Health Administration
The purpose of this study is to show that there are many reasons why nurses leave their profession, but that financial reasons often rank very high on their list of concerns. Managed care issues and job dissatisfaction also play large roles in the minds of nurses when they decide to seek employment elsewhere. A review of current and pertinent literature indicates that most nurses are leaving because they are unhappy with pay and working conditions. These same reasons are cited by many of those who have considered being nurses and then changed their minds.
An analysis of the relevant data indicates that this trend is continuing and that nurses are much more put upon and underpaid than they used to be. This is not because they are being paid less, but because their salaries have not risen through the years like the salaries of other professions, and because nurses today…...
mlaBibliography
Aiken, L., et al. (2002, October). Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. JAMA. 288(16): 1987-1993.
Aiken L., et al. (2001, May/June). Nurses' Reports on Hospital Care in Five Countries. Health Affairs. 20(3):43-53.
Beu, Burke. (2002). Nursing Issues. The Association of Perioperative Registered Nurses. Retrieved October 14, 2003, at http://www.aorn.org/journal/2002/novhpi.htm
Hofmann, M.A. (2001). Patient rights bill gains momentum; Senate set to begin debate this week. Business Insurance, 35, 1.
Veteans Health
Veterans Health Administration (VHA)
Locale of the firm
The Veterans Health Administration (VHA) is the conveyance of the United States Department of Veterans Affairs (VA) head by the Under Secretary of Veterans Affairs for Health that executes the therapeutic back course of the VA the considerable distance through the administration and methodology of a few VA outpatient centers, clinics, medicinal focuses as well as extended-standing healthcare offices like nurturing homes. The VHA segment has more laborers than each alternate essentials of the Veterans Administration shared. The VHA is assorted as of the U.S. Division of Defense Military Health System of which it is not a part (va.gov, 2012).
Corporate Structure
The size and structure of the VHA framework is entirely better than most private management groups. The framework combines:
• More than 1400 healing centers, facilities and nurturing homes
• 14,800 specialists
• 61,000 attendants
• 5 million patients
The head of the VHA is a bureau-level position,…...
mlaReferences
Mayo, R. (2006). Veteran's Health Administration: The Best Value In Healthcare . Retrieved April 18, 2012, from himss.org: http://www.himss.org/foundation/docs/rachelmayo.pdf
Mitkowski, A. (2007). Dr. Kizer Considers Radical Surgery on an Ailing System. Retrieved April 18, 2012, from yale.edu: http://pse.som.yale.edu/sites/pse.som.yale.edu/files/Cases_VHA%20Final%20and%20Complete.pdf
va.gov. (2012). Department of Veteran Affairs. Retrieved April 18, 2012, from va.gov: http://www.va.gov
The organization being analyzed is the Veterans Health Administration (VHA), which is the largest integrated healthcare system in the U.S. VHA is a component of the U.S. Department of Veterans Affairs and it is led by the Under Secretary of Veterans Affairs for Health. The organization is charged with implementing medical assistance programs for Veterans Affairs (VA) by administering and operating various VA medical centers. The organization offers it care service at 1,243 healthcare facilities that include 170 VA medical centers and 1,063 outpatient sites. VHA serves over 9 million veterans each year (Veterans Health Administration, n.d.). The mission statement for the organization is \"To fulfill President Lincoln\'s promise “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s Veterans."
The VHA medical centers offer a wide range of services that include traditional…...
Health Care
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).
Identify the milestone you chose in the history of quality improvement in the first…...
mlaReferences:
1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81
2) Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.
