...The nursing profession is the largest section of the country’s healthcare labor force employing over three million workers. Multiple obstacles stop nurses from responding effectively to the quickly changing healthcare system. Nurses must overcome these barriers; only then will they be able to lead change and begin a new era in healthcare. On October 5, 2010, the Institute of Medicine (IOM) released its advice on nursing in the United State in the scholarly article “The Future of Nursing: Leading Change, Advancing Health.” IOM is a non-governmental, non- profit organization created in 1970, under the congressional charter of the National Academy of Science. IOM provides leaders counsel on the topics of biomedical science, medicine, and health. Different states provide different stances regarding what a nurse can actually do. Multiple states allow nurse practitioners and certified nurse midwives to prescribe medication without a physician’s direction and partnership. There is widespread agreement in the United States that healthcare must become more patient-centric. Primary care and prevention must have a greater function compared to specialty care. Reports shows that states with a greater proportion of primary care providers receive better outcomes and drops in mortality rates. Nurses with differing degrees of education participate in vital jobs in primary care. Education and evaluation are crucial components of primary care. RNs, advanced...
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...report that was obtained in 2010 shows us the importance of nursing in patient centered care and the delivery of more primary care than specialty care as well as the focus of shifting care into the community instead of the acute care setting. If we as professionals can alter this shift in healthcare we will provide advanced quality care, decrease errors and provide better safety. The call for the advanced degree practitioner (APN) and physician assistant (PA) is vast; the IOM report is calling for advanced degree practitioners (APN) and physician assistants (PA) to be able to practice to the extent in which they were trained so that they may be able to take some of the burden off the shrinking medical profession and an already fragmented healthcare system. The hope is by giving the APN and PA a less restrictive role in health care it will help to streamline the fragmented healthcare system as well as significantly bringing down costs. These streamlined plans have already proved effective in the Geisinger Health System of Pennsylvania, U.S. Department of Veteran Affairs and Kaiser Permanente. Comprehensive care was given at a greater value to the patient and the institutions by escalating and intellectualizing the role of its nursing work force. The significance in learning that APN’s and PA’s would eventually take the place of the general practitioner was strongly evident and is now abundantly...
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...SINGAPORE’S INNOVATIVE HEALTH FINANCING SYSTEM Introduction Health care costs are escalating rapidly in many countries. This reflects several factors, such as aging populations, changing disease patterns, high-cost technology and prescription drugs. But, it is also a consequence of health financing systems. Traditional indemnity insurance, which guarantees third-party payment for service provided, contributes to these cost pressures since patients and physicians are shielded from the real cost of those payments. In an effort to contain costs, governments, employers and insurers have modified payment schemes and coverage. This increasingly leads to rationing, restricted consumer choice and, in some cases, denial of care. Singapore’s ‘3M’ health financing system combines universal medical savings accounts (MSAs) with unique supplementary programs to protect the poor and address potential market failures in health financing. The results have been impressive, with excellent health outcomes, low costs and full consumer choice of providers and quality of care. This note describes Singapore’s experience and its possible application to other countries. Background Despite Singapore’s small size, with only 3.22 million residents in a land area of 660 square kilometers, the country has been a stellar economic performer, rising from impoverishment only 40 years ago. Its per capita GDP increased from US$427 in 1960 to US$24,740 in 2000, one of the highest in the world...
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...| | |Risk ,Quality and Performance Management | |Their role in Healthcare | | | |Linda Hyll | |8/5/2013 | | | The purpose of implementing a quality management program should focus on developing and communicating a customer-focused mission, strategies and action plans; listening and responding to the customers’ needs and expectations; encouraging employees to continuously improve and increase their overall job satisfaction, processes and environment and the gathering and analyzing key performance indicators to improve overall organizational and process results. A quality...
