...Introduction There is an increasing need for better management of Long Term Conditions (LTC) within Primary Health Care (PHC) that requires practice development processes and adaption to models of care that are person centred. Within my clinical setting implementation of a pilot scheme is underway with a common vision to work alongside the accompanying community pharmacy for better sharing of knowledge and information to enable optimum care for our mutually registered LTC patients. Analysis of evidence based practice, facilitation of roles and responsibilities, and appropriate health care frameworks will support how a plan is being developed that reflects nursing management and integrated service collaboration towards best health outcomes. Important to note that throughout this essay, reference will be made to Long Term Conditions, Chronic Conditions and Chronic diseases, these terms all relate to the same context. Evidence Mismanagement of chronic conditions is the leading cause of hospitalisations in New Zealand (NZ) (National Health Committee, 2007). The mantra ‘better, sooner, more convenient’ targets the role that primary health care in NZ must assume in order to reduce acute hospital admissions, through better management of patients with chronic conditions and, active support of high needs populations (Ministry of Health, 2011). The World Health Organisation (WHO, 2005) define long term / chronic conditions as having one or more of the following descriptions...
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...Module #4: Chronic Diseases Jonathon Odem University of North Carolina-Charlotte In the article pertaining to Daniel Houser, who is 13 years old and is diagnosed with Hodgkin’s lymphoma. He was diagnosed at the doctor’s office with his parents in the room who refuses treatment right away for Daniel due to religious beliefs. Daniels family thought that alternatives to chemo would be better to Daniel. Once the word got out that the parents were refusing treatment the court ordered that this needed to be investigated for the child’s health. Judge John Rodenburg ruled against the family using the statement “medically neglected” and ordered that Daniel needed to be in the hands of child protective services for his safety. I believe that the court ruling was unfair to the family. The family of Daniel serves the right to make whatever medical decisions they choose. Daniel is not 18 so his voice would not have any role in the decisions therefore it is up to his parents to choose treatment or not. If they felt is if it was morally wrong to their beliefs it is not fair to force the treatment upon them or even taking there child to protective services. If Daniel wanted treatment and parents still refused the treatment I could understand where the court needs to be involved on making the decisions due to maybe a financial problems or something along those lines. In my eyes the policy for cancer treatment should be in the hands of the patient and their family. If the patient...
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...Part 1 Quality Data, a) 75% of hospital patients would recommend the hospital, 67% Maryland average, and 71% national average. b) The rate of readmission for Pneumonia patients is not available for the hospital or the national rate due to data suppressed for one or more quarters by CMS. c) 9.4% of patients at P.R.M.C had a follow-up mammogram, within 45 days, compared to the Maryland average of 9.5% and national average of 8.8%. Peninsula Regional Medical Center in Salisbury, Maryland is above the Maryland and National averages when it comes to recommending the hospital to other people. This hospital rated at average of above average on all questions pertaining to the patients stay, such as level of noise, cleanliness, and information received. The hospital rates all reflect a high level of personal care and attention. The hospital should continue to be heavily patient focused. The rate of follow up mammograms indicates a low-level of cancer missed and a low rate of unnecessary testing. There is no data for readmission with Pneumonia because the “Centers for Medicare and Medicaid Services are not reporting five admission measures and one complication measure due to an issue with categorization of hospitals as better, worse and no different than the national average.” (www.ahanews.com July 9,2013). Since Peninsula rates so highly on patient satisfaction with staff interactions it is important for the hospital to maintain satisfied employees and high morale within their staff...
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...on healthcare quality. Critically evaluate approaches that you, as a healthcare manager, could use to improve the quality of care provided by your organization. Introduction The concept of "quality" has been contemplated throughout history and continues to be a topic of intense interest today. Quality of service is rendered extremely important in any industry and it has been a subject of study and research in many fields. (Reeves and Bednar, 1994) This essay will look at definitions of quality in healthcare; examine the theories of quality in healthcare and approaches taken toward evaluating and improving quality of health services in Uganda’s public health sector with the main focus on the implementation of Millennium Development Goals. The discussion will focus on patient satisfaction as an aspect of quality and how it influences quality of care provided from a District healthcare manager’s perspective, analyse factors that influence patient satisfaction, how the MDGs aim to improve the quality of care provided to patients by exposing the gaps between healthcare management perceptions of service quality and how the service is actually being delivered to the consumers. Social constructionism in healthcare In social constructionism it is important to look at social settings and human way of life when focusing on healthcare in different cultures and societies. Class and social stratification can have profound implications for the way we experience health and illness and...
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...Quality assurance was born in the industrial setting in the 1950s. There it stayed, evolved, and thrived until the early 1990s when it made the crossover into the health care arena, (Sollecito & Johnson,p 20 2013). In the modern era, striving for excellence and the assurance of quality is a staple of health care and, with the transition to pay-for-performance and evidenced-based practices in medicine, it is becoming more important and more visible. In the healthcare setting, quality assurance (QA) teams work throughout the hospital system to design policies and procedures that promote the best possible outcomes for their patients and, in turn, their facility. That means ensuring compliance with a multitude of regulations, policies, and laws...