3) Kelly, D.L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press
4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1
The penalties for being out of compliance when OSHA comes knocking should be enough to motivate any healthcare facility to devise a plan to make sure that they are in compliance with OSHA's regulations. The startling thing is that it took an initiative like NEP to wake these facilities up and get them thinking about being compliant. Since they deal with people and their well being on an everyday basis, these are things that they should have been doing all along and not just because there is an increased probability of getting into trouble by OSHA.
eferences
Harris, S. (2012). OSHA in Health Care: Out of Sight & Out of Mind? etreived from http://ohsonline.com/articles/2012/04/01/osha-in-health-care.aspx
Healthcare workers. (2012). etrieved from http://www.cdc.gov/niosh/topics/healthcare/
New OSHA inspection initiative focuses on healthcare. (2011). etrieved from http://www.puresafety.com/public/workingwell/?p=1209#.UAa4aFJ6EM
Occupational Safety and Health Administration ("OSHA") Targets Nursing and esidential
Care Facilities. (2012). etrieved from http://www.hancocklaw.com/p/OSHA_Newsletter_212_May_H1768037.PDF
Prepare Your Facility for the National Emphasis Program (NEP). (2012).…...
mlaReferences
Harris, S. (2012). OSHA in Health Care: Out of Sight & Out of Mind? Retreived from http://ohsonline.com/articles/2012/04/01/osha-in-health-care.aspx
Healthcare workers. (2012). Retrieved from http://www.cdc.gov/niosh/topics/healthcare/
New OSHA inspection initiative focuses on healthcare. (2011). Retrieved from http://www.puresafety.com/public/workingwell/?p=1209#.UAa4aFJ6REM
Occupational Safety and Health Administration ("OSHA") Targets Nursing and Residential
d).
The health care industry is heavily regulated and has several special risk areas that need to be looked out for. An effective compliance program is necessary in order to mitigate these risks. In addition to the challenges that are associated with taking care of patients, health care providers are subject to huge and sometimes intricate sets of rules that govern the coverage and reimbursement of medical services. Because federal and state sponsored health care programs play such a big role in paying for health care, compliance with these rules are necessary in order to avoid penalties that can occur. These penalties can include such things as recoupment of improper payments, along with sanctions imposed by Medicare and Medicaid against health care businesses that engage in abuse or fraudulent practices (Corporate esponsibility and Corporate Compliance: A esource for Health Care Boards of Directors, (n.d.).
A good health care administrator will define and…...
mlaReferences
Corporate Responsibility and Corporate Compliance: A Resource for Health Care Boards of Directors. (n.d.) Retrieved April 3, 2009, from Office of the Inspector General Web site:
http://oig.hhs.gov/fraud/docs/complianceguidance/040203CorpRespRsceGuide.pdf
Health Administration. (n.d.). Retrieved April 3, 2009, from Web site:
Such equipment should be adequate to ensure personnel are protected from chemical exposure to the eyes, skin, and respiratory tract. PPE may be upgraded or downgraded by the site industrial hygienist, HSM, or qualified Site Safety Officer based upon site conditions and air monitoring results (Levin, et al., 2002)
Work practice and administrative controls
Administrative controls or work practice controls are changes in work procedures such as written safety policies, rules, supervision, schedules, and training with the aim of reducing the interval, frequency, and sternness of exposure to hazardous chemicals or situations. Workers who handle hazardous chemicals in the workplace should be familiar with the administrative controls required fewer than 29 CF 1910.1200, and the OSHA Hazard Communication Standard. This controls are perhaps most important, because they impact your people directly. On the one hand, they are the simplest, since all it takes is education. On the other hand, education about…...
mlaReferences
Annual report on 9/11 health (September, 2009). Retrieved on March 20, 2010 from http://www.nyc.gov/html/fdny/pdf/2009_wtc_medical_working_group_annual_report.pdf
Burright, D. et al., (1999). Evaluation guidelines for air sampling methods utilizing chromatographic analysis. OSHA Salt Lake Technical Center, U.S. Department of Labor: Salt Lake City, UT.
Harris, J.S., (ed.) (1997). Occupational medicine practice guidelines: Evaluation and management of common health problems and functional recovery in workers. The American College of Occupational and Environmental Medicine. Beverly, Mass.: OEM Press.
