Healthcare Discussion Questions

Importance of Coagulation

Coagulation is the final formation of a fibrin mesh to trap blood cells in an attempt of the Body’s homeostatic function to reduce blood loss after an injury that damages a blood vessel. Nair & Peate (2013) explain that the coagulation cascade is a three pathway mechanism; the intrinsic, extrinsic and the common pathways. After the fibrin meshwork formation, coagulation retraction occurs (Hoffbrand, 2002). This is a process that serves to clear the obstructed vessel for a renewed blood flow. Hoffbrand (2002) explains that the edges of the damaged vessel wall are brought together. Similarly, the platelets in the clot rearrange to construct the cytoskeleton of the vessel.

Blood – Brain Barrier

The blood-brain barrier is an endothelial layer that separates the brain’s extracellular fluid from the circulating blood in the system by employing a highly selective permeability membrane barrier. Nair & Peate (2013) point out that the barrier poses as an important mechanism for protecting the brain from the fluctuations of the plasma circulation and other circulating agents such as neurotransmitters capable of obstructing or influencing neural function. The barrier acts to protect the brain from pathogen entry minimizing cases of blood-borne diseases of the brain (Nair & Peate, 2013).  The endothelial cells in the brain form tight junctions to achieve this. The junctions and the cells connect with blood capillaries to form a gate that allows health substances such as oxygen to pass diffuse through. To strengthen the capillaries, brain astrocytes surround them allowing for a better connection with the endothelial cells (Nair & Peate, 2013). Common bacterial infections in the brain are very rare due to this separation of the circulatory system from the neural system. This is as a result of the large sizes of bacterial pathogens compared to what is allowed to pass through this barrier (Nair & Peate, 2013). The selectivity on what passes through cuts off antibodies and antibiotics as well hence hindering immune-mediated actions in case of an infection and treatment options respectively. In this case, the permeability feature serves as a protective advantage provided the pathogens stay outside the barrier.Padridge (2005) points out that the brain barrier poses as a security mechanism to the brain; food poisoning instances with neurotoxins such as botulinum can only affect the peripheral nervous system but not the brain. The brain barrier acts to prevent such toxins from reaching the central nervous system where they could be fatal. However, the Blood-brain barrier cells participate in the active transportation of glucose across the barrier (Padridge, 2005).

Also, the barrier is crucial in maintaining the volume of the brain fluid. This is done by constant regulation and limiting of the movement of salts and water from the circulatory system of the organism into the extracellular system of the barrier. Similarly, the blood-brain barrier regulates the secretion of brain extracellular fluid to help maintain the brain volume (Hoffbrand, 2002) Apart from the compartmentalization and protective functions, the barrier allows passage of various substances into the brain. Padridge (2005) points out the earlier scientists such as Paul Ehrlich worked on experiments to determine the exact permeability capability of the barrier by injecting dye into animal models. The organs of the animals would be stained except the brain. The introduction of a dye into the cerebrospinal fluid dyed the brain. This was the basis of molecule size concept in determining what can pass through this barrier. Among the substances that can pass through are those important for the execution of metabolic activities such as glucose which is used for energy needs of the brain. Oxygen passes through the barrier to ensure adequate respiration while amino acids are allowed for the purpose of building proteins needed by the brain.

Problem List

Problem lists are medical documents that serve to identify and state the most important medical problems of a patient such as injuries, non-transitive diseases or any other abnormally facing the patient in the course of treatment. Gartee ( 2011) points out that design of the medical list provides a clear image of the health problems, facing the patient, that require urgent consideration and medical intervention.  Healthcare providers utilize a problem list for purposes of guidance in providing customized care to the patients. This is achieved through identification of the most crucial and life-threatening factors that face the patients (Gartee, 2011). The list ensures that the problems of each patient are on the physician’s radar and concern to ensure effective healthcare delivery.

On the other hand, a problem list significantly contributes to the computerized provider order entry by linking diagnoses to given specific order sets and consequently assisting clinical workflow. This is aimed at linking patient problems with therapeutic medical interventions or diagnoses. Similarly, the provider uses the list to facilitate order entry and associate documentation to definite patient problems (Gartee, 2011). The provider can filter the list, add, review and edit previous and current challenges of the patient; this critically fosters communication and interoperability between health care providers in the different departments.

Computerized Findings

The information-intensive nature of medical work hence includes critical activities that the providers need to partake to ensure smooth workflow. Information processing and flow include collection, documentation of collected data and sometimes retrieval of patient information. All these tasks must be integrated into one piece and verified ( Gatree 2011). Computerized control of information-based practices attempts to minimize time in between the tasks efficiently. Similarly, data integration, sharing, and communication of patient related information are greatly improved. Computerized data analysis soft wares are important is such practices.

On the same note computerized findings on work coordination directly translate to the efficient workflow by eliminating minor communication issues between providers (Gatree, 2011). For instance, phone calls reduce due to electronic data dissemination and utilization tools which are faster. Similarly, there are fewer interruptions due to an organized working force in the system.  Coordination practice involves synchronization, scheduling, and temporally allocation. This spatial dimensions of tasks are reduced in a computerized system regarding the time difference and provider organization during daily operations. Lastly, the coordination saves money while improving patient safety through computerized monitoring and evaluation of the patients. The practice cuts on communication costs due to the cheap nature of computerized communication between providers on the same network.

Charting Time

Mapping key workflow processes are crucial to achieving efficiency and improved patient outcomes. Charting and mapping workflow incorporates a concept of making the invisible visible to allow the practice to find ways of improving process outcomes, efficiency, and error reduction. Computerized systems affect key areas in the charting of workflow processes such as communication, coordination, and paperwork (Gatree, 2011). The automated systems function to reduce the time taken, for mapping key workflow factors and improving efficacy. Similarly, computerized systems function in improving provider productivity. This is exhibited when a comparison between a digital system workload per day is weighed with another workload from a traditional system.

Mapping time is reduced by the quick responses provided by these systems. For instance, data collection and analysis uses lesser time compared to the regular human input on the same.  Similarly, computerized systems allow for quicker cross-referencing and consultations between providers in case of a new idea in the workflow charts. This means that discussions and comparisons are done through online systems rather than the traditional meeting systems which require hours of planning and additional time for provider views on the mapped workflow.  Lastly, computerized provider order entry systems save the provider time that would otherwise be used walking through hospital wards or responding to calls from other providers for clarity on the patient information (Niazkhani, Pirnejad, Berg, & Aarts, 2009).

Problem list on Efficient Healthcare

Healthcare providers are tasked with figuring out how to effectively structure, identify a good problem list for the greater implication on service delivery. Gatree (2011) points out the challenge of defining and being accountable of the contents a medical problem list. The problem list requires attention since it can be used to identify disease-specific populations since it allows for easier data analysis (Gatree 2011). This allows for accurate identification of patients with a common disease in electronic health records. Niazkhani, Pirnejad, Berg, & Aarts (2009) explains that this is used as a preventive measure to successfully contain endemic illnesses. Similarly, quality improvement programs in health centers require the input of medical problem lists to help identify and provide follow-up care in an attempt to confirm containment of disease-specific populations and meeting good healthcare practices ( Gatree, 2011). Standard measures in healthcare and report cards for practitioners utilize information provided by problem lists. This reports directly impact on service delivery to the patients. On the other hand, the joint commission among other roles regulates maintenance of problem lists in a health care organization. The Commission similarly helps in maintaining healthcare standards and accrediting hospitals through regular surveys to monitor the hospital responses towards ensuring the safety of patients.

Advantages of CPOE

Computerized provider order entry can be used to Standardization care (Gartee, 2011). This is because it has a variable mechanism that prompt diagnosis, treatment, and any other specific decisions a physician can order. The specific decisions include that of the optimal use of medication, recommendation of adjunct and additional orders. The CPOE improves the efficiency of care delivery(Gartee, 2011). In a way that the order entry automates a manual task. This will allow the movement of information easily in the organization. The smooth flow of information will reduce turnarounds time for medication delivery.

Advantages of pending order tracking are; the tracking improves the customer services offered.  This is done in a way that it gives the patient the information on where their goods are. Pending order tracking enhances the visibility of the performance of the supply chain. This is because all-important details concerning the package are displayed and can be checked out by a tracking number. The other advantage is that it enables patients to acquire insights into the operation of world-class logistics.To view pending order tracking, the following few steps should be followed. The first step is ensuring one has a order tracking number which will be used to enter google store order entry. Thereafter, one will find the order that wants to be tracked. The next step to click on the “order details” space. The final step is to click on the “track it” space.

 

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