...Dying in a Hospital Setting Elizabeth Allegro Aspen University Abstract Acute hospitals play a significant role in end of life care, it is the place where most people die. Evidence suggests that end of life care in hospitals needs improvement. The purpose of this paper was to investigate patient and family experiences of hospital death, the weaknesses within the hospital setting and possible solutions to improve. A literature search identified common themes, these included: * Hospitals are seen as a place of treatment and cure; death may be viewed as a failure. * Good communication between physician and patient is vital for a patient to make an informed choice regarding their care. * Patients may not receive palliative care if end of life is diagnosed too late. * A lack of resources such as short staffing contributes to suboptimal end of life care. Dying in a Hospital Setting Most Americans die in hospitals; many suffer unnecessarily due to the lack of knowledge about end of life care. Some patients receive aggressive treatments up until the time of death. Patients often suffer in vain attempts to prolong life instead of receiving compassionate, comfort care. Death is part of life, sooner or later everyone will face death. It would be easier if one was prepared for it. Communication is important to prepare for death. There is often an expectation of a cure when a patient is hospitalized;...
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...changing. Patient care is reported out to the public by WebMD, Google, and quality surveys. Patients are more informed, but don’t have the full context to base their opinions in reality. Hospital visits, whether inpatient or outpatient are measured by HCAHPS. (The Hospital Consumer Assessment of Healthcare Providers and Systems) The survey is a great tool to measure patient outcomes and level of quality provided by hospital staff members. The disadvantage is the data is collected weeks, to months afterwards and the feedback is not being addressed in a timely manner. The “Quality Survey Server” is a new opportunity, a new and immediate way to collect and make data-driven decisions. The QSS is a service that hospitals can use to acquire their patient experience outcomes. The survey questions will measure patient’s experience either before their appointment or after. The development of the survey will be based on management choices. Data will be collected and put onto a survey poll report that the manager or leader of the department can view real-time. The Quality Survey Server has other modules available for purchase. The QSS dashboard is a service which aggregates the data and delivers a comprehensive quality metrics dashboard. The dashboard will provide detailed analysis and graphics providing leadership with their chosen metrics which they can analyze and deliberate with staff. The additional modules can be patient safety, hand washing, risk, and patient experience. The QSS...
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...The Shouldice Hospital was created by Dr. Edward Earle Shouldice who is the inventor of the Shouldice method which is a hernia surgery designed to reduce recovery time and improve surgical results. The method was in response to men who couldn’t enlist in the military due to complications and it would quickly restore their physical fitness for military training. Due to high demand and scarce hospital space, Dr. Shouldice decided to open up his own hospital specializing in his unique hernia repair method. At the Shouldice hospital, only external types of hernias were performed creating a facility that offers expertise and specialization in their service. There are numerous characteristics of the Shouldice hospital that differ from most other hospitals. The most significant difference is the performance of a single operation and nothing else. This helps provide customers were assurance that they are being taken care of by knowledgeable professionals who have performed hundreds of similar operations. Not only were they getting a quality service, but a speedy recovery time helped to add value to their experience. In addition to the surgery received, the entire experience of a quick check in, a comfortable atmosphere, an opportunity to create relationships, well prepared meals, and the freedom to move around are all services which help to differentiate themselves from your typical hospital. This helps to relieve stress and anxiety many people have when getting a surgical procedure...
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...quantitative, observational study with cross-section design Objective: To examine whether the proportion of hospital RNs educated at the baccalaureate level or higher is associated with risk-adjusted mortality and failure to rescue (deaths in surgical patients with serious complications). Purpose: "We tested whether hospitals with higher proportions of direct-care RNs educated at the baccalaureate level or above have lower risk-adjusted mortality rates and lower rates of failure to rescue (deaths in patients with serious complications). We also examined whether the educational backgrounds of hospital RNs are a predictor of patient mortality beyond factors such as nurse staffing and experience. These findings offer insights into the potential benefits of a more highly educated nurse workforce." Conclusion: In hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates. "Our findings indicate that surgical patients cared for in hospitals in which higher proportions of direct-care RNs held bachelor's degrees experienced a substantial survival advantage over those treated in hospitals in which fewer staff nurses had BSN or higher degrees. Similarly, surgical patients experiencing serious complications during hospitalization were significantly more likely to survive in hospitals with a higher proportion of nurses with baccalaureate education." "Nursing education policy reports...