Levin, S. et al.,. (2002). Health effects of World Trade Center site workers. America Journal of Industrial Medicine 42:545 -- 547.
WHO rates France as having the best healthcare ("World Health," 2000). In addition to universal healthcare, France also has non-profit supplementary providers, which means that the government subsidizes 70% of regular expenses but pays 100% of more expensive or long-term treatment plans (Sandier, Paris, & Polton, 2004). Money for subsidies comes from mandatory earnings contributions such as 5.25% salary, capital income, and gambling winnings (Sandier, 2004).
An argument that often arises is that people say they don't want the government deciding what medical procedures they can have. However, decisions regarding what procedures are covered by a particular health plan are made by the healthcare insurance companies, which are for-profit ("Insurance Verification," n.d.). Many people are denied treatment regardless of the illness. As already mentioned, some of the other nations with universal healthcare have supplementary plans in addition to the government plans that allow the patient more choice.
There are many arguments…...
mlaReferences:
Carrasquillo, O., Himmelstein, DU.,Woodhandler, S., Bor, DH. (1999). A Reappraisal of Private Employers' Role in Providing Health Insurance. NEJM, 340(1), 109-114.
"Insurance Verification & Eligibility Services." (n.d.). Retrieved from http://www.globaledgeusa.com/insurance_verification_eligibility_services/
Mahon, Mary. (2010, June 23). U.S. ranks last among 7 countries on health system performance. EurkAlert. Retrieved from http://www.eurekalert.org/pub_releases/2010-06/cf-url062210.php
Reid, T.R. (Producer). (2008, April 15). Frontline: Sick around the world [Television broadcast]. New York: Central Broadcasting Service.
Stated to be barriers in the current environment and responsible for the reporting that is inadequate in relation to medical errors are:
Lack of a common understanding about errors among health care professionals
Physicians generally think of errors as individual that resulted from patient morbidity or mortality.
Physicians report errors in medical records that have in turn been ignored by researchers.
Interestingly errors in medication occur in almost 1 of every 5 doses provided to patients in hospitals. It was stated by Kaushal, et al., (2001) that "the rate of medication errors per 100 admission was 55 in pediatric inpatients. Using their figure, we estimated that the sensitivity of using a keyword search on explicit error reports to detect medication errors in inpatients is about 0.7%. They also reported the 37.4% of medication errors were caused by wrong dose or frequency, which is not far away from our result of 50.5%. (Hui, Colombia…...
mlaBibliography
Discussion Paper on Adverse Event and Error Reporting In Healthcare: Institute for Safe Medication Practices Jan 24, 2000
Patient Safety/Medical Errors Online at the Premiere Inc. page located at: http://www.premierinc.com/all/safety/resources/patient_safety/downloads/patient_safety_policy_position_2001.doc
Medstat / Shortell, S. Assessing the Impact of Continuous Quality Improvement on Clinical Practice: What It Will Take to Accelerate Progress.
Health Policy Monitor (2001) A Publication of the Council of State Governments Vol. 6, No. 1 Winter/Spring 2001 PO18-0101
Figure 1 portrays the state of Maryland, the location for the focus of this DR.
Figure 1: Map of Maryland, the State (Google Maps, 2009)
1.3 Study Structure
Organization of the Study
The following five chapters constitute the body of Chapter I: Introduction
Chapter II: Review of the Literature
Chapter III: Methods and Results
Chapter IV: Chapter V: Conclusions, Recommendations, and Implications
Chapter I: Introduction
During Chapter I, the researcher presents this study's focus, as it relates to the background of the study's focus, the area of study, the four research questions, the significance of the study, and the research methodology the researcher utilized to complete this study.
Chapter II: Review of the Literature in Chapter II, the researcher explores information accessed from researched Web sites; articles; books; newspaper excerpts; etc., relevant to considerations of the disparity in access to health care services between rural and urban residence in Maryland and the impact of the lack of financial resources. The…...
mlaPotter, S. (2002) Doing Postgraduate Research. London: Sage.
