Community/Organization of Interest:
Health and medical services in Bella Vista, PA, a South Philadelphia neighborhood
The cultural perspective
Bella Vista, PA, a South Philadelphia neighborhood, is a largely Italian-American ethnic enclave dominated by white, working-class residents. Although recent scholarly literature has focused upon the deficit of healthcare knowledge and services in lower-income nonwhite populations, deficits in knowledge and willingness and ability to access vital resources to improve their health still persist across population groups. For example, one study of non-Hispanic and Hispanics found that there were high levels of systemic barriers to obtain colorectal screening, including: scheduling and financial barriers; fear of diagnosis and pain; and lack of motivation amongst all study participants (Green et al. 2008). Culturally and psychologically in many communities, there is often an unwillingness to seek medical treatment in the form of screening. Even though Bella Vista is not a poor community cultural attitudes towards healthcare can still be…...
mlaReferences
Breen, T. (2013). Overview of the 2013-2014 Medicaid payment increase for primary care services. The Advisory Board Company. Retrieved:
Brown, E.R. (et al2004). Effects of community factors on access to ambulatory care for lower-
income adults in large urban communities. Inquiry - Excellus Health Plan, 41(1), 39-56.
Emergency Medical Services System Act of 1973 helped to establish national standards for emergency medical systems, with broad implications for education and public health. The Act follows a series of seminal events that drew attention to weaknesses in emergency response, including the lack of proper, regulated, or consistent training for personnel. Moreover, the Act helped to ensure that healthcare infrastructure would be modernized to minimize instances and costs related to accidental injury and death. The Act includes provisions for training in emergency medical services, offering funding and support for training programs that conform to a set of federal standards. Interestingly, Nixon had initially vetoed the Emergency Medical Services System Act, and it was subsequently reworded to omit mandate for a Public Health Service Hospital system -- something Nixon believed was "unnecessary," (Shah, 2006, p. 1). Passing the EMS Systems Act of 1973 meant that the Department of Health, Education,…...
mlaReferences
EMS Systems Act of 1973. Public Law 93-154
Shah, M.N. (2006). The formation of the Emergency Medical Services System. American Journal of Public Health 96(3): 414-423.
The facts that you have provided indicate extremely troubling circumstances that could seriously jeopardize the welfare of your organization. It is well-settled law that entities contracting for the services of subsidiaries are legally responsible for legal and ethical improprieties committed by those subsidiaries irrespective of whether or not the contracting organization had any specific involvement in or knowledge of those actions. Accordingly, we would strongly advise that you take immediate action to rectify the situations described in the manner outlined in our recommendations below.
ecommendations
To avoid the potentially serious criminal, civil, and financial consequences arising under MWHC's respondeat superior responsibility to prevent fraud and abuse in connection with its association with subsidiaries, it is hereby recommended that MWHC immediately:
1. Instruct the subsidiary to cease and desist from offering its contracted home health agency employees compensation of any kind in connection with client durable medical equipment (DME) orders from the subsidiary.
2. Instruct…...
mlaReferences
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
USDHHS. (2004). U.S. Department of Health and Human Services-Office of Inspector
General-Statement of Organization, Functions -- and Delegations of Authority.
Federal Register. Vol. 69, No. 127; July 2, 2004. Retrieved November 14, 2010,
Health are -- Medical Retention Laws
Medical records retention requirements, whether Federal or State, are apparently aimed at maintaining records for a significant length of time after a patient's discharge. HIPAA does not impose a specific requirement for retention of a patient's medical records and leaves that task to State legislatures. alifornia meets and far exceeds Federal requirements in multiple requirements from multiple laws. Meanwhile, Nevada takes a far simpler tack while still adhering to Federal requirements.
Federal
HIPAA does not impose a length of time for which patients' medical records must be retained (U.S. Department of Health and Human Services, 2009); rather, that requirement is left to the states. However 45 .F.R. §164.530(j) does require that an entity governed by HIPAA must retain its "privacy policies/procedures, privacy practices notices, disposition of complaints, and other actions, activities, and designations that the Privacy Rule requires to be documented" (U.S. Department of Health and Human…...
