctors don’t handle well in fifteen-minute clinic visits. Our nation lacks strong infrastructure in rural population health. Organizations and agencies that are strong in public or population health have little acquaintance with rural issues and communities. Low population density and resulting measurement challenges can become an excuse to not do anything. We’re not likely to turn around the deterioration in the health of rural communities until we get better rural data collection, problem identification, and program evaluation than we’re getting today. This report puts those needs and possible solutions into focus…”

Disparities in the health status of rural Americans exist for a variety of reasons and disease conditions. For most Americans, heart disease and stroke are among the greatest threats to their lives. This is particularly true for rural Americans, where the presence of risk factors such as obesity, diabetes, hyperlipidemia, and hypertension are sometimes greater than in urban areas. In many parts of the country, the consequences of heart disease and stroke are exacerbated by pre-existing contributing factors such as geographic inaccessibility to health care, lack of specialized health services, and lower socioeconomic status. Racial and ethnic disparities may also be more pronounced in some rural setting In addition, rural residents may not have as many opportunities to receive essential education on (1) prevention of cardiovascular disease (lifestyle modification or self-management of risk factors) and (2) recognizing the signs and symptoms of hear disease and stroke. Providing rural communities with more accessible healthcare solutions, as well a targeted population-specific prevention education, should be our primary focus to achieve—for rural Americans—the Healthy People 2020 goal of reducing heart disease and stroke. Elizondo AL, Morgan A; 2012)

 

Rubric

  0

Not Present

1

Needs Improvement

2

Meets Expectations

3

Exceeds Expectations

Sub-Competency 1: Describe how the delivery of care is affected for those with and without insurance about cost, quality, and access.
Learning Objective

LO 1.1: Describe challenges and barriers to access, affordability, and availability for individuals with and without insurance.

Comparisons between patients’ history of care and possible health outcomes are missing. Response inaccurately describes the different challenges and barriers to access, affordability, and availability for the individuals in the case presented. Or, issues of access, affordability, and cost are not discussed.

 

Challenges and barriers do not illuminate differences between insured and uninsured individuals.

Response accurately describes the different challenges and barriers to access, affordability, and availability for the individuals in the case presented.

 

Challenges and barriers illuminate differences between insured and uninsured individuals.

 

Response demonstrates the same level of achievement as “2,” plus the following:

 

Response includes examples about how health insurance affects patient and population health outcomes and impacts life expectancy.

 

Response describes challenges and barriers for a third individual (hypothetically) to highlight additional nuances related to access, affordability, and availability of individuals with and without insurance.

Learning Objective

LO 1.2: Describe potential social, economic, and health outcomes if prevention has a higher priority in the U.S.

Description of potential social, economic, and health outcomes if prevention has a higher priority in the U.S. is missing. Response vaguely or inaccurately describes potential social, economic, and health outcomes for the individuals in the case presented, given an increase in preventative care in the US, or Response does not address the situations of both individuals in the case.

 

Response accurately describes potential social, economic, and health outcomes for the individuals in the case presented, given an increase in preventative care in the US.

 

Response demonstrates the same level of achievement as “2,” plus the following:

 

Response provides examples of two preventative care programs and how they affect social, population, economic, and health outcomes.

 

 

  1. Define the continuum of care process, including objectives and the relationship to organizations and patients. (2–3 sentences)

 

It is a concept whereby all patients are tracked for a long period at different levels and intensity of care. The objective is to ensure that the patient’s health is improved, reduced costs and clear information regarding the medical history of the patient through coordination. Different healthcare organizations that have handled a given patient share the patient’s information to understand the patient better for better services. “Continuum of Care can include a wide set of services, and does not usually refer to a formal system of care delivery. The following are examples of the types and settings of healthcare services that are regularly connected through the Continuum of Care” ( HIMSS HIE Common Practices Survey, n.d)

  • Acute healthcare services
  • Hospitals • Emergency departments
  • Inpatient services • Outpatient services
  • Urgent care • Physician practices
  • Long-term care • Assisted living
  • Skilled nursing facilities • Rehabilitation centers
  • Home care • Visiting nurse services
  • Hospices • Wellness care
  • Government • Care management