Qualitative research: Approaches, methods, and rigour, (2008, Nov. 7). Microsoft PowerPoint Qualitative Research AdvC08 RS.PPT. Retrieved March 10, 2009 from www.unimaas.nl/bestand.asp?id=11629
Wolvovsky, Jay. (2008). Health disparities: Impact on Business and Economics Summit. Maryland's healthcare at a glance. The Heart of Community Health Baltimore Medical Syste. Retrieved March 10, 2009 at http://dhmh.maryland.gov/hd/pdf/2008/oct08/Jay_Wolvovsky.pdf
Other ways to celebrate achievements would be to send thank-you cards, congratulatory notes, make phone calls, and send emails.
4. Being able to set challenging goals - people often strive to achieve what is expected of them, but if they are presented with a set of challenging goals they will work even harder to accomplish them.
5. Being able to provide the necessary tools to succeed - no team will stay motivated if they do not have the necessary tools that are required to do their job. This includes: equipment, internal support, inventory, marketing materials, and training among other things.
6. Performance management - teams expect their leader to manage individuals who do not perform up to standard. Many managers often ignore these situations because they are afraid to deal with them. They hope instead that the situation will resolve itself. This is never the case; bad situations that are ignored will…...
mlaReferences
5 Little-Known Giant Health Care Issues Facing the United States. (2007). Retrieved November
11, 2009, from Nursing Online Education Database Web site:
http://noedb.org/library/features/5-little-known-giant-health-care-issues-facing-the-united-states
Francis, Margaret. (2007). Effective Management. Retrieved November 11, 2009, from Changing
These needs are only beginning to be addressed in Canada and while there do not appear to be many well-established initiatives there is a growing recognition of the need for such if Canada's healthcare sector is to gain and retain the necessary workers to deliver optimal healthcare in Canada.
ibliography
Polls & Research (2006) Health Care, Environment Top Issues in Canada. 1 Nov 2006. AngusReid Global Monitor. Online available at: http://www.angus-reid.com/polls/view/13653
ack, Chris (2008) Current and Emerging Trends: Occupational Health and Safety in the C Healthcare Sector. 19 Sept 2008. Prepared for the OHSAH Stakeholder Meeting. Online available at: http://www.ohsah.bc.ca/media/240-OHS-Current-and-Emerging-Trends-full.pdf
Canadian Institute for Health Information, Workforce Trends of Registered Nurses in Canada, 2006 (Ottawa: CIHI, 2007).
Canadian Nursing Advisory Committee, Full-time Equivalents and Financial Costs Associated with Absenteeism, Overtime, and Involuntary Part-time Employment in the Nursing Profession, February 15, 2002.
Canadian Health Services Research Foundation, What's Ailing our Nurses? A Discussion of the Major Issues…...
mlaBibliography
Polls & Research (2006) Health Care, Environment Top Issues in Canada. 1 Nov 2006. AngusReid Global Monitor. Online available at: http://www.angus-reid.com/polls/view/13653
Back, Chris (2008) Current and Emerging Trends: Occupational Health and Safety in the BC Healthcare Sector. 19 Sept 2008. Prepared for the OHSAH Stakeholder Meeting. Online available at: http://www.ohsah.bc.ca/media/240-OHS-Current-and-Emerging-Trends-full.pdf
Canadian Institute for Health Information, Workforce Trends of Registered Nurses in Canada, 2006 (Ottawa: CIHI, 2007).
Canadian Nursing Advisory Committee, Full-time Equivalents and Financial Costs Associated with Absenteeism, Overtime, and Involuntary Part-time Employment in the Nursing Profession, February 15, 2002.