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...Measuring physician’s quality can enable them to strive for high performance. In order to create an atmosphere where physicians are meeting quality standards there needs to be an improvement program implemented to insure quality. According to article I researched “Performance measurements coupled with feedback (that is, audit and feedback) to health care providers has been shown to improve the quality care. Computerized clinical decision to support can improve quality.” (Persell, Dolan, Friesema, Thompson, & Kaiser, 2010) By using these methods it can increase quality performance and have less medical errors. Offering financial incentives if “performance measurements increase” can create results that are not true to form and have measurement errors. What may happen is physicians “may prescribe tests and treatments to patients for whom the benefits are insignificant because of concern that it will hurt their remuneration or publicly reported quality performance. (Persell, Dolan, Friesema, Thompson, & Kaiser, 2010)” When measuring the assessments if physicians believe that the tools used to measure their performance maybe incorrect what can happen is they may not heed to decision support or they may dismiss the findings even if they are not achieving the results that are expected of them. (Persell, Dolan, Friesema, Thompson, & Kaiser, 2010) In managed care one solution is to incorporate a standardization way for clinicians to record medical exceptions or to look at when...
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...The evaluation of quality in healthcare has a long history. The beginnings of monitoring healthcare quality can be traced back to a surgeon, E. A. Codman from Massachusetts General Hospital in the early twentieth century who advocated for systemic performance assessments of the care he provided to his own patients (Kongstvedt, 2013). The Health Maintenance Organization (HMO) and the application of computers in healthcare in the 1970 led to the large scale ability to analyze data (Kongstvedt, 2013). In the 1990s with increased efforts to control cost and increase quality there were many drivers to implement quality management programs including: a) state laws requiring quality assurance plans in HMOs, b) federal regulations requiring quality...
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...Quality Improvement consists of systematic and continuous actions that lead to measureable improvement in health care services and the health status of targeted patient groups. (hrsa.gov) Improving customer satisfaction can be an overwhelming task. Unfortunately most health care offices (especially specialists) are packed with impatient patients. Even with the implementation of quality initiatives there could still be some challenges. There may be some unforeseen emergencies, among other problems that will arise. The goal is to implement practices that ensure the best patient experience possible. One quality initiative could be giving out surveys to patients after their visit. They would be designed to address any concerns or problems the...
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...Quality and Values Initiatives in Health Care Introduction The relationship between the external quality and value initiatives in health care has been widely discussed in academic literature. Actually, this issue is of great importance as it reflects the role of patient satisfaction in healthcare. According to researchers, “in health care, the whole notion of quality has become a source of confusion and sometimes a distraction from genuine value improvement” (McClellan, 2008, p. 23). Quality is affected by patient outcomes and satisfaction. At the same time, quality helps to determine the value in healthcare. Many quality and value initiatives are aimed at reducing health care disparities that exist in American healthcare system, as well as at improving the quality of care (McClellan, 2008). Generally speaking, various quality of care initiatives contribute to the overall success of any health are organization, including financial success and success of nursing practices. To achieve higher level of quality of health care services, it is necessary to use effective mechanisms, which involve certain changes, such as additional staffing, new equipment, adequate audits, and other changes. Health care organizations should be focused on overcoming any barriers to successful quality improvement. Quality and values initiatives in health care help to achieve this goal. The major goal of this paper is to discuss the relationship between the external quality and value...
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...Development Bank Social Protection and Health Division (SCL/SPH) TECHNICAL NOTE Quality Improvement of Health Care in Belize: Focusing on Results Ian Mac Arthur Jennifer Nelson Martha Woodye No. IDB-TN-661 May 2014 Quality Improvement of Health Care in Belize: Focusing on Results Ian Mac Arthur Jennifer Nelson Martha Woodye Inter-American Development Bank 2014 Cataloging-in-Publication data provided by the Inter-American Development Bank Felipe Herrera Library Mac Arthur, Ian. Quality improvement of health care in Belize: focusing on results / Ian Mac Arthur, Jennifer Nelson, Martha Woodye. p. cm. — (IDB Technical Note ; 661) Includes bibliographic references. 1. Health services administration—Belize. 2. Public health administration—Belize. I. Nelson, Jennifer. II. Woodye, Martha. III. Inter-American Development Bank. Social Protection and Health Division. IV. Title. V. Series. IDB-TN-661 http://www.iadb.org The opinions expressed in this publication are those of the authors and do not necessarily reflect the views of the Inter-American Development Bank, its Board of Directors, or the countries they represent. The unauthorized commercial use of Bank documents is prohibited and may be punishable under the Bank's policies and/or applicable laws. Copyright © 2014 Inter-American Development Bank. All rights reserved; may be freely reproduced for any non-commercial purpose. Ian Mac Arthur, ianm@iadb.org Quality Improvement of Health Care in Belize: Focusing on Results...