 

The Continuum of Care will vary for each patient depending on their unique needs. Common characteristics and conditions include:

  • Prenatal care • Genetic birth defects causing pre-/postnatal morbidity/mortality
  • Genetic anomalies that increase risk of physical or behavioral illness
  • Newborn care • Healthy patient / Preventive care
  • Healthy lifestyle counseling • Unhealthy lifestyle / High risk factor care
  • Acute illness • Acute injury
  • Chronic illness or morbid conditions • Recovery from physical illness
  • Recovery from mental illness or addiction • Rehabilitation for physical injury
  • Imminent death • Deceased – care for the emotional, financial and societal needs of the family, as well as public health and research”

(HIMSS HIE Common Practices Survey, n.d)

 

All of these continuum of care is responsible for a healthier patient and population. The organizations are able to prevent future surgeries and complications. They are also able to share the experience of someone who benefited from Continuum of care with others so as to boost their health. The individuals benefit from it by working to prevent any grave illness that might affect their future.

 

Rubric

Sub-Competency 2: Explain the continuum of care process in a variety of settings.
Learning Objective

LO 2.1: Define the continuum of care process.

Definition of the continuum of care process is missing. Response vaguely defines the continuum of care process. Response defines the continuum of care process, including objectives and the relationship to organizations and patients. Response demonstrates the same level of achievement as “2,” plus the following:

 

Response provides examples that illustrate the benefits of the services along the continuum of care.

 

  1. Describe the following settings and types of care, including objectives and basic components. (2–3 sentences each)
  • Primary care
  • Secondary (general hospital)
  • Tertiary (teaching)
  • Specialty hospitals
  • Outpatient programs (surgery, outpatient rehab)
  • Nursing homes
  • Rehabilitation settings
  • Assisted living
  • Home health
  • Hospice

