...Contents Executive Summary 4 Analysis of the existing HHS foundation for execution 4 Definition of the Operating Model for HHS 5 HHS – H&C, Unification Model 6 HHS – P, Coordination Model 7 HHS – RF, Coordination Model 7 Operating Model Summary 8 Steps to Implementing the Operating Model 9 Proposal for an Enterprise Architecture 11 IT Capability 12 Business Objectives 12 Funding Priorities 13 Key Management Capability 13 Who Defines Applications 13 Key IT Governance Issues 14 Strategic Implications 14 Summary of HHS Architectural Stage 14 Setting Priorities to implement Enterprise Architecture 15 Changes in Business Process 15 Changes in Business Roles 16 Rationale for Changes 16 Changes in Organizational Structure 16 Changes in Business Partner Relationships 17 Setting Priorities Summary 17 HHS IT Engagement Model Recommendations 18 Companywide IT Governance 18 Project Management 19 Linking Mechanisms 19 Business Partner Communications 21 New Opportunities 21 Outsourcing Opportunities - Recommendations 21 Size and Scale Matter 22 Simple Example 22 Not so Simple 23 Complex Outsourcing 23 Plug and Play 24 Growing the Organization - Recommendations 25 Organic Growth 25 Growth Through Mergers and Acquisitions 26 Optimization before Growth 26 Operating Model Dependency 26 Growth Summary 29 Summary of Enterprise Architecture Proposal for HHS 29 References 31 ...
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...Accountable Care Organizations (ACO) When some doctors, healthcare providers and hospitals get together to give their patients a high quality and well coordinated care, forms an organization. This organization is known as Accountable care organizations. ACOs are based on integrated systems of delivery and posses a range of doctors and physicians, virtually connected. The aims of this organization is to look after the patient and deliver them right treatment at the right time and also coordinate all the efforts so not to overlap or repeat anything. This results in reduction of the medical errors. This procedure saves the cost of medical treatment. Another important aim is to stop spread of diseases through preventive measures and spreading education. The most important objective is to bring reduction in costs and reduce the waste of money in healthcare system. The conditions which will result in ACOs,if physicians and other related professionals are practicing in a group, or they have form a network or there exists a collaborations between physicians, hospitals and professionals. If these conditions exist anywhere it will be called as ACOs. The requirements any ACOs need to fulfill are, it must have a formal legal framework to distribute the savings, it should possess a minimum of 5,000 numbers of beneficiaries, it should agree to take part for three years or so. An organization must fulfill these requirements to form a ACOs. (American Hospital Association, 2010) This new treatment...
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...Accountable Care Organizations: Key to Transforming Healthcare? The Talia Goldsmith, MHA Candidate 2011 Suffolk University Sawyer Business School HLTH 890AE: Healthcare Strategic Management Professor Richard H. Gregg, M.A., M.B.A. April 28, 2011 Table of Contents Objective .....................................................................................................................................3 Introduction ..............................................................................................................................3 Overview of ACOs as a Mandate and an Opportunity for Healthcare Organizations............................................................................................................................4 Examples of Missions, Visions, Values and Goals for ACOs........................................6 Mission ................................................................................................................................................. 6 Vision ....................
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...Navigation and the Impact on Breast Care Christina Reid-Brown California Baptist University Foundations of Management BUS 503A February 9, 2015 Dr. Marc Weinger Abstract This research paper evaluated the relationship between navigation and navigator roles as they relate to the patient journey with breast cancer. The goal of the research was to determine if these care coordination models eliminated institutional barriers experienced by patients trying to coordinate breast care in a complex healthcare system. It also evaluated the effectiveness of the navigator role as it supports the elimination of barriers to care for minorities and women living in low-income and underserved communities. This study reviewed the results from surveys given to women being treated for breast cancer at different hospitals, and cancer clinics to determine if navigation improves patient access to appropriate evidence-based healthcare. The findings showed higher patient satisfaction and compliance, continuity of care, decreased anxiety levels, and increased social support systems from families and friends when navigation services were provided. Key Words: Patient Navigator; Breast Care Coordinator; Breast Care Patient Navigator; Breast Cancer in Women; Current Studies involving Breast Cancer Introduction Breast cancer is the second leading cause of death and the most common disease found in women living...
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...J O U R N A L F O R N U R S E S I N S T A F F D E V E L O P M E N T Volume 22, Number 1, 15–20 A 2006 Lippincott Williams & Wilkins, Inc. The Clinical Scholar Model (CSM) is a . . practice–education partnership focused on . . Clinical Scholar Model improving the outcomes of clinical nursing . . . education by bridging the academic and . . Providing Excellence in Clinical service settings. An expert clinical nurse . . . Supervision of Nursing Students serves as a clinical scholar (CS) to . . coordinate, supervise, and evaluate the . . clinical education of nursing students in . Gayle Preheim, EdD, RN, CNAA, BC . . collaboration with school of nursing faculty. . Kathy Casey, MS, RN . This article describes the model’s evolution, . . Mary Krugman, PhD, RN, FAAN . how the model is differentiated from . . traditional clinical instruction roles and . . responsibilities, and the benefits to the . . . collaborating clinical agency and school . . of nursing. . . . ................................................ . he shortage of nurses and nursing faculty experienced throughout the nation provides opportunities for increased collaboration between clinical agencies and schools of nursing (Rice, 2003). Recently, nursing schools across the nation have increased enrollments to address the nursing workforce demands (American Association of Colleges of Nursing [AACN], 2003b; National League for Nursing, 2004). Clinical agencies have responded to these expanded enrollments by adding...
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...improving Quality and Value in the U.S. Health Care System August 2009 Preamble The Bipartisan Policy Center (BPC) is a public policy advocacy organization founded by former U.S. Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole, and George Mitchell. Its mission is to develop and promote solutions that can attract the public support and political momentum to achieve real progress. The BPC acts as an incubator for policy efforts that engage top political figures, advocates, academics, and business leaders in the art of principled compromise. This report is part of a series commissioned by the BPC to advance the substantive work of the Leaders’ Project on the State of American Health Care. It is intended to explore policy trade-offs and analyze the major decisions involved in improving health care delivery, and discuss them in the broader context of health reform. It does not necessarily reflect the views or opinions of Senators Baker, Daschle, and Dole or the BPC’s Board of Directors. The Leaders’ Project was launched in March 2008. Co-Directed by Mark B. McClellan and Chris Jennings, its mission is (1) to create a bipartisan plan for health reform that can be used to transform the U.S. health care system, and (2) to demonstrate that health reform is an achievable political reality. Over the course of the project, Senators Baker, Daschle, and Dole hosted public policy forums across the country, and orchestrated a targeted outreach campaign to...
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...Access to health care is limited in the rural setting so it becomes imperative to educate the patient regarding their illness, treatments, management, medications and when to seek medical assistance. Providing this information to the patient and educating them, the patient is better able to self-manage their condition. Kouame (2010), identified the key challenges facing the rural population as: low population density, limited to no services, disproportionate numbers of elderly, low-income, and minorities, social isolation and a high incidents of chronic illnesses. Health promotion is defined as the process of enabling people to increase control over and improved their health. Improving health literacy is key in empowering the rural community...
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...Introduction: The first Part of this paper will review the literature to define Classification. Briefly Discuss DSM IV and ICD 10 and list the main categories of clinical disorders. The paper will discuss the main dangers of classification identified as labelling and Stigma which have lifelong implications for those diagnosed with a mental illness. The main advantages of classification such as most appropriate treatment and community education Definition of the Classification system used to Diagnosis Mental illness. As Social workers it important to try and grasp the concepts of how classification of mental illness is arrived at and to have a basic knowledge of the types of mental disorders people can be classified as having so we can understand the basis of a diagnosis. According Mendelson (2001) “Classification refers to ordering of objects into groups on the basis of their relationship. The result is a classificatory system. Nomenclature related to agreed names that have been assigned to disease or syndromes. Taxonomy covers principles and methods underlying the practice of classification. Finally, nosology denotes the conceptual system that supports the strategy of classifying.” ( Mendelson 2001 p. 63) Golightley (2004) text states that classification is an important step towards the diagnosis of a mental disorder. Mental disorder is broken down into various classifications that represent groups or syndromes of symptoms. Thus if a series of symptoms fits into...
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...Accountable Care Organizations May 5, 2012 Accountable Care Organizations represent a strategy outlined within the Affordable Health Care Act to control costs and improve quality. They require partnerships between providers, hospitals, and communities. There are challenges in health systems where private practice is the predominant practice structure. Key issues and challenges to an effective ACO are cost reduction and utilization management, business model shifts, risk sharing and population management, consolidation, a changing role of IT and value of data, physician integration, clinical process improvement, and consumerism and the patient. How to reduce cost is a question that has been pursued, and it needs to be looked at, as well as utilization of management. Does this mean that homes for critically ill children or a hospital that cares only for transplant patients is becoming the future of health care in the USA? Why Accountable Care Organizations? No one will dispute the high cost of health care in the United States. Critics often say that it is the result of how health care providers are paid. They claim that—with a fee for each service— this results in increased and wasteful spending. Critics say that this system rewards providers just for doing more procedures, rather than for providing efficient and high-quality care (Matthews, 2012). In an effort to handle this problem, the United States Government has passed legislation: The Affordable...
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...Abstract The population of mental illness who seek treatment solely through a primary care physician raises question for concern. Many healthcare facilities and organizations are working on a plan to integrate diverse professions into one comprehensive medical model home to optimize effective patient-centered care outcomes. The goal is to reduce costs, expand the healthcare teams knowledge base while improving patient outcomes. How can the core competency of teamwork and collaboration impact the healthcare delivery system? How can we treat older adults that are more likely to seek and accept psychological services in primary care verses specialty mental health care settings? What are the challenges healthcare providers are facing that impede collaboration? There are many obstacles to face and barriers to cross before health care providers can work together more efficiently to achieve a higher level of teamwork and collaboration. Teamwork & Collaboration in Health Care Teamwork and collaboration among health care providers allows each profession to function competently within their own scope of practice as part of the interdisciplinary team to collaborate on shared goals, respect different views, communicate measureable processes for a positive effective outcome, and expand our knowledge base while providing patient-centered care. The IOM stated that: “An inter-disciplinary /inter-professional team is composed of members from different professions...
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...Barbara Heard MSN 285637 Mentor: Ronda Arnold March 15, 2015 C159/UUT2 – POLICY, POLITICS & GLOBAL HEALTH TRENDS POLICY ANALYSIS TASK Introduction: This assignment requires that I develop and thoroughly analyze a public policy in order to advocate for one that improves the health of the public and/or the nursing profession globally (local, state, national or international). To do this, I must reflect on several aspects of being a policy maker within the nursing profession. I was instructed to consider the following: · Why did I select the health or nursing profession policy issue? · How does this issue affect nursing practice, healthcare delivery and health outcomes for individual, families and/or communities? · What are the values and the ethical positions that underpin my perspectives? · What criteria will I use to evaluate the success (outcomes) of my proposed policy change? I will use both, a top-down and bottom-up approach, in order to analyze and bring the nursing perspective to policy makers and stakeholders. By identifying the values and ethical perspectives that underpin my position, I will develop criteria to evaluate the success of my work which will lead to the creation of a policy brief that can be sent to decision makers and create a plan to work with an organization/community to promote policy change at the local level. Nursing research to support my position is vital in guiding me to my conclusion and will include principles of...
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...Accountable Care Organization is a healthcare organization characterized by a payment and care delivery mode. lt seeks to tie provider reimbursements to a quality metrics and reductions in the total cost of care for an assigned population of patients. A group of coordinated health care providers form an ACO, which then provides care to a group of patients. The ACO may use a range of payment methods, (e.g. capitation, fee-or-service with an asymmetric or symmetric shared savings). The ACO is accountable to the patients and the 3rd party payer for quality, appropriateness, and efficiency of the health care provided. The Centers for Medicare and Medicaid Services (CMS), an ACO is considered an organization of health care providers that agree to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program. This paper identifies the differences between HMO’s and ACO’s but also correlates the similarities between ACO’s and Patient Center Medical Home (PCMH). The ACO’s place a degree of financial responsibility on the providers in hopes of improving care management and limiting unnecessary expenditures while continuing to provide patients freedom to select their medical services. The success and challenges of ACO are identified and explored. By increasing care coordination, ACO’s can help reduce unnecessary medical care and improve health outcomes, leading to a decrease in utilization of acute care services...
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...Health Care Spending The United States is one of the biggest spenders when it comes to health care. In 2010, the U.S. spent over $8,000 per person totaling $2.6 trillion. Currently 18% of our Gross Domestic Product (GDP) is health care expenditures according to Romer (2009). Half of the expenditure payments go to hospital and physicians. With all this spending why are we not healthier than countries that spend one-third less on health care? Here are some key points of our nation’s health care The Kaiser Family Foundation (2012) notes: • In 2010, the U.S. spent $2.6 trillion on health care, an average of $8,402 per person. • The share of economic activity (gross domestic product, or GDP) devoted to health care has increased from 7.2% in 1970 to 17.9% in 2009 and 2010. • Health care costs per capita have grown an average 2.4 percentage points faster than the GDP since 1970. • Since 2002, the rate of increase in national health care spending has fallen from 9.5% to 3.9%. • Half of health care spending is used to treat just 5% of the population. • Although only 10% of total health expenditures, spending on prescription drugs has received considerable attention because of its rapid growth (114% from 2000 to 2010). • In 2008, 27% of the nonelderly with 3+ chronic conditions spent more than 10% of their income on health, compared to 11% of the total nonelderly population. • Many policy experts believe new technologies...
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...y Name: Institution: Course: Tutor: Date: Organizational Systems & Quality Leadership Introduction The core objective of health care is to provide high-quality care to all patients to guarantee positive health outcomes. This principle is a major driver for the commitment of nurses and other care providers. Care providers are required to work in collaboration and include patients in the process of care. Nurses form the core of health care delivery in all facilities. The role they play in the coordination of care is essential for the professionalism of care providers. In the process of care delivery, it is important to understand the medical history of the patient to determine the most appropriate interventions to employ. Care providers should employ interventions that are besides guaranteeing positive health outcomes address the needs and interests of the patient. It is important to include family members in the treatment program since they understand the patient and his needs better. This paper employs Root Cause Analysis approach together with the Failure Mode and Effect Analysis to determine the impact of the events that resulted in the death of a patient Mr. B. A. Root cause analysis The principal purpose of the Root Cause Analysis is to conduct an evaluation of the highest level of the problem to identify the actual cause. In the case scenario, the root cause analysis rules out the possibility of inadequate patient assessment as a contributor to the factors...
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...Organizational Systems & Quality Leadership Name: Institution: Course: Tutor: Date: Organizational Systems & Quality Leadership Introduction The core objective of health care is to provide high-quality care to all patients to guarantee positive health outcomes. This principle is a major driver for the commitment of nurses and other care providers. Care providers are required to work in collaboration and include patients in the process of care. Nurses form the core of health care delivery in all facilities. The role they play in the coordination of care is essential for the professionalism of care providers. In the process of care delivery, it is important to understand the medical history of the patient to determine the most appropriate interventions to employ. Care providers should employ interventions that are beside guaranteeing positive health outcomes address the needs and interests of the patient. It is important to include family members in the treatment program since they understand the patient and his needs better. This paper employs Root Cause Analysis approach together with the Failure Mode and Effect Analysis to determine the impact of the events that resulted in the death of a patient Mr. B. A. Root cause analysis The principal purpose of the Root Cause Analysis is to conduct an evaluation of the highest level of the problem to identify the actual cause. In the case scenario, the root cause analysis rules out the possibility of inadequate patient...
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