HSA 300 Week 9 Assignment 2 – Middleville Regional Healthcare
HSA 300 Week 9 Assignment 2 – Middleville Regional Healthcare
Assignment 2: Middleville Regional Healthcare
Due Week 9 and worth 160 points
Middleville Regional Health Care is one (1) of three (3) hospitals serving a community of 350,000 people. Summary statistics on Middleville and its competitors, from the AHA Guide, are shown below in Table 1. All three organizations are not-for-profit.
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Table 1: Middleville, Brierfield, and Greystone Health Care Systems
Name
Beds
Admissions
Census
OP Visits
Births
Expenses (000)
Personnel
Middleville
575
13,000
350
221,000
2,300
$125,000
2,000
Brierfield
380
17,000
260
175,000
1,200
$130,000
1,875
Greystone
350
10,000
180
40,000
900
$80,000
1,200
The governing board of Middleville hired a consulting company to evaluate its strategic performance, specifically in the areas of Human Resources, Information Technology, Financing, and Marketing. As part of the consultant’s evaluation, several leaders of Middleville’s units were asked their perspective of the organization’s performance.
You are working for the consultant. Your job is to identify the issues from the response that should be considered further by the consultant team and possibly discussed with the governing board and the CEO. The firm has a rule, “Never offer a criticism or negative finding without suggesting how the client organization can correct it,” so you must indicate what sort of correction you would recommend as part of your list. Because you know there were about two (2) dozen other interviews, you decide you should rank your issues in importance, to make sure the most critical are discussed.
Write a six to eight (6-8) page paper in which you:
Explain the governing board’s role in these strategic initiatives, determining its responsibility and involvement.
Evidence-based management means that operational and strategic decisions are made based upon the evidence that goals and objectives are actually being met. Quantitative measurements must be identified and measured. This data is then used to evaluate the HCO’s performance. Name three (3) performances Middleville can use to measure its success in providing quality healthcare to the community, and identify quantifiable, measureable indicators that can be used to do so. Explain the importance of each performance measurement.
Given the statistics of Middleville and its two (2) competitors provided in Table 1, recommend to the HCO what areas it should focus on to maintain its competitive market share as well as continue to provide healthcare to the community in the 21st century.
Some of Middleville’s Board members are very interested in pursuing advanced technology systems over the next five (5) years, while others are concerned about the enormous expense and need assurance that the investment in technology will be worthwhile. In both monetary and process terms, describe the costs and benefits associated with implementing EMR and associated health data systems. Lay out a plan for how various systems can be implemented.
Middleville has faced many challenges in recruiting and retaining nurses and other clinical employees. The economy has hit the area very hard and budgetary limitations have reduced the amount of money available for salary increases. The Board knows it needs to provide other benefits to their valued employees. Provide at least two (2) suggestions to Human Resources to promote employee satisfaction and, therefore, retain experienced personnel.
Use at least three (3) quality resources in this assignment. Note: Wikipedia and similar Websites do not qualify as quality resources.
Format your assignment according to the following formatting requirements:
a. Typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides.
b. Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page is not included in the required page length.
c. Include a reference page. Citations and references must follow APA format. The reference page is not included in the required page length.
The specific course learning outcomes associated with this assignment are:
Examine how healthcare management concepts and theories are applied to critical issues in healthcare organizations.
Analyze the critical management issues, purpose, functions, and performance measures of different departments within healthcare organizations.
Explain how public policy has shaped the development of the U.S. healthcare system.
Use technology and information resources to research issues in health services organization management.
Write clearly and concisely about health services organization management using proper writing mechanics.
Click here to view the grading rubric for this assignment.
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Nursing Assignments- Cardiovascular Alterations & Discussion 2: Anaphylactic Shock
Nursing Assignments- Cardiovascular Alterations & Discussion 2: Anaphylactic Shock
Discussion 1: Cardiovascular Alterations
At least once a year, the media report on a seemingly healthy teenage athlete collapsing during a sports game and dying of heart complications. These incidents continue to outline the importance of physical exams and health screenings for teenagers, especially those who play sports. During these health screenings, examiners check for cardiovascular alterations such as heart murmurs because they can be a sign of an underlying heart disorder. Since many heart alterations rarely have symptoms, they are easy to miss if health professionals are not specifically looking for them. Once cardiovascular alterations are identified in patients, it is important to refer them to specialists who can further investigate the cause.