Your Response

  • Primary Care is where the patient regularly goes for health checkups and when ill for preventive and curative purposes as well as linking al care that a patient receives. It has primary care physician, which coordinates with other specialists. In linear time sequence, primary care is first-contact care and is regarded as the portal to the health care system (Kahn et al. 1994).  Primary care providers follow through the course of treatment and coordinate various activities, including initial diagnosis, treatment, referral, consultation, monitoring, and follow-up. Primary care providers serve as patient advisors and advocates. Their coordinating role is especially important in continuity of care for chronic conditions. Specialty care is episodic and, thus, more focused and intense Buchbinder, S. B., & Shanks, N. H. (2016).
  • Specialty hospitals provide few services, especially cardiac, orthopedic and surgical procedures. It can admit other patients requiring special care, but 75% suffer at least one of the above conditions. It has specialists provide curative services for patients who have a specific type of disease or medical conditions excluding psychiatric care and substance abuse. The two most common types of specialty hospital are children hospitals and rehabilitation centers (Shi, L., & Singh, D. A. 2015).
  • Outpatient programs (surgery, outpatient rehab) contains a team of highly specialized physicians nurses and even social workers. The facility has highly specialized equipment that can be used to treat and provide rehabilitation procedures on patients that do not require overnight specialization. Outpatient services do not require an over-night inpatient stay in an institution of health care delivery, such as a hospital or long-term care facility, although certain outpatient services may be offered by a hospital or nursing home. Many hospitals, for instance, have emergency departments (EDs) and other outpatient service centers, such as outpatient surgery, rehabilitation, and specialized clinics. Outpatient services are also referred to as ambulatory care. Strictly speaking, ambulatory care constitutes diagnostic and therapeutic services and treatments provided to the “walking” (ambulatory) patient. Hence, in a restricted sense, the term “ambulatory care” refers to care rendered to patients who come to physicians’ offices, hospital outpatient departments, and health centers to receive care. The term is also used synonymously with “community medicine” (Wilson and Neuhauser 1985) because the geographic location of ambulatory services is intended to serve the surrounding community, providing convenience and easy accessibility (Shi, L., & Singh, D. A. 2015).
  • Rehabilitation settings is a place where patients are helped to prevent or slow the rate of the loss, restore or compensate for the lost function. Stakeholders include clinicians, caregivers, patients and community members. Rehabilitation hospitalsspecialize in therapeutic services to restore the maximum level of functioning in patients who have suffered recent disability due to an episode of illness or an accident. According to Medicare rules, to be classified as a rehabilitation hospital, 75% of a hospital’s inpatients must require intensive rehabilitation for conditions such as stroke, spinal cord injury, major multiple trauma, and brain injury (Grimaldi 2002). Intensive rehabilitation refers to at least 3 hours of therapy per day. Rehabilitation hospitals also serve amputees, victims of accident or sports injuries, and those needing intensive cardiac rehabilitation. Facilities and staff are available to provide physical therapy, occupational therapy, and speech-language pathology. Most rehabilitation hospitals have special arrangements for psychological, social work, and vocational services and are required to have written arrangements with a general hospital for the transfer of patients who need medical, obstetrical, or surgical care not available at the institution (Health Forum 2001).
  • Secondary hospital is a higher hospital after primary healthcare. It includes health services provided by medical specialists and other health professionals who do not have the first contact with patients. Secondary care is often delivered in a hospital/clinic with the initial referral being made by the primary care professional. Secondary health care can also refer to ongoing services that are not provided in the hospital (Health Issue Center, n.d).
  • Tertiary hospital is bigger and have more specialists who provide tertiary care for patients referred from both primary and secondary hospitals. Has highly specialized staff, and equipment and accompanied by teaching services often for inpatients and on referral from a primary or secondary health professionals and often includes particularly complex medical or surgical procedures (Health Issue Center, n.d).
  • Nursing homes have a set up just like hospitals but are run by nurses mainly who provide medical healthcare. People who are cared are mostly those who suffer from mental diseases like Alzheimer’s disease. A nursing home is a place for people who don’t need to be in a hospital but can’t be cared for at home. Most nursing homes have nursing aides and skilled nurses who are available 24 hours a day. Some nursing homes are set up very similarly to a hospital in which the staff provides medical care, as well as physical, speech, occupational and other therapy. Other nursing homes are created to have a more homey feeling without having a fixed day-to-day schedule and in which staff and occupants are encouraged to have a fluid and more laid back relationship (MedlinePlus, n.d)
  • Assisted living is a facilities where disabled patients or old adults who cannot live independently. Usually, the care given to the patients is paid, and therefore it is a business setting for providing service care. “Assisted living is a great option for individuals who have difficulty with daily activities at home. Residents at assisted living communities are free to live an independent lifestyle, but also receive regular support for a range of daily activities ranging from cleaning to meal preparation. Housekeeping and maintenance services are often included in the monthly rental of an apartment, along with laundry services, utilities, transportation and meals. In addition to enjoying the peace of mind that comes from this maintenance-free lifestyle, residents can take advantage of a full calendar of events, activities, out-trips, and countless opportunities for social engagement. Additional care services, such as medication management or assistance taking a shower, are also readily available” (UMH, Bemis, 2017).
  • Home health is a kind of service that is provided at home rather than in hospital. Home health care is a wide range of health care services that can be given in your home for an illness or injury. Healthcare service provider visits a patient at home for services like injections, nutrition therapy or wound care. Home health care is usually less expensive, more convenient, than and just as effective in hospital care. Some examples of skilled home health services include: wound care for pressure sores or a surgical wound, injections, monitoring serious and unstable illnesses, intravenous therapy amongst others. (Medicare.gov, n.d)

 

  • Hospice is a care where terminally ill patients are attended to, including emotional and spiritual needs. It is not curative center but a place, like home setting where patient’s pain is managed. “Hospice focuses on caring, not curing and in most cases care is provided in the patient’s home. Hospice care also is provided in freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities. Hospice services are available to patients of any age, religion, race, or illness. Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations. Typically, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill individual. Members of the hospice staff make regular visits to assess the patient and provide additional care or other services. Hospice staff is on-call 24 hours a day, seven days a week” ( National Hospice and Palliative care Organization, 2017)

Rubric

Sub-Competency 2: Explain the continuum of care process in a variety of settings.
Learning Objective

LO 2.2: Describe various healthcare settings and types of care.