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...Running head: WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 1 David M. Dowling Operations Management I Southwestern College 20 January 2011 Week 3 – The Culture & Quality at Arnold Palmer Hospital Running head: WOULD YOU RECOMMENT A FRIEND TO OUR HOSPITAL? 2 Abstract In this paper I will demonstrate the importance of instilling a culture of quality in employees and why it’s essential to establish a concise mission statement, code of ethics, procedures and processes that employees can utilize in order to carry out the hospitals philosophy and mission. I will also show what systems and processes I would set up in a new hospital to achieve a culture of quality in a hospital. The paper will also show some of the processes that the Arnold Palmer Hospital in Orlando, Florida uses to achieve such a high success rate in customer satisfaction. The bottom line of this paper is that it’s easy to claim or make the statement that a hospital provides a quality service. It’s another thing to deliver. Learned and established techniques from this text will help an operations manager achieve the desired goal for establishing an environment of quality, excellence and profitability. Running head: WOULD YOU RECOMMEND A FRIEND TO OUR HOSPITAL? 3 INTRODUCTION...
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...Hospital Comparison Many people are interested in how their local hospital or hospitals are performing and are interested in a grading system that will allow them to evaluate the level and safety of patient care that is being provided (medicare.gov). On the Medicare website, http://medicare.gov/hospitalcompare, consumers are able to evaluate this information. This site provides information on several aspects of care including timely and effective care, use of medical imaging and readmission complications and deaths (medicare.gov). This paper will look at comparing Platte Valley medical center in Brighton Colorado, with Columbus community hospital in Columbus Nebraska. Both these hospitals are smaller facilities and are acute care hospitals. The comparison of these two hospitals will be in the category of timely and effective care. First a comparison will be done on timely and effective care for heart attack care. The next comparison will be conducted on Heart failure care. The comparison will look at these two similar hospitals and assess how effective and timely the care is in these two areas and will also compare them to the national average. The first subcategory to compare will be “Outpatients with chest pain or a possible heart attack who received aspirin within the first twenty four hours of arrival or before transferring from emergency department (medicare.gov). This is an important measure to look at as there is evidence based practice and studies that indicate...
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...Healing Hospital: A Running head: HEALING HOSPITAL: A DARING PARADIGM 1 Healing Hospital: A Daring Paradigm Ruth Casanova Grand Canyon University Spirituality in Health Care HLT 310V March 25, 2012 Healing Hospital: A Healing Hospital: A Daring Paradigm Introduction The healing hospital paradigm is a hospital model that focuses on the recovery and 2 wellness of the patient as a whole. Unlike traditional care models that mainly focus on cures for ailments by way of medications, procedures and other medical interventions, healing hospitals take into consideration the whole person; body, mind and spirit as well as the environment in which they are cared for as an integral part of the healing process. In these hospitals, a holistic and family-centered care approach is crucial. There are 3 major elements that are basic to a healing hospital: a culture of fundamental love, an environment that fosters healing and aids in recovery and finally an integration of technology and an efficient work design to deliver safe and timely care. This paper will present the elements that comprise a healing hospital, the role that spirituality plays in the recovery of health as well as potential challenges that may impede progression towards the future implementation this model of care. Elements of a Healing Hospital A healing hospital is more than the physical building and the grounds that surround it. A healing hospital is a complete entity that is comprised of the patients, their...
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...Patient Satisfaction Introduction [The medical field is very important to us all, and when you become the patient in a hospital your mindset changes all together. This paper will be about patient satisfaction while in the hospital. There are major concerns when patients or their family are admitted into the hospital. Hospitals are very concerned with patient satisfaction and the scores that come with it. Patient satisfaction is very important in hospital settings. The patients are the heartbeat to the large body of doctors, nurses, aids, and dietary. Being able to effectively make the patients stay or visit more satisfactory is important in a hospital. The hospital process is strict on patient satisfaction being admitted, dietary, and being discharge has a major effect on patient satisfaction.] No One Likes To Be Admitted [When you or a family member has to take a trip to the emergency room they think that they will be fixed and (took out they) back home they go. The time spent in the hospital emergency room is one thing, but when it is time to be admitted things change for the family. After you have been seen and you find out your or your family will be admitted, the process of patient satisfaction and the scores begin. Patient satisfactions while being admitted to the hospital different things occur. The process of being transported from the emergency room to the unit can affect patient satisfaction scores. In measuring quality...
