...facing the overcrowding of emergency rooms within the United States. There is a current epidemic of the population that relies on emergency room care as primary care. “The 2004 National Hospital Ambulatory Medical Care Survey (NHAMCS) reports an 18% increase in the number of visits to emergency departments from 1994 to 2004.” This causes long wait times and may cause emergency room doctors and nurses to be overworked allowing for a possibility for mistakes to handle the volume. “Overcrowding is defined as a situation in which demand for emergency services exceeds the ability of a department to provide quality care within acceptable time frames.” Overcrowding can delay care which is a patient safety issue and can lower patient satisfaction. “The Joint Commission on Accreditation of Healthcare Organizations' review of sentinel events has attributed patient deaths to delays in patient care. In hospital emergency departments, delay of treatment is the most common type of sentinel event.” It is stated in this article that of the 14 million visits to the emergency room only 12.9% are considered emergent. The problem is stated that some emergency rooms only employ physicians and the can burden the physicians with the non-emergent complaints. There is evidence the use of nurse practitioners in the emergency department do provide high quality care. This description of the problem is...
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...Executive Summary A community assessment of the Frogtown and Summit communities along the University street corridor revealed several health disparities and flawed processes in the way care is delivered to these populations. One of the most pervasive problems is not accessing the correct level of health care when illness, injury or disease occurs. There are many factors for this occurrence. These include a lack of awareness, different cultural norms about health, language barriers and an ineffective or absent health care triage system. The identified problem is knowledge deficit of accessing appropriate health care related lack of knowledge related to accessing proper level of health care as evidenced by inappropriate use of emergency services for non emergent care needs. Background and context Four intrepid nursing students from St Catherine University undertook a community assessment of University Avenue from Snelling Avenue east to the capitol buildings otherwise known as Frog Town. Conversations occurred with stakeholders including paramedics and local citizens at a Salvation Army. One disturbing trend that was identified is the use of emergency medical services and emergency rooms for routine care needs such as stomach flu. This occurs and is reinforced for several reasons. One of these is the 1986 legislation EMTALA that enforces that all hospitals must see and treat everyone regardless of their ability to pay. This is an unfunded mandate which means no reimbursement...
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...available to care for patients, and the lack of follow through on ED protocols. This section will address two key issues pertaining to EMC. These issues are fast tracking the ED at EMC and the need for specialty physicians to care for patients. The average occupancy rate of the hospital is 50 percent. The emergency room was created for 16,000 visits but sees over 45,000 visits. EMC serves the medical needs of the local community, regardless of social, ethnic, or religious background. EMC’s customer base is a growing, aging, and culturally diverse population. Over half of the ED visits are by uninsured or underinsured patients. EMC was the last independent hospital in the area. Managed care was encroaching on the area, including Kaiser Permanente. Kaiser was set to make significant inroads to the EMC service area in the next 18 months. EMC expected the strong possibility to contract with or be acquired by Kaiser. An additional threat by Kaiser Permanente existed because they were planning to build a facility close to Emanuel Medical Center. With the implementation of EMTALA, hospitals were required to give access to emergency medical care for all regardless of the ability to pay. HMO’s and government programs lowered reimbursement rates to the hospital. The ED continued to remain a financial burden as well as an unsatisfactory experience for patients. The service standards are declining, morale is low, and staffing is an issue. Patients seek primary care at the ED because...
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...Regulations Health care in the United States has changed over the years and the federal government saw need to establish regulatory agencies such as the Centers for Medicare & Medicaid Services (CMS) to ensure the elderly, disabled and low income receive quality and cost-effective health care. As a result of health care costs sharply increasing, the government determined it needed to have oversight on the health care industry and pushed for the establishment of managed care organizations (MCO). CMS enforces the Emergency Medical Treatment & Labor Act (EMTALA); this act was created to ensure health care organizations provide a minimum of a medical screening exam to determine if complaint is emergent or not. Most importantly for EMTALA is the obligation to treat emergent cases regardless of the patient’s ability to pay for services. In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was approved by the United States Congress to regulate the use of and protect patient health records and the Department of Health & Human Services oversees the compliance and violations of HIPAA (Department of Health & Human Services, n.d.). The intentions of many of these regulatory agencies is to oversee that the health care industry is providing quality, affordable health care and treating patients with fairness and privacy. In 2008, the Centers for Medicare & Medicaid Services (CMS) projected that by 2017 the “annual health care spending in the United...
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...stakeholders in the community. At VODI, Lucille Smith was instrumental in coordinating our site visits, interviews and focus groups and an essential resource through the course of the project. We would also like to thank Amani Younis for her help in facilitating two of our focus groups. The Voices of Detroit Initiative is a partnership between the leading health system providers in Detroit, federally qualified health centers and the Detroit Health Department. VODI focuses on bringing all segments of the community together to address the issues of access to cost-effective health care for the uninsured. We would also like to acknowledge William Schramm at the Henry Ford Health System for providing us with important information and resources regarding the emergency department at Henry Ford Hospital. The Urgent Matters team would also like to recognize the many individuals in the Detroit health care community who gave generously of their time and provided important and useful insights into the local safety net system. The Detroit, Michigan, Safety Net Assessment would not have been possible without their participation. We are especially grateful to Pam Dickson, MBA, Minna Jung, JD, Chinwe Onyekere, MPH, John Lumpkin, MD, MPH, Calvin Bland, MS, and Risa Lavizzo-Mourey, MD, MBA, of The Robert Wood Johnson Foundation for their support and guidance throughout this project. Finally, we would also like to thank...