mlaCalifornia's record retention laws are at least as strict as federal law, as required, and are often stricter. Beyond the HIPAA requirements binding covered entities, California has various strict retention requirements stemming from several laws. California's Code of Regulations §70751(c) (22 C.C.R. §70751(c) requires hospitals to keep patients' medical records for a minimum of 7 years after any patient's discharge and, if the patient is a minor, the records must also be retained for a minimum of 1 year after the minor has reached the age of 18 (California State Legislature, 2013). Also, the Welfare & Institutions Code §14124.1 states that the medical records of Medi-Cal patients must be kept by the provider for 3 years after the last date of service rendered under the Medi-Cal Program (California State Legislature, n.d.). In addition, the Health & Safety Code §1797.98e (b) states that providers reimbursed by the Emergency Medical Services Fund must keep patients' records for 3 years after the last reimbursed service was rendered (California State Legislature, n.d.). The Health & Safety Code under §11191 also requires that prescription books with issued prescription copies must be kept for 3 years after the last noted prescription was issued and that a provider who "prescribes, dispenses or administers a controlled substance classified in Schedule II" is required to make and keep a record of each such transaction for 3 years (California State Legislature, n.d.). Furthermore, under California's Code of Regulations §1300.67.8 (28 C.C.R. §1300.67.8), managed care plans governed by the Knox-Keene Act must also retain all "records, books, and papers of a plan" for 2 years, keeping the records available for inspection by the Commissioner of Corporations (California State Legislature, 2009, p. 54.5). California's Code of Regulations §39.5 also requires that in cases of Worker's Compensation, all qualified medical evaluators must retain patients' medical-legal reports for 5 years after the employees' evaluation (California State Legislature, 2013). Finally, regarding its state Occupational Safety and Health Administration (OSHA) program, California's Code of Regulations §3204(d) (8 C.C.R. §3204(d) requires that in cases of employees who were exposed to "toxic substances or harmful physical agents," providers must keep medical records for a minimum of the duration of employment plus thirty years (California State Legislature, 2013).
Nevada
Nevada's laws regarding medical records retention
Ethical Issues in EMS
While one might not think so, there are ethical issues galore when it comes to the emergency medical services (EMS) sphere. Indeed, there is a valid question when it comes to the obligations that arise during the job and what must or should be done when those obligations conflict. Given that eventuality, there can and should be an analysis of what to do when such a situation arises and how to properly react and make the right decision. Whatever decision is made, there has to be an ensuring that the needs of the patients as well as the organizations in question are being properly balanced and prioritized. While the aforementioned balancing act can be difficult to pull off, it is something that any proper practitioner in the field must strive to accomplish.
Analysis
Many EMS personnel and managers are prone to rely on spur-of-the-moment judgement and reason when it…...
mlaReferences
Becker, T., Gausche-Hill, M., Aswegan, A., Baker, E., Bookman, K., & Bradley, R. et al. (2013). Ethical Challenges in Emergency Medical Services: Controversies and Recommendations. Prehospital and Disaster Medicine, 28(05), 488-497. http://dx.doi.org/10.1017/s1049023x13008728
Byrd, G. & Winkelstein, P. (2014). A comparative analysis of moral principles and behavioral norms in eight ethical codes relevant to health sciences librarianship, medical informatics, and the health professions. J Med Libr Assoc, 102(4), 247-256. http://dx.doi.org/10.3163/1536-5050.102.4.006
Macklin, R. (2014). Can one do good medical ethics without principles?. J Med Ethics, 41(1), 75-78. http://dx.doi.org/10.1136/medethics-2014-102354
Nelson, W., Taylor, E., & Walsh, T. (2014). Building an Ethical Organizational Culture. The Health Care Manager, 33(2), 158-164. http://dx.doi.org/10.1097/hcm.0000000000000008
Mass Casuality Decontamination
Mass Causality Decontamination
Throughout the past era, worries about possible terrorist acts concerning weapons of mass destruction (WMD) directed Congress and the President to obtain a complete counteract terrorism strategy that was aimed at stopping a chemical, biological, or nuclear attack and improving domestic attentiveness. The organization of choice for national significance management has been the Department of Defense. Of the $1.2 billion taken in the FY 2000 business plan purposely for WMD reply, most of it went to DOW Overreliance on the military for domestic (Wynd, C. 2006) WMD defense, nevertheless, may reduce the military's war combating capacity and holds the potential for breach of individual rights. Given that these attacks are confronting to avoid and may take place anywhere and at any time, mass decontamination is one of the significant factors to controlling the distresses of such an occurrence, saving lives, and limiting the number of injuries.
To…...
mlaReferences:
10th european congress of trauma and emergency surgery. (2010). European Journal of Trauma and Emergency Surgery, 35, 1-1-188. doi:10.1007/s00068-009-8001-z
Cabrera, Suzanne Lobaton, R.N., M.N., & Beaton, Randal D, PhD., E.M.T. (2009). The role of occupational health nurses in terrorist attacks employing radiological dispersal devices. AAOHN Journal, 57(3), 112-112-9; quiz 120-1.