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...Article Review: Excellence in Patient Satisfaction within a Patient-Centered Culture Executive Summary Hospitals should be preparing now for a decade of reduction in Medicare payments that will result from the Affordable Care Act and Budget Control Act of 2011. Many healthcare leaders are anticipating the Centers for Medicare and Medicaid Services’ (CMS) value based purchasing program (VBP), a strategy used by employers, and increasingly the Federal government, to use their market power as a force to promote quality and value of health care services. The overarching goal of VBP is a health care system, built on value, with a clear return for every dollar spent. According to AHRQ, value-based health care purchasing enables buyers to hold providers of health care accountable for both cost and quality of care. Value-based purchasing brings together information on the quality of health care, including patient outcomes and health status, with data on the dollar outlays going towards health. It focuses on managing the use of the health care system to reduce inappropriate care and to identify and reward the best-performing providers. To qualify for the incentive payouts, hospital executives need to look intently at ways to boosts Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. At Windber Medical Center (WMC), this is a 54-bed capacity hospital in western Pennsylvania, invested in a patient-centered culture that helped facilitate improvements in their...
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...Shouldice Hospital Limited Group Project: Summer 2012 Operations Management BUSI-411 D02 Ashley Edwards, Yvette Dennis, Andrew Evans, and Rachel Gillespie Respectfully submitted to Dr. Raja Selladurai Liberty University 8/13/12 Facility The facility of Shouldice Hospital took many years to design and was designed to help aid in the recovery of the patients (Hesket, 2005). Everything was designed around helping the patient to be comfortable, yet encourage movement and socializing of the patients. The design encourages postoperative ambulation, which Shouldice believed aided in recovery (Bendavid, 2003). The building is also efficient in its housekeeping and cafeteria services to help minimize costs. The facility is located in one building that has three floors, with the two lower floors opening out to ground level (Hesket, 2005). This design minimized the need for steps, which can cause discomfort for those who just had surgery. The top two floors contained open lounge areas which creates an environment for socializing. The Florida room is an all glass window room that allows plenty of sunlight to come through, allowing a view of the 130 acre estate. According to Franklin (2012), gazing at scenery such as a gardens or mountains can help speed healing from surgery. The recreational area contains pool tables and exercise equipment. These activities require movement. Shouldice believed that movement and socializing would speed up recovery of patients (Bendavid...
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...improve the current state of health care delivery. As such, the Centers for Medicare and Medicaid Services (CMS) will use the Hospital Consumer Assessment of Health care Providers and Systems (HCAHPS) survey. The CMS website (2013) states, the HCAHPS survey is “the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.” This data set is important to CMS in meeting the Triple Aims goal set by the Department of Health and Human Services National Quality Strategy (DHHS-NQS) of providing better care and improved health at affordable cost while making decisions on how reimbursements will be redistributed to institutions meeting these goals. Our group chose this system structure because the analysis generated by the use of HCAHPS will greatly help change delivery of quality care in the next five to ten years. How the Structure Applies HCAHPS is rapidly becoming the national standard on assessing patient experience. The survey is randomized to adult patients admitted to medical, surgical, and maternity care service lines; the survey is not limited to Medicare beneficiaries (Long, 2012). The survey asks recently discharged patients about characteristics of their stay that they are individually able to answer (Saxon & Finkelstein, 2012). The goal of HCAHPS is to be a more objective evaluation than traditional patient satisfaction tools. HCAHPS rates three aspects of care: 1. Processes of care 2. Outcomes of...
