Health Reform & Stakeholder Impact

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Health Reform & Stakeholder Impact

(Health Reform & Stakeholder Impact)

HEALTH POLICY ASSIGNMENTS

Case Study Reflection

Write a 4-5 page paper. Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Pocket Guide to APA Style to ensure that in- text citations and reference list are correct. Submit your assignment to the Dropbox by the end of this Unit.

In 2007 San Francisco began its Healthy San Francisco Plan designed to provide health care for all San Francisco citizens. In 2007, it was estimated that San Francisco had 82,000 uninsured citizens. Under the plan, all uninsured citizens residing in San Francisco can seek care at the city’s public and private clinics and hospitals. The basic coverage includes lab work, x-rays, surgery, and preventative care. The city plans to pay for this $203 million coverage by rerouting the $104 million the city currently spends treating the uninsured in the emergency rooms, mandating business contributions, and requiring income-adjusted enrollment fees. The plan requires all businesses with more than 20 employees to contribute a percentage toward the plan. Many business owners consider this a burden and warn they will not stay in the city. The Mayor sees universal health access a moral obligation for the city.

Take one of the following positions.

· San Francisco has an obligation to provide its citizens with health access.-OR-

· San Francisco does not have an obligation to provide its citizens with health access.

Discuss the following in your assignment:

1. What is the government’s role in regulating healthy and unhealthy behavior?

2. Has the balance between personal freedom and the government’s responsibility to provide health and welfare of its citizens been eroded? Why or why not?

3. Written Assignment

4. Review the following report at:

5. https://kapextmediassl-a.akamaihd.net/healthSci/HA545/HA545_1703C/u5_as.pdf

6. Using this Congressional Report for members of Congress and your textbook, write a 5-page memorandum/paper on the topic of rulemaking.

7. You are a summer intern with Harry Smith, a Congressman from your home district. He has to advise his congressional committee on the impact of interest groups on legislation. Write the memorandum to explain the purpose and influence on rulemaking in the operation of the legislation. You should offer suggestions on the importance of the implementation phase of the legislation.

Paper

Write a 7-9 page paper with bibliography. Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Pocket Guide to APA Style to ensure in-text citations and reference list are correct.

You will synthesize your understanding of why Medicare Part D passed, as well as the influence of the various interest groups and governmental entities during this process. Make sure to discuss both the policy process and the policy environment—that is, the key players involved and other circumstances that shaped this policy-making effort. For this assignment, address the following questions, doing further research as needed:

· How did various stakeholder groups influence the final outcome of Medicare Part D legislation?

· What were the specific strategies and tools that were used most effectively?

· Does the fact that Medicare Part D passed corresponds with your understanding of policy and politics, or did this surprise you? Explain your response.

Paper

Write a 7-9 page paper with a References List. Your written assignment must follow APA guidelines. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Pocket Guide to APA Style to ensure in-text citations and reference list are correct.

You will synthesize your understanding of why Clinton’s Health Plan was unsuccessful. Discuss the features of the Clinton health care reform plan and provide reasons why it failed and describe the influence of the various interest groups and governmental entities during this process. Make sure to discuss both the policy process and the policy environment—that is, the key players involved and other circumstances that shaped this policy-making effort. Consider and discuss the following:

1. Take a position in support or opposition

2. Discuss the context of this legislation – name the expected demanders and suppliers as outlined in our textbook, Chapter 3.

3. Describe the expected interest groups and there specific arguments.

4. Describe the expected interplay between demanders and suppliers, interest groups and analyze the public policy environment.

 
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Patient-Centered and Safe Care

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Patient-Centered and Safe Care: Ensuring Quality in Health Care Delivery

(Patient-Centered and Safe Care)

The Institute of Medicine (IOM) developed six specific aims to ensure the delivery and improvement of health care. Choose two from the six aims: Safe, effective, patient-centered, timely, efficient and equitable (Institute of Medicine, 2001). Of the two aims you chose, discuss the effects on the delivery of quality care. Give an example of how a hospital or physician practice can meet these aims.

 

Your initial post should be 250-500 words and utilize at least one scholarly source from the Ashford University Library to justify your choices. Sources must be cited in APA format as outlined in the Ashford.

Patient-Centered and Safe Care

Ensuring Quality in Health Care Delivery

The Institute of Medicine (IOM), now known as the National Academy of Medicine, identified six essential aims to transform health care delivery: safe, effective, patient-centered, timely, efficient, and equitable care. Among these aims, patient-centered and safe care are fundamental for enhancing the quality of health services. Both aims not only address immediate patient needs but also contribute to long-term health outcomes by minimizing risks and prioritizing patient preferences.

Patient-Centered Care and Its Impact on Quality

Patient-centered care emphasizes the importance of understanding and respecting each patient’s unique preferences, values, and needs. This approach encourages active patient participation in decision-making processes, fostering a sense of empowerment and collaboration. By prioritizing patient involvement, health care providers are better positioned to deliver care that aligns with the individual’s expectations, ultimately improving satisfaction and trust.

For example, a hospital implementing patient-centered strategies may create personalized care plans, actively engage patients and families in discussions about treatment options, and offer culturally sensitive care. Such measures help bridge communication gaps, reduce misunderstandings, and ensure that care plans reflect patient desires and health goals. Research has shown that when patients feel respected and heard, adherence to treatment protocols improves, and clinical outcomes are more favorable (Epstein & Street, 2011).

A practical example of patient-centered care in action is the use of shared decision-making models in chronic disease management. In a primary care setting, physicians collaborate with patients to explore various treatment pathways, weighing the benefits and risks of each option. This shared responsibility not only educates patients about their health conditions but also enhances their commitment to follow prescribed therapies, resulting in better health outcomes and reduced hospital readmissions.