Consider the following scenario:
A 16-year-old male presents for a sports participation examination. He has no significant medical history and no family history suggestive of risk for premature cardiac death. The patient is examined while sitting slightly recumbent on the exam table and the advanced practice nurse appreciates a grade II/VI systolic murmur heard loudest at the apex of the heart. Other physical findings are within normal limits, the patient denies any cardiovascular symptoms, and a neuromuscular examination is within normal limits. He is cleared with no activity restriction. Later in the season he collapses on the field and dies.
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To prepare:
· Review the scenario provided, as well as Chapter 24 in the Huether and McCance text. Consider how you would diagnose and prescribe treatment for the patient.
· Select one of the following patient factors: genetics, ethnicity, or behavior. Reflect on how the factor you selected might impact diagnosis and prescription of treatment for the patient in the scenario.
QUESTIONS to be addressed in my assignment:
1. A description of how you would diagnose and prescribe treatment for the patient in the scenario.
2. Then explain how the factor you selected might impact the diagnosis and prescription of treatment for that patient.
3. Summary with Conclusion
REMINDERS:
1) 2-3 pages (addressing the 3 questions above excluding the title page and reference page).
2) Kindly follow APA format for the citation and references! References should be between the period of 2011 and 2016. Please utilize the references at least three below as much as possible and the rest from yours.
3) Make headings for each question.
Discussion 2: Anaphylactic Shock
The treatment of anaphylactic shock varies depending on a patient’s physiological response to the alteration. Immediate medical intervention and emergency room visits are vital for some patients, while others can be treated through basic outpatient care.
Consider the January 2012 report of a 6-year-old girl who went to her school nurse complaining of hives and shortness of breath. Since the school did not have any medication under her name to use for treatment and was not equipped to handle her condition, she was sent to an emergency room where she was pronounced dead. This situation has raised numerous questions about the progression of allergic reactions, how to treat students with severe allergies, how to treat students who develop allergic reactions for the first time, and the availability of epinephrine in schools. If you were the nurse at the girl’s school, how would you have handled the situation? How do you know when it is appropriate to treat patients yourself and when to refer them to emergency care?
To prepare:
· Review “Anaphylactic Shock” in Chapter 23 of the Huether and McCance text, “Distributive Shock” in Chapter 10 of the McPhee and Hammer text, and the Jacobsen and Gratton article in the Learning Resources.
· Identify the multisystem physiologic progression that occurs in anaphylactic shock. Think about how these multisystem events can occur in a very short period of time.
· Consider when you should refer patients to emergency care versus treating as an outpatient.
· Select two patient factors different from the one you selected in this week’s first Discussion: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the process of anaphylactic shock.
QUESTIONS to be addressed in my assignment:
1. An explanation of the physiological progression that occurs in anaphylactic shock.
2. Describe the circumstances under which you would refer patients for emergency care versus treating as an outpatient.
3. Explain how the patient factors you selected might impact the process of anaphylactic shock.
4. Summary with Conclusion
REMINDERS:
1) 2-3 pages (addressing the 4 questions above excluding the title page and reference page).
2) Kindly follow APA format for the citation and references! References should be between the period of 2011 and 2016. Please utilize the references at least three below as much as possible and the rest from yours.
3) Make headings for each question.
RESOURCES:
Readings
· Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.
o Chapter 22, “Structure and Function of the Cardiovascular and Lymphatic Systems”
This chapter examines the circulatory system, heart, systemic circulation, and lymphatic system to establish a foundation for normal cardiovascular function. It focuses on the structure and function of various parts of the circulatory system to illustrate normal blood flow.
o Chapter 23, “Alterations of Cardiovascular Function”
This chapter presents the pathophysiology, clinical manifestations, evaluation, and treatment of various cardiovascular disorders. It focuses on diseases of the veins and arteries, disorders of the heart wall, heart disease, and shock.
o Chapter 24, “Alterations of Cardiovascular Function in Children”
This chapter examines cardiovascular disorders that affect children. It distinguishes congenital heart diseases from acquired cardiovascular disorders.
· McPhee, S. J., & Hammer, G. D. (2010). Pathophysiology of disease: An introduction to clinical medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical.
o Chapter 10, “Cardiovascular Disorders: Heart Disease”
This chapter begins by exploring the normal structure and function of the heart. It then examines the etiology, pathophysiology, and clinical manifestations of five heart disorders: arrhythmias, congestive heart failure, valvular heart disease, coronary artery disease, and pericardial disease.
· Jacobsen, R. C., & Gratton, M. C. (2011). A case of unrecognized prehospital anaphylactic shock.Prehospital Emergency Care, 15(1), 61–66.