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...HEALTH INSURANCE POLICY PROCEDURE Name: Institution: Date: Introduction Many families are unable to afford the high cost of health insurance. These families are living without essential provision of good health. The American citizens when they visit hospital and are diagnosed with major illnesses, are hampered with a huge debt, they are left with worry and pain of figuring out how to pay it. This issue still remains part of a huge political debate in the government. The increasing insurance cost has even affected organizations and private sectors where lesser of these organizations are offering health insurance to their employees. It is the citizens who are left to suffer (WHO 2012). Problem Analysis 47 million Americans have no health insurance coverage, which would account for around 18,000 premature deaths per year (Robinson 2007). United States hast the highest spending in the world yet, among the 30 nations that make up Organization for Economic Co-Operation and Development (OECD), United States on most health indicators ranks near bottom (Robinson 2007). Health Provision is the primary goal for any hospital. This paper seeks to design a policy and procedure that can be implemented in hospital to address this issue. According to a federal report on health care quality released in July 2012, The 2011 State Snapshots report based on key health indicators such as cancer...
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...HMA1: Trends in Healthcare Western Governors University Healthcare Management Case Study HMA1 Linda Gunn August 21, 2010 HMA1: Trends in Healthcare The American healthcare system is in the midst of change. No other time in history has the call for healthcare reform been so strong. It is the emergence of expensive new technologies with an aging population and a new call for equitable quality access of health services for all citizens that have pushed for the impending change. Successful managers will need to understand the impetus for this change. The challenges will provide many opportunities for a manager that is properly prepared to lead and guide their organization. Model trends in the United States. Historically, the United State’s healthcare system has been provider dominated. Physicians ordered and directed care without concern for cost or resources. While complex and ever-changing, the focus was on treatment of infectious diseases such as polio, influenza, small pox. (Shortell & Kaluzny, 2006) Our current model of healthcare places much of the responsibility and burden of the cost of medical care on the individual. American healthcare spending approaches 17% of our gross domestic product (GDP), the highest of any member of the World Health Organization. Our performance consistently underperforms in comparison to our peer nations in such measures as life expectancy, infant mortality and overall level of health. (World Health Organization [WHO], 2000) ...
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...Abstract During this module the class was asked to provide further insight to the following topics as they pertain to the case study and the article written by Zinn titled A good look back over our shoulders Nursing Homes & Long Term Care Management: discussion of the evolution of nursing homes in the United States; what features "shocked" or "surprised" the reader the most during the reading while reading the reader was asked what new information was learned about long term care and facilities in the United States? This assignment also discusses wither regulatory bodies are believed to justified in their formulating so many strict rules and regulations in governing long term care? To close the assignment we answered, how does the past of long term care inform the future of quality assurance in long term care settings? Discuss the evolution of nursing homes in the United States. What features "shocked" or "surprised" you the most? What new information did you learn about long term care and facilities in the United States? Are regulatory bodies justified in their formulating so many strict rules and regulations? How does the past of long term care inform the future of quality assurance in long term care settings? In the twenty-first century, nursing homes have become a standard form of care for the most aged and incapacitated persons. However, historically nursing homes were often thought of dark drab places that Americas would send their elderly when they have...
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...Access to Healthcare in the United States Many would argue that here, in the United States, we have the best healthcare in the world. We benefit from the most up to date medical technologies, medications, and services. People come from every corner of the world to take advantage of our top notch physicians and facilities. One would questin is this reputation warranted, and if so, at what cost? These costs rank us among the highest of industrialized nations (Lundy, 2010). Does this high expenditure equate to better outcomes? According to the National Scorecard on US Health System Performance (2008), the US received a 65 out of 100 possible points. Compared with 19 other industrialized nations, the US came in last place in preventable mortality. Preventable mortality means just that, deaths which could have been prevented if “timely and effective care” could have been provided (The Commonwealth Fund on a High Performance Health System, 2008). In 2000, the World Health Organization performed their first ever comparison of the health systems of the world. They reviewed 191 different countries and ranked them on numerous parameters, the United States ranked 37th for overall health system performance (WHO, 2000). Is it that our healthcare system is truly that poor, or is it that our care is only excellent for those patients who can actually afford it? A universal healthcare system would not only provide healthcare for all, it could also decrease our healthcare spending and potentially...
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...successful or unsuccessful systems? How do these companies use their system failures to enhance learning opportunities for continued company improvement? How should they study this success or failure? The determination was related at workshops directed by the AMIA to enhance opportunities for future successes, with a research agenda and recommendations. The AMIA was convicted to take a leadership role and come up with practical projects that would likely succeed in a health care setting. Introduction In February 2009 Congress appropriated $20 billion for health information technology as a part of the President’s stimulus package. Then the United State joined with other countries to benefit from healthcare technology. Because of the changes made to Medicare and private insurance plans, new paradigm for payments have been made to reflect Value-Based Purchasing (VBP), or pay for performance initiatives (P4P). These initiatives rely on electronic health records to document clinical services. There is growing concerns about how that technology is ultimately designed and deployed. The United States National Research Council advised that nationwide deployment of...
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...Introduction In Health care, quality and utilization management have been forced into the spotlight by an insatiable demand for technologically advancing services, a legal system that compels physician to order unnecessary services, and the costs that are soaring higher than ever. The inconsistent use, overuse, misuse or even under used healthcare services has created inefficiencies and value concerns that demand oversight to ensure the best care is received while utilizing resources in the most efficient manner. "The knowledgeable health reporter for the Boston Globe, Betsy Lehman, died from an overdose during chemotherapy. Willie King had the wrong leg amputated. Ben Kolb was eight years old when he died during "minor" surgery due to a drug mix-up."[i] The Institute of Medicine Committee on Quality of Health Care in America identified strategies for quality improvement through two historic reports: To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century[ii]. The IOM published the "To Err is Human" study which showed that these horrible examples (commonly referred to as "Never Events") were only the tip of the iceberg. The study found that adverse events occurred in 2.9 to 3.7 percent of every hospitalization and that over half of all adverse events had resulted from medical errors that could have been prevented. To apply these numbers across American's nearly 34 million hospital admissions in 1997...
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...INDEX Sl. No. 1. 2. Executive Summary Chapter 1 – Introduction Chapter 2 - Financing Healthcare for the Aged The aged in India—National Policy for the aged--Policy framework for reforms in Health in India— Health of the ageing population in India—Provision of healthcare: Access and Service quality— Financing of Health in India: Public and Private expenditure — Need for financial protection. Chapter 3 – Health Insurance in India Development of Insurance in India—Evolution of Health Insurance in India— Current Perspective. Chapter 4 – Need For Reforms In Health Insurance Existing Regulatory provisions- Need for Reforms from the Senior Citizens’ perspective Chapter 5 - Access To Health Insurance For Senior Citizens Products currently available for Senior Citizens—Underwriting practices of insurers—Affordability and accessibility Chapter 6- Product Design Proper product design—Design mechanisms: Insured persons; Providers; Insurers --- Basic, Standard, Enhanced products—Policy clauses—Health Insurance data—The ‘age’ factor— Overseas Travel Insurance— Government Subsidized and Low Cost Health Insurance Plans for Senior Citizens---Recommendations. Chapter 7– Risk Based Underwriting And Pricing Pricing adequacy and equity—Pricing of the mandatory cover for Senior Citizens—Underwriting based on health status-Affordability -Recommendations. Chapter 8 - Expanding The Coverage Of Health Insurance Socio-economic scenario in India—Penetration of Health Insurance in India—Health insurance...