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...Sexual Harassment in the Workplace EXPERIENCES OF WOMEN IN THE HEALTH SECTOR Paramita Chaudhuri Health and Population Innovation Fellowship Programme Working Paper, No. 1 This report is the result of a project entitled “Understanding Sexual Harassment in the Health Sector,” undertaken as part of the Health and Population Innovation Fellowship (HPIF) awarded to the author in 2004. The HPIF programme is administered by the Population Council, New Delhi and is a continuation of the MacArthur Foundation’s Fund for Leadership Development (FLD) fellowship programme that continued over the period 1995 to 2004. The Council is grateful to the MacArthur Foundation for its support to this programme. The HPIF programme aims to support mid-career individuals who have innovative ideas, leadership potential, and the capacity to help shape policy and public debate in the field of population, reproductive health and rights in general, with a focus on two priority themes – maternal mortality and morbidity, and the sexual and reproductive health and rights of young people. Since the transfer of the programme to the Population Council through 2006, a total of 17 individuals have been supported under the HPIF programme. For additional copies of this report, please contact: Paramita Chaudhuri Senior Programme Officer Sanhita 89B Raja Basanto Roy Road Kolkata 700 029 Email: sanhita@cal.vsnl.net.in Phone: 033-24227965 Population Council Zone 5A, Ground Floor India Habitat Centre, Lodi Road...
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...LINCOLN COUNTY HOSPITAL HAWKEYE (Telemedicine program) Overall idea: We plan to propose that the hospital continue its quality initiatives and advertise to patients via low-cost options. We think the hospital could market telemedicine to in-home users, cardiac patients and a range of inpatients (expanding services offered to inpatients). Our assessment differs from others in that negotiating with payers (where possible) is also a consideration. 1. Background/Situation Assessment SWOT Analysis Strength: Strong partners (providence sacred heart) Physician alignment Competition is less First telemed program there 24 hours (ER, helipad) Low cost Funding from local club organizations Advanced technology (detailed monitoring) Weakness: Limited resources Community is small Unknown community reaction to new technology Single service line (cardio, one machine) Accurate assessment of internal buy-in? Threats: Competition can be there (other telemed program Valley or Deaconess or other national chains/organizations) Patient can lack confidence, as it’s new Policy critical access status Poor outcomes Opportunities: With ACA, re-admissions can decrease, patient satisfaction can increase Reducing costs, shared savings programs with 3rd party insurers Expand service lines/ inpatient Increase in revenue and reimbursements InTouch Reduces cost for patient Improving community good-will Increased appeal for Physician recruitment Federal...
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...THE HEALING HOSPITAL The Healing Hospital Grand Canyon University Spirituality in Health Care HLT 310V The Healing Hospital A traditional hospital is an institution that is devoted to the delivery of comprehensive health care to patients, utilizing conventional medicine with the intent of diagnosing, treating, and curing disease through scientific evidence based procedures and interventions. Traditional medicine is focused on the biomedical science of addressing the disease and inadvertently not incorporating or connecting the psychological and spiritual aspects of the human experience with illness. Traditional medicine is dedicated to the innovation and advancement of eradicating disease and uses a scientific approach to address the disease; it values the objective more than the subjective, and it does not involve or address the emotional and spiritual needs of the individual. The healing approach encompasses the whole person, both body and mind, to optimize the best overall outcome (Geffen, 2004). The healing environment facilitates the healing process by integrating and utilizing conventional medicine, scientific technology, alternative and complimentary therapies, aesthetic surroundings, and caring health providers who believe in and practice the art of compassionate care to promote healing. The healing environment optimizes overall healing and patient experience (www.siib.org). A healing hospital is devoted to the delivery of integrated patient center care...
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...Literature Review Patient Education for Post-Hospitalization Home Care Debra Scully Walden University NURS 6010-11 Advancing Nursing through Inquiry and Research April 8, 2012 Patient Education for Post-Hospitalization Home Care Changes in health care delivery brought on by financial constraints have affected the length of stay for certain patient procedures, resulting in an early discharge. Patients discharged from hospitals sooner than anticipated are finding themselves ill prepared, regarding insufficient education and instructions on self-management for home care, post-hospitalization. Patient education in nursing should be a focal priority, yet is often slighted due to time constraints, and lack of staff, preparation and materials. The purpose of this paper is to discuss the importance of sufficient patient education prior to discharge for patients with residual home care. Research on this topic could have beneficial implications for patient satisfaction pertaining to quality education for home care prior to discharge. Evidenced-based research has illustrated that the development of educational tools to aid nursing in providing succinct and pertinent information of discharge criteria has attributed to a rise in patient satisfaction. Considerations for educational materials were preferred language, specificity of patient concerns, and simplicity of educational materials. Summary Contemporary day surgery: patients’ experience of discharge and recovery ...
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