DA-az, G. (2005). Different approaches to the difficult relationship between intelligence and policy: A case study of the cuban missile crisis of 1962 vs. The 2003 war in iraq. UNISCI Discussion Papers, (9), 93-93-126.
Disaster Response: Principles of Preparation and Coordination. (1989). St. Louis: Center of Excellence and Disaster Management.
Medical trauma triage management requires skillful curriculum development, which in turn depends on an assessment of needs and an anticipation of potential barriers to implementation. The initial needs assessment has revealed required resources of about four or five medical services providers such as physician assistants and nurse practitioners. Support personnel may be provided, but an additional challenge will arise when implementing the curriculum in a real world setting such as a trauma center, emergency room, or intensive care unit. Adequate space and time must be carved out for the curriculum implementation, without disturbing standard operating procedures. At the same time, improving trauma triage management will ultimately facilitate patient service delivery and maximize care outcomes, goals that should continually be communicated to the institutional administration as well as all participants in the program.
Each phase of the ADDIE model, an industry benchmark for curriculum development, "requires constant evaluation," (Allen, 2006, p. 439).…...
mlaReferences
Allen, W.C. (2006). Overview and evolution of the ADDIE training system. Advances in Developing Human Resources 8(4): 430-441.
Bass, E.B. (n.d.). Step 1: Problem identification and general needs assessment.
Swanson, R.A. & Holton, E.F. (2009). Training and development practices. Chapter 12 in Foundations of Human Resource Development.
Services Presentation in Older Adults
Approximately 75 million baby boomers were born in the United States between1946 and 1964. This generation will stress the healthcare system as has no other generation in history. There are many services available for older adults in relation to their psychosocial, cognitive, and emotional issues. This work will identify available services for older adults in a specific facility and address the issues relating to older adults and mental health programs or the psychosocial health of older adults in this facility. The facility at focus in this work is Tripler Army Medical Center in Hawaii.
Program Description
The adult psychiatric treatment program for older adults at Tripler Army Medical Center in Hawaii is such that focuses on depression experienced in older adults. The U.S. Department of State examines the issues of dealing with elderly parents by those in the service so that the health care of the elderly parent…...
mlaReferences
Aging Baby Boomers In a New Workforce Development System (nd) report updates and revises an earlier study by the Urban Institute, The Aging Baby Boom: Implications for Employment and Training Programs, June 1997, by Stacy Poulos and Demetra Smith Nightingale.
American Legion giving little ground over proposed cost-shifting (2011) The American Legion Legislative Point Paper (2011) TRICARE. 4/6/2011. Retrieved from: http://www.legion.org/files/legislative_pointpapers/legislative_tricare.pdf
Caring for Elderly Patients (2010) U.S. Department of State. Retrieved from: http://www.state.gov/m/dghr/flo/c23141.htm
Department of Defense Health Care System and Military Facilities (2010) Brown, Bauman & Smith. Attorneys. Retrieved from: http://www.brownbaumansmith.com/newsletters/Elder-Law/?launch_pg=NewsletterDetailLayout&launch_sel=1000283&title=Department+of+Defense+Health+Care+Benefits
Secondly, in my opinion, it is irrational and insensitive for the rich to continue spending billions of dollars on luxuries as millions across the world continue to suffer. For instance, why would an individual own several luxury cars while another person cannot even afford to settle his or her medical bills? Similarly, why should an individual have billions of dollars lying idle in the bank as scores of people across the world die of hunger? In my opinion, luxury items are insignificant when compared to the basic needs of others including but not limited to food, shelter, and medical attention. In the final analysis, it does not make much sense for one to live in luxury as others wallow in poverty. e therefore have an obligation to give up some of our luxuries so as to help the less fortunate amongst us.
Lastly, I am convinced that helping the poor would…...
mlaWorks Cited
Gupta, Bina, ed. Ethical Questions: East and West. Maryland: Rowman & Littlefield, 2002. Print.
MacKinnon, Barbra. Ethics: Theory and Contemporary Issues. Concise Edition. Boston, MA: Cengage Learning, 2010. Print.
Medical Companies
How do these companies provide care?
Aetna provides care by being a health insurance company that offers a range of services in the field of medical, pharmaceutical, dental, behavioral group, long-term care, and plans for those who are disabled. Humana is also a health insurance company that offers its services in numerous states. United Health Group operates two businesses, known as United Healthcare and Optum, and similar to the two aforementioned companies, it offers health insurance to individuals, which includes seniors.
