Legacy Emanuel:
A healthcare organization audit summary
Legacy Emanuel Medical Center, at 2801 North Gantenbein Avenue, Portland, Oregon is
is an IRS 501 (c ) 3 not-for-profit, tax-exempt corporation comprised of five full-service hospitals and a children's hospital. The Center's award-winning facilities offer an integrated network of health care services: acute and critical care, inpatient and outpatient treatment, community health education and a variety of specialty services.
The area's largest locally owned, nonprofit health system, Legacy Health's is a lead healthcare institution in the region, committed to comprehensive service provision to clients through a network of healthcare providers toward a healthier and wellness community. Projected growth for the institution under the direction of the Office of Development advances the mission and vision of Emanuel Medical Center, dedicated to legacy of good health for 'Our people, Our patients, Our communities, Our world' through development of sustainable programs that generate private support and foster charitable giving.
The Hospital organization is comprised of a general medical and surgical hospital, and houses: a variety of specialty services, including the Oregon Burn Center, the Legacy Center for Maternal Fetal Medicine, Legacy Wound Care Center and Legacy Emanuel Children's Hospital. A level I Trauma Center and the base for Life Flight Network, the Medical Center also manages the region's critical care transport service. Legacy Emanuel Children's Garden is a therapeutic retreat for patients, their families and visitors, hospital staff, and the general public. In support of evidence-based practice, the Medical Center is a 'learning institution' for physicians, dedicated to the cultivation of professional knowledge exchange through clinical trial research support, internships, and onsite training workshops.
Summary of Research
The Legacy Emanuel Hospital and Health Center organizational audit was designed as an open ended, semi-structured assessment of an institution well-known for its persistence in service to a community that during the 1960's and 1970's was plagued by a high incidence of violence leading to an exceptionally high rate of admissions per capita in the City of Portland. The field audit offered keen insights into the Medical Center's ongoing support and contribution to North Portland residents, through targeted initiatives such as the outreach healthcare consortium, Project Access, which coordinates the care between uninsured patients and doctors and hospitals who will accept charity care patients.
Data analysis to the organizational audit is conducted by way of Six Sigma qualitative assessment tool, SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis and theory based approach, Porter's Five Forces in review of RN Stakeholder interests. A composite SWOT of the findings from the research is illustrated in Table 1.
Table 1
Strengths
Institutional Legacy
Established stakeholder network
Large municipal context
Multi-scale service provider
Physician & RN staff commitment
Weaknesses
Nursing shortages in sector
Nonprofit finance
Low Income neighborhood means max capacity
Opportunities
Knowledge sharing network
Robust service menu may be enhanced by technology
Advancement of referral partnerships through both
Threats
Decreased contributory finance to 501 ( c) 3 institutions since global economic crisis, 2008
Incapacity to respond adequately through research grants support may mean institutional finance in operational areas may be reduced
Table 1. SWOT of Legacy Emanuel Medical Center
Organizational Structure
An institution of scale, Legacy Emanuel Medical Center is under the direction of President and Chief Executive Officer, George J. Brown, MD. Senior Vice President and Chief Nursing Officer, Carol Bradley, RN provides direction and supervision to the programmatic structure of the institution's RN staff, and adherence to policy and procedures at the Medical Center. Carol Roberts, RNC, CNS, MN, nurse manager of labor and delivery unit provides supervisory oversight to unit operations. Additional direction and management support is in part to the framework of Hospital administration. Vertical leadership in organizational composition is furthered through an extensive horizontal collaboration by professionals at all levels in the practice setting, and partner referral network. Core Staff include six (6) nurses, an OR Technician, OB Hospitalist, OB anesthesiologist, and Resident. At present, Staffing is adequate. Nurses can be transferred temporarily from other units when needed. Methods used to mitigate against staffing shortages and/or difficulties are mandatory standby, resource pool, and on-call staff.
An example of the joint provision in oversight within the Hospital organization's practice setting is seen in accountability to the Director of Children's Services in oversight of the Maternal-Child unit by its Unit Manager. The goal of 2W Maternal-Child 12 bed unit is to stabilize patients and keep then safely pregnant for as long as possible. With more than 50% of the patients classified as 'high-risk' pregnancies, the unit...
Wound Care Chronic wounds represent a devastating health care problem with significant clinical, physical and social implications. Evidence suggests that consistent, meticulous and skilled care provides the primary means by which successful wound care and healing is promoted. The occurrence of wounds has plagued humankind throughout recorded history and remains a major source of morbidity and mortality in several disciplines of clinical medicine. Within this thesis, an effort will be made
In this regard, the documentation should include the four main assessment components; which are, nutrition, wound etiology, wound appearance and pain (Assessment and Documentation Issues in Wound Care). In other words a careful written as well as visual record should be kept of all the possible factors and variables relating to the patient's condition and to the progression or otherwise of the healing process. There are two further reasons that are
This highlights the seriousness of the need for proper wound care in long-term care facilities, demonstrating the extent to which the nurse must define and provide oversight to standards in this area. What steps should be taken to ensure proper wound care? The first and most important aspect of ensuring that wound care is attended with proficiency is the provision of comprehensive training for nurse professionals. There are an array of
Certification for wound care are available but wound care is not typically addressed as an area of specialization for nurses. There is a corresponding lack of wound care training for nurses in key fields including those who work with diabetics. Research shows that proper wound care can minimize complications related to lack of mobility including bed sores, and reduce the rates of amputations. Comprehensive wound care training is therefore
Chronic Wound Care: Nursing Assessment And Intervention Chronic Wound Care: Nursing Assessment and Intervention Chronic Wound Care: Nursing Assessment and Intervention Chronic wounds are a challenge for both the clinician and the patient. For the nurse, issues of chronic wound care include the type of wound, the condition of the patient, and presence of infections, possible antibiotic therapy, and patient education on chronic wound care management. For the patient, issues revolve around how the
Wound Healing Quantitative Research Critique Vogt, Uhiyarik, & Schroeder (2007) conducted a study that compared Aquacel dressing vs. standard wound care for primary closed vascular surgical wounds. The results of the study found that there was no difference in length of stay in the hospital, complications, patient comfort, or healing time between the two wound care methods. The only difference was that the Aquacel dressing required fewer changes than conventional dressings, but
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