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...University of Phoenix Material Week 2 Health Care Terms Worksheet Understanding health care terms is a prerequisite for both academic and professional success. This assignment is intended to ensure you understand some of the basic terms used in this course. Complete the worksheet according to the following guidelines: • In the space provided, write each term’s definition. You must define the term in your own words. • In the space provided after each term’s definition, use the term in a sentence as it applies to the health care industry. You may wish to consider the following: o How has it influenced heath care? o What role has the term played as health care developed over the years? Save the completed worksheet as a Microsoft® Word document with your name in the file name. Submit the file to your facilitator. Submitted by: Term Definition Use the term in a sentence as it applies to the health care industry. Health Promotion It allows for people to take more control over their well being Patients should be taught about health promotion to encourage them to living healthier happy lives. Disease Prevention Actions that are put into place to prevent the onset of a disease by early detection Hand washing is the number one disease prevention that can be done to avoid spreading it to other people. Diagnosis Identifying the cause of a disease The blood work came back this morning and it confirmed the patient’s diagnosis. Rehabilitation A place where...
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...This paper will explain how the past health care has change and the dynamics behind the changes in the health care industry today. Also in this paper the importance of financing and technology in the health care. The discussion of the complexities that is associated with changing demographics and emergent diseases, and the fluctuating and daunting challenges that management mortality trends that the Baby Boomers generation predicate. Summarize the key milestones involved in the past and present shaping and transitional dynamics behind changes in the present healthcare industry. 1850-1900 was a time were the environment condition such as water sewage disposal, contaminated food, inadequate housing were the cause of illness of infectious disease in the United States. People had to rely on home remedies, or woman who took care of the ill and no medical care was available. Doctors had little training in the scientific technology field and hospital was dirty run down which bought about a threat to life because of the diseases. Public health problems came about with such epidemics of acute infectious diseases. Before World War II military families and officers could get free of charge medical care. The federal government was not involved, they left it up to the states and the states had little to do with it. They left it up to private and programs that were voluntary. By 1930s hospitals were giving services to individuals on a pre-paid basis which, allowed for members to...
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...of Australia States gradually devolve their powers in relation to ex-nuptial children to federal court. States maintain individual jurisdiction for child protection. 1987 Legislation in NSW Ascension of Children (Care and Protection) Act. (see hand out) Supporting Families Emergent view that it is better to support families and have children safely remain in the family unit than to remove the child. Late 20th Century Foster Care Growing body of evidence indicating foster care is preferred model of out of home care over residential care models. UN Convention on the Rights of the Child Development of convention. First developed by the League of Nations in 1924. Ratified by UN in 1990. Australia one of the first signatories. Mandatory Reporting The new legislation brings in mandatory reporting. That all professionals whose work is associated with children must report instances where they are “at risk of harm”. Out of home care (OOHC), Non-Government organisation (NGO), and Children’s guardian (OCCG) Increased use of non-government out of home care placements. NSW Children's Guardian introduces standards framework for OOHC. 1998 New Legislation in NSW Assentation of new child protection legislation, Children and Young Persons (Care and Protection) Act....
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...The EHR alerts the nurse to the presence of two SIRS criteria. This step does require an element of critical thinking by the nurse. Nurses use the clinical assessment and the data from the EHR to help develop a clinical picture of the patient's condition. The application of expertise and intuition is driven by the nurses exposure to sepsis scenarios. Does the patient have assessment findings or any history element that leads the clinician to believe that the activation of the alert was related to early sepsis? Policies guide sepsis care and allow for autonomy of the nurse to order the screening panel if criteria are met. To execute this decision, the workflow involved includes knowledge related to sepsis, history and physical assessment details of the patient, and knowledge related to the alert...
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...other problems. By focusing on those emergent health problems common in seniors, the need for some resources is greatly reduced (Sancya, 2011). Health Issues Facing Seniors Health issues seniors commonly face include Diabetes, high blood pressure, heart disease, stroke, infections, dehydration, dementia and Alzheimer’s disease, infections, injuries from falls, and cancer. Coronary heart disease, cancer, stroke, pneumonia, and influenza can all be serious conditions requiring urgent care (Levy, 2013). Hospitals catering to aging populations have an opportunity to compete with institutions that treat all adults, by focusing on treating the conditions seniors face, as a competitive advantage. Institutions that cater to seniors can focus on hiring only those specialists that have specific Knowledge related to treating the illnesses common in seniors. Supportive care for influenza and knowledge of epidemiology may be one specialty. Cardiology, Neurology and Oncology may be other specialties requiring specialized knowledge and experience of providers. Organizations Serving Seniors Seniors seek medical care in a variety of places. Senior residential facilities are typically utilized for those who can no longer care for themselves, due to decline in physical health or mental functioning. Seniors in such facilities may receive basic care, such as assistant with daily activities and monitoring/administering medication. They may receive total care for a multitude of health problems...
