...THE PRIMARY CARE CLINIC Your name here Professor’s name here School name here Date The Primary Care Clinic Patients in today’s busy world demand convenience which has lead to the rise of local centralized primary care facilities. The purpose of this paper is to look at forces that have influenced the development of the clinic, a mission statement, key performance indicators to measure effectiveness, decisions regarding clinic expansion, the role of the clinic in the community, and influences of public healthcare policy on outpatient clinics. Discuss the key political, economic, and social forces that may have influenced the development of the clinic. Politics can hamper development of private healthcare organizations by compromising quality, limiting accessibility or feasibility, or increasing the cost of healthcare through laws, regulations, policies, requirements of private practice, and monitoring of services (Griffith & White, 2007). The primary care clinic must balance the requirements and regulations of private practice while creating a market for quality healthcare in the community marketplace. The clinic model has advantages over other models in that it allows practitioners a level of economy in sharing their medical facilities, equipment and staff with others, minimizing overhead and allowing them to keep the rising cost of healthcare lower by sharing equity. Improved patient quality is...
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...Financial Managers and Quality Initiatives in Health Care Post University Tina M Dixons Abstract This paper will discuss the importance of why financial manager should be concerned with quality initiatives in the health care setting. The topic will describe why quality initiatives are a key role in the financial success and failures in healthcare. Delivery of healthcare is synonymous with finance and the task related to quality improvement and quality initiatives that support accuracy in documentation and treatment. There is a strong correlation between providers and finance. Key words: Finance, Quality initiatives, Providers, Patient care. Financial Managers and Quality Initiatives It is clear that if good quality of services, successful outcomes and customer satisfaction are presented in a healthcare setting, then the financial stability may sustain. As financial managers collaborate to achieve health care quality, they know that there are several variable factors that must manifest in order to sustain and earn profits for their organization. Some variables include reduction in medical error, appropriate diagnostics, medical analysis, education programs, staff training, prevention, primary care, financial reimbursements, technological advancements and minimizing waste. Error and Accuracy Medscape reported that “Eight years ago, the Institute of Medicine's (IOM) report To Err is Human revealed that between 44,000 and 98,000 Americans...
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...is a need for Advanced Practice Registered Nurses to have expanded ability to offer comprehensive complete care to the public. Republican Senator Cary Pigman who is also a medical doctor has recognized the necessity of this need. He has put forth a bill that would enable nurse practitioners the ability to practice without restrictions within the scope of their practice. He has introduced this bill as well as others to support the ability of nurse practitioners to offer comprehensive care to their patients. All Registered Nurses and Nurse Practitioners need to support these efforts so that we can provide needed primary care services within Florida. HB 547 expresses many changes that are needed in Florida today in medical care. The bill requests the reduction of supervision required for nurse practitioners. One major point in the bill is that nurse practitioners would be enabled to provide care independently of a physician. This bill also would enable nurse practitioners to prescribe medication including narcotics independently. This would alleviate the need for primary care providers to seek other treatment that they may require if nurse practitioners were able to fully treat their patients without restrictions’. There is a primary care shortage in Florida and nurse practitioners routinely fill that void and with this bill enacted it would enable those patients to receive comprehensive care by one provider instead of multiple visits to specialists to obtain the same result...
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...Elderly Health Service, Department of Health, Hong Kong. E-mail: w_m_chan@dh.gov.hk ABSTRACT Care for the elderly was one of the 3 main policy objectives of the Hong Kong Special Administrative Region in 1997. Many policy initiatives have been introduced in terms of financial support, better housing, and long-term care services. For active ageing, an innovative project known as the ‘Elder Academy’ aimed at promoting intergenerational cohesion, which is now under threat owing to changing social patterns. With the rapid increase in the number of ‘old-olds’, more resources on dementia care, community support, professional staff development, carer training, and coordination of care are necessary. In terms of financing, shared responsibility is the only viable option. In the 2012-13 budget speech, a pilot for community care service voucher as a means of promoting ageing at home was announced. As the coming cohorts of elders are more affluent and knowledgeable, they tend to be healthier and have different demands and expectations, such as independent living with better quality of life. The private sector may explore the markets of community care services and elder-oriented products. To meet the emerging needs, a holistic approach should be adopted, with modifications of the labour laws to make use of the talents of elders and to provide more flexible work arrangements for family members to care for elders. Key word: Health services for the aged AN UNFORESEEN SITUATION “Population...
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...HADM 339 – Essay Major themes in health care in Canada include access to services. Identify the issues, identify the changes you believe are needed and discuss the approach you would propose to implement these changes. Simply put, access in the health care sector refers to the ability for a patient to receive the care and services required to maintain a healthy quality of life. Access to health care services continues to be a key issue for Canadians and health policy makers.1,2 Key issues exist in several dimensions of the health care process, including access to a specialist, non-emergency surgery and non-emergency diagnostic testing. More specifically, it is the significant amount of time one will spend waiting for their opportunity to receive these services that remains a concern. Among those who had waited for specialist visits, 29% reported unacceptable waits. This was also true for 17% of patients who were waiting for a non-emergency surgery and 20% for those waiting for diagnostic testing.3 Median waiting times for all specialized services remained relatively stable between 2003 and 2005 at 3 to 4 weeks, depending on the kind of care. Approximately 18% of individuals who visited a specialist indicated that waiting for the visit affected their life, compared with 11% and 12% for non-emergency surgery and diagnostic tests respectively.4 Despite several efforts made by government agencies, access still remains one of the foremost issues identified. Billions...
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...AP Photo/LisA BiLLings Confronting America’s Childhood Obesity Epidemic How the Health Care Reform Law Will Help Prevent and Reduce Obesity Ellen-Marie Whelan, Lesley Russell, and Sonia Sekhar May 2010 w w w.americanprogress.org Confronting America’s Childhood Obesity Epidemic How the Health Care Reform Law Will Help Prevent and Reduce Obesity Ellen-Marie Whelan, Lesley Russell, and Sonia Sekhar May 2010 Contents 1 Fast Facts on Childhood Obesity 3 Introduction and summary 6 Provisions included in the Patient Protection and Affordable Care Act that address childhood obesity 6 Childhood Obesity Demonstration Project 7 Nutrition labeling 7 Community Transformation Grants 9 Broader measures in the Patient Protection and Affordable Care Act to tackle childhood obesity 9 Prevention and public health 15 Primary care and coordination 18 Community-based Care 20 Maternal and child health 22 Research: Doing what works in obesity prevention 23 Data provisions that will help with tracking and providing improved outcomes to measure obesity prevention 25 What else is needed? 27 Beyond health care 29 Conclusion 30 Appendix: The White House Childhood Obesity Initiative 32 Endnotes 34 About the authors Fast Facts on Childhood Obesity Our nation’s children today are on track to have a lower life expectancy than their parents The obesity epidemic poses serious health problems for children including cardiovascular disease,...
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...should select quality measures for reporting such as commonly treated conditions, the types of care that are frequently delivered, the settings in which care is given, quality improvement goals and other quality reporting options that are available or being considered. A couple of options available are Physician Quality Reporting System and Value Based Purchasing. Both programs are based on quality of care rather than the amount of services they may provide. (CMS, 2014) Reimbursement for Healthcare Services Currently Medicare’s reimbursement for service is by the Prospective Payment System. This system is based on a fixed amount for the service provided and also based on the classification of where the service was provided as well. For example, Medicare will provide payment for both the operating and capital-related costs of the acute care hospital as well as the long-term care hospitals. (CMS, 2014). Patient Access to Care When everyone works together to coordinate the patient care, the patient receives better quality care and everyone will see a decrease in costs. Here are just a few options available that could help patients with access to care. Partnership for Patients hopefully will help to reduce the amount of hospital-acquired conditions and help improve the transitions in the care received. Bundled Payments for Care Improvement will seek to improve the patient care by allowing more flexibility in selecting the types of conditions to bundle for the provider,...