Descriptions of various healthcare settings and types of care is missing. Response inaccurately describes the following settings and types of care and does not include objectives and basic components.

·  Primary care

·  Secondary (general hospital)

·  Tertiary (teaching)

·  Specialty hospitals

·  Outpatient programs (surgery, outpatient rehab)

·  Nursing homes

·  Rehabilitation settings

·  Assisted living

·  Home health

·  Hospice

Response describes the following settings and types of care, including objectives and basic components.

·  Primary care

·  Secondary (general hospital)

·  Tertiary (teaching)

·  Specialty hospitals

·  Outpatient programs (surgery, outpatient rehab)

·  Nursing homes

·  Rehabilitation settings

·  Assisted living

·  Home health

·  Hospice

Response demonstrates the same level of achievement as “2,” plus the following:

 

Response describes how the services may be coordinated for a particular patient.

 

  1. Describe the personnel who should be part of a multidisciplinary team that focuses on patient-centered care in an inpatient setting. Include at least six disciplines and provide a rationale for each, including each member of the team. (1 page.

Your Response

Nurses

They are one of the important team in an impatient setting. Everything that takes place in a hospital revolves around nurse department. They are the ones that records basic data for patients and send the patient to the right physicians for further examination and care. Caring of the patient is done why the nurse. Prescription of medicine, care of the wound, preparing surgical room and assisting in the process of surgery. Care of the patient until discharge is done by nurse team. They direct patients as they are constantly in contact with them.

Because of the above reason, a nurse is important in a multidisciplinary team as they are able to provide a much more patient centered care as directed by the doctor when the doctor is unavailable. “As the healthcare system recognizes that patient education is crucial to recovery and reduces costly readmissions to hospitals, the role of nurses continues to expand. Nurses are now responsible for following up with patients to provide greater resources to those with chronic conditions, such as diabetes and heart disease. By working with the patients to monitor their conditions, nurses play a role well beyond the hospital. Care coordination fits well with many nurses’ interest in bedside care and their focus on the whole patient rather than an episodic problem.” (LSUA, n.d). Without a nurse on the multidisciplinary team, the patient would not get a more tailored direct care as he/she would with a nurse present.

Doctors

They are the most important part of the team. They have different specialization and attends to patients when called upon. They also make diagnosis and give the goa head to other departments to start testing and or administering medication. They make major decisions reading the best course of action regarding a medical problem, after accessing laboratory results and other evidences based outcome. There are different types of doctors regarding their qualifications. There are senior consultants who are specialists in a given part. The physician also takes medical histories and performs a physical examination to assess the patient to determine a possible diagnosis for both acute and chronic conditions. Diagnosis is a key feature of a physician’s expertise in medical practice and is based on strong assessment skills. Diagnosis is a core cognitive skill, based on both knowledge and judgment (healthipe.org, nd).

Pharmacy department

They are the one who give patients the right medication, after being given the health status of the patient. They are the custodians of the drugs, and anything related to effects of drugs on the body including allergens is the area of their concern. A pharmacist’s unique role is in ensuring the safe, effective, and appropriate use of medications. This involves evaluating the patient for medication-related issues, collecting and interpreting the data, prioritizing the patient’s needs, recommending, implementing, and observing and adjusting the pharmaceutical care plan as needed. “Pharmacists work collaboratively as members of an inter-professional healthcare team to provide patient-centered care by functioning as the medication expert. For example, the pharmacist would evaluate a patient’s drug therapy for appropriate indication, safety profile, drug interactions and interactions with other consumed products such as food and alcohol, and a patient’s response to drug therapy.” (healthipe.org, nd).

