...Healthcare organization use data collection and reporting for a variety of areas and reason. One main reason is statistics for several department/areas. This information is used to increase quality of care, to determine if there is an increase in a specific health diagnosis, as well as hospital census, which will help to determine the level of staff needed to provide that quality of care. The government also needs to maintain statistics on the population in order to provide services. HIM professionals compute most of the data collected for healthcare facilities. They will often be asked to produce an almost limitless number of rates from data collection. All organizations concerned with healthcare collect and use statistics. • Hospitals – use data information for staffing issues and to determine the types of services provided with regards to bed counts. • Cancer Registries – use data information to calculate diagnosis, treatment, and follow-up of cancer patients. • Nursing Facilities – use data information to determine type of payers their patients have. • Home Health Organizations – use data information to determine the types of services used by their patients. • Hospices- use data information to determine the type of illness being treated to pare up with the appropriate caregiver. • Mental Health Facilities – use data information to determine if they are providing the proper services for the community. • Drug and Alcohol Facilities – use data information to show...
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...Management and Budget, in 2013 the United States government spent $1.3 trillion on healthcare, mainly on Medicare and Medicaid, which are the government funded health insurances primarily for seniors and people with disabilities and low incomes. This report not only surprises us but raises a crucial question. Is there a way to reduce the cost of the healthcare, yet provide high quality of medical services? To resolve the high cost issue in Medicare and Medi-Cal, the California state government and the federal government agreed to introduce a new healthcare plan called the Coordinated Care Initiative (CCI), which will combine Medicare and Medi-Cal into one system. The CCI will bring notable plan changes to the people who have both Medicare and Medi-Cal, called the dual beneficiaries. The implementation of the CCI is the solution to the government funded health insurance since it will prevent the abusive use of Medicare and Medi-Cal plans yet provide beneficiaries well-coordinated healthcare and easier access to the healthcare providers. First of all, the CCI is the solution to the high cost in healthcare since it will prevent imprudent use of Medicare and Medi-Cal. Abusive uses of healthcare plans by dual beneficiaries have been a persistent problem. According to the Centers of Medicare and Medicaid Services, the average medical bills spent by the dual beneficiaries, who are 100% covered by their plans, were approximately ten times more than that of beneficiaries who only own Medicare...
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...legislature and regulations on quality of healthcare services The impact of legislature and regulations on quality of healthcare services The health plan exchange program required from the Patient Protection and affordable care Act (PPACA) became in effect as of 2014. This very important piece under the Affordable Care Act (ACA) regulates, that all states would be required to form health insurance exchanges. A marketplace in which people and businesses would be able to purchase healthcare coverage. In California this is what is known as Covered California. In creating these exchanges the state would also need to address different issues to ensure that these exchanges meet the needs of the public. Some of those regulatory issues would include how much the government would need to be involved in the management of these exchanges, structure and governance of the exchanges, requirements for insurance to also offer an option of exchanges and the structure of the exchanges themselves (Hoffman, 2012, p. 881). A few very important steps that may make a huge impact in healthcare regarding these government requires exchanges can be the future reportable results for 13 clinical quality measures set forth in order to compare the different exchanges. Some benefits to the new health plans exchange system is individuals can no longer be denied coverage due to a pre-existing condition or premiums cannot increase due to health conditions. With the new health plan exchange requirement,...
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...other Healthcare facilities have become more scientific organizations. More and more, people are recognizing their need for Healthcare and the importance it plays in their lives. My Museum Hall of Fame will focus on the changes in Health Insurance and its many different policies. The depression in the 1930’s changes Healthcare with Employer-Based Health Insurance, which made health insurance much more accessible to working, middle-class Americans. By the mid 1950’s 45 percent of the population had health insurance coverage. Coverage then skyrocketed and by 1963 about 77 percent of people were covered by some form of Health Insurance. It seems Commercial-Based Insurance companies may have put an end to Employer-Based Insurance, but may have opened the door for insurance to improve and grow in other ways. Development Description Analysis (How does the development affect the current U.S. health care system?) 1. Employer-Sponsored Health Insurance During World War II the federal government controlled employer’s wages, forcing employers to search for another way to attract and hold onto workers. The labor market was suffering because of the increased need for goods and the decreased number of workers during the war. Employers decided on offering workers benefits, such as health insurance as an incentive. Employer-Sponsored Health Insurance is often called Group Health Insurance. Employers are responsible for a large portion of the employee’s Healthcare expenses...
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...Quality Improvement in Healthcare In today's healthcare industry, many facilities search for ways to obtain an advantage from other facilities in the market. One way to obtain an advantage over other facilities is to have a reputation of providing the highest quality of care to the patients. Maintaining and continuously striving to improve the quality of various processes and procedures within the facility is important. Foundation frameworks, stakeholder differences, roles of clinicians and patients, need for quality management, areas to monitor, regulatory agencies, and resources represent the various points that will be addressed throughout the paper. Foundational Frameworks of QI There are several foundational frameworks within the subject of QI. There are several QI models derived from ideas and theories of leaders. According to Ransom, Joshi, Nash, and Ransom, (2008) PDSA/PDCA, API, FOCUS PDCA, Baldrige Criteria, ISO 9000, Lean, and Six Sigma represent various frameworks used to improve the quality of healthcare. Edward Deming described the Plan-Do-Study-Act (PDSA) cycle a plan to learn and improve the quality of work dated back to 1950s. Later Walter Shewhart developed the Plan-Do-Check-Act (PDCA) cycle for the basis for planning and expressing QI endeavors. The PDSA/PDCA model helps the facility to focus on how to plan for the improvement, how the improvement will be implemented, how the improvement will be identified/monitored, and what was learned from the...
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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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...Introduction United Healthcare comes under UnitedHealth Group, the largest healthcare industry in United States. It was established in the year 1977. United healthcare’s goal is to provide quality healthcare to all its members and better serve all the users (physicians, members, employers) with better functionality (tools, services, health benefit plans etc). Strategy Information Systems plays an important role in United Healthcare, as a implementer of business strategy and source strategic advantage/resource. The striving effort of United HealthCare is to provide public with better tools, services and products by conducting innovative research that improves the quality of healthcare and admits to user needs. United Healthcare mainly focuses on delivering quality of health care to its customers. UHC came up with a new strategy called Bridge2Health; an integrated approach which helps users to gain better health. This approach allows the physicians to know more about the member’s health information which helps them to take better decision and provides appropriate guidance. UHC started a new program which assists users in searching for physicians and hospitals depending on their specialization and rating; this reduces users time and cost. The program was mainly established to support users from not being wrongly diagnosed with poor quality care. It consists of “712,622 health care professional (physicians), 5,594 hospitals and 64,000 pharmacies [1]”. This large network allows...
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...Organizational Systems and Quality Leadership Task 3 Organizational Systems and Quality Leadership Task 3 Bronagh Paladino Western Governors University 1 Organizational Systems and Quality Leadership Task 3 A1. The country that I pick to compare to the U.S. healthcare system is Great Britain. According to the PBS Frontline program, “Sick Around The World”, by T.R. Reid, Great Britain uses a government run National Health Service (NHS), which seems too close to socialism for most Americans. For about half of what the U.S. pays per person for healthcare, the NHS covers all U.K. citizens and has better health statistics. (Palfreman, Reid, 2008). According to the World Health Organization (WHO), the total expenditure on health per capita is $3,311 in the U.K., whereas in the U.S., the total expenditure on health per capita is $9,146. (WHO, n.d.). In the U.K. the NHS’s proposition is that the citizens never have to pay a medical bill, no insurance premium and no co-pay. The British pay for their healthcare out of tax revenue as the government owns the hospitals and the doctors are salary government employees. The British pay much higher taxes than the Americans to cover their healthcare. (Palfreman, Reid, 2008). The U.S. healthcare system is based on a regulated market system as it is regulated by state or federal legislation. The U.S. healthcare is paid for by a combination of public and private sources by third-party private or public insurers and out-of-pocket...
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...Healthcare Disparities amongst minorities Racial and ethnic minorities have a predisposition to obtain a lower quality of healthcare than those of non-minorities, even when access-related factors, such as a patients’ insurance status and income, are measured. The sources of these disparities are complex, and are rooted in historic and contemporary injustices, and includes numerous participants at several levels, including health systems, their administrative and bureaucratic processes, utilization managers, healthcare professionals, and patients. Research and studies have found indications that stereotyping, prejudices, and uncertainty on the behalf of healthcare providers can all contribute to unequal treatment. The situations in which many clinical encounters take place - written off as high time pressure, cognitive complexity, and pressures for cost containment, may perhaps increase the chance that these practices will consequently result in care poorly matched to minority patients’ needs. Minorities can experience a range of other barriers to accessing care, even when insured at the same level as Caucasians; which may include language barriers, geographical areas, and cultural familiarities. Furthermore, financial and institutional arrangements of health systems, as well as the legal, regulatory, and political atmosphere in which they function, may have unequal and negative effects on minorities’ capability to reach quality care. A widespread, multi-level...
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...page 1 1. (TCO A). You are a healthcare consultant hired by the Midwest Healthcare System to assist them in developing their organization's strategic plan that will shape the development of a comprehensive network of services for their community. The organization provides the usual array of inpatient services expected in a moderate-sized community hospital. A local nursing home and retirement community is for sale, and the organization is considering the purchase of that agency. There is a regional hospital that is trying to establish a statewide hospital network. There is a local county health department that provides some clinic services, primarily for the uninsured. You’ve been asked to give a presentation to the board of directors on options for restructuring their local delivery of healthcare services. The hospital's president has asked you to focus your presentation on the elements of a comprehensive delivery system and to highlight innovative methods to restructure the hospital. The presentation will lay out the requirements of an integrated healthcare delivery system. (Points : 25) 2. (TCO B). You are the newly hired Vice President of Human Resources for the Bayside Regional Health System. You have the responsibility for all of the usual human resources functions, including retention plans, the training and development function, and the recruitment process. In addition, you have the additional departments of volunteers and the...
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...GDP among developed nations yet it fails to deliver a widespread and affordable health care to its citizens. Will health care reform be able to deliver quality services at affordable cost with its existing workforce crisis in the healthcare system? Number of uninsured Americans has significantly increased, mainly due to aging population and income change. The prevalent issue of America’s healthcare system is insurance coverage, access to healthcare. Americans believe this issue should be prioritized, and it is the direct responsibility of federal government to ensure medical care for those citizens that lack insurance. This essay include history of United States healthcare system, its evolution and how healthcare providers can contain costs of healthcare and provide quality and access to healthcare for everyone. From the beginning of 2014 Affordable Care Act by Obama government is trying to solve the enduring issue of American healthcare system. It is a step in the right direction but this reform is facing lots of resistance from Republican Party, that this reform will put country in debt stress. Many Americans are concerned with quality and access to healthcare with the influx in number of insured entering the healthcare system which is already facing the workforce crisis. United States Health care History Healthcare in United States is enduring issue and it is very sensitive subjects for Americans. United states from the beginning choose a market approach to medical...
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...2010 Edition Nursing: Scope and Standards of Practice Second Edition [pic] American Nurses Association Silver Spring, Maryland 2010 Library of Congress Cataloging-in-Publication data The American Nurses Association (ANA) is a national professional association. This ANA publication ( Nursing: Scope and Standards of Practice) reflects the thinking of the nursing profession on various issues and should be reviewed in conjunction with state board of nursing policies and practices. State law, rules, and regulations govern the practice of nursing, while Nursing: Scope and Standards of Practice guides nurses in the application of their professional skills and responsibilities. Published by Nursesbooks.org The Publishing Program of ANA http://www.Nursesbooks.org/ American Nurses Association 8515 Georgia Avenue, Suite 400 Silver Spring, MD 20910-3492 1-800-274-4ANA http://www.NursingWorld.org Design: Typesetting: Printing: Editorial services: © 2010 American Nurses Association. All rights reserved. No part of this book may be reproduced or utilized in any form or any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from the publisher. Contents Contributors Overview of Content Foundational Documents of Professional Nursing Audience for This Publication Scope of Nursing Practice Definition of Nursing ...