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...Running head: QUALITY AND SAFETY IN HEALTH CARE MANAGEMENT 1 Quality and Safety in Health Care Management Murimi Stephen muriets@gmail.com JKUAT December 2014 QUALITY AND SAFETY IN HEALTH CARE MANAGEMENT 1. Introduction 2 Although health care facilities are designed to ensure people are safe, they remain a dangerous place to be (Mitchell, Gardner, & McGregor, 2012). The sources of risks in the hospital include medical errors, falls, and health care associated infections (HAIs). The World Health Assembly (WHA) held on 18th May 2012 passed a resolution that addressed the issue of patient safety and quality in health care (Briš & Keclíková, 2012). WHA called for continued improvements in health care quality and patient safety (Briš & Keclíková, 2012). Therefore, there is a need to evaluate the existent health care systems in order to identify the causes of risks and come up with a plan that can improve health care standards. The plan should also aim at improving the safety techniques applied in other high risk industries, such as the mass transportation, chemical engineering, and nuclear power generation sectors (Shillito, Arfanis, & Smith, 2010). According to the accident causation model developed by Reason in 1990, accidents are caused by many factors that work in concert (Shillito, Arfanis, & Smith, 2010). Such accidents must be prevented by instituting the necessary checks and controls within the system (Shillito, Arfanis, & Smith, 2010). According to Shillito...
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...U.S. Health Care Quality Analysis: Legislative History Following up to the 1999 release of the Institute of Medicine (IOM) report, To Err Is Human, in 2002 a Kaiser Family Foundation survey found that only about 5% of physicians considered medical errors as a primary healthcare concern.[1] Congress, however, did not share the physicians’ nonchalant attitude and gave the Agency for Healthcare Research and Quality (AHRQ) an estimated $50 million towards minimizing medical errors.[2] Senator James Jeffords (R-VT) of the 107th Congress introduced the Patient Safety and Quality Improvement Act (S.2590) to the Senate on June 4, 2002[3] attempting to improve the safety of patients and “…reduce the incidence of events that adversely effect patient safety.”[4] In 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act (P.L 108-173).[5] A section of this law authorized AHRQ to research effectiveness in treatments in order to set a guideline to improve the quality of care.[6] John Eisenberg helped build this program that generates summaries that can help provide health care providers with evidence-based practices that help improve quality of care delivered.[7] Realizing the importance of this research to quality of care, the president signed the Under the American Recovery and Reinvestment Act of 2009 (H.R. 1) into law on February 17, 2009, providing additional funding to continue effective research.[8] This helps to demonstrate the...
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...Quality Oversight in Health Care Organizations HCA 497 Ms. Gloria Wilson September 17, 2012 Introduction A considerable amount of emphasis has been placed on the quality that is provided by the US health care system and substantial investments have been made for research to address the concerns that relate to health care quality. Promoting quality of care is essential for every person within healthcare organizations, from top-level management to non-clinical personal. The quality of care that is provided by every health organizations is not only the core of the whole health care industry, but the reputation of each health care organization (Baily, M., Bottrell, M., Lynn, J. & Jennings, B., 2006). According to the Institute of Medicine quality can be defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Jost, 2003). The oversight of quality in healthcare is acknowledged as a main obligation to healthcare organizations. The purpose of this paper is to discuss organizations and or agencies that provide quality oversight; in addition to, other stakeholders and the role they play in health care. Joint Commission for Accreditation of Healthcare Organizations The Joint Commission for Accreditation of Healthcare Organizations is a, not for profit organization that was established in 1951and evaluates and accredits more...
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...Health care quality can be improved in various ways and which can help in increasing the patient safety. One of the approaches is by developing a better registry for quality. This involves having registries that enable a provider to assess and track how their patients are doing regarding key aspects of care and potential complications so as to identify areas for improvement (Quick, 2013). This measurement identifies opportunities for improvement thus improving patient services and reducing the chances of risk that patient may have. For example, setting up registries and implementing other changes in care delivery helps to improve health care among patients with complicated conditions. It avoids unnecessary costs and delays during an office...
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...Organization The Division of Health Care Quality (DHCQ), a division of the Massachusetts Department of Public Health, oversees the enforcement of both federal and state regulations and licensing procedures for over 6,000 heath care facilities. Its mission statement is as follows: “The Mission of the Division of Health Care Quality is to promote, protect and preserve the health and safety of everyone in the Commonwealth across all settings.” Currently the Surveyor staff is divided into two main groups: Licensing & Recertification and Complaint Investigation, both of which are divided into 4 manager pools. The Licensing & Recertification manager groups are divided by state regions (north, south, west, metro), while the Complaint unit is divided by two specialty focuses (Hospital and Abuse groups) and two long term care (LTC) groups. The Licensing & Recertification section has approximately 60 surveyors, and the Complaints section has approximately 25 surveyors. In the last year, the division has had a change of director (who has since resigned), has lost the assistant director in charge of Licensing & Recertification, and has lost a manager of one of the complaint surveyor pools. Research Initiative The primary focus of this study is to look at the two largest work groups of the DHCQ that both primarily do investigation/survey work for the state and federal government. We will identify the strategic constructs, and focus on recommendations that will lead to improved efficiencies...
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