What types of plans do they have?
Aetna offers various types of plans under its various insurance, which as mentioned before, include medical, dental, vision, medicare, disability, pharmacy, life, student, behavioral health, health expense funds, and wellness products and discounts. Under medical insurance, a person can get a quote via state, which may include individual HMO health benefits plan or QPOS individual advantage health benefits and health insurance plan. Under dental,…...
mlaReferences
Aetna - Health Insurance, Dental, Pharmacy, Group Life and Disability Insurance. (n.d.). Aetna - Health Insurance, Dental, Pharmacy, Group Life and Disability Insurance. Retrieved December 19, 2011, from http://www.aetna.com
HUMANA - Guidance when you need it most. (n.d.). HUMANA - Guidance when you need it most. Retrieved December 19, 2011, from http://www.humana.com/
UnitedHealth Group - Featured News - Products & Services. (n.d.). UnitedHealth Group - Featured News - Products & Services. Retrieved December 19, 2011, from http://www.unitedhealthgroup.com
Medical Home Model and Health Disparity
Nursing esearch Proposal
The Impact of the Medical Home Model on Health Disparities
The Impact of the Medical Home Model on Healthcare Disparity
Medical homes are primary care practices where a physician or NP establishes a long-term care relationship with patients and provide patient/family-centered, coordinated, and culturally-sensitive care (AANP, n.d.; Strickland, Jones, Ghandour, Kogan, & Newacheck, 2011). The benefits include improved healthcare access, quality, and safety. A number of states have enacted statutes supporting the medical home model after research findings revealed health disparities for racial and ethnic minorities were reduced (NCSL, 2013).
As a nurse practitioner I am interested in how effective a medical home model would be in reducing healthcare disparities, especially for racial and ethnic minority children residing in underserved communities. Nurse practitioners have traditionally practiced in underserved communities and will continue to do so; therefore, any strategy that could improve the quality of care with…...
mlaReferences
AANP (American Association of Nurse Practitioners). (n.d.). Medicare legislation: Fact sheet: The medical home -- What is it? How do nurse practitioners fit in? Retrieved from: http://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/349-the-medical-home .
Abrams, M., Nuzum, R., Mika, S., & Lawlor, G. (2011). Realizing health reform's potential: How the Affordable Care Act will strengthen primary care and benefit patients, providers, and payers. The Commonwealth Fund. Retrieved from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Jan/1466_Abrams_how_ACA_will_strengthen_primary_care_reform_brief_v3.pdf .
NCSL. (2013). Health disparities: State laws. Retrieved from: http://www.ncsl.org/research/health/health-disparities-laws.aspx .
Strickland, B.B., Jones, J.R., Ghandour, R.M., Kogan, M.D., & Newacheck, P.W. (2011). The medical home: Health care access and impact for children and youth in the United States. Pediatrics, 127(4), 604-11.
In other words, the facilities that are available will be laid out in the best possible pattern and fashion so as to maximize efficiency and convenience for people who use the services (Handler & Mirchandani, 1979). There is obviously no way to put all of the facilities into the same space, and some of them take up more land than others, but there is no reason that urban planning officials, city leaders, and companies that want to build in a particular area cannot work together to meet everyone's needs. Often they want to accomplish this, but they simply are not sure what the best way to go about it would be.
Consider, as an example, a network model of an urbanized area, shown on the following pages and reproduced from Larson & Odoni, 1997-1999 http://web.mit.edu/urban_or_book/www/book/chapter6/6.5.2.html.
All of the nodes (a through H) indicate points at which service demands are being generated.…...
mlaBibliography
Beltrami, E., & Bodin, L., (1974). Networks and Vehicle Routing for Municipal Waste Collection, Networks, 4 (1), 65-94 (1974).
Chan, D.W.M. And Kumaraswamy, M.M. (1996). An Evaluation of Construction Time Performance in the Building Industry. Building and Environment, 31(6), 569-578.
Church, R.L., & Garpinkel, R.S., (1978). Locating an Obnoxious Facility on a Network. Transportation Science, 12, 107-118.
Frank, H. & Frishch, I.T., (1971). Communication, Transmission, and Transportation Networks, Addison-Wesley, Reading, Mass.
Also, ratings of performance on a questionnaire can be highly subjective, and one person's rating of 'excellent' may be another person's 'acceptable.'
How can Sam maximize the response rate to the survey?