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...2010 Edition Nursing: Scope and Standards of Practice Second Edition [pic] American Nurses Association Silver Spring, Maryland 2010 Library of Congress Cataloging-in-Publication data The American Nurses Association (ANA) is a national professional association. This ANA publication ( Nursing: Scope and Standards of Practice) reflects the thinking of the nursing profession on various issues and should be reviewed in conjunction with state board of nursing policies and practices. State law, rules, and regulations govern the practice of nursing, while Nursing: Scope and Standards of Practice guides nurses in the application of their professional skills and responsibilities. Published by Nursesbooks.org The Publishing Program of ANA http://www.Nursesbooks.org/ American Nurses Association 8515 Georgia Avenue, Suite 400 Silver Spring, MD 20910-3492 1-800-274-4ANA http://www.NursingWorld.org Design: Typesetting: Printing: Editorial services: © 2010 American Nurses Association. All rights reserved. No part of this book may be reproduced or utilized in any form or any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from the publisher. Contents Contributors Overview of Content Foundational Documents of Professional Nursing Audience for This Publication Scope of Nursing Practice Definition of Nursing ...
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...most recent reform in healthcare. The Patient Protection and Affordable Care Act (PPACA) promised to provide quality and affordable healthcare for all Americans, whereby even those people with lower incomes would be able to purchase insurance. This plan has many advantages in that it ensures that no American is shut out of healthcare because they cannot afford it. The statute, however, also has disadvantages. Many companies are shying away from taking care of their employees insurance. The “Cadillac tax” that has been introduced in luxurious health plans has made luxurious insurance way too expensive. The ObamaCare has pros and cons, and some people are for it whereas others are against it. Its execution has been postponed more than once and people are even losing faith in it. About the Obamacare The Patient Protection and Affordable Care Act (PPACA), popularly known as the ObamaCare, was introduced in 2009 and signed into law in 2010 (ObamaCare Facts, 2014). It is meant to make quality healthcare affordable by all Americans. The ObamaCare aims at reducing healthcare spending by enacting provisions that address the issues related to healthcare insurance companies. The healthcare industry in the US is a “private for profit industry” which has been making quality healthcare only available to those who can afford insurance. The healthcare system has been free of imposing change for the longest time. Almost all presidents of the US have proposed healthcare reforms without success...
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...Individual Experiences in Healthcare Services A Qualitative Analysis October 3, 2013 Introduction All individuals need or will need healthcare throughout their lifetime. The issue of care and how people feel about the way they are treated by physicians and staff members, as well as, the cost involved in treatment are vital aspects of patient rehabilitation. If an individual is not satisfied with the healthcare services provided, they will not continue with the treatment plan and therefore, go without managed care which can affect their quality of life. The purpose of this study was to examine common factors and experiences of adult students and to also compare the quality of healthcare among social class. Research Question This study seeks to answer the following research question: What factors affect the healthcare experiences of the adult learner? Literature Review One of the peer reviewed journal articles that I read relevant to this to this subject was titled Practice, Policy, & Perspectives; A Survey Evaluating Patients’ Satisfaction with the Social Work service provided at a Rehabilitation Centre from an Australian Social Work Journal published by Routledge in March 2012. It exemplified the need to develop relationships between patients and the administrators of healthcare services to achieve satisfaction of complete care. The study proclaimed that patient satisfaction is an important indicator in the quality of healthcare. Iliffe et al. (2008)...
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