Retrieved from the Walden Library databases.
This article provides information relating to the diagnosis and management of anaphylactic shock. It also explores difficulties encountered when diagnosing uncommon clinical presentations of anaphylactic shock.
Optional Resources
· American Heart Association. (2012). Retrieved from http://www.heart.org/HEARTORG/
· Million Hearts. (2012). Retrieved from http://millionhearts.hhs.gov/index.html
· National Heart, Lung, and Blood Institute. (2012). Retrieved from http://www.nhlbi.nih.gov/
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Unit 2: Theories Of Morality – Discussion
Unit 2: Theories Of Morality – Discussion
Consequential, Nonconsequential, and Virtue Theory
In this week’s Discussion, you will explore the major groups of ethical theories we call consequentialist (teleological), nonconsequentialist (deontological), and virtue theories. There are multiple theories in each category that you will be able to address in this week’s Discussion. These theories will serve as the foundation for all future Discussions and Assignments for the course. Having an opportunity to discuss these with your instructor and peers will help you understand how to use them to address ethical issues and questions.
To what extent do you believe that members of your family or your friends use consequential, nonconsequential, and virtue theory? Pick one example from each approach and describe how these approaches work or don’t work for them. Compare the strengths and weaknesses of your three chosen theories.
200 words with intext reference
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HLT-310V Personhood Chart
HLT-310V Personhood Chart
Personhood Chart
This chart contains a grid for different philosophical anthropologies that answer the question of personhood.
Complete the following chart in the context of defining what it means to be human according to Christianity, Materialism, and your own Personal View. Refer to the assigned reading for explanation of characteristics listed on the left.
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Christianity
Materialism
Personal View
Relational
Multidimensional
Sexual
Moral
Mortal
Destined for Eternal Life
Destined for eternal life:
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Using Health Information Technology As A Source Of Evidence-Based Practice
Using Health Information Technology As A Source Of Evidence-Based Practice
Using Health Information Technology as a Source of Evidence-Based Practice
Before the digital revolution, health information technology supplied very limited support for evidence-based practice. If nurses wanted to be informed about cutting-edge research, their best bet was to either subscribe to leading journals or make periodic trips to the library. With the establishment of research databases, however, nurses became empowered to learn about and facilitate interdisciplinary and translational research. Databases are just one example of how health information technology supports evidence-based practice.
To prepare:
Read the following scenario from the text (McGonigle & Mastrian, 2011, p. 482):
Twelve-hour shifts are problematic for patient and nurse safety, and yet hospitals continue to keep the 12-hour shift schedule. In 2004, the Institute of Medicine (Board on Health Care Services & Institute of Medicine, 2004) published a report that referred to studies as early as 1988 that discussed the negative effects of rotating shifts on intervention accuracy. Workers with 12-hour shifts realized more fatigue than workers on 8-hour shifts. In another study done in Turkey by Ilhan, Durukan, Aras, Turkcuoglu, and Aygun (2006), factors relating to increased risk for injury were age of 24 or less, less than 4 years of nursing experience, working in the surgical intensive care units, and working for more than 8 hours.
Consider how the resources identified in the scenario above could influence an organization’s practice.
Select an issue in your practice that is of concern to you. Using health information technology, locate at least three evidence-based practice resources that address your concern and that could possibly inform further action.
Follow these for my assignment outline:
1. A description of your practice concern.
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2. Outline how you used health information technology to locate evidence-based practices that address this concern.
3. Cite and include insights from the resources.
4. Analyze how health information technology supports evidence-based practice.
*Please use articles/references only from the period of 2011 to 2016… Make 2-3 pages…Thank you.
Required Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Readings
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge(Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 26, “Nursing Research: Data Collection, Processing, and Analysis”
The authors of this chapter relate nursing research to the foundation of knowledge model. The chapter assesses informatics tools for collecting data, storing information, and processing and analyzing data.
Chapter 27, “Translational Research: Generating Evidence for Practice”
In this chapter, the authors differentiate evidence-based practice and translation research. They also describe models used to introduce research findings intro practice.
Hynes, D. M., Weddle, T., Smith, N., Whittier, E., Atkins, D., & Francis, J. (2010). Use of health information technology to advance evidence-based care: Lessons from the VA QUERI program. Journal of General Internal Medicine, 25(Suppl. 1), S44–S49.
Retrieved from the Walden Library databases.