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...Healthcare in India follows universal healthcare system run by the constituent states and territories if India. Every state in India promotes health and wellness by raising the level of nutrition and standard of living of its people and improves public health. Government hospitals, some of which are among the best hospitals in India, provide treatment at taxpayer expense where drugs are offered free of charge in these hospitals. Government hospitals provide treatment either free or at minimal charges. For example, according to Wikipedia, For example, an outpatient card at AIIMS (one of the best hospitals in India) costs a one-time fee of rupees 10 (around 20 cents US) and thereafter outpatient medical advice is free. In-hospital treatment costs depend on financial condition of the patient and facilities utilized by him but are usually much less than the private sector. For instance, a patient is waived treatment costs if he is below poverty line. Another patient may seek for an air-conditioned room if he is willing to pay extra for it. The charges for basic in-hospital treatment and investigations are much less compared to the private sector. The cost for these subsidies comes from annual allocations from the central and state governments. In the greater India, the hospitals are run by government, charitable trusts and by private organizations. The government hospitals in rural areas are called the (PHC) primary health center. Major hospitals are located in district head quarters...
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...The U.S. health care system is the subject of much differentiating debates. On one side we have those who argue that Americans have the “best health care system in the world”, pointing to our freely available medical technology and state-of-the-art facilities that have become so highly symbolic of its system. On the hand we have those who criticize the American system as being fragmented and inefficient, pointing to the fact that America spends more on health care than any other country in the world yet still suffers from massive un-insurance, uneven quality, and administrative waste. Understanding the debate between these two diametrically opposed viewpoints requires a basic understanding of the structure of the U.S. health care system. This paper will explain the organization and financing of the system, as well as explain the U.S. health care system in a greater perspective. For most people, the frightening prospect of being unemployed, losing health insurance coverage, having inadequate insurance benefits, or living in a rural community without a physician raises one vital access-related question: Will I be able to get the care I need if I become seriously ill? Because of health care's special status, society has an ethical obligation to ensure that all people have access to an adequate level of health care including access to new technologies as well as existing ones, without facing excessive burdens in obtaining such care. Society's recognition and implementation of...
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...Abstract Patients are our primary customers. It is therefore important to measure their health care expectations and strive to meet those expectations 100% of the time. When a patient’s expectations are not reasonable, it becomes imperative to educate so that, over time, reasonable expectations are achieved. Often, perceived medical outcomes are poorly defined and arise from experiences from family and friends. Therefore, an opportunity exists to set the expectation of medical care and subsequent outcomes through education. Patient satisfaction has shown to relate directly to how well the health care team has informed the patient and family of the disease process and its treatment and whether they were allowed to participate in treatment decisions. For quality improvement strategies, health care professionals strive constantly in improving and developing the standards of care. They meet the challenges required of health care providers to be effective leaders who foster a culture and develop partnerships that embrace innovation. Quality delivery As consumer expectations rise, patient care becomes more complex, while resources shrink, leaving hospitals to find extraordinary means to define, organize, and staff quality assurance functions. Improving quality requires a unified hospital consensus about what quality means, who is responsible for it, and how to communicate those quality issues across the institution. Adaptation of a quality management method to organize...
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...Evolving Practice of Nursing and Patient Care Delivery Models The Speech Hello, my fello nurses. Thank you for being here at the Summit of Nursing Evolution. My name is Chhay Yann-Ly and I am a nurse. We are living in an era where the United States (US) health care system is going through tremendous changes and challenges, with sky-rocketing health care costs, fragmented and poor quality of care, high volume of aging population, and passage of the Patient Protection and Affordable Care Act (PPACA) in 2010. A summary of the PPACA is basically to improve the health care delivery system, expand coverage, and control cost (Democratics Senate Gov/Reform, n. d.). With these changes, comes the evolutionary nursing professional transformation process. This speech is a crash course on the evolving practice of nursing and patient care delivery models. The goal of this speech is to discuss the continuity or continuum of care in relation to accountable care organizations, medical homes, and nurse-managed clinics health care models. Since nursing is the backbone of health care, all of these care delivery models require a robust nursing contribution for success (American Nurses Association (ANA), 2010). The first model is the accountable care organizations (ACO). ACOs is a “shared savings” with Medicare (part A & B). The ACO, according to the ANA (2010), is “a collaboration among primary care clinicians, a hospital, specialists and other health professionals who accept joint responsibility...
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