Laboratory department

Laboratory technicians are the people who undergoes medical tests according to the doctors’ order. They run various test and submit results to the doctors for further actions. Clinical laboratorians provide specific information that contribute to exploiting the effective delivery of care in today’s intricate healthcare system by guaranteeing that the correct test is performed on the right person, at the right time and producing accurate test results that enable providers to make the right diagnostic and therapeutic decisions using the right level of health care resources available. Without the laboratory professionals, neither the physician nor the nurses would be able to fully understand the depth of a personal illness and or recommend appropriate treatment. (ASCLS.org, 2001)

Dietetic department

Dietitians are one of the patient-centered personnel in a hospital. They are responsible for proving a healthy are recommended diets to patients of different ailments for quick recovery and being fit. Dieticians offers a great opportunity to enhance the overall quality of patient care, advance clinical outcomes, and diminish costs.  When a patient is treated with diseases such as obesity or diabetics, a dietician is the best referral a doctor can give to help prevent the patient from returning to their former self ( Ziegler & Gary & Malone & Parkurst & Quatrara & Tappenden, 2013).

Physical Therapists

“Physical therapists provide services that help restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities in patients with injury or disease. They restore, maintain, and promote overall fitness and health. Physical therapists are the leaders in the rehabilitation that allows individuals with chronic conditions to return to productive lives. Physical therapists also are key health care team members who address prevention initiatives, such as reducing falls, improving physical activity to mitigate chronic disease and secondary health conditions, and tailoring wellness programs for populations that have chronic conditions and/ or disabilities. The enhancement of rehabilitation services is a necessary focus in any reform initiative including a multidisciplinary team. (apta.org, n.d)

 

I believe that each of these healthcare providers bring important but individual skills that is helpful for a multidisciplinary team. Once there is a collaboration of these skills, the patients are bound to do better in their road to treatment and recovery.

Rubric

Sub-Competency 3: Explain processes, roles, and responsibilities in the delivery of healthcare.
Learning Objective

LO 3.1: Describe the disciplines that should be part of a multidisciplinary team for a particular healthcare context.

Description of the disciplines that should be included in a multidisciplinary team is missing. 0775135771 Response vaguely describes or describes fewer than six disciplines that should be part of a multidisciplinary team focused on patient-centered care in an inpatient setting.

 

Response provides limited or illogical justification for inclusion of the disciplines chosen.

Response thoroughly describes at least six disciplines that should be part of a multidisciplinary team focused on patient-centered care in an inpatient setting.

 

Response provides a logical justification for the choice of disciplines included in the multidisciplinary team.

Response demonstrates the same level of achievement as “2,” plus the following:

 

Response describes how team composition and expertise benefit patient outcomes.

 

  1. You are assisting the human resource director at a large general hospital. As part of a report to the chief executive officer (CEO), she has asked you to outline specifi1c roles and goals for at least three clinical, three technical, and three administrative departments (minimum of nine departments). List these hospital departments, and describe the roles and goals of each.  (1–2 pages)

Your Response

Technical department roles

Provide all engineering support and maintenance. This include maintenance of laboratory equipment, biomedical equipment and even electrical equipment that the hospital uses. Technical department is also responsible for environmental issues like waste disposal and management as well as all other environmental services like landscaping. The role of this department is to provide planned corrective maintenance of medical equipment.  The goal of this department is to create functional and safe hospital equipment and environment for the smooth flows of all hospital activities.

  • Biomedical Engineering
  • Solid Waste Management (Clinical and Nonclinical)
  • Health Informatics Analyst

Administrative department

The role of administrative department is to coordinate all functions and departments in an hospital to ensure better service delivery given to patients. This department is also act as a liaison between the hospital and outside stakeholders like government and funders. Development of medical quality assurance and ensuring that all departments’ works towards achieving set standards. Hiring of all nurses and doctors.  The goal for administrative department is to create a conducive environment where all stakeholders feel comfortable and to attain better quality healthcare to the patients.

  • Human Resource Department

This department is responsible for providing customer focused services to employees to enable them to serve patients efficiently. The goal of this department is to create a conduce environment for staff for efficient service delivery.

  • Admissions Department

It records all relevant information regarding the patient as well as signing consent forms before admitting a patient and also facilitate the patient’s discharge process. The goal of this department is to provide seamless admission, record keeping and all data concerning patients for ease of handling customers.

 

Clinical department has several sub departments like department of emergency medicine which covers all emergency services like trauma. Department of medicine concerns with clinical care.

  • Maternity department

To handle all birth-related cases like antenatal care, delivery of babies and postnatal support. The goal is to ensure successful deliveries of healthy babies.

  • Critical care department

It care for seriously ill patients, whose life is at stake. It is also called intensive care. The goal is to ensure survival of patients in the intensive care unit.

  • Nutrition and dietetics

Aims at providing correct nutritional needs for patients that will enhance their healing process. The goal is to see healthy patients through having the right diet in right proportion (“Hospital Departments: Definitions & Lists – Disabled World,” 2018).

 

 

 

 

 

 

Rubric

Sub-Competency 3: Explain processes, roles, and responsibilities in the delivery of healthcare.
Learning Objective

LO 3.2: Define the roles of clinical, technical, and administrative professions in the delivery of healthcare.

Description of the roles and goals of hospital departments is missing. Response vaguely describes the roles and goals of hospital departments. Response thoroughly describes at least three roles and one goal of clinical, technical, and administrative departments. Response demonstrates the same level of achievement as “2,” plus the following:

 

Response describes how the departments work together to achieve organizational and outcome goals.

 

  1. Admission policies can differ between various types of healthcare organizations. Provide compare and contrast how admission policies could differ between for-profit and nonprofit organizations, and how this difference relates to access to care.
Must for-profit and nonprofits admit all patients to their service? When can they turn patients away?  When can they not turn patients away?  How do the services provided by both types of organizations affect patient access to care?

 

Your Response

The for-profit and non-profit healthcare organizations differ in admission policies and other items.  Firstly, the non-profit organizations benefit from this status since the government exempt them in charging levies and the charges that they were supposed to raise are diverted to the for profit health organizations. Here, the tax benefits are assumed to be payment to the community through the provision of free health services. Secondly, the admission policies in for-profit organizations are associated with revenues and profits while their non-profit counterparts simply aims at providing quality healthcare services to the community.

Both for-profit and non-profit organizations earn income by selling products and services. However, while the latter also depend on the private contribution, grants sourced from foundation and more, its former counterpart depends entirely on the products and services that they sell. Therefore, the admission policies in for-profit organizations encourages higher charges to cater for the organization’s financial needs while the non-profit charges less for services since part of their financial needs are met by other bodies.

Also, taxes sets a difference between the admission policies of the two organizations. While non-profit health organization enjoys tax exemption from corporate income taxes, the for-profit counterparts does not. Therefore, this difference is extended to the admission policies whereby the latter charges more to cater for these huge taxes. The implication of the difference in admission policies between these types of organizations on the access to healthcare is that the accessibility is more enhanced in the non-profit health organization compared to its for-profit counterpart (Sloan & Arrow, 2018).

 

Rubric

Sub-Competency 3: Explain processes, roles, and responsibilities in the delivery of healthcare.
Learning Objective

LO 3.3: Explain how admission policies differ in various types of healthcare organizations and how this relates to access to care.

Explanation about how admission policies differ in various types of healthcare organizations and how this relates to access to care is missing. Response vaguely explains how admission policies differ in various types of healthcare organizations and how this relates to access to care; and the differences between for-profit and not-for-profit healthcare organizations are unclear or missing; and/or only one difference is addressed. Response clearly explains two differences about how admissions policies differ in various types of healthcare organizations and how this relates to access to care.

 

Response includes differences between for-profit and not-for-profit healthcare organizations.

Response demonstrates the same level of achievement as “2,” plus the following:

 

Response provides clearly written descriptions of two types of nonprofit and two types of for-profit hospitals and the types of patients they serve.

 

 

 

  1. There are many different organizations and institutions that are major players in the healthcare system. Briefly describe how each of the following influences healthcare: (4–6 sentences each). Please consult at least one reference other than the website in formulating your answer, for each organization.
  • Pharmaceutical Research and Manufacturers of America (PhRMA)
  • Food and Drug Administration (FDA)
  • American Medical Association (AMA)
  • American Hospital Association (AHA)
  • Joint Commission (JC)
  • Centers for Medicare and Medicaid Services (CMS)
  • State Department of Health (student’s state)
  • Centers for Disease Control and Prevention (CDC)
  • S. Department of Health and Human Services

Your Response

Pharmaceutical Research and Manufacturers of America (PhRMA)

This is an association that was founded in 1958 to represent the companies in the industry of pharmacy in US. The objective of this organization was to ensure that the public policies were adhered to. Hence, one of its establishment purposed to achieve this objective was that it encouraged the discovery of new medicine that could be more effective for patients in companies that were registered under this organization.

Food and Drug Administration (FDA)

The FDA is a federal agency in the department of Health and Human services in the US. It aims to promote and protect the public health by controlling the supervision of food safety, dietary supplements, and such stuff. The implication of this body in healthcare is enhancement of safety, hence, promotion of healthcare in the society.  FDA budget is funded by the companies in the pharmaceutical industry all striving to promote health.

American Medical Association (AMA)

This association was founded in 1897 and is considered the largest among all the physician’s associations. The objective of this organization was to unite physicians and communities to ensure that the nation’s health is observed.  Furthermore, this association is responsible for publishing the American Medical Association journals which is considered the most renowned among the weekly medical journals. All activities done by this association are aimed at improving the nation’s health.

American Hospital Association (AHA)

The American Hospital Association (AHA) is a professional association seeking to enhance quality in the healthcare setting. It aims the hospitals and the health networks by providing the public policy that should be followed to ensure quality in health provision. Therefore, information regarding quality provision in all the healthcare service context are provided by this association. The implication of this body in the healthcare setting is that it has improved the outcome of healthcare services by ensuring that hospitals and other healthcare networks adheres to quality standards.

Joint Commission (JC)

This is a US Based non-profit tax exempted organization accrediting over 21,000 healthcare programs.  Being joint implies that it is an international branch that is agreed upon by all the healthcare settings in these counties. Therefore, this form of accreditation is recognized by many countries, mainly US. It is based in Chicago, and it has made the healthcare networks and hospitals to work as per the standards offered by the Joint Commission (JC).

Centers for Medicare and Medicaid Services (CMS)

This is a federal agency that was previously referred to as Health Care Financing Administration. This agency aims to administer the program of medicare. It also partnered with the state government in administering the Medicaid. This agency has promoted affordable healthcare setting.

State Department of Health (student’s state)

This agency also referred to as State Health Agency is a department in the US that focuses on the health of the public. The chief executive official in several states of US takes the topmost position in the executive followed by the chief administration officer. The presence of this agency in the US is that the public health has been promoted.

Centers for Disease Control and Prevention (CDC)

This is the leading national public health in the US that is established under the department of Health and Human Services. The headquarters of this institute is Atlanta Georgia. Like the state department of health, the Centers for Disease Control and Prevention (CDC) aims at protecting the public health. Therefore, an enhanced public safety is the implication of the establishment of this instituted.

U.S. Department of Health and Human Services

The U.S. Department of Health and Human Services is also referred to as health department of the United States. It was initially known as Department of Health, Education, and Welfare. This department strives to ensure that the health of all Americans is protected and that the provision of essential human services is guaranteed. Therefore, this department has enabled the provision of quality healthcare services in America.

 

Rubric

Sub-Competency 4: Describe the organizations and institutions that are major players in the healthcare system.
Learning Objective

LO 4.1: Describe how major healthcare organizations and institutions influence healthcare.