This article presents a study that evaluated the role of health information technology (HIT) in the Department of Veteran Affairs’ Quality Enhancement Research Initiative. The authors convey their findings on how HIT provided data and information to aid implementation research, and how implementation research helped further HIT development. Additionally, the text details methods of overcoming common HIT barriers to implementation research.
Jamal, A., McKenzie, K., & Clark, M. (2009). The impact of health information technology on the quality of medical and health care: A systematic review. Health Information Management Journal, 38(3), 26–37.
Retrieved from the Walden Library databases.
This text details a study that reviews the published evidence concerning the impact of health information technology (HIT) on the quality of health care. The study investigated the use of HIT in medical care and allied health and preventive services. The authors primarily focus on the impact of electronic health records, computerized provider order-entry, and decision support systems.
Umscheid, C. A., Williams, K., & Brennan, P. (2010). Hospital-based comparative effectiveness centers: Translating research into practice to improve the quality, safety and value of patient care.JGIM: Journal of General Internal Medicine, 25(12), 1,352–1,355.
Retrieved from the Walden Library databases.
This article revolves around the usage of the hospital-based comparative effectiveness (CE) center model. The authors highlight the model’s benefits and the increasing usage of CE evidence. The article also reviews solutions to overcoming many of the challenges to operating hospital-based CE centers.
Optional Resources
Chlan, L., Tracy, M. F., & Grossbach, I. (2011). Pulmonary care. Achieving quality patient-ventilator management: Advancing evidence-based nursing care. Critical Care Nurse, 31(6), 46–50.
Retrieved from the Walden Library databases.
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HospitalInformation
HOPPS/ASC: Use the information found in figures 1–5 below to completethe OPPS payment calculations in table 1 and the ASC PPS payment calculationsin table 2. Determine the OPPS and ASC reimbursement rates for acataract procedure. Answer the discussionquestion.
Click and download the exercise and the answer sheet. Submit answer sheet via blacboard by or before 11/9/2015
Figure 1: HospitalInformation
Bedsize:
Teachingstatus:
Wage index:.9971
300 beds
Non-teaching
Cost to Charge Ratios(CCRs)
RC250
Pharmacy,general
0.408344
RC270
Supplies,general
0.796788
RC271
Nonsterilesupply
0.796788
RC272
Sterilesupply
0.796788
RC276
Intraocularlens
0.796788
RC301
Chemistry
0.291546
RC312
Pathology,surgical
0.291546
RC360
Operatingroom
0.404314
RC370
Anesthesia
0.321246
RC710
Recoveryroom
0.404314
RC730
EKG
0.38251
RC920
Diagnosticservices
0.88447
Figure 2: Claim Information Hospital OutpatientDepartment
Admitdate
2/20/2015
Dischargedate
2/20/2015
Sex:F
Age:70
LOS: 1day
Admitdiagnosis
366.9
Cataract,unspecified
Principaldiagnosis:
366.10
Senile cataract,unspecified
Principalprocedure:
66984
Cataract extraction with IOLinsertion
ChargeDetail
RevenueCode
CPT/HCPCSCode
CodeDescription
Charge
250
$475.25
270
$380.25
271
$1178.18
272
$1297.07
276
$551.00
301
36415
Routine venipuncture
$10.00
301
82565
Assay ofcreatinine
$33.75
301
84132
Assay ofserum potassium
$33.75
301
85014
Hematocrit
$34.75
312
88304
Tissue examby pathologist
$83.50
360
66984
Cataractextraction w/IOL
$801.33
370
$574.00
710
$341.00
730
93005
Electrocardiogram, tracing
$124.50
920
90772
Ther/proph/diaginj, sc/im
$75.50
TOTALCharges
$5,693.83
Medicare beneficiary copaymentamount:
$531.88
Figure 3: Claim Information Ambulatory SurgeryCenter
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CPT Code:66984
Cataract extractionwith IOL
Charges: $2,500.00
Medicare beneficiary copaymentamount:
$192.76
Figure 4: Fee Schedule Information (CY 2012; to get current year seewww.cms.gov)
RevenueCode
CPT/HCPCS
FeeSchedule Amt
StatusIndicator
301
36415
$3.00
A
301
82565
$7.26
A
301
84132
$6.51
A
301
85014
$3.35
A
Figure 5: APC Information (CY 2012; to get current year seewww.cms.gov)
RevenueCode
CPTCode
APC
Relative Weight
StatusIndicator
312
88304
0343
0.5262
X
360
66984
0246
23.8786
T
730
93005
0099
0.3823
S
920
90772
0436
1.8104
S
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