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...take the National Council Licensure Examination also referred to as the NCLEX. Following successfully completion the NCLEX, graduates are well-informed to accomplish physical evaluations, and to administer medications. Nursing graduates from these degree programs are similarly well-informed of medical equipment and are proficient in life resuscitating procedures, such as wound care, lacerations, drains, cardiovascular oxygen transport. In today’s nursing environment, more and more are expected from nurses which includes more than just following physician’s orders and commencing IVs. (Forster, 2008)Today’s nurse should be able to make vital decisions regarding a patient’s care. (Forster, 2008)There are significant differences between programs that will ultimately influence nursing care and end-results for patients. (Clarke, Donaldson, 2008)This paper will review the differences in the competency levels of nursing graduates and their functions in an advancing, vigorous health care environment. Due to a shortage of nurses the ADN/ASN programs was established. (Mahaffey, 2002) Although the initiative was only to be a provisional solution, nevertheless the impact of these programs on the nursing profession has been nothing less than outstanding. (Mahaffey, 2002) Today, two thirds...
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...Nursing Professionals In 2010, comprehensive health care legislation was passed by Congress and signed into law by President Obama. These laws were the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act, collectively known as the Affordable Care Act (ACA). The ACA represents the largest changes to health care since the creation of Medicare and Medicaid programs 45 years prior. It is expected to allow more than 32 million Americans to finally afford health insurance. In the same year that the ACA was passed into law, the Institute of Medicine (IOM) wrote a report entitled The Future of Nursing: Leading Change, Advancing Health. The report was designed to show that nursing could help lead the future to a better health care system. A system that will meet the changing and challenging demands that will be realized with the implementation of the ACA. By virtue of their regular, close proximity to patients and their scientific understanding of care processes across the continuum of care, nurses have a considerable opportunity to act as full partners with other health professionals and to lead in the improvement and redesign of the health care system and its practice environment (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine [RWJF], 2010, Chapter 1-2). Because nurses have such a close, direct, and trusted effect on patient care, it stands to reason the IOM...
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...needles, it should require and assist health care providers in offering these services to create a plan of prevention with proper continuity. Agencies must ensure adequate allocation of federal funding to these initiatives. An important policy initiative should include offering routine rapid-testing. Patients are more likely to test when it is recommended by a physician, but many do not because of the time involved and subject matter (Wolf, Donoghoe, & Lane, 2007). Implementation of the ACA provides access to preventative services, and many can access these services without a co-pay or deductible (Office of National AIDS Policy, 2015). A study of the Hawaii Medical Service Association's promotion and prevention services found that those participating in the program found consistently lower health care cost showing the importance of prevention in containing health care cost (Schwartz, Ireland, Strecher, Nakao, Wang, & Juarez, 2010). Preventative services are of utmost importance in reducing the spread of HIV and should be readily available and offered by all health care providers to create cohesive...
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...as the president signed comprehensive healthcare legislation into law. The legislation, cumulatively referred to as the Affordable Care Act (ACA), offered 32 million, previously uninsured Americans, access to affordable health insurance (IOM, 2011). As Americans rejoiced and signed up for insurance, concern mounted as to whether the current healthcare system could tolerate the increased patient load. The nursing profession, in particular, was expected to face several obstacles in response to a transformed healthcare system (Trouble, 2014). According to an article in Health Affairs, addressing these obstacles requires effective production and use of the nursing workforce (Rother & Lavizzo-Mourey, 2009). In an effort to guide the impending increase of Americans expected to seek healthcare, the Institute of Medicine (IOM) along with the Committee on the Robert Wood Foundation (RWJF) formed an initiative on the future of nursing. The 2-year initiative served as an action-based model for the restructuring of the nursing profession (IOM, 2011). The committee identified four key messages that guided the IOM discussion including the future of nursing education, nursing practice and the nurse’s role as a leader. The key messages and recommendations of the initiative on nursing provided nurses with the unique opportunity to further define its role in the healthcare field. Impact on Nursing Education To ensure the delivery of safe and effective patient care, the committee recognized...