Description of how major healthcare organizations and institutions influence healthcare is missing. Response vaguely or incompletely describes how each of the following influences healthcare:

·     Pharmaceutical Research and Manufacturers of America (PhRMA)

·     Food and Drug Administration (FDA)

·     American Medical Association (AMA)

·     American Hospital Association (AHA)

·     Joint Commission (JC)

·     Centers for Medicare and Medicaid Services (CMS)

·     State Department of Health (student’s state)

·     Centers for Disease Control and Prevention (CDC)

·      U.S. Department of Health and Human Services

Response clearly and accurately describes how each of the following influences healthcare:

·     Pharmaceutical Research and Manufacturers of America (PhRMA)

·     Food and Drug Administration (FDA)

·     American Medical Association (AMA)

·     American Hospital Association (AHA)

·     Joint Commission (JC)

·     Centers for Medicare and Medicaid Services (CMS)

·     State Department of Health (student’s state)

·     Centers for Disease Control and Prevention (CDC)

·      U.S. Department of Health and Human Services

Response demonstrates the same level of achievement as “2,” plus the following:

 

Response provides examples about how patients are directly impacted by two or more of these major players.

 

  1. Define vertically integrated health systems and horizontally integrated systems, including the business goals and patient outcomes. Then, explain the impact these systems have on healthcare today. (1 page) Good start, but more detail, analysis, and use of references is needed.  In addition, there are several statements which are not true as written, and require additional clarification

Your Response

A vertically integrated health systems refers to a set of arrangements whereby the health care organization provides a range of patient care and supportive services either directly or indirectly. This health system is preferable to many people especially those who don’t have a particular health concern and would wish to identify them. The current healthcare system is required to perform a range of services since the concerns in the healthcare market is increasing. Therefore, the market forces and strategic considerations drives the current trend requiring vertically integrated health systems. The business goals of this healthcare system is to conveniently reach many patients driven by the market forces.  With the rise in vertically integrated health systems, the healthcare system today is convenient since people can visit any healthcare organization unlike before when the healthcare systems dealt with a specific healthcare concern.

On the other hand, a horizontally integrated systems comes out as a result of a coordinated and integrated network linking multiple care providers through a mutual ownership or contractual terms across the three main domains, economy, non-economic domains, and clinical domains. The essence of this healthcare system is to provide various services to a particular group of patient population, community or a defined geographical group. Therefore, this healthcare system is liable for any clinical and fiscal issues concerning those groups of patients. The implication of this healthcare system in the current health sector is creating affordable means where a specific group of patients can access healthcare services. Regarding the objectives, the horizontal integrated system was purposed to offer healthcare services to the vulnerable in the society with affordability (“Horizontal Versus Vertical,n.d)”.

 

Rubric

 
Learning Objective

LO 4.2: Define vertically and horizontally integrated health systems.

Definition of vertically and horizontally integrated health systems is missing. Response vaguely defines vertically and horizontally integrated health systems and/or does not include the business goals and/or patient outcomes.

 

Response vaguely explains how these systems impact healthcare today.

Response clearly defines vertically and horizontally integrated health systems, including the business goals and patient outcomes.

 

Response explains how these systems impact healthcare today.

 

Response demonstrates the same level of achievement as “2,” plus the following:

 

Response provides an example of vertically and horizontally integrated health systems.

 

 

 

 

 

 

 

 

 

 

References

Horizontal Versus Vertical. (n.d.). Retrieved from https://www.northbay.org/blog/ceo/2015/Horizontal-Versus-Vertical.cfm

Hospital Departments: Definitions & Lists – Disabled World. (n.d.). Retrieved from https://www.disabled-world.com/definitions/hospital-departments.php

Sloan, F. A., & Arrow, K. J. (n.d.). Commercialism in nonprofit hospitals. To Profit or Not to Profit, 151-168. doi:10.1017/cbo9780511625947.010

Types of Hospital Jobs Available and How to Find Them. (n.d.). Retrieved from https://www.verywell.com/types-of-hospital-jobs-1736336

Ward, B. W., & Martinez, M. E. (2014). Health Insurance Status and Psychological Distress among US Adults Aged 18-64 Years. Stress and Health31(4), 324-335. doi:10.1002/smi.2559

 



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