Personalizing the submitting responses is essential -- sending follow-up emails to individuals who do not respond is a good idea as is electronically 'thanking' those who do submit a response. The latter practice will ensure that responders will continue to respond to such surveys in the future. Also, if at all possible, having a small prize for a randomly selected questionnaire, such as a gift certificate, will likely improve the response rate.
The extracts of Sam's questionnaire you have seen do not include any of the amendments suggested by her pilot test. What amendments to these questions do you think Sam made after the pilot testing?
The extract measured the gap between expected service and actual service. Describing exactly what types…...
Service Demand & Supply
Service Demand and Supply Planning
Planning is considered the most important function of every project and organization (Singla, 2011). Successful organizations spend their more than 60% of the time in the planning process. It is because strong planning makes the subsequent steps easy. If planning is poor, the rest of the activities are bound to fail. It is, therefore, mandatory to spend maximum time and put in the best efforts in the phase of planning so that execution and implementation can be made possible without hassle.
In the context of business organization, the major game to play around is maximizing profitability (Tulsian, 2002). It is the core objective of every commercial organization and the very survival and existence of organization depends upon the ratio of profits it earns. The simple formula of profit calculation is revenue less expense. In order to maximize profits, organizations adopt any or both of…...
mlaReferences
1. Arlbjorn, Jan, Vagn, Freytag and Henning, De. 2011. "Service Supply Chain Management." International Journal of Physical Distribution & Logistics Management 41: 277-295
2. Arlbjorn, Jan. 2010. Supply Chain Management. Denmark: Academica.
3. Costes, Fabbe, Marianne, Jahre and Christine, Roussat. 2009. "Supply chain integration: the role of logistics service providers." International Journal of Productivity and performance Management 58: 71-91.
4. Holmstorm, Jan, Ala-Risku, Timo et al. 2010. "Demand-supply chain representation: A tool for economic organizing of industrial services IMS." Journal of Manufacturing Technology Management 21: 376-387.
In this case, that power dynamic was only exacerbated by the fact that the entire MSICU nursing team had never received training in management of the type of clinical issues presented and by the fact that they were excluded from any consultation in connection with a post-operative management plan.
Therefore, it is recommended that the institution immediately implement a policy of "see something, say something" according to which all members of healthcare teams are encouraged to speak up irrespective of power differentials. Furthermore, that protocol must include a statement of policy insulating any member of a healthcare team who does voice a legitimate concern in good faith from any retaliation or other negative response that could conceivably deter such diligence. Finally, the record of this case also indicates the immediate need for protocols requiring all members of the healthcare team to identify themselves to other members of the team, especially…...
mlaReferences
Bosk, Charles L. (2003). Forgive and Remember: Managing Medical Failure.
Gawande, Atul. (2008). Better: A Surgeon's Notes on Performance.
Groopman, Jerome. (2008). How Doctors Think.
Timmermans, Stefan. (2003). The Gold Standard: The Challenge of Evidence-Based
As health care’s share of gross domestic product (GDP) grows, people are struggling with how to estimate the value of the health care industry in the economy. While it might seem like a straightforward answer, simply looking at the total amount paid for healthcare in proportion to the total GDP, that valuation would be a gross oversimplification. Generally, GDP is viewed as a proxy for standard of living, but in the United States standard of living might actually drop for many people as the percentage of GDP attributable to healthcare grows. It is important to keep in....
For several years, healthcare has been an important topic, not just in the world at large, but also in academia. Healthcare has been one of the fastest growing sectors of our economy, has offered a boom in terms of employment, and is a hot button political issue since access to healthcare remains very class-based in the modern United States. The COVID-19 pandemic and what it has meant about access to health care and the quality of healthcare that is being provided has only made it that much more important to focus on
Third party payment, such as health insurance companies or government programs, can distort the healthcare market in several ways:
1. Increased demand: When individuals are not directly paying for their healthcare services, they are more likely to utilize medical services without considering the cost. This leads to increased demand for healthcare services, which can drive up prices and strain the resources of healthcare providers.
2. Lack of price transparency: Third party payment often creates a lack of price transparency in the healthcare market. Since patients are not directly paying for their services, they may not be aware of....
Title: The Impact of Technology on Modern Society
Introduction:
Technology has become an integral part of our daily lives, significantly transforming various aspects of modern society. In this paper, we will explore the profound impact technology has had on areas such as communication, education, and healthcare. By examining both the positive and negative effects, we aim to gain a comprehensive understanding of how technology has shaped our lives.
I. Communication:
The advancements in technology have revolutionized the way people communicate with each other.
A. Improved connectivity:
1. The emergence of smartphones and social media platforms has allowed individuals to stay connected 24/7.
....
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