Safe Care and Its Impact on Quality

The IOM defines safe care as the prevention of harm to patients during the provision of health services. Ensuring safety in healthcare settings requires systematic efforts to prevent medical errors, reduce risks, and maintain a secure environment for patients. Safe care is a cornerstone of quality because it directly affects patient survival, recovery rates, and overall trust in the healthcare system.

Hospitals can meet the aim of safe care by implementing evidence-based protocols that minimize errors and enhance patient monitoring. For instance, the use of checklists in surgical settings has been proven to reduce the incidence of preventable complications. A study by Haynes et al. (2009) demonstrated that the implementation of a surgical safety checklist led to significant reductions in morbidity and mortality rates. This tool ensures that critical steps are not missed during surgery, improving patient safety and confidence in the healthcare team.

Meeting Both Aims in Practice

To effectively integrate both patient-centered and safe care, healthcare organizations can adopt Electronic Health Records (EHRs) that enhance communication, streamline documentation, and facilitate access to patient information. EHRs allow physicians to track patient histories comprehensively, reduce medication errors, and customize care plans according to patient needs and medical history.

By prioritizing both patient-centered and safe care, healthcare providers can significantly improve the delivery of quality services, ensuring that patients receive not only effective but also compassionate and secure care. These principles, grounded in evidence-based practice, pave the way for a more resilient and trustworthy healthcare system.

References

Epstein, R. M., & Street, R. L. (2011). The values and value of patient-centered care. Annals of Family Medicine, 9(2), 100–103. https://www.annfammed.org/content/9/2/100.full

Haynes, A. B., Weiser, T. G., Berry, W. R., Lipsitz, S. R., Breizat, A.-H. S., Dellinger, E. P., … & Gawande, A. A. (2009). A surgical safety checklist to reduce morbidity and mortality in a global population. New England Journal of Medicine, 360(5), 491–499. https://www.nejm.org/doi/full/10.1056/NEJMsa0810119

 
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Public Health On Hiv/Aids

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Public Health On Hiv/Aids

(Public Health On Hiv/Aids)

Public Health

please read attachments…. please…Your public health presentation should be 10 slides in length, use an appropriate application (PowerPoint, Prezi, etc.), and comprehensively address the public health issue using speaker notes and scholarly resources for support. Support for your speaker notes will come from scholarly resources, including the following: at least two scholarly resources for the background of the public health issue, at least two scholarly resources for response to the problem, and at least two scholarly resources for current directions to address the problem.

It should be a complete, polished artifact containing all of the critical elements of the final product.

I am attaching the topic and artifacts and critical elements for your 10 slide public health presentation.

General Guidance for Presentations Consider your presentation as consisting of two complementary elements: the narrative and the visual. Your speaker notes are the equivalent to the narrative, so write them clearly, succinctly, and with proper grammar and spelling, so they are easily understood by a general audience. (Note that you will not be speaking, just writing.) The visual element, the slides themselves, support the narrative. Visuals keep the eyes involved in the presentation while the presenter speaks. As such, they should not repeat the narrative. Graphics that support the narrative are best: charts, tables, timelines, illustrations, and photographs. Visuals should never be simply “window dressing,” like a group photograph of a meeting; they must specifically support the points being made in the narrative. Bullet points are acceptable in combination with or, if necessary, without graphics. If possible, keep each bullet point to a single line. Powerful quotes from your resources can sometimes drive home your point. Finally, do not be tempted to fill the entire visual space. Insufficient white space results in visual clutter, prompting your audience to spend too much effort figuring it out (distracting the audience from the speaker) or simply ignoring it. The following are recommended steps for each section:  Write your speaker notes first, using the worksheets from your milestone assignments.

 Create the visual element.

 Read the narrative to test for easy comprehension.

 Add visual elements that support the speaker notes. Try to visualize what the notes are saying.

(Public Health On Hiv/Aids)

Develop a presentation (using PowerPoint, Prezi, etc.) that describes a public health issue and national goals set for that problem on Healthy People 2020. The presentation will give an overview of the distribution of the problem in the United States, factors associated with the problem, social determinants of the problem, and any health disparities. Your presentation must contain speaker notes that fully address the contents below. Support for your speaker notes will come from scholarly resources. Specifically, the following critical elements must be addressed:

I. Background: Provide a clear background of your selected priority public health issue. Be sure you address the issue’s goal statements and relevant context for the issue in terms of the ecological model, citing scholarly support.

II. Epidemiology

A. Analyze the epidemiological patterns, causes, and effects of the health issue in the population. For example, how is the issue distributed in the population?

B. Describe the social determinants associated with the issue. How do these determinants impact the health of those affected by the issue?

C. Describe known disparities (i.e., socioeconomic, demographic, cultural, and geographic) associated with the health outcomes of your specific population with regard to the public health issue.

(Public Health On Hiv/Aids)

III. Public Health Interventions: In this section, you will examine public health interventions published in the scholarly literature for how they addressed your selected public health issue.

A. Analyze two published public health interventions used to address the issue, including the theoretical basis of each intervention. In other words, what were the strategies used to address this problem and what was the rationale for those actions, according to the scholarly resources?

B. Explain how the selected interventions reflect primary, secondary, and/or tertiary intervention strategies for public health prevention.

C. Explain how the interventions address social determinants of health and the disparities in healthcare associated with the issue.

IV. Public Health Response: In this section, you will inspect the public health landscape to identify who is involved in responding to your public health issue and what actions they are taking.

A. Describe the public health organizations involved in the response to the public health issue at the national and local levