Tag: Healthcare

Communication Modality Used For Marketing Healthcare – Assignment Instructions

There are a variety of communication modalities available to health care consumers and health care providers. These modalities and venues of communication may entail benefits and challenges to both consumers and providers.

Select one communication modality used for marketing in health care.

Write a 700- to 1,050-word paper about a communication modality used in health care. Include the following in your paper:

  • Identify one specific mode of communication used by consumers and health care providers, such as e-mail, a web-based forum, or electronic medical records.
  • List and discuss the following:
    • One benefit to the patient
    • One aspect relating to the values and importance of maintaining patient confidentiality when using this mode of communication
    • One reason this mode is an effective means of communication between consumers and providers
    • How does this mode of communication differ from others?
    • How might media and social networking change communication in health care?
    • How is this mode of communication used to market health care products or services, if applicable?

Include a minimum of three peer-reviewed references, not including the textbook.

Format paper consistent with APA guidelines.

Statistics and Statistical Forecasting Process In Healthcare

Statistical Forecasting Process

Forecasting process involves a number of steps that need to accomplish. These steps assist in broadly define and identify the tools and need of health forecasting. According to Wright, Lawrence and Collopy (1996), healthcare forecasting process requires the use of framework containing dynamic process. The process involves seven main steps. The first step involves identifying the ideas and concepts which address a significant health condition which is of significant cost and great burden to the health care service.  This offers a precise health outcome specification to be forecast and a clear forecasting horizon of definition. The second step entails the use of literature to acknowledge highly correlated and casual variables which are related with the identified health results measures in step 1 (Ganguly & Nandi, 2016). The third step involves data sources identification for both measures of health outcome and all of the possible predictors, and ascertaining the completeness and availability of data. The fourth step involves preparing the sets of data for primary statistical analysis that include descriptive patterns and the forecast algorithms development. Some primary activities include data management and cleaning, and the supplementary variables generation for further analysis. Step five involves the generation of predictive models and their validation by use of various sets of same historical data. The sixth step entails determining and evaluating the final indicators lists required for great predictive model founded on the practical access to other data. The final step involves developing tailor-made and very unique health forecast services for unique client or purpose and for to update the model periodically (Ganguly & Nandi, 2016).

Example of Statistical Analysis Tools Used for Forecasting

Techniques of forecasting can be groups in two extensive groups that include qualitative and quantitative. Quantitative techniques are highly used in healthcare organization. These techniques involves mathematical models that include neuro network, moving average, expert system, regression, straight line projection, simulation, and exponential smoothing among others. Some of the forecasting tools that will be used to enhance data analysis in healthcare system include a time series. Time series refer to gathering of sequentially measured observations over time. Thus, time series forecasting is thus a statistical model method or tool where the same variables past observations are analyzed and collected to create a model describing the underlying relation (Ganguly & Nandi, 2016). There are excess of techniques to time series modeling which include traditional statistical methods which comprise of Autoregressive Integrated Moving Average (ARIMA), exponential smoothing, and moving, or nonlinear complex models that include the Autoregressive Conditional Heteroscedastic (ARCH) model, Threshold Autoregressive (TAR) model, and bilinear model. Nevertheless, as a result of its implementation and understanding simplicity, the linear models popularity as an applied tool has exceeded its nonlinear counterparts by far. The time series essence lies in the reliance of the adjacent observation and the analysis of time series is concerned with the dependence analysis and can offer foundation to various managerial decisions (Ganguly & Nandi, 2016).

Another tool to be used in forecasting analysis is the Quantile Regression Model (QRM). Quantile regressions refer to linear-regression models extensions that fail to assume the dependent variable normality. They model the provisional quintiles as predictors’ functions, specifying modifications in any provisional quintile. Contrary to linear regression models, QRMs contain the aptitude to typify the association between the independent variables and dependent variable, especially in the distribution extremes. QRMs contain common medical reference charts application, and could be utilized in initial medical diagnosis to acknowledge uncommon subjects by offering robust regressions for approximating extreme values. Quantile Regression Models in addition have the ability of forecasting and predicting extreme chronic health condition such as asthma. Some of the possible predictions include rate of admission (Soyiri & Reidpath, 2013).

The third tool is the fractional polynomials models (FPM). FPM is a probabilistic method that can be used for forecasting extreme health conditions or situations.  FPM is also said to be employed in modeling particular dependent variables categories in a linear data distribution, and therefore, target particular groups more accurately. FPM is used in categorization which provides clear advantages since it permits a full non-linear relationship representation between outcome and predictor variables. This model can be extended to an extensive range of health conditions and situations (Soyiri & Reidpath, 2013).

Role of Statistical Forecasting in the Qualitative Healthcare Decision Analysis Process

Health forecasting involves foretelling health situation of forewarning future events and disease episodes. It can as well be regarded as a kind of preventive care or preventive medicine which involves planning in public health and is focused as facilitating provision of healthcare services in populations. Health foretelling has been frequently applied to visits in emergency department, admissions, and daily attendance in hospitals. Forecasting is a crucial component in the medicine practice with its chief purpose being to improve both individual patient outcome and provision of health service. For instance some forecasting models integrate rule-based model which predicts threats based on environmental situations, with an anticipatory intervention care to offer information that is then communicated. This service allows care providers and patients to take precautions in enhancing delivery of health service and reduction of disease events. Healthcare forecasting is based on four main principles that include the focus, measuring of errors and uncertainty, healthcare forecasting horizon and the data aggregation nature and how it impact accuracy.

Forecasting start with identification of healthcare problem, and gathering of the necessary primary and secondary data. Data collection is done accurately using accredited tools and by certified researchers to ensure high level of accuracy, validity and reliability. The data is effectively analyzed mostly using quantitative research methods. The analysis results provides clear picture of the situation at hand. Predictive model validated with historical. Once validated, these models are used to make prediction of what may happen in the future if the situation is not harnessed. The models are also used to determine what may happen when different possible solutions are adopted. Based on the prediction results, the healthcare providers are able to make a decision on the best measure to take to enhance health care performance. This implies that statistical forecasting provide clear information of the situation on the ground and give possibilities of events that may follow when various measures are employed. They therefore provide a guide in decision making process (Wright, Lawrence &Collopy, 1996).

HR Practices that can be Utilized by Healthcare Organization to Improve organizational and Employee Performance

The performance of any healthcare organization is highly determined by the general operation of its workers. It is therefore important for human resources management department to develop management strategies that will enhance efficient and effective HRM practices to attain the desired objectives and goals. One way to achieve this is through the employment of strategic human resource management. Strategic HRM refers to a process which entails the utilization of overarching techniques to the HR strategies development that are horizontally integrated with each other and vertically integrated with the business strategies. These strategies describe plans and intentions associated to the general organizational considerations that include organizational efficiency, and to more explicit people management aspects, that include employee relations, resourcing, reward, as well as development and learning (Cania, 2014).

Another way to ensure good organizational and individual work performance is by working to enhance high level of job satisfaction in a health care organization. This touches on the recruitment process, work supervision, workers interaction, appraisal, and compensation. In this case, individuals should be employed in the right work position where the job description fits their academic and professional qualifications. Workers should be provided social and technical support to fit well in their role. HRM should ensure respect and social harmony in the work place, regular appraisal should be conducted where individuals are promoted based on their performance.In addition, a good and competitive compensation plan should be adopted. Wok scheduling should be reasonable and with a high level of balancing (Bharnagar&Srivastava, 2012). This willpromote a high level of health care workers job satisfaction and hence, promoting workers morale and dedication to their work, which translate to good individual and general organization general performance.

Evolution of US Healthcare System since Post Industrial Period

Post-industrial era can be trace from late 1800s. During this time American physicians acquired professional dominion and fought against national health care. The health care system during this period was facilitated by patient dependency, urbanization, institutionalization, science and technology, organization and autonomy, as well as patient dependency. Urbanization was characterized by people living away from their families and entering of women in the workforce. In the health care system, urbanization resulted to minimized physician services opportunity cost, and physicians increased productivity. Science and technology was characterized by cultural authority which included general reliance on and acceptance of the profession members’ judgment. There was a reduction on familial treatments reliance and a growing demand for expert services. The period was also characterized by a number of major revolutionary medical discoveries. They include the X-ray imaging in 1895, Anesthesia in 1846, antiseptic surgery in 1865, aseptic techniques in 1860, antiseptic surgery in 1865, and penicillin in 1929 (Jbpub.com, n.d).

The institutionalization also impacted the health care system in that there was pooling of resources which was necessitated by urbanization, professionalization and medical technology. Hospital became essential health care delivery institutions. There was dependency developed by expectation of the society that medical care should be given to the sick to get better, and the cultural authority of the profession. The health care system also experienced education reforms in this period. The medical education was reformed by John Hopkins and Harvard. There was addition of laboratory science and instruction to the curriculum. Medical education turned to be a graduate training course. The medical education was controlled by the American Medical Association (AMA).Organization and cohesiveness of professionals in healthcare system was brought about by economic and social changes. Specialization and hospital growth created need for physicians support especially for patient referrals and facilities access to admit their patients. The ability of physicians to be free of control from insurance companies and hospitals remained a conspicuous American medicine feature.  AMA which was formed in 1847 started to concentrate more on medical education since 1904. This cohesiveness and organization was also promoted by passing of legislations that include the 1870 Medical Practice Acts, guiding on licensure of medical practices in the United States. Licensure laws were revised in 1890s and late 1880s to demand licensure of all medical candidates that included individual holding medical degrees. There was also a demand to pass the education before the licensure (Jbpub.com, n.d).

The 20th century was characterized by specialization in the medical field, with more and more physicians specializing on specific field. The current level of specialization to general practice is at 48: 52. The 20th century was also characterized by development of neuropathology which scientific treatment and study of mental illnesses.  There was also development and advancement of public health as a separate entity of the normal medical system. This focused on public health practices including study of epidemics. There was also the establishment and development of veterans’ health services after the First World War. This was characterized by nursing homes outpatient clinics, and hospitals, mostly caring for individuals with disabilities. In 1914, there was birth of the first extensive-coverage of health insurance in form of compensation program for workers. By 1990, there was development of health insurance policies which eventually resulted to the development of private health insurance. In 1965, there was enactment of Medicare and Medicaid law, providing alternative for private health insurance to the public. Medicare and Medicaid focused on protecting the indigent, disabled and elderly. This law has also experienced various modifications to enhance better services which included the 2003 Medicare prescription drug, improvement, and modernization act. Since the enactment of the Medicare, there have been various legislation changes focusing on making medical health more affordable and ensuring proper care. The 2010 Affordable Care Act made it possible for American to have patient protection and reduced health services cost (Jbpub.com, n.d.).

Healthcare Marketing : Premier Healthcare – Environmental Assessment

Demographics and Demographic Trends

Premier Healthcare would target married people who are between 21 and 35 years old. These people generally have at least one child. In addition, their education level is beyond high school. The above target market has a combined annual family income of more than $50,000. Therefore, they can afford to pay for some of the services that the healthcare facility would offer. The healthcare facility would target people who live within the New York area. The above market segment would require various services that the healthcare facility offers. Therefore, focusing on the market segment would enable the healthcare facility to maximize its revenue and profits.

The population of people in the market segment has been stable. The stability of the number of people in the market segment would provide Premier Healthcare with a continuous flow of customers. In addition, due the fact that people in the market segment require various healthcare services, the healthcare facility would be able to maximize its income.This would require various healthcare services, the healthcare facility would be able to maximize its income. This would guarantee the future financial stability of Premier Healthcare.

Policy, Law, Regulations

Premier Healthcare should ensure that its activities align with existing laws and regulations of the state of New York. The healthcare facility would ensure that it does not involve in unethical activities to attract customers. In addition, it would ensure that it has all the relevant certifications to provide services to people in New York and its environs.

Competitor Analysis

There are several healthcare facilities in the New York area. The healthcare facilities specialize in the provision of various healthcare services. Public healthcare facilities account for a significant number of healthcare facilities in the industry. Public healthcare facilities are non-profit organizations. However, they do not offer high quality services. Premier Healthcare facility would offer high quality services to its customers. In addition, offering specialized services would help in attracting customers. Very few healthcare facilities in the New York area offer specialized healthcare services. Therefore, Premier Healthcare would differentiate its services from those of the competition. This would enable the healthcare facility to have a competitive edge over other healthcare facilities in the industry (Kay, 2007).

Market Research

Market research would a key component of the marketing plant of Premier Healthcare. Market research would help in determining potential customers, their opinions on healthcare services, trends, and future expectations. It would also help in determining the demographic characteristics of consumers. Therefore, determining the customer profile is one of the major aims of market research. Determining the customer profile would enable Premier Healthcare to provide services that the customers would appreciate. In addition, it would enable Premier Healthcare to determine similarities between the healthcare services it offers and the services of competitors (Kay, 2007).

Research shows that very few healthcare facilities offer services that are similar to those offered by Premier Healthcare. Research also shows that customers value high quality services. Healthcare facilities that offer high quality services have loyal customers. Offering high quality services would be one of the major factors that would make Premier Healthcare have a competitive edge over other healthcare facilities in the industry. Healthcare insurance providers cater for a significant proportion of healthcare costs. Therefore, it is vital for Premier Healthcare to ensure that it has the necessary certifications to enable it receive payments from healthcare insurance providers (Devers, Brewster & Casalino, 2003).

Download Healthcare Marketing : Environmental Assessment Sample Paper Here

Confidentiality and Truthfulness – Healthcare Case Study

Case One

Mary Stokes is in need of a kidney transplant, and her parents and siblings have been tested for compatibility. Her father is afraid of operations and knows that kidney trouble runs in the family. Before the test, Mary’s father tells the doctor that he does not want anyone, especially his wife, to know that he is compatible. He explains that if the family knows they will pressure him into being a donor. The father turns out to be the only one who is compatible. Mary asks the doctor, “Are you sure no one in my family is compatible?”

Is the father a patient and protected by confidentiality? Even if he is not a patient, is his explicit request, which was not refused, a protection of his confidentiality? If the matter is confidential, what can the physician say or do to protect the secret?

Sample Answer

The medical professions have a duty that come out of the association between doctors and patients. According to Moskop (2016), the principle remains that confidentiality of a patient must be safeguarded at all cost. This is because some information is sensitive and the person may want to protect their family from harm resulting from such news. However, a breach of this can result to professional misconduct that can result to a legal case. This paper analyses the case of Mary Stokes and seek to analyze if her father is protected through confidentiality, whether his explicit request a protection of confidentiality, and the action the physician can take to conceal the secret.

The father in this case is a patient as he will have to be operated to remove the kidney. However, he is afraid of the surgery and his mental condition is not set to donate his kidney. Donor selection criteria states that before someone accept to donate any part of the body, they must be physically and emotionally prepared. Mary’s father is physically suitable and the organs are compatible but he has fears and reservation making him unable to offer his kidney. The doctor has an option of either keeping this data confidential or to be truthful to Mary. There is no provision that is either legal or ethical barring the doctor from disclosing such information.

Consent is refers to an agreement to an act that is based on familiarity of actions and likely consequences(Longenecker, 2013). For explicit consent, the patient must either express it orally or in writing. Unless the disclosure of such information is in the public interest and intended to protect people from risks of serious harm like communicable ailments or harm to the patient and the third party, the doctor should uphold the confidentiality as requested by Mary’s father. The explicit request to maintain confidentiality that the doctor did not object should be maintained.

There are a number of things that the physician can do to protect the secret. The physician can disclose data that is anonymous without breach of data protection regulation or confidentiality. Also, the physician can remove the personal details of the patient’s such as age, address, name and any other information that can result to his personality identified. The data should be processed in a secure environment that has capacity and is proper for processing the information.



Case Two

Dr. Curious has a habit of wandering around the hospital and looking at the records of friends who are in the hospital. The nurses have tried to stop him, but he has retaliated by making their lives miserable and belittling them in public at every opportunity. The nursing administration has been notified but has done nothing, as it wants to avoid rocking the boat.

What are the nurses’ ethical obligations after they have done everything mentioned in the text? See Chapter 2 (Garrett). Is “not wanting to rock the boat” a sufficient excuse for the administration to do nothing further?

Sample Answer

This case study talks about truthfulness and involves a doctor who has a habit of checking the records of his friends who have visited the hospital. Dr. Curious has belittled those nurses that have been trying to stop him from this uncouth and unethical behavior. This analysis seek to examine the nurses ethical obligations after the attempt to stop him are futile. Further, it will examine if not wanting to rock the boat or causing trouble a sufficient excuse for the management not to put extra efforts to eliminate the vice.

The nurse should ensure that they limit access to records and patient’s information. This would minimize the risk of other health practitioners and Dr. Curious to breach the confidentiality policies. They should have a safe place to keep the records where they are not easily accessible. Additionally, they should report the matter to the administration for action every time such an incident occurs(Moskop, 2016).

The management should discipline Dr. Curious for practicing unethical behavior in the workplace. The management can check on the policy of the hospital on regards to confidentiality to ensure that the data is consistent with the laws. If Dr. Curios have been given warnings on this unethical behavior and he has repeated it, he should be summoned to the disciplinary committee through a written notice. The administrations should then listen to his plea before making a choice that would ensure such a behavior is not tolerated. It is the responsibility of the management to ensure that they educate the health employees on confidentiality and to ensure that they are aware of their responsibility to safeguard and keep the patient’s data in secrecy.

Rocking the rock is not satisfactory excuse for the management to take actions. They should take the necessary disciplinary action even if it means to dismiss or expel him from job. It is the responsibility of the health facility to ensure that the information about patient’s visiting is confidential.According to Longenecker(2013), the legal requirement for this process is to ensure that any process is well documented, fair, and within the confine of the law.

Healthcare Legislation – S103: Enters New Jersey in Multistate Nurse Licensure Compact


The Compact is an agreement between states that ties the party states to the provisions as outlined in the compact (Evans, 2015). Different states have laws that vary, which makes it difficult for professionals such as nurses and doctors to practice across the states. Registered nurses who work on volunteer for Red Cross, travel nurses, nurses working temporarily for summer camps, nurses doing telephone triage, and nurses working for healthcare teams that provide services over the internet, often face work challenges. Most of the services of these healthcare professionals involve provisions of services across the states. It is with consideration of these challenges that the state of New Jersey developed the S103 bill that allows it to enter into compact with other states.

The compact enables the nurses to practice in his/her state and the other state(s) that is part of the compact (Evans, 2015). The compact currently has a total of twenty five (25) member states. These include the states in the Middle Atlantic Area, which include Delaware, Maryland, Virginia, Maine, Rhode Island and New Hampshire. The S103 would allow New Jersey to issue multistate license, thus authorizing the state home nurses to practice in compact member states.

Bill Sponsors

The S103 bill was initially tabled in the Assembly (as Bill 3917), with Moriarity and Conaway as its sponsors. The bill was also tabled with the Senate as bill 103, with Senate sponsors being Senators Joseph Vitale and James Whelan and Senator Fred Madden as co-sponsor (LegiScan, 2016)

. Both the Assembly and Senate bills were introduced and referred to the committee. The bill is currently in the Senate Health, Human Services and Senior Citizens Committee.

Issues Raised by the Bill

The Nurse Licensure Compact (NLC) shall allow the nurses to practice both physically or electronically in other remote states, which are members of the NLC. The NLC will help in eradicating regulatory restrictions from remote states owing to different practice laws. These uniform licensures promote public safety and health benefits.  Through the NLC, patient access will be increased, care continuity for patients regardless of the state and facilitation of discipline cases across the state boundaries. However, the major challenges of the Nurse Licensure Compact are the technology and new practice modalities, which makes the nurse licensure laws of the individual states more complex.

Stakeholders and their Influence

The major stakeholders include the healthcare providers, including advanced practice registered nurses (the New Jersey State Nursing Association), compact advocacy collations, the non-governmental organizations, the healthcare insurance providers and the state communities. These stakeholders exert great influence on the healthcare policies, shaping the way healthcare is provided. The healthcare insurance providers are keen to ensure the mobility of the patients under their coverage, while the patients are keen to access healthcare services without state restrictions. All these stakeholders hold substantial influence in shaping the bill though its enactment and legislation.

Challenges, Problems and Next Steps

The major challenges/problems in adoption of the NLC are the retrieval of the criminal records of the applicants and practice modalities. The individual states should make criminal background checks for registered nurses before their application for the NLC licensure. These include obtaining the finger prints of the applicants and retrieval of their criminal records from the Federal Bureau of Investigations and other security agencies. The states should also ascertain the professional prequalification of the applicants prior to the application for NLC licensure.

Human Services Practice in Criminal Justice versus Mental Healthcare Settings


  •  While the human services practice’s subjects, or clients, in mental healthcare settings seek and get specific human services out of own volition, the clients in criminal justice contexts are obligated to get services (Cohen, 1985).
  •  While the human services practice’s subjects, or clients, in mental healthcare settings have no motivation, or interest, to lie to human service practitioners about own investments, goals, conduct, or related variables, those in criminal justice contexts are keen on presenting themselves as favorably as possibly to the practitioners.



  • The same cadres of paraprofessionals and professionals offer human services in both criminal justice environments and in mental healthcare environments (Abramsky, Fellner, Saunders & Ross, 2003).
  • The paraprofessionals and professionals in the two environments hold the same generic skills, attitudes, and knowledge. For instance, they all appreciate human systems’ nature and appreciate the circumstances that limit or enhance the systems’ performances

Leadership Plan to Address Financial Gaps Within A Healthcare Organization

Create a 10–12-slide PowerPoint presentation that communicates a leadership plan to address financial gaps within your organization. Use Kaltura or another technology to narrate and record a 10–15-minute audio presentation.

Note: You are strongly encouraged to complete the assessments in this course in the order

To remain viable, health care organizations need leaders who can meet financial targets by effectively leading their teams. Whether you work for a nonprofit, for-profit, or government facility, financial goals and targets will influence your leadership priorities. These internal benchmarks, when considered with respect to finite, available resources, create leadership challenges for maintaining fiscal and clinical balance. You may recall a quote from Irene Krause, who started the idea of “No Margin, No Mission.” So, regardless of what your corporate structure might be, all leaders must contribute towards the financial health and profit margin of the organization.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 3: Analyze characteristics of effective team leadership. (L5.4, L26.5, L1.4)
  • Analyze evidence-based strategies of effective team leadership in a plan to motivate team members to achieve departmental financial targets within a health care organization.
  • Competency 4: Examine how financial forecasts guide organizational leadership. (L8.4)
  • Identify financial targets including performance indicators and measurements for a department within a health care organization.
  • Analyze gaps in financial targets versus YTD performance or goal attainment for a department within a health care organization.
  • Propose a leadership plan to close identified financial gaps for a department within a health care organization.
  • Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration. (L6.1, L6.2, L6.3, and L6.4)
  • Develop a presentation that is clear, concise, well organized, and appropriate for internal stakeholders.

Questions to Consider

  • To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of the business community.
  • What leadership strengths could you utilize to address the task of motivating your team to engage in meeting financial targets?
  • What organizations are you aware of that can help you improve your financial skill sets?

Wyoming Mental Health Professional Licensing Board – Healthcare Licensing


Wyoming Mental Health Professional Licensing board carries out the important function of regulation and licensing of social workers, addictions, family and marriage therapists. The board of the licensing body has six members. The six members are all licensed and who include a clinical social worker, family and marriage therapist, addictions therapist, a professional counsellor and two members in the public domain total six members. The experience required of the four professionals on the board is three years. The board members are Sue Lat, Kristin Sweden, Gordon Mickelson, BJ Ayers, Kelly Heenan, and Lance Goede. The board is gender sensitive as they are almost equal numbers of men and women. Goede is a Dutch name and the other names are further diverse. Most of the board is as clearly representative of the needs of the community as most of the members in the board are gender sensitive. As such, the community needs are clearly met by the different professional who are balanced by the genre sensitive board in place. Since there are, two members form the public on the board they provide a wider scope on the understanding of consumer needs in the community (Robiner & Crew, 2000).

The economic challenges facing various models in healthcare organizations are changing to models that are value based. Since the value, based systems will include the healthcare facilities engaging in local markets, which will further need them to adapt to the local environment (Swayne et al., 2012). Growing and securing the market share is going to be a problem to the healthcare sector, as they will have to weigh various options in entering different markets especially in collaborating with other businesses in obtaining a larger market share. Coming with other revenue options is another challenge, which needs more business options that are not directly related to the care of patient and may include pharmaceutical research, telemedicine and ambulatory services among other alternatives. As such, the licensing agencies among other companies face these challenges and therefore the dynamics in the health market are quite far reaching and thus affecting the healthcare service provision.


Detection and Reporting of Adverse Events – Healthcare

An adverse event can be described as any untoward or unfavorable medical occurrence in a clinical investigation subject. Mostly, it occurs when a clinical officer administers pharmaceutical product that have no casual relationship with the treatment. It results to abnormal signs in the laboratory findings, symptoms, and disease that cause physical and psychological harm. There are different types of adverse event that can occur during a clinical trial that are portrayed in various conditions. Whenever the researcher notices any sign of an adverse event, he/she should consider reporting. The urgency of reporting an adverse trial after detection varies with the type. It is therefore, important to explain different types of adverse event, the conditions related to it, and how fast it should be reported after detection.

Types of adverse event

  • Serious adverse event

It is characterized by life-threatening where the subject is at risk of death. Again, when the subject is hospitalized or there is prolongation of hospitalization after the drug is administered. Incapacity in congenital incongruity, birth defect or any other disability that occur due to the effect pharmaceutical reaction is also considered as a serious adverse event. Example of such condition include; internal bleeding and hemorrhaging with an abrupt drop in blood pressure resulting to unconsciousness (Morgan et al, 2010). When a serious adverse event is detected, the researcher should report immediately to the principal investigator or the sponsor. The maximum time should be 72 hours after detection.

  • Non-serious adverse event

These are adverse events that are not life threatening. These adverse events do not have any serious implication of the patient health and are easily managed without hospitalization or surgery. The events do not expose the victim to serious life conditions. They are characterized by nausea, dizziness, loss of appetite, and body weakness.  The researcher should report if the symptoms continue after 7 days.

  • Serious unsuspected adverse event

It is an essential medical event that may not cause death to the victim, but is life threatening. It occurs when the patient’s condition is jeopardized after medication. The condition demands the patient to receive further medication or to undergo a surgery (Morgan et al, 2010). Example of such condition are; allergic bronchospasm that require intensive treatment in an emergency room, blood dyscrasias, the patient developing drug dependency, and convulsions. It should be reported within 72 hours after detection.

  • Serious unexpected suspected drug reaction

This is a serious adverse event with some degree of probability that the cause is a reaction of administered drug where the reaction is unexpected. The adverse event in this case is only caused by drugs. Sometime the patient may not show the reaction immediately. It is characterized hemorrhaging with an abrupt dropped blood pressure, unconsciousness, and convulsions (Morgan et al, 2010). The condition can occur between 7 and 8 days. The researcher should report immediately after detection of the symptoms (within 72 hours). The team must start an initial or full report within 7 days of after the occurrence of unexpected drug reaction. If there is a need of a follow-up report, it should be conducted within 8 days after the initial report.

  • Unanticipated serious adverse device event

This adverse event in this case happens when the degree of probability relate to the effect of a medical device. The device is supposed to help the patient in the normal functionality, but cause serious reaction to the health. The reaction also varies with individuals. Unanticipated serious adverse event mostly affect the nervous system. The researcher should report immediately after the detection.

In conclusion, adverse event is an untoward medical reaction to pharmaceutical clinical investigation subject. Some events can cause death, disability, and genital incongruity. The condition of the adverse event include internal bleeding and hemorrhaging with an abrupt drop in blood pressure resulting to unconsciousness, allergic bronchospasm, blood dyscrasias, drug dependency, and convulsions in severe case. The adverse event should be reported with 72 hours after detection. The researcher, sponsors, and regulatory authority should ensure due care to minimizes the case of adverse event.

Effective Communication and Cultural Competence within Healthcare facilities

A well-integrated communication in healthcare facilities.

The healthcare sector if full of dynamics and diversification in which their incorporation calls for an effective mode of communication within the various healthcare service facilities. The healthcare uses the art of communication as an essential tool towards the achievement of productivity and maintenance of strong working relationships at every level of the organization (Darley& Royal College of Nursing, 2002).

A well-integrated communication within the healthcare facility becomes a crucial integral part of the activities co-ordination and facilitation of various aspects of the organization. Employees who have invested their energy and time in delivering explicit lines of communication generally build up high levels of trust among employees and the management team, resulting into increases in output, productivity and maintaining high levels of job morale.

Effective communication becomes a vital building blocks to successful organizations. A well-integrated communication becomes essential in health care in a number of ways: An effective communication is important to the healthcare service facility in that the managers of the organization use it in performing basic functions of management, for instance, organizing, controlling, staffing, and planning. Through communication the mangers can perform their responsibilities and duties (Bryan, 2009, p. 148). Every aspect of critical of essential information is communicated to the managers who in-turn communicate the plans so as to ensure they are implemented. Additionally, there must be effective communication among the team leaders and also with their subordinates in order to facilitate the course of achieving the stipulated goals.

Communication is a critical source of information to the members of the organization in rationalized decision-making process since it helps in identification and assessment of alternative course of actions.

The two methods that the healthcare facility uses as their primary mode of communication are:

  1. Written communications dispatched through mail- These take the form of statements details on payment schedules and tax liabilities.
  2. Oral communications- This takes divergent approaches such as clients to the healthcare facility making inquiries through phone calls. There is direct communication from the management to the employees and vise versa, and also among the management and employees themselves (Van, 2009).

Cultural competence in the U.S. healthcare system

The cultural diversity within the American society has been a factor which calls for clear consideration and strategized tackling measure due to the diverse backgrounds of the American nationals (Rose, 2013). The U.S. healthcare system is a sector that strive to embrace the ability to interact effectively with personalities of various socio-economic and cultural backgrounds.

Cultural competency becomes critical towards ensuring reduced healthcare disparities and improving the access to higher level-quality healthcare, for instance a healthcare that is responsive and respectful to the needs of the diverse patients. A well developed and implemented framework of cultural competence ensures that the agencies, professional groups, and the system itself to effectively function in understanding the needs of the various groups accessing the healthcare or health information-or the research participants within an inclusive partnership in which the provider and the information user converge on common ground (Kosoko-Lasaki, Cook & O’Brien, 2009).


The healthcare facilities should acknowledge that an efficient and effective communication system entails managerial efficacy in delivery and reception of messages. Analysis of different barriers to communication should be timely done by the line managers, scrutinize the reasons such occurrence and institute preventive measures to avoid the hindrance created (Bryan, 2009). The prime responsibility of a manager is to ensure he/she develops and maintains an effective communication system within the healthcare facility.

According to the study by Gibbons (2008), effective cultural competence in the U.S. healthcare system is a great step towards achievement of equitable, affordable and respectful healthcare services to the patients of divergent backgrounds.

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HSA515 Healthcare Policy, Law and Ethics

You have just been hired as a new chief executive officer of a new full-service 200-bed for-profit health care organization. Twenty-four (24) hour emergency room services will be provided. The services offered will focus on adult care. The physicians under consideration for employment at the new facility are world renowned for their highly successful treatment rate for the most difficult cancers. About five miles away exists a non-for-profit teaching hospital that has also developed a great reputation in the community for providing great adult care services.

Prepare an eighteen to twenty (18-20) slide PowerPoint slide presentation in which you:

  1. Provide a detailed organizational chart for your new facility.
  2. Organize a mission, vision, and values statement for the new entity.
  3. Compile procedures that govern the hospital-physician and physician-patient relationship including negligence and liability issues.
  4. Describe referral services that will be offered.
  5. Create a peer review system.
  6. Provide a synopsis of how HMO insurance will be handled.

The specific course learning outcomes associated with this assignment are:

  • Differentiate among the ways that health care institutions can be organized and managed.
  • Define negligence and liability as they relate to health care.
  • Explain the concept of peer review and its relationship to medical staff privileges.
  • Use technology and information resources to research issues in health care policy, law, and ethics.
  • Write clearly and concisely about health care policy, law, and ethics using proper writing mechanics.


Financial Factors that Make Healthcare Organisations Merge

There are varied strategic financial considerations that make healthcare organisations keen on merging with others. The considerations include allowing financial growth in the organisations, bolstering market shares, gaining a foothold in new markets, and getting new products. Notably, all these considerations are geared towards the bolstering of the organizations’ financial standings (Dunham-Taylor & Pinczuk, 2004). Commonly, the organisations envision opportunities for growing their financial leverage and scope by growing. That often bolsters liquidity and increases capital access. The growth of the organisations enhances the organizations’ financial performance and prospects via leveraging elementary economies of scale (Healthcare Financial Management Association, 1982; Gale Group, 1999). Even then, when integrated with other synergies, which are strategic, the healthcare organizations’ sizes serve them as the means and basis for improved market share, product enlargement, and penetrating new markets. As well, by and large, the sizes occasion a clear competitive advantage.

Many healthcare organisations merge to enhance their financial prospects and performances owing to the resulting growth in their market shares. They merge when they establish that their competitions for clients are unviable as client bases keep move moving and the related product loyalty weakens or strengthens. Organisations grow their market shares by capturing their competitors’ customer loyalty and building in it to build their share more. Even then, it is noteworthy that growth in the organizations’ sizes does not necessary lead to enhanced financial performances and competitiveness (Banerjee, 1987; Sherman & Sherman, 2011). (Healthcare Financial Management Association, 1982; Gale Group, 1999). (Banerjee, 1987; Sherman & Sherman, 2011).

Some healthcare organisations ready themselves for it while many others do not. Commonly, as new products go past their beta phases, cheaper brand or knockoff developers and competitors are before now distributing competing offerings, injuring the products’ prices thus affecting the financial returns of the organisations dealing with them. Notably, varied technological advances have assisted in shortening the durations taken in promoting and delivering given products to particular marketplaces (Dunham-Taylor & Pinczuk, 2004; Sherman & Sherman, 2011). That is why many healthcare organisations are opting to buy out established producers rather than creating the products to avoid prolonged durations of marketing, as well as procuring, the products. That is especially so in cases of products which are oddly costly and unlikely to yield the anticipated outcomes.


Globalization and Diversity Impact on Healthcare Organizations

Unit outcomes addressed in this Assignment:

  • Explain the attributes of a successful health leader.
  • Describe issues related to globalization, power, followership, and culture change from a health leader’s perspective.

Course outcome addressed in this Assignment:

  • Evaluate approaches to leading individuals and teams, and eliciting support from senior principles.
  • Identify change management practices by discussing change sponsorship versus agency of change theory.
  • Evaluate leadership strategies essential to successfully accomplish change including interpersonal, organizational, and cultural dimensions.


For this Assignment, outline issues related to globalization, power, followership, and cultural change from a health leader’s perspective. Identify at least three major global health issues that have impacted the U.S. health care system, and describe how this has affected and influenced stakeholders.

Relate the global leadership style differences and similarities within the constructs of transformational leadership. Discuss at least three critical elements of culture and diversity on the modern health care organization. Also, provide a table or list of cultural attributes to be cognizant of.

Finally, categorize global leadership differences according to a leader’s use of power, technology, and knowledge management. Provide at least two leadership approaches for implementing change.


  • Your paper must be at least 5 pages in length.
  • Use a minimum of three academic references.
  • Cite all references using APA format.

Analyzing Healthcare Policies – Obamacare

The United States has recorded tremendous changes in health care policies over the recent past. The Affordable Care Act or the ObamaCare is one of the best known aspects of Health Care Reforms in the United States. The ObamaCare was signed into law on March 23, 2010 (The American Occupational Therapy Association, 2014). The goal of ObamaCare legislation was to expand access to health insurance coverage for many uninsured American citizens through expansion of eligibility for Medicaid and creation of affordable subsidies for uninsured persons. The Affordable Care Act also intended to change the heath care delivery system to improve patient outcomes at reduced costs. Since its implementation in 2010, the Affordable Care Act or the ObamaCare has brought new changes to the American Healthcare System (The American Occupational Therapy Association, 2014). Other people are worried about the negative impacts of taxes recently added to the Affordable Care Act particularly on employees and employers.

ObamaCare has contributed greatly to Medicaid Expansion across different states of the United States. The most significant expansion of Medicaid in the United States took place in 2012 when it was ruled by the Supreme Court that expansion of Medicaid should now be left to the states (Tanner, 2014). Following the Court’s decision, approximately 50 percent of states have expanded their Medicaid programs. Those states that have expanded Medicaid have reaped positive fruits out of the program. For instance, Medicaid has boosted the economic standards of the poorest residents, which has encouraged other states that had negative attitudes about Medicaid to begin expanding the program (Eibner, 2015).

The Affordable Care Act has affected individual decisions to use health care and obtain insurance. Since its implementation, ObamaCare has resulted into an increase number of insured employees. For this reason, more workers are now able to get access to quality care than before. The ObamaCare addresses several issues beyond expansion of health insurance including reduction of health care costs for the United States citizens and improvement of health care delivery across various states (Tanner, 2014).

In order to increase the number of available options for health insurance coverage, the ObamaCare has created new health insurance marketplaces that allow citizens to make private health care plans. For instance the individual insurance marketplaces are online systems where eligible citizens can purchase coverage. These may be operated either by states or by federal government through state invitation. Small business insurance marketplaces are online systems that help organizations with 50 workers or less to cover their employees (Eibner, 2015).

The ObamaCare or the Affordable Care Act allows consumers to take charge of their own health care. Through this legislation, American citizens attain the flexibility and the stability they need to make personal decisions about the type and quality of care they need. Many American people support the ObamaCare due to the nature of coverage it offers (Tanner, 2014). Since its implementation in 2010, the ObamaCare has ensured maximum inclusion for children in the health care plans. Health care plans in the United States now extend benefits to children below 19 years old due to pre-existing condition. In addition, the ObamaCare now make young adults aged below 26 to be covered under their parent’s health care plans. In addition, insurers can no longer cancel clients’ coverage due to minor mistakes. The ObamaCare guarantees clients’ rights to appeal in order for denial of payment to be reconsidered (Tanner, 2014).

Since the Affordable Care Act became law, American citizens have had the freedom of choosing the quality of care that they may need depending on their health conditions (Tanner, 2014). For instance, ObamaCare covers preventive care at no cost to clients. In addition, the law allows the American people to choose the primary care doctor that they want from their plan’s network. The American citizens can also seek emergency care at health care institutions outside their health plan’s network due to the presence of the Affordable Care Act (Eibner, 2015).

Over the recent past, the Affordable Care Act or the ObamaCare decided to include the Cadillac Tax as a way of controlling the escalating health care costs. The Tax was meant to put pressure on employers to offer cheaper health insurance plans than they have been offering. The main idea here is that, if people compare the direct costs on their health care to that of insurance, they will be encouraged to stick to their insurance. The Cadillac Tax will start operating in 2018 and it is expected to pose a levy of 40 percent on the costs of family health plans greater than 27, 500 dollars and 10, 200 dollars for individual coverage. Each dollar above these thresholds will be taxed at a rate of 40 percent (Mangan, 2014).

The United State health care system analyzed the anticipated impact of the Cadillac Tax that is yet to be exercised by the ObamaCare on employer-sponsored health plans. According to Mangan (2014), large companies are likely to spend huge dollars starting 2018 when the Cadillac Tax is expected to become operational. The looming ObamaCare excise tax might make employees stuck with much costs if their employers ignore the tax bill. The American Health Policy Institute states that, big companies will be compelled to pay approximately 2.1 million dollars each year between 2018 and 2024. This is equivalent to 2, 700 dollars per worker. Suppose companies choose to adjust employees’ wages as a result of the tax, more than 10 million workers are likely to have their wages increased, which translates into higher taxes (Mangan, 2014).

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Article Summary – Clinical Nurse Specialist, a New age Healthcare, Implementation Challenges in Nigeria

Dauda, S., Yahaya, H. & Lola, N. (2015). Clinical Nurse Specialist, a New age Healthcare, Implementation Challenges in Nigeria. Journal of Research in Nursing and Midwifery, 4(4): 059-065.

This article addresses the challenges facing clinical nurse specialist in the new age healthcare. According to this article clinical nurse specialist is an advanced nurse practice that focuses on a specific care for patient population in clinical setting. Clinical nurse specialists focuses on specific type of diseases including cardiovascular, diabetes diseases among others. The daily routine of clinical nurse specialists include management, consulting, research, teaching and clinical practice. According to this article, clinical nurse specialists encounters challenges in their daily practice such as barriers to the title, billing and reimbursement problem, ambiguity of roles and implementation of scientific findings. In many countries, the implementation of clinical nurse specialists faces hurdles due to monopolistic doctors in healthcare system and lack of policies to support the program. The article concluded that clinical nurse specialists would significantly improve health care delivery in the rural and remote areas where there are no nurses

Implications of Health Economic Concepts for Healthcare

There is an increasing desire for effective and equitable medical services around the globe. This has not been possible because of the increasing demands and limited resources. There is also a limitation of health economics at the microeconomic level because of the limited information gathered by health economists in their areas of operation. There ought to be a good relationship between health economists and those administering primary care if the industry desires success. Pragmatic frameworks from decision makers will be vital in the process of drawing various principles and concepts related to primary care (Berendes, 2011, p. 12).

Health economics is currently putting pressure on decision makers and other health professionals without considering the limited resources. This has made these two groups to clearly understand the provisions of health economics to ensure effective operations in the healthcare industry.  Through the system, decision makers have learnt the importance of efficiency and quality services in the health sector. Health economics is crucial as it presents important principles that regard demand, supply and resource utilization. Health economics focuses on all things that pertain health care from their economics point of view. It all allows decision makers how they can produce their products and who will be the beneficiaries (Hosseinpoor, 2012).

Briggs (2013) confirms that many years ago doctors were presented with limited options while dealing with their patients. The patients also had to follow all the instructions given to them by their doctors without any compromise. All the values that were seen as contributing to the whole process were only provided by the doctors themselves. However the limited health care resources necessitated various health economics concepts and principles for the doctors. Such concepts help decision makers have past, present and future information concerning their operations.

Health economics is vital in the industry as it focuses mostly on the organization of healthcare and how it can be financed. It also provides a framework to deal with a range of issues in a more concrete manner. Various changes like that of the implementation of the Institute for Clinical Excellence and the devolution of decisions on primary care has made most organizations to look into the complex system of healthcare (Hripcsak, 2013).

Decision makers are currently able to put value into healthcare services within their regions of operation. This is important as it enables them to know the influence of demand and supply in the industry. Through this knowledge the decision makers can be able to budget, monitor and plan all the operations in the industry.

Economic evaluation is known to be the most relevant element for health economists when they desire more information from the sector. The exercise is vital as it makes them to have a framework that helps in comparing costs and benefits of various interventions in the health care segment.

Making consideration of the complex system of health helps the concerned parties understand all the regulations embedded in the system. Understanding a system better is vital as it helps decision makers and all the stakeholders to make plans that are valid. Almost all the aspects in the medical field have one or more bodies governing them. Clearly understanding the complexity in the industry helps all the players to know which body to make use of during problems. The complexity and scope of the health care system is easily dealt with parties who have more information in the area (Simou, 2014).

The government is currently active in ensuring health care provisions to all the citizens in the US. This has been done with the aim of executing their machinery to ensure access to health care to all persons in the nation. Poor people often desire to have clinics in their regions of stay and get access to various medical services. Learning the benefits of the government involvement will help people understand their operations and also critique them where necessary. Most times governments have been found to misuse taxpayers’ money under the pretence that it is allocated in the health sector. Learning such government operations can also ensure that all the stakeholders in the industry are provided with the information they need.

Quality is essential for all health care in every region in the world. The government is usually given the mandate to ensure that all the citizens receive quality services from various hospitals. In the US, issues of quality have been discussed for a long period now. The centers for disease and control in their website have in the past indicated that more than ninety thousand people die yearly. These people are said to succumb to infectious diseases in different hospitals. Learning such information will give people an idea of how the medical system is handled by the government and make demonstrations when they feel that they are not given quality provisions.

The government is supposed to analyze gathered information and disseminate it to relevant authorities. Individuals need to get this information and learn various statistics that are provided to ensure minimal risks in most medical procedures. Learning of various outcomes of procedures can greatly assist members of the community to plan ahead with ease. Getting to know issues of cost and service provision can also enable members take different membership organizations that provide relevant care to their needs and desires (Siciliani, 2014).

The government has increased the private sector involvement in the health sector. Patient health care is always improved when the private sector desires to involve themselves in the provision of health products and services. Contracting services from the private sector provides different players in the industry to provide such services with ease. It also assists members of the society to choose best service providers and maintain them in their various regions of operations. Learning the operations of different players from the private sector is beneficial as it assists the government to work with those that cater the needs of their people fully. Such organizations can be funded or provided large operation areas to ensure a wide coverage of such services. Individuals and other stakeholders ought to learn the private sectors provisions for purposes of aligning their functions with those of the central government.

In conclusion, hard decisions in the health care of people from around the globe are inevitable. This has made most practitioners and the medical fraternity to always provide fair and explicit decisions for their operators. There are various methodological limitations with the health economics, but it is able to provide the medical fraternity with economic principles that are crucial for development (Siciliani, 2014). It is vital for all practitioners to understand the basic concepts for purposes of appreciating them.

Investigating Stereotyping In A Healthcare Facility – Assignment Instructions

Having a safe and appropriate organizational culture involves developing employees understanding of how the patient population characteristics can influence clinical decision-making. As a hospital administrator, you hear some complaints and want to investigate whether the problem of stereotyping exists at your facility.

Using the South University Online Library or the Internet, research various types of stereotyping such as racial, ethnic, religious, and gender. Based on your research and understanding, respond to the following:

  • How will you conduct the investigation? What will you do if the problem does exist at your facility?

Recently staff has been complaining about abusive physician behavior. A process introduced to deal with abusive physician behavior alienates some doctors. As a direct result of the staff complaints, one of every three doctors threatens to leave the hospital. Recommend a system for addressing the grievances along with a long term solution focused on the interpersonal conflict.

Long Term Care Sector – Healthcare Principles and Practice


The following research paper will focus on the Long Term Care Sector which is part of the health care delivery system. It will look at the historical development of the sectors and the challenges and issues facing it prior to health care reform. It will also look at the specific challenges in the sector, and the benefits and risks it faces in the future associated with health care reform. Despite the US having one of the best medical care services in the world, it is only accessible to those who have health insurance plans or resources. It is has not been universally accessible to all American citizens. The Affordable Care Act ensures that all Americans have access to affordable health care.  Current health reform has focused on the key issues of those who are uninsured, and has not looked critically at long term care especially for the future.

Long term care users fall into two categories; the frailed elderly and the disabled. The long term care sector is a crisis in the horizon as the 77 million baby boomers enter retirement. The number of people requiring long term care in future will increase including the non-elderly persons with disabilities. Policy makers need to look at the key issues affecting the sector in order to come up with health reforms that will assist avert the crisis that will happen with long term care in the next 30-40 years. The costs of long term care are high and the existing systems do not have clear mechanisms for payment and delivery.

Historical Development and Current State of Long Term Care Health Care Delivery

In order to understand the historical development and current state of long term care in health care delivery one must look at the US Health Care Delivery system as a whole. The Health Care Delivery system consists of major components and processes that enable people to receive health care. Most developed countries have a National Health Insurance programs that enables all citizens to receive health care services. However, in the US not all citizens are entitled to routine and basic health care services. Despite the US Health Care Delivery System having evolved, there are concerns on access, cost, and quality as the system does not provide a universal basic health care package at an affordable cost. Organizations, individuals involved in health care include educational and research institutions, medical insurers, suppliers, claim processors, and health care providers.

The US health care delivery system has various subsystems that include managed care, military medical care system that caters for vulnerable populations, and the integrated system that consist of various forms of ownership between hospitals, physicians, and health insurers. Long term care is normally provided through managed care. Long term care is any arrangement where a Medicaid program contracts an organization to provide benefits which will include some level of long term care benefits.

The following are the main characteristics of the US Health Care System. The system has no central governing agency, and has little integration and coordination. The health care costs under the system are high and there is unequal access. Legal risks influence practice behaviors, and there is conflict through the health care system in terms of market justice vs. social justice. The access to health care under this system is selectively based on insurance coverage. There is a quest for integration and accountability.  The US expenditure on primary health care is the highest in comparison with other developed countries and is almost 13% of the Gross Domestic Product.

The US has a unique Health Care system, but it lacks universal access to all American Citizens. Health care in the US is compromised by disintegration in delivery limited access and high costs. The two groups of patients that suffer under this system are those with complex long term care needs and those with low income or no health insurance. Access is restricted to those who have health insurance through their employer; those covered under a government health care program; those who can afford to buy health insurance using their own funds; and those who are able to pay for services with their own funds. In most developed countries the Government plays a central role in the provision of health care to its citizens. In the US this is different where the private sector plays a leading role.

In 2003, managed long term care market was expected to grow dramatically. However, only 2.3% of this market using public long term care is receiving these services. Managed long term care is provided mainly through large local non- profit plans or those that have progressed due to responses from particular states. The growth of long term care services has been very slow due to several factors. These include complex programs that take a relatively long time to plan, startup periods, and resistance of long term care providers, federal policies, and inadequate infrastructure. However, despite these challenges long term care is popular in the states where it is well established and has the potential to grow in the future (Fronstin, 2010).

In the 1970’s long term care services was mainly through nursing homes. This brought about large increases in nursing home expenditures and raised the issue of whether the long terms services system was sustainable. In the 1980’s there was the introduction of home and community based waiver (HSBC) so that states would create flexible community based services. The HSBC waiver program grew rapidly, however the nursing home expenditures continued to increase. This meant that the HSBC waiver could not control the growth of institutional care.

In the 1990’s several states planned initiatives on long term care based on Medicaid managed care. Different states had different legislation on long term care. In 2003, 3.1 million elderly persons and persons with disabilities received long term care through Medicaid financed long term care. Of these, over half a million were in nursing homes and half a million went through community based waiver services program. Examples of managed long term care programs include Arizona’s Long Term Care System, Florida’s Frail Older Option, and San Francisco’s On Lok Program. Minnesota, Colorado, and Wisconsin are among the leading states providing innovative models on long term care.

Challenges and Issues Prior to Health Care Reform

The major challenges and issues facing long term care prior to health care reform relates to access, cost and quality. Prior to health care reform, states had showed interest in using managed care models to purchase Medicaid benefits for those populations that required long term care. In developing these programs, States needed businesses that had managed care plus expertise in clinical, social management of long term care populations. Traditional health plans prior to health care reform did not have this expertise. On the other hand, those that had expertise to provide services for long term care did not have any experience in managed care. For the long term care market to succeed, it required the merging of managed care expertise with experience in long term care populations. Due to this the managed care institutions expanded into long term care or long term care institutions expanded into managed care. The market before health care reform was dominated by long term care businesses expanding into managed care (Baer & O’Brien 2010).

The role of the aging network advocates was another challenge facing long term care. Advocacy from aging networks has a huge impact on various long term care programs. For example, the aging network advocates were opposed to long term care reforms based on partnership models that involved integration of acute and long term care. This was because such plans would be dominated by medical HMO’s thus reducing the role of the aging network.

The other challenge is that there are not many private long term care businesses to offer long term care to the aging populations.  Prior to health care reform law, there were two major for profit players in the long term care market; Amerigroup and Evercare which is the leading player. Evercare has long term investment plan and it targets frail elders and all persons with disabilities. The company is working across the country and is also active at federal and state levels. Amerigroup on the other hand is Evercare’s major competitor, but long term care is not its core business. Most providers of long term care have developed a managed care service (Fronstin, 2010).

Another challenge is whether managed long term care can offer more value in comparison to HCBS services. HCBS or fee for service programs depend on the case manager who coordinates the long term care. Managed long term care increase the use of home and community based services, and reduces the use of institutional services. They also have high customer satisfaction levels. In addition preventable admissions and high death rates are not a concern.

Policy issues and complex program designs are a challenge to managed long term care. The managed long term care programs that have been implemented are very diverse across different states. Differences exist in payment methods, managed care suppliers, competition, and whether enrollment is mandatory or voluntary. Most states do not have a clear picture of which program models they should replicate. However, Arizona stands out as one of the most successful long term care programs (Grabowski, 2006).

Legal authority over managed long term care has advanced positively, however difficult policy issues often emerge that complicate program development. Payment challenges will always remain controversial and technical for most managed long term care programs. These need to be refined in the future. Constituents are concerned about political resistance to managed long term care from the established fee for service systems. Infrastructure is a challenge which affects access, and it is does not exist in some states where the target population for long term care lives. Managed long term care was in its infant stages prior to health care reform, where only 3% of the potential market has enrolled in managed long term care plans.

Challenges in the Long Term Care Sector

The biggest challenge that the long term care sector will face in the future is that baby boomers are set to retire and the number of citizens seeking long term care will increase. In addition new technology and medical advances are increasing life longevity. It is estimated that there are about 77 million baby boomers. Most of this population prefers to receive medical care from home or their community and not in nursing home. Very few of them have prepared for long term care either through insurance or savings. Majority of the baby boomers have fewer children and will most likely be divorced. It is therefore unlikely that they can have family to informally take care of them (Johnson, & Wiener, 2006)

Currently health care reform laws and associated regulations are concerned with the populations that are uninsured and the rising health care costs. However, long term care need to be considered as it may soon become a crisis in the future. Many elderly people live in fear that chronic diseases will drain them financially. This aging population may have to depend on their children or welfare, and this will limit how they want to live at the end of their lives. Long term care will soon become the issue after the health reforms on acute health care systems.

Policy makers need to reform the health care system to ensure that this aging population can access affordable long term care in the future. The current system does not meet the demands of the frail and elderly who require assistance in normal daily life tasks such as bathing, toileting, dressing, cooking, transportation, housekeeping, and managing finances. Long term care is expensive and the cost will continue to rise in future. Long term care is currently funded through Medicaid and Medicare (63%), with out of pocket expenses covering 22%, and the remaining 15% from private sources. Medicaid covers long term care, but Medicare only covers some level of long term care for short durations after hospitalization. Most of the people approaching retirement are unaware of this fact (Johnson, & Wiener, 2006).

Private financing of long term care is through long term care insurance. Currently about 8 million Americans have some form of long term care insurance. These policies vary as long term care insurance is a relatively new product in the health insurance market. Cases of difficulty in getting long term care benefits under some of these policies have been reported. The market for long term insurance is small because families, who can afford to but it earlier in life, do not because they are in denial about ending up in a nursing home when they retire. Other families do not have the necessary information to make a decision and sometimes they do not understand the insurance technical language. High premiums is also another factor that deters families from purchasing long term care insurance (Baer & O’Brien 2010).

As the baby boom generation approach retirement, most of them do not have financial plans for their retirement. This leaves them with insufficient savings to take care of their expenses in retirement. The average nursing home costs about $ 80,000 a year, whereas some of this generation end up with about $70-75,000 in savings when they retire. Additional policy effort is required to deal with the challenges that the long term care sector will face in future. Medicaid and Medicare are already facing huge financial strains due to high health care costs and an increase in demand for services (Calmus, 2013).

Potential Risks and Benefits

As discussed earlier the number of people requiring long term care will increase as baby boomers grow older and the number of non-elderly persons with disabilities increase. The Patient Protection and Affordable Care Act also known as the ACA or Obama care makes long term care services more affordable and protects the rights of consumers. All citizens are entitled to health care until they retire.  The law ensures that people can receive long term care services and support in their homes or community. It provides existing tools, new options and financial incentives for States to provide home and community based services. The aging population will have increased access to health care and the law will ensure quality of service (Gruber, 2011).

The health care reform provides enhance federal funding to states for the provision of person centered and home and community based attendant services. This will increase the ability of individuals with disabilities to live within their community. The law increases access to non-institutional long term services support (LTSS). The Money Follows the Person (MFP) was extended under the law for a further five years. The MFP allows for individuals who are provided with long term care to move out of institutions into their homes and other community based environments. In the area of quality, the law provide for a grant program (TEFT), demo grant for testing experience and functional assessment to test quality measurement tools and ensure quality of long term care services (Gruber, 2011).

The possible risks to long term care associated with health care reform are that the current health reform laws have not critically looked at the future. Long-term care should be part of efforts to improve health care for all Americans. It is believed that long term care affects only a small percentage of the population. 70 percent of people turning age 65 will need long-term care as they age, and about 33% will spend some time in a nursing home  (Wiener, 2009)

There are four critical factors that need to be considered when looking at the possible risks for long term care associated with health care reform. The first one is that the aging population and people with disabilities is going to grow dramatically in the future. The financial burden for long term care will be much greater than before. Health reforms need to consider how this part of the population will access long term care. Reforms need to consider the demographics or characteristics of the people who will require long term are in future as this is very different from those receiving long term care today (Wiener, 2009).

Secondly, federal and state governments are spending huge amounts of money on long term care. Public spending on long term care will increase substantially in the next 20-30 years. Long term care is one of the health sectors that is dependent on public funding. Thirdly, most of the older people with disabilities also incur high acute care expenses as these are related to their underlying chronic diseases. Fourthly, the current health care system under the existing reform laws does not have a proper financing and delivery system. There are no proper mechanisms in place to help people plan and pay for long term care as they grow older (Calmus, 2013).

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Federalism in the U.S Healthcare

Federalism is a national system of government that has both central authority and autonomous jurisdiction in constituencies or states (Holtz, 2008). Without central authority, there cannot be overarching nation state. In the U.S, the Medicare is a national insurance program that is administered by the U.S federal government. This program has been running since the year 1966 and currently uses about 30 insurance companies. Through the Medicare, citizens are guaranteed access to insurance especially those aged over 65 years and have worked and paid for the insurance in the system(Holtz, 2008). The state government, on the other hand, supplements the role of the federal government in providing healthcare. The state government, for instance, monitors quality healthcare evaluates health practices and technologies, supports the acquisition of knowledge for healthcare as well as develops the workforce of healthcare.

Federalism in the U.S is responsible for allocating responsibilities and power between the national and state government (Kronenfeld & Kronenfeld, 2004). Some of the responsibilities may be exclusive to the federal government and the state government and yet in many areas either or all may act. In America’s history, both the state and the federal governments have evolved drastically with philosophies changing to address the needs of Americans. Over the last century, the responsibilities of the state and the federal government have grown alongside the medical responsibilities of the state to improve the well-being of the U.S citizens.

The system from both forms of government is working. Federal funding for instance has jump-started innovation in services and healthcare products at critical junctures where private funding would otherwise prove inadequate. Health information technology has led to cost-cutting and the improvement of healthcare delivery in a number of ways (Shi & Singh, 2012). Policies by the federal government have also supported financing models and the innovation of health service delivery.

The system by the state government is working well in ensuring incentives are being used in a number of programs to support quality reporting and electronic medical records. Such incentives have reduced the time of marketing biologics, devices and drugs(Shi & Singh, 2012). Moreover, incentives for sustainable private investment in high quality and efficient delivery systems in product innovation and delivery models have been a result of the state government.

Improvement can be made among programs and applications beyond their original use. Comparative research can be made through a number of secondary uses such as the gathering of evidence for analysis and comparison of post-marketing activities and effects of drugs for manufacturers of pharmaceutical products. Moreover, the Affordable Care Act through the Accountable Care Organizations can offer opportunities for building on their initial value.

In conclusion, the federal government plays a crucial role in providing quality healthcare to citizens. Through incentives by the federal government, stake holders in both the public and private sectors can work together to ensure that quality and affordable healthcare isbeing delivered to American citizens.

The Role of the Executive in Healthcare Policy

The delivery of healthcare involves many stakeholders who work together to ensure quality delivery. These stakeholders include healthcare practitioners, regulatory bodies, research institutions as well as the government. The government has a particularly important role not only in terms of standards, facilitation and oversight, but also, in terms of policy development. The government safeguards the interest of the public and ensures that they are able to access quality healthcare, through its policies. In its capacity as a health stakeholder, all three branches of government are involved at various levels of governance, from federal to local. The role of the executive branch is examined.

The executive is a branch of the government which constitutionally, is tasked with the implementation of policies developed by Congress (Patel & Rushefsky, 2014). Authority in this branch is centralized around the president, who is the chief executive. He/she possesses executive orders that allow him to make changes. However, this power is limited in that major policy changes require the approval of the Congress. According to Shi & Singh (2014), the executive like the legislative, is a supplier of policy. Different members of the executive including the president, governors and others propose policy amendments which they then push the legislative or Congress to pass into law.

Another manner in which the executive makes policy is through the development of rules and regulations by executives and administrators of governmental departments and agencies. Such rules and regulations are normally a means through which statutes and programs are implemented (Shi & Singh, 2014). This can be understood by considering (Patel & Rushefsky, 2014) contention that laws passed by Congress are usually vague or broad. It is therefore up to the executive branch to fill up the specific details that are required to make the laws fully functional. A good example is provided by Goodman, Hoffman, & Lopez, (2006) who relate that the Health Insurance Portability and Accountability Act enacted by Congress contained broad language. The process of providing detailed guidance was left to the department of health.

The executive also plays an important role by addressing specific areas of health. This role is particularly practiced through regulatory agencies, which form part of the executive (Goodman, Hoffman, & Lopez, 2006). An appropriate example is the Occupational Health and Safety Administration (Patel & Rushefsky, 2014). This institution was tasked with the creation of policy and regulation to address the plight of workers’ health, safety and privacy at the workplace. The executive has moved to take up a more proactive role in governance and healthcare policy.

Clearly, the legislative and executive arms play interdependent roles in the development of health policies. However, the executive should have the largest role in health care. Firstly, this is because of the specialized nature of the executive which has many different departments that contain expert specialist in the particular area of policy development. Thus, such individuals understand the needs of the health care sector. For instance, Goodman, Hoffman, & Lopez, (2006) indicate that public health agencies are tasked with the assessment of a community’s health status. Secondly, the executive unlike the Congress is more readily able to devote itself to the healthcare sector to develop elaborate and detailed policy. This is explicated by the vague and broad policies enacted by Congress which executive arms must detail. Finally and more importantly, the executive is usually non-partisan and this does not interfere with its ability to deliver policy. This is unlike Congress which is sometimes unable to enact policies owing to partisanship amongst its members (Patel & Rushefsky, 2014). This hinders effective policy enactment and as such, this task should be left to the executive.

Step-by-Step Guide of Collecting, Reviewing and Application Of Data to Make A Decision in a Healthcare Setting

A step-by-step guide of identifying the manner in which a person will collect, review, and apply data to make a decision in a healthcare setting.

Data collection

In order to reduce adverse trends in healthcare, hospital or clinic management require keeping correct data of the patients regarding their ethnicity, race and language. According to Walsh and Antony (2007), adoption of a four-step technique shall entail the following steps:

  1. Defining the correct data categories
  2. Developing a data collection methodology
  3. Training and equipping the staff
  4. Monitoring progress or assigning accountability

These data is essential in the sense that it enables the management in charge of an outpatient clinic to stratify product measures to acquire a comprehension of the sources of disparities. It also helps the management to consider, with urgency, where to concentrate its resources and time, and to develop intervention that centre around the patients.  In addition to the above steps, the following steps are essential in collection and management of data in outpatient a clinic setup:

  1. Assembling toolkit for managing data: Data Management Plan (DMP) tool comprises of sample DMPs from various institutions, which facilitate federal funding. It, also, includes of new DMPs writing (Walsh & Antony, 2007).
  2. Planning using DataONE Best Practices and DMPTool (Walsh & Antony, 2007): a plan should always be there as the process develops. It is advisable to revisit the outpatient data management on a regular basis in order to make appropriate changes.
  3. Accurate collection of data as well as checking it (Walsh & Antony, 2007): this can happen in an effective way with the use of DataONE Best Practices. In the event that there are many collectors of data, one requires using a template in order to collect contextual data.
  4. Description and documentation of the data: this can happen with the use of DDC Disciplinary Metadata and DataONE Best Practices (Walsh & Antony, 2007). Comprehensive documentation of data forms the basis of future interpretation and understanding of data.
  5. Selection for a repository for data: tools such as DataONE Best Practices and Databib can facilitate this step in an effective manner (Walsh & Antony, 2007). In this case, the community that shall benefit from the collected are the outpatients.
  6. Storage and preservation of data: it is significant to implement a plan for preserving data that can facilitate the recovery of data in a case where the physical file goes missing (Walsh & Antony, 2007).

Step to be taken in reviewing data:

  1. Review, refine and re-engineer clinical processes (Huang, 2013): the market today has sophisticated databases to offer innumerable functions. Data management process in a clinical setup entails the movement of information through the organization as well as through the database.
  2. Development of proper training and documentation (Huang, 2013): these two processes normally happen hand-in-hand. Training and documentation become essential the moment the management completes reviewing a clinical process and starting the installation.
  3. Develop and strictly stick to data standards (Huang, 2013): this entails storage of correct information in the database, and this happens by following the rules.
  4. Collect data continuously (Huang, 2013): it is essential to continue collecting and updating data in a clinical setup because appearance of new patients with new and different complications everyday.
  5. Always know the kind of information needed from the database: the clinical management should settle on the database system that can perform the duties that it needs. In other words, the database system should always remain effective.

Application of data in an outpatient clinic entails identification of gaps, evaluation and improvement of management activities, and strengthening planning efforts (Walsh & Antony, 2007). This information can help the clinical management to develop a strategy that would help reduce the amount of time that patients take at the clinic whenever they visit it. According to Walsh and Antony (2007), a clinical management map for outpatients can appear as follows:


Patients enter the clinic         secretaries   enter PT into Cerner            secretaries take the chart to the nurses           patients taken to the rooms          essential information taken          chart to resident            chart reviewed by the resident           patient seen by the resident           consult with attending           resident revisits PT          patient released to checkout            Patient leaves clinic to checkout         patient seen by checkout secretary          patient finally the clinic.

One becomes aware of the trend in question by acknowledging that healthcare, today, is an industry that is rich of data, but poor of information. Clinicians collect various points of data, which entails taking every essential element into account. The data that a clinician would want to collect about a patient include names, ethnicity, race and language (Klassen & Yoogalingam, 2013). This is essential for establishing the susceptibility of the community segment in regards to a given condition of sickness. This happens prior to measuring such elements as temperature that would lead to the treatment of the patient. A clinician can apply a qualitative approach to collect the information about the patient. This can happen in form of words, direct interviews, and observation and intensive care studies (Klassen & Yoogalingam, 2013). These methods have the capacity to develop a comprehensive description of specific relationship, people, event or context in a contextual manner that is broad. Qualitative data, in this case, is preferable because it gives information from a patient’s viewpoint. The data would facilitate the response of a clinical officer to an adverse trend by enhancing care prior to a medical process with a patient. The clinician would then concentrate more on the prevailing medical condition than on the non-procedural medical intervention (Klassen & Yoogalingam, 2013). The litigation of the crisis of malpractice affects all care professionals in clinical health. Patients, most cases, sue healthcare providers for professional negligence that results into injury from intentional acts and omissions, breach of contract and defective products. In healthcare delivery, it is essential to uphold an altruistic focus; however, managers and clinicians ought to promote appropriate malpractice risk management.

Healthcare Innovation – The Google Glass

Innovation is now one of those drone words that means several things to various individuals such as advance in technology, discovery, or inventiveness. Regardless of its definition, steady and constant innovation has developed the medicine world to new and greater heights, and thus we are the recipients of the ever- advancing health care system (Hwang, 2010). However, most of these advancements and improvements in healthcare systems have been liable for aggravating the high rising costs. As a consequence, there is the existence of venerable oppositions and inconsistency in our stance toward healthcare. Conversely, advanced technologies are gripped as sustenance to better medical care, however, belittled or denigrated as a determined route to self-crumble.  Therefore, the above absurdity needs people to understand that innovation is not just advanced technologies but the implementations of the chosen technologies (Banova, 2013).  Nonetheless, the expertise and technical can be easy and straightforward but the permanent changes in many industries.

 Select and describe a medical innovation that exists today in the medical industry.

The Google Glass

The wearable technology is in its formative stage, although it has begun to have extensive influence in many career fields and industries. It is known that Dr Rafael Grossmann, the first surgeon to use the wearable technology, and to be precise the Google Glass. The innovation of the Google Glass is continually advancing and improving the health care systems, and both the practitioners and the patients are significantly benefiting from the wearable technology.  Additionally, the Google Glass has the capability to improve how patients and practitioners interrelate and interact with one another, which is increasing patient’s satisfaction, producing competent doctors, and efficient communication between the involved parties.

Further, the wearable technology has created telemedicine opportunities, which permits medical practitioners to offer medical care in concrete and particular capabilities. Nonetheless, the technology is now implemented by professionals providing clinical counsel through email or phone, for instance, the wearable technology is now greatly used in the United States (Plesk, 2003).  Consequently, the innovation of Google Glass is paramount, as it has now reduced deaths caused by emergencies and traumas. Since the capability of the patients and doctors to communicate using the wearable technology is significantly saving lives.

Explain how the innovation will benefit patients or the health care industry.  For example, explain if the innovation will improve the quality of life.

The change of the Google Glass is significantly enhancing the quality of life as it both merges human expertise, and technology. The surgeons now have the ability to perform an operation, when observing the vital signs of the patients simultaneously. Also, the nurses and medical assistants have the capability to obtain the patient’s information through their glass screen at their bedside.

Consequently, the doctors are ecstatic about the great prospective of the Google Glass in the healthcare system (Katz, 2013). Further, medical students are significantly benefiting from the wearable technology as they now prepared with expertise that allows them to combine human intelligence and artificial strengths. Therefore, the medical students will be equipped scientific insight, which is needful to run the health systems in the future.

Explain if you believe the medical innovation will increase or decrease health care spending

While, the general effects and impacts of health care innovation are advantageous, from a societal standpoint, some innovation is profligate, and decadent. Most developers spend a lot of resources on expanding, protecting their markets, or making adjustments to their current and existing product lines so as to differentiate their products from the rest. Consequently, health care innovation will increase the health care spending. Since the developers of the innovations are striving and seeking profits, and only attracted to fields, innovates, and industries which they believe that they can make profits, and the medical field is one of the profitable avenues the developers are eyeing (Katz, 2013). Conversely, the government should implement policies to govern and reduce the health costs, and also safeguard innovation in the healthcare systems.

Explain why this innovation will or will not be a trend in the future.

The health care innovation will still continue to be a trend in the future. The innovation has benefited many patients and brought improved and progressive changes to the health systems. However the medical practitioners and healthcare workers need to be concerned and enhanced in research, patient care, and training. The advancement of technology and innovation in health systems have resulted in prolonged years of terminal illness and increased the survival rates of patients with genetic disorders (Katz, 2013). Consequently, the advanced technology and innovation have placed more power in the hands of the patients, and the greatest challenge for the researcher is to learn how to fight and combat disorders through connecting and harnessing the body’s capability to grow and heal. However, the advanced healthcare innovations have brought some challenges such as high health costs.

In conclusion, innovation in health systems is very significant as it has allowed interaction between doctors and patients. Also, it has helped to increase the survival rates for patients with terminal illnesses and genetic disorders. Therefore, innovation has significantly contributed to advancing the medicine world.

Impact of Nursing Theory upon Healthcare Organization

A mid-range theory in nursing is an approach to sociological theorizing focused on assimilating theory and empirical research. In the nursing field, several middle-range theories are required so as to cope with the entire phenomena contained in a conceptual model since each approach takes care of only some degree of the absolute reality covered by a theoretical model. Every conceptual model, therefore, is more fully spelled out by several middle-range theories.

Mid-range theories get applied in many instances in the field of nursing. In fact, they get applied by nurse leaders or nurse managers in dealing with administrative issues. In reality, all nurses are leaders who employ entrepreneurship, creative decision making, and life-long learning to produce a work environment that is cost-effective, efficient and committed to quality care.

An example of a mid-range theory that nurse leaders and nurse managers can use to deal with administrative issues is Adam’s conceptual model.   Adam came up with the theory, and he believesthat a theory can get employed in more thanonediscipline. However, aconceptualmodelfor a subject applies to that particulardiscipline (Fitzpatrick, & Whall, 2005). A conceptualmodelconsists of beliefs,assumptions,andvalues,and other majorunits.

By this model, the goal of nursing for nurse managers and leaders is maintaining or restoring the client’s independence in the satisfaction of their fundamental needs. Each need has physiological, biological, and psychosocial aspects. The nurse supplements and complements the client’s knowledge, strength, and will. Resultantly, if this theory gets strictly employed, then crisis can be avoided especially when it comes to staff performance.