EM Systems
Benefits of esearch-based EM Systems
esearch is an investigation conducted on the sources and study materials for the researcher to establish facts and offer new conclusions on a given subject matter. Currently, research is the main factor considered before an organization implements an idea on the product service to be offered to the customers. In this case, it is important for the health care institutions to utilize research concerning the benefits of Electronic Medical ecords (EM) (Greenberg et al., 2016). EM is an electronic record of any information related to health care of individuals, which can be gathered, created, consulted, and managed by nurses, clinicians, and other authorized staff within healthcare organizations.
With the help of research conducted, health care institution can understand the benefits of EM systems before implementing the systems. The research will enable the healthcare managers, stakeholders, and other authorities to compare the benefits of EM systems…...
mlaReferences
Greenberg, A. E., et al., (2016). Development of a Large Urban Longitudinal HIV Clinical Cohort Using a Web-Based Platform to Merge Electronically and Manually Abstracted Data from Disparate Medical Record Systems: Technical Challenges And Innovative Solutions. Journal of the American Medical Informatics Association, 23(3), 635-643.
Hazlehurst, B. L., et al., (2015). CER Hub: An Informatics Platform for Conducting Comparative Effectiveness Research Using Multi-Institutional, Heterogeneous, Electronic Clinical Data. International Journal of Medical Informatics, 84(10), 763-773
VHA Managerial Challenge
In recent years, the United States Department of Veterans Affairs has experienced a great deal of challenges ranging from lack of accountability and lack of employee apprehension to mismanagement of finances. In particular, a key managerial challenge that the VA faces today is the lack of timely provision of health care to veterans across the nation. Increased wait times at the various VA medical facilities are a key hindrance to obtaining timely medical health care. These protracted wait times have led to hindered accessibility to health care, which causes severe and abrupt occurrences, disability and death of the patients. There is need to assimilate financial and operational decision making to efficaciously meet this challenge and enhance organizational performance. This is because the agency caters to more than six million patients who require health care and benefits. To begin with, there is need to provide funds to employ extra…...
mlaReferences
Boyer, D. (2016). VA still plagued by problems two years after scandal. The Washington Times. Retrieved from: http://www.washingtontimes.com/news/2016/apr/3/va-still-plagued-by-problems-two-years-after-scand/
Fales, A., Choi, J., Borger, C., Gernoversa-Wong, K. et al. (2016). 2016 Wounded Warrior Project® Survey Report of Findings. Westat. Retrieved from: https://www.woundedwarriorproject.org/media/2641/2016-wwp-annual-warrior-survey.pdf
Globerman, S., Esmail, N., Day, B., & Henderson, D. R. (2013). Reducing wait times for health care: what Canada can learn from theory and international experience.
Heath, S. (2016). Patients Still Struggle to Access Mental Health Care at VA. Patient Engagement HIT. Retrieved from: http://patientengagementhit.com/news/patients-still-struggle-to-access-mental-health-care-at-va
Public Health Assessment ToolThe Community Health Assessment and Group Evaluation (CHANGE) is a tool developed by the Centers for Disease Control and Prevention (CDC) to help public health practitioners assess the needs of their communities and develop action plans to address those needs. The assessment consists of four main components: 1) community health status; 2) community assets and resources; 3) community health problems and concerns; and 4) community capacity for change. Each of these components is further divided into sub-components, which are then used to generate a report that can be used to guide community health planning. The CDCs CHANGE assessment is designed to be conducted on a regular basis, as it provides a snapshot of the current state of community health and can be used to track progress over time (Centers for Disease Control and Preventions, 2010).The CHANGE assessment tool is a community-level health assessment that helps groups identify…...
mlaReferencesCenters for Disease Control and Prevention. (2010). Community Health Assessment and Group Evaluation (CHANGE) Action Guide: Building a Foundation of Knowledge to Prioritize Community Needs. Atlanta: U.S. Department of Health and Human Services.Keppel, K. G., & Freedman, M. A. (1995). What is assessment?. Journal of Public Health Management and Practice, 1-7.Turnock, B. (2012). Public health. Jones & Bartlett Publishers.
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