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Assignment 1: The Primary Care Clinic
Rosalyn R. Gatson
HSA 3007/28/2013
Dr. Kate Milburn |

Assignment 1: The Primary Care Clinic
1. Discuss the key political, economic, and social forces that may have influenced the development of the clinic.
Several economic, social, political and religious factors tend to impact the lives of people and ultimately influence health status. People from the middle-class and the upper crusts of society are at a better position to seek care in case they are affected with any health issue. This is because socioeconomic status plays a major role in one’s ability to access and use the healthcare system. Besides, another factor that could be playing a role is educational levels, occupational status, and awareness of the need to have better control over one’s health. Social and economic factors are very important when consideration is given for health status, as they can shape the health condition of the entire community and the individuals that live in that community. Primarily, social factors play a vital role in determining of the individual would stay healthy or would the health status deteriorate. Hence, an important part of the social determinants of health is the Primary care center. Under the legislation and the functioning of the political policies, lie the political determinants of health. Political factors can play a major in ensuring that an appropriate policy is being implemented on a long-term basis so as to improve the health of the community and improve access and conditions in the healthcare center. One such legislation being proposed in the US is the Patient Protection and Affordable Care Act, 2010, which along with the universal healthcare access system aims to decrease the rate of uninsured people in the US and make healthcare more affordable in the US. Politics can improve the access and affordability of healthcare. Together, political, social and economic issues play a vital role in influencing the development of this clinic. The clinic has been setup on the basis of improving the access and affordability of healthcare to the local community, with huge concerns for the public health. 2. Create a comprehensive mission statement and explain what makes it a comprehensive mission statement. The mission statement of a healthcare organization should clearly mention the objectives of the organization and the means of achieving these objectives. The Mission statement would be: “With an intention to promoting the community health in a holistic manner and advance wellness of the community, along with provision of quality preventive, family, therapeutic, diagnostic, specialized and rehabilitative health services”.
The health clinic would aim to provide basic healthcare services along with specialized healthcare services for the communities of the area. Along with this it would also cater to some of the specialized requirements including specialty services, consultations, referrals, etc. The health center would be committed towards providing care for the lower socioeconomic groups and those sectors of the communities who are in need of good healthcare services.
3. Identify three (3) performance measures you would use to measure the clinic effectiveness and provide the rationale for each performance measure. As proposed by the Institute of Medicine, the performance measures need to a comprehensive, efficient and transparent means of determining and measuring performance through certain indicators which should be present and monitored through the system (CMSS, 2007). Performance measures can help to track errors, identify inequality issues and determine the presence of any lag in the care. Some of the organizations that have developed performance measurement tools include the Agency for Healthcare Research and Quality (AHRQ), Centre for Medicaid and Medicare Services (CMS), the Joint Commission (JCI) and the Leapfrog Group. The critical features of the primary care system is that it is first contact services, needs to be comprehensive services provided, the care should be patient-centered rather specialty-centered, and there needs to be greater coordination between the healthcare providers. The quality of care in a primary clinic needs to be determined at the individual patient level and the community level. Besides, access and effectiveness need to be taken into great consideration. Effectiveness would include interpersonal care and clinical care. For measuring the interpersonal care effectively, the General Practical Assessment Questionnaire is useful. This questionnaire concentrates on asking the patient feedback on appointments, communication with various professionals, and maintenance of continuity of care. In Europe the European Practice Assessment Practice Management (EPA-PM) is used in European Countries to measure the quality of management in the organization so as to improve the quality in 5 domains namely infrastructure, HR, information, quality and safety and finance (Smith, Mossialos, Papanicolas, and Leatherman, 2011). 4. Describe how you would approach decisions regarding clinic expansion and annual plan approval. To ensure that the decisions made are ethical, managers, need to carefully plan clinical expansion and think very toughly about the annual planning of approval. The first important thing is to actually determine if clinical

Expansion would be beneficial to the organization and the community at large. In case the expansion is expected to affect performance, then such expansion should be delayed till improvement of services can be made. A cost-beneficial analysis is vital before planning out for any expansion. The second issues are that the expansion itself should be within the scope of the goals and objectives of the organization. In this case, the mission statement should be taken into consideration and a strong examination should be made between the mission statement and the expansion plans. When decisions regarding annual planning approvals are final. The goals and objectives of the organization and future development of the organization need to be taken into consideration. The clinical expansion and annual plan approvals should be made only if these factors are constantly being met. The managers and the senior administration of the hospital play a vital role with respect to the strategic planning of the clinic (Hall, 2006). 5. Describe the role of the clinic as a component of the healthcare delivery system in your community. A healthcare system is made up of various resources in an organization or box aimed at functioning towards meeting the healthcare needs of the people present in the environment. In general, such an environment is composed of patients, healthcare providers and the institutions that provide the health services. The patients, society, family and the community would include the patients and would be receiving the services as consumers. The healthcare providers include various healthcare professionals including doctors, nurses, therapists, technicians and managers who work in the particular healthcare system towards fulfilling the goals and the mission statement of that organization. The institutions or organizations include healthcare centers, primary care units, hospitals, insurance companies, governmental agencies, etc., who would be playing a vital role towards the delivery of healthcare services to the patients. Residents in that particular area may be belonging to the lower-socioeconomic groups and hence such services targeted at these consumers. The clinic should be providing such services at an affordable price. The institution has to procure all resources required to provide the services (Smith, 2011). 6. Examine how public healthcare policy has influenced the formation of outpatient clinics in the healthcare system. Public health policy plays a vital role towards the ambulatory services that are provided in the healthcare system. As the focus shifts from therapeutic and rehabilitative to preventive, screening and wellness management, greater would be the need for the government to develop an adequate public health policy in this regard. When the public health policy has been created there is a need for greater creation of outpatient clinics in this regard so as to reduce the cost of healthcare, improve outcomes and reduce the length of stay in the hospital. In order to make the healthcare system more affordable and accessible, it has proposed to launch primary clinics in various rural and far-flung areas. The primary care center would function as a one-stop solution for healthcare and provide referrals to patients if needed. In this way, the health of the community and the population can be improved.
Reference
CMSS (2007). ‘The Measurement of Health Care Performance: A Primer from the CMSS Hall, R. (2006). ‘Patient Flow: Reducing Delay in Healthcare Delivery (International Series in Operations Research & Management Science) Smith, P.C., Mossialos, E., Papanicolas, I. & Leatherman, S. (2011). ‘Performance Measurement for Health System Improvement’,

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Professional Development of Nursing Proffesionals

...With nurses being the majority of the healthcare workforce, they are encouraged to lead the charge on changes in the healthcare system. This report discusses the effects of safe, effective and affordable care rendered at the primary level. Nurses can further this initiative by taking their education to the next level, which will allow stronger leadership roles and in turn will lead directly to improved care at the primary level. Transforming Practice Access to healthcare has been rewritten with the implementation of The Affordable Care Act of 2010 (ACA). This will allow open access to healthcare for millions; in turn increasing demands on healthcare professionals. In keeping with IOM report, ways in which a practicing nurse can implement changes are varied; in current practice it would begin with education and prevention early in the acute care stay in order to be preemptive in post-acute care period also early in a nurse’s education familiarizing oneself with the patient care needs in under-served communities, which allows for an insightful nurse to keep with the goals of primary care. Finally, continuously seeking reeducation on providing culturally competent care. The changes nursing will endure following the ACA are: Practice Setting- At the height of transforming practice in healthcare is the when and where of primary care. The need to shift care from acute care settings, and into the homes,...

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