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...Washington University Medical Center School of Public Health and Health Services Department of Health Policy Acknowledgments The Urgent Matters safety net assessment team would like to thank our community partner, the Voices of Detroit Initiative (VODI), for its help in identifying key safety net issues in Detroit and connecting us with stakeholders in the community. At VODI, Lucille Smith was instrumental in coordinating our site visits, interviews and focus groups and an essential resource through the course of the project. We would also like to thank Amani Younis for her help in facilitating two of our focus groups. The Voices of Detroit Initiative is a partnership between the leading health system providers in Detroit, federally qualified health centers and the Detroit Health Department. VODI focuses on bringing all segments of the community together to address the issues of access to cost-effective health care for the uninsured. We would also like to acknowledge William Schramm at the Henry Ford Health System for providing us with important information and resources regarding the emergency department at Henry Ford Hospital. The Urgent Matters team would also like to recognize the many individuals in the Detroit health care community who gave generously of their time and provided important and useful insights into the local safety net system. The Detroit, Michigan, Safety Net Assessment would not have been possible without their participation. We are especially...
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...in 1991, the Florida Department of Elder Affairs (DOEA) is authorized by the Older Americans Act (OAA- 1965) and constitutionally designated by Florida voters to “serve as the primary state agency responsible for administering human services programs for the elderly” Fla. Stat. § 430.03 (2014). Furthermore, Florida has two specific statewide laws directed towards Osteoporosis. Fla. Stat. § 381.87 (1996) created the Osteoporosis Prevention and Education Program to promote public awareness of the causes...
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...Health Care Coordination Models: Benefits and Challenges Traci L French Salem International University Abstract: Care coordination refers to several forms of patient care management that is patient- rather than provider-focused and has the end goal of the “Triple Aim”-improved patient experience, improved population health and decreased per capita costs. These goals are achieved by developing healthcare models which promote collaborative care between providers, increase communication between health care entities, actively engage patients in health care and lifestyle choices and rely heavily on health technology to extend provider services, personalize care and monitor quality improvement efforts. The main barriers to care coordination implementation include poor reimbursement for services, difficulties with provider network communications, shortages of trained care coordination personnel and ambiguity in provider roles and responsibility, which can lead to provider accountability issues. When well-established, care coordination models allow patients to form substantive, long-term personal relationships with providers and increase personal accountability for health care choices. These relationships increase compliance with care regimens in the ambulatory setting and decrease costs with overall improvement in patient quality of life. Care coordination refers to several forms of patient care management which is patient- rather than provider-focused and has the end goal of...
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...EXECUTIVE SUMMARY The Marcus Island healthcare system is characterized as socialized medicine where all residents have access to primary care, pharmaceuticals and diagnostic testing. While residents have access to care, they are responsible for a small portion of the payment at the time of service, and in some cases, those who are willing to pay a premium are afforded better access to services. While patients themselves believe their healthcare is either adequate or good, there are several aspects of the Marcus Island healthcare system that suggest care could be better. Specially, Marcus Island’s health care system has been running increasing budget deficits for the past five years. The health care system lacks access to comprehensive services including preventive care and screenings, mental health, dental service, and specialty care. Long wait times for appointments are an issue, as well as continuity of care between providers. Furthermore, there is no system in place to track quality of care indicators. An overhaul of the health care system is needed, including improvements in budgeting and increasing access to the full range of comprehensive health services. In addition, implementation of an electronic health records system would allow for greater continuity of care, improved efficiencies in services, and tracking of quality indicators. DEMOGRAPHICS Demographics: Marcus Island has thirty million residents; the population is growing. Family size is generally...
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