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...The Uninsured Persons Access to Healthcare March 8, 2015 The Uninsured Persons Access to Health Care Health insurance is a luxury. This is something that has become apparent listening to the ongoing debate about healthcare reform. The Center for Disease Control and Prevention reports that in 2013 there were 44.3 million uninsured people under age 65 in the United States. The purpose of this paper is to discuss how these 44.3 million are able to access healthcare and how there lack of access is detrimental to everyone. The Uninsured Two-thirds of people who are uninsured are between the ages of 18-65, have a job and more than half of these older adults have an increased risk of serious health problems. Being uninsured breaks all gender and ethnicity barriers and affects mainly the poor or near poor (Mason, Leavitt & Chaffee, 2014). Uninsured people have less access to preventative services and have more trouble finding a doctor or finding one that will take them as a new patient than those with public or private insurance (Gindi, Kirzinger & Cohen, 2012). When they do seek out medical attention many times it is in an emergency room and there illness may be in more advanced stages which means that there treatment will be more expensive. According to the Agency for Healthcare Research and Quality (AHRQ) the average ER visit can cost around $1500, the subsequent bill for these visits can be difficult to pay when that is more than you make...
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...Reporting Practices and Ethics Paper HCS405 July 29, 2012 Professor C. Brew Reporting Practices and Ethics Paper Financial accounting and financial management are the basis for health care accounting. The GAAP is a cornerstone of all accounting practices. Financial management aides and guides health care accounting practices in today’s health care settings. These two elements are the building blocks for a solid health care organization. Without the two, there is risk of fraud and unethical practices within health care. In financial accounting there are four elements of financial management. The first element is planning. In the planning element of financial management, the objective is determined and then the steps needed to reach that objective are identified so that the goal of accomplishing the objective can be met. The second element of financial management is controlling. In controlling the goals set in the planning element are monitored to ensure that the goal is on track. In the controlling stage of planning, managers use reports to track the goals, compare information and to gain feedback on the status of the goals. Organizing and directing is the third financial management element. In this element the manager works daily to track the progress of the goals, reviews daily the results of the organizing and is active daily in the progress of the goals. The final element of financial management is decision making. In the decision making element the financial...
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...Health Care Resources Matrix Research 4 to 5 health care laws related to health care resource allocation. Complete the table below: |Health Care Law |Describe the health care law (75 to 150 words) |Analyze the importance of the law (75 to 150 words)|Analyze the impact the law has on health care | | | | |resource allocation | | | | |(75 to 150 words) | |Affordable Care Act (ACA)- March 23, 2010 |The Individual directive requires all Americans|Affordable Care Act (ACA) or Obama Care is making |The ACA prohibits a health plan from canceling | | |to maintain health insurance. The Employer |health care more affordable and more accessible to |coverage of an enrollee except in the case of fraud | | |directive requires all employers with 50 or |all people. The Affordable Care has provided |or intentional distortion. Before the ACA the | | |more full-time equivalent employees to offer |affordable care to many...
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...Emergency Room (ER) overcrowding has become a big issue within the healthcare industry. Many people had high expectations that the Obama Affordable Care Act would help reduce the high volume of patients seen in the Emergency Departments. Instead, ER visits have increased. Although Obama Care has increased healthcare services within the medically uninsured and underserved populations through Medicaid and Medicare programs, this community of people tends to utilize the emergency department as a form of primary medical care, and most of these visits are not actual emergencies. In fact, ER visits are costlier compared to routine primary care visits, and the high cost of ER visits affects hospitals tremendously, a hospital cannot turn away patients....
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...that the Emergency Department has become overwhelmed with individuals seeking health care most of who do not have emergent conditions, but are unable to access health care through other means. Moreover, he adds that “the city has a lack of adequate medical facilities especially for low-income individuals or indigents.” The doctor also suggested that citizens should be educated on particular symptoms because most of the time an injury or sickness can be treated at home. This increasing hospital capacities force people to come to the Emergency Department for basic health care treatment thereby increasing the waiting period to exceed six hours. ED sees critical capacities in Episode 7 addresses a community health issue. In accordance with Stanhope & Lancaster (2008), the “focus of community health nursing practice is the health of individuals, families, and groups and the effect of their health status on the health of the community as a whole” (p.17). Flu deaths expected to rise: Episode 11 According to N. Mckinney, health officials are preparing for the worst this flu season. They are claiming that they expect flu-related deaths will increase. Additionally, the officials maintain that the groups most at risk for flu and dying from the disease are the elderly, those with chronic health conditions, and infants. This past year, many people died from the flu statewide. Health care professionals have attempted to create a salience with health fairs; however, they fear...
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