Discussion: Healthcare Administration

Discussion: Healthcare Administration ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Healthcare Administration Instructions and assigned reading is attached below. The instructions are pretty self explanatory. If you have any questions please feel free to ask. The budget for this assignment is $35. Discussion: Healthcare Administration attachment_1 attachment_2 Instructions: This assignment must be done in APA format. A minimum word count of 1600 for the overall assignment (without references included) is required. A minimum of four (4) scholarly references along with in-text citations is also required for this assignment. However, each question ask for different things so please pay attention. Also, although this assignment is in APA format; please keep the question and answer line up (see example below) For Example: Question: XYZ Answer: XYZ Reference: XYZ Note: Please FOLLOW instructions and keep the above format. Each question is separate. DO NOT COMBINE. Knowledge: What are the key things to “know” about each of the 3 systems discussed? Why are they “key” issues? Discussion: Healthcare Administration Comprehension: What is your understanding of why there are three different / separate models? Application: Give an example of one of the three systems as to how it works in real life. A personal story of yours / someone you know or a case study from the research or an example from your work. Analysis: From the example you gave what are the pros and cons of the experience? What casued the events you describe to happen? Synthesis: Offer a new and unique idea of yours or from the research as to how the example you gave could have been handled better. What could have been improved? Your own new idea or a known best practice. Evaluation: Why would your idea be better / same / worse than what happened in your example? Has your idea been tried / practiced before? How did it work out? Or why hasn’t it been tried? Obstacles? Instructors Note: Each of these needn’t be long or expansive. Brevity is the soul of wit (Shakespeare). Practice efficiency and directness in your answers. Get to the point quickly. Avoid unnecessary “backfill”. Every word needs to make a contribution to the end points that you intend to make. Part Two Write a 150 word response to each discussion post. A minimum of two references per post is required. In-text citations must be included and cited properly. Note: Write the response as if you are talking to a person in person. Post One Knowledge Hospitals: Hospitals are a very complex organization that can offer a large array of services and provide minor care and all the way up to severe trauma cases that require life support (Williams & Torrens, 2008). Long term care facilities/programs: Long-term care is any type of care that requires a degree of time to either heal from any type of injury, surgery or illness and can also be a form of assisted living for the elderly and disabled. Mental Health efforts: Mental health is based on a population-based public health model that is characterized by the concern for the health of a population and the physical and psychosocial environment (Williams & Torrens, 2008). Mental health is a very vague diagnosis because there are many types of mental illnesses that can range from a mild form of ADHD all the way to severe psychosis. Comprehension Hospitals- Hospitals are more focused on acute care and treating the condition that the patient is currently presenting with, whether it be an emergency room visit, surgery or outpatient testing. Some hospitals also offer hospice care, which is typically care for terminally ill or elderly patients who are nearing the end of their lives within a few days to a few months. Long term care facilities/programs- Long-term facilities differ from hospitals in the fact that they focus on a longer-term type of care, which typically last months, years or until the person passes away. There are many levels of care involved with long term care facilities that are all dynamic in their own ways. Two examples of different types of care would be assisted living that is self-pay that is accredited by JCAHO and requires only personal care staff while hospice is primarily paid by Medicare and accredited by JCAHO and CHAP and requires multiple professional staff led by an MD (Williams & Torrens, 2008). Mental Health efforts- Because any type of mental illness is classified as such, it does not differentiate levels of intensity or minor disorders that could be very mild versus more dangerous or high risk. This can be an issue when addressing mental illness because there are some mental illnesses that are highly managed while others prohibit the individual from being a productive member of society and carries a high risk of harm to themselves or other. Being able to address and properly label mental health is important for future development and treatment for these individuals. Discussion: Healthcare Administration Application Hospitals: Hospitals started off as an institution for the poor and ill, however with new advancements in technology and the focus on clinical medicine we are able to provide patients with a vast array of services and care (Williams & Torrens, 2008). American hospitals were started by religious, ethnic and community groups to serve healthcare needs and this was created by the immigration into eastern cities that required the creation of education and service facilities to serve these populations (Levin, 2011). Catholic sisters were all over the country establishing schools and hospitals to provide medical care for the sick as well as spread their religious beliefs and this all occurred between 1850 up until the 1950’s. Shortly after the 1950’s, hospitals started losing its religious affiliations due to woman playing more of a leadership role in other aspects in society (Levin, 2011). However, Catholic-affiliated churches made a comeback from 2001 to 2011 by increasing by 16% while non-profit hospitals declined in numbers (Melling, 2015). Non-profit hospitals are down in numbers primarily due to lower reimbursements and are no longer profitable. Long term care facilities/programs: Long-term care facilities and nursing homes are an integral part of the final years of elderly, terminally ill or disabled. Since the population age is increasing, the need for long term care increases and although the majority of long-term care is provided by family and friends, there are different levels of care that is needed (Williams & Torrens, 2008). These services have increased over the years and is being closely monitored by governing agencies such as the Joint Commission. These are being closely monitored because these long term care facilities are primarily paid for by Medicare & Medicaid Services and they have set standards that need to be in place for effective nursing home compliance in order to receive reimbursement and be compliant for the Patient Protection and Affordable Care Act (Herrmann, 2018). Mental Health efforts: Mental health care and efforts have grown significantly from decades ago with both how the patient is treated and diagnosing these patients. We have developed our technological aspect of healthcare that is able to better understand, diagnose and treat mental health disorders. MRI now offers a model that can diagnose ADHD and Autism, both of which cannot be easily tested or diagnosed like many mental health illnesses (Sen, Borle, Greiner & Brown, 2018). Advances like these allow us to look at mental illness better than ever and to be able to properly care for these patients. Analysis Hospitals: The biggest issue with hospitals are the government tax cuts, with $3.6 billion dollars cut in 2018 and even more expected for 2019 (Phillips & Hoban, 2018). These cuts are detrimental to healthcare facilities and decreases services and offerings to the communities. With so many advancements in healthcare, we have access to many services and life-saving treatments that may be harder to receive if the government keeps cutting funding to hospitals forcing more and more hospitals to close in the near future. Long term care facilities/programs: Long term facilities, although they offer a range of different levels of care, serve primarily as a bridge between being hospitalized and returning to as normal of a life as possible with the assistance of trained professionals (Bowman, 2015). A big problem of these facilities is that many patients are back and forth from these facilities and hospitals because they are either discharged too quickly or the facilities do not have the proper resources to handle some critically ill patients. Being able to close the gap and have a better system in place would most likely prevent these readmission rates that are up to 25% in a 30-day period for those who were admitted originally for heart failure. Mental Health efforts: Society has started to change their perspective on mental health from a time where we used to reject people who had mental illnesses and diseases into an asylum to now being able to get a better understanding and classification of mental illnesses. Mental health efforts have increased with insurance coverage being increased for those between 19 and 35 years old ever since the Affordable Care Act was passed to better care for mental health that was once ignored (Olfson, 2018). This unfortunately decreased the coverage for older patients. Synthesis Hospitals AND Long-term care facilities: Because hospitals and long-term care facilities can be closely related, having high-risk individuals that are terminally ill or need 24/7 assistance would be best if hospitals adopted long term care as part of their services. This would be implemented in an attached building or a certain floor within the hospital that acts as a small home for the patients whether it be for a few days or few years. These patients would essentially be living in a hospice/assisted living type of room and would have access to hospital services such as x-rays, lab work, rehab and other services that may be needed. It would be for terminally ill or high-risk patients that cannot be cared for at a nursing home. Mental Health Efforts: An idea for mental illness would be labeling it green, yellow or red to differentiate risk, dangers, etc. of each patient to protect staff and patient from harm. This would assign those with no or low-risk and mild mental illnesses to be labeled as green and those with red labels would be those that have suicidal or homicidal ideations or have psychotic breaks. At my facility, we are the first hospital in North Carolina to be “dementia friendly” by labeling patients that have dementia with a picture of a seahorse outside the room, this allows staff such as radiology know that this patient may have a breakdown and may not comprehend procedures and this would be the same as labeling the outside of these patients with mental health issues that could save staff or the patient from harm. Discussion: Healthcare Administration Evaluation Hospitals AND long-term care facilities: Having a hospital and long-term care facility integrated into one space can be a challenge due to limited space, resources and money that many hospitals face. It would be challenging to evaluate what patients qualify for this living, someone who is constantly in and out of the hospital with illnesses and falls versus someone who has terminal cancer and has no family to take care of them may be hard to decide and evaluate who would be the best candidate for that type of living. However, those who are able to stay there would benefit most from the services and the continuous care that may not be offered at at-home care, nursing homes and other assisted living facilities. Mental Health efforts: Labeling a patient’s room as green, yellow and red may raise some flags for patients and visitors and may even agitate patients more that they are being labeled as high risk if they find out why they are labeled the way they are. However, this would help communication with staff that may not know the patient’s history and can avoid harm to all that may be involved in the patient’s care. Post Two Knowledge: Hospitals are entities that provide services that are related to an acute illness or injury. These services range from emergency care, inpatient care, and surgical services. These services are only provided to the patients for a short period of time. Once the illness or injury is treated the patient will be discharged home or possible to another type of institution for long-term care. Long-term care is a type that will need to be provided for an extended period of time and can a wide variety of things. This focus of this care is to assist with a person’s daily living needs. These services include physical and mental disabilities and are not just limited to medical care. These services include rehab facilities, nursing homes, home health and assisted living. This is only a small list of examples. Mental health services are services provided to those who need mental, behavioral, and emotional support. These services can be provided on an inpatient and outpatient bases. These services are provided to those with an actual mental disorder such as bipolar disorder and also to those who don’t such as an addiction. These services also include emotional support for those who may have recently lost a loved one or any other type of change that can be difficult to deal with. Comprehension: Healthcare in the United States has been called a “broken system” for many years. These three types of healthcare are “fragmented” pieces that provide a comprehensive healthcare system. The way this comprehensive care system works is that the pieces work together to provide care. The patient goes to the hospital for their acute illness or injury. After the treatment, the patient could be discharged to home with home health and or physical therapy or to a rehab facility or long-term care facility or even a mental health facility. The healthcare professionals at each of these facilities work together to provide comprehensive care to each patient. This care has a greater comprehension when the facilities are affiliated with each other or if there are associated physician groups. The viability of each group is reliant on their comprehensive work. This is largely due to the advancement of ambulatory care, technology, and money. When two of the pieces are not comprehensive then the system is broken. Application: Vertical integration is beneficial in comprehensive healthcare. Vertical integration is when many different health care delivery systems are integrated together (Williams & Torrens, 2008). I currently work for a healthcare system that has recently increased their vertical integration and will further that in the future with the possibility of creating a specialty hospital within the system. The system has increased their vertical integration due to the location of the system and to provide a greater comprehensive care to those in the communities it serves. The system that I work for is made up of six hospitals, a free-standing ER, two rehab facilities, EMS, a cancer care center, a free-standing imaging center, surgical center separate from the surgery within some of the facilities, home health, hospice, mental health facility, walk-in clinics, numerous PT sites, and numerous family care physicians. By having this much integration the system is able to provide comprehensive care and keep patients within the system for a majority of their care. This integration is key because of things of rural hospitals closing and because of the previously stated; ambulatory care and technology advancement and money. The integration and healthcare are all about the money. Discussion: Healthcare Administration Analysis: These three pieces are all different and each of them has their own responsibility to the overall healthcare system. Due to the advancements in ambulatory care and technology and money (which is largely reimbursements and payments) these three pieces are being affected in different ways yet each of effects on one-piece bleeds over to the others. That being said these three pieces have to find ways to help each other to decrease the effects and stay viable. This is especially important for smaller and rural communities. This comprehension is not only good for the patients because it should provide a higher quality of care, but it is also good for communities via jobs and revenue. Since money is the root of the problem if there is no cohesiveness and comprehension then it is going to impact one of the pieces by cause closures and loss of jobs. Synthesis: Comprehensive health in the United States is a complicated issue. To help combat this the three pieces (Hospitals, LTC, and Mental Health) have to work together to ensure the patients do not fall through the cracks and receive all of the necessary medical and non-medical care. The new idea that I have is for each patient in a hospital, either during their stay or near discharge, have a patient care meeting revolved around the future of their care. These meetings would consist of their primary hospital physician (or someone from that group), LTC specialist/mental health specialist (some representative from the type of care that will be received after the hospital), a case manager, and a social worker. More than one patient can be discussed at each meeting, but each patient will have a future plan of care once the meeting is over with. Each patient or patient representative can be involved directly in the meeting and decision-making process. This idea is especially important when the system vertically integrated. During my research, I found a study from Norway where the team concept was used in a rehabilitation setting. The study reported that this team concept had better patient-reported continuity of care and higher ADL-benefit scores (Hustoft, Biringer, Gjesdal, A?mus, & Hetlevik, 2018). Evaluation: This idea will allow each patient to be involved in their care process which should be beneficial to the patient’s outcome. It will also allow each patient to receive the comprehensive care each one deserves. This meeting will not allow the patient to fall through the cracks or miss any type of necessary service. The negative part of this idea is that it requires a number of people to be at this meeting which can be time-consuming. I believe that these meetings should occur every day or almost every day, which is also time-consuming and possibly costly. An unexpected consequence is that the patient does not agree to the care or does not want the care. There is also the possibility that the patient will back out of the planned care. There is also the possibility that the patient may not be accepted to any facility which leaves the hospital to care for the patient or there could be an issue with the patient’s insurance. Post Three Knowledge Hospitals provide “specialized” care to the patients that need these services (Patterson, 2017). These services include “intensive and critical care units, acute and chronic care” (Patterson, 2017; Winpenny, Corbett, Miani, King, Pitchforth, Ling, . . . Nolte, 2016). In addition, some hospitals offer emergency and trauma services, and perform surgeries. Different hospitals have different missions (e.g. “profit, non profit, specialty, horizontal/vertical integration, community”) [Williams & Torrens, 2008; Winpenny et al., 2016). Hospitals are finding ways to increase their income by making processes to care for outpatients also (Vogenberg & Santilli, 2018). Rural hospitals are the beacons of hope to bridge the gap in the lack of healthcare services for the people living in those communities. One of the ways for hospitals to survive is the capacity of their leadership to “recruit and retain surgeons” (Yoshinor, Yuichi, Sayaka, Hiroto, Hiroshi, & Tomohiro, 2018). This will give the hospital a competitive advantage. The viability of the hospital seems great due to the “specialized” services that they offer of emergency, “critical care”, and trauma (Patterson, 2017; Winpenny et al., 2016). Some services may be provided on an “ambulatory basis” but not all services (Williams & Torrens, 2008). The use and role of long term care is to provide assistance to people that need help with “functional disabilities” (Williams & Torrens, 2008). The patients need some assistance with their conditions. “Residents centered care” is the model in the long term care industry to teach clients to have autonomy as much as possible (Azios, Damico, & Roussel, 2018). The main reason for these long term care setting is to help people get better. The challenges is to change the attitude of the staff and the culture of the place to be dedicated to helping the patient get better (Azios et al., 2018). Not all long term care places have this problem, but the environment is a challenging place to work. “Dementia” is one of the problems that results in disability that requires assistance to the patient (Chenoweth, Jessup, Harrison, Cations, Cook, & Brodaty, 2018). Sometimes “antipsychotic drugs” are recommended as treatment, but they have side effects (Chenoweth et al., 2018). Adequate inservice training is beneficial to staff to prepare to work in this setting. The expected “increase in the elderly” group of people will increase the need for long term care (Kokonya, 2018). This will provide the opportunity to build more “long term care facilities” (Kokonya, 2018). Discussion: Healthcare Administration Behavioral services help clients to resolve internal crisis and non crisis with mental health concerns [e. g. “Depression, suicide, anxiety, substance abuse, mild intellectual disability, eating disorders”] (Cleverly, Gore, Nasir, Ashley, Rich, Brown, Hanssman, Holmes- Haronitis, Villafana, Kish, & Leavy, 2018). When hospitalization is needed for mental health, care providers can help them to transition back into life with less interventional services. Comprehension Hospital administrators can obtain feedback from patients through “Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys” and in other ways (Patterson, 2017). This will give some insight into what processes and procedures are working and which ones are not working. This will enhance the determination of the viability of the hospital. The scores and comments will allow the administrator to focus on adjustments that need to be made to improve in those areas that have deficiencies. According to the American Hospital Association, (n.d.), “71% of hospitals or health systems” plan to join together with “providers and payers” to enhance health care delivery in the immediate future. Application The Hospital Corporation of America has several hospitals across the country as an example of horizontal integration (HCA, n.d.). I worked in a long term care facility, Mur-Ci Homes, Inc as a supervisor several years ago. The facility served the needs of clients with developmental disabilities. Some of the staff falsified documentation and I had to take disciplinary action for their error. I was not popular or liked, but I had to be an advocate for the clients. It is challenging to work in that setting and it was challenging to obtain adequate staffing for the facility. Vanderbilt University Medical Center’s Psychiatric hospital offers behavior, health for “inpatients and outpatient services” (Vanderbilt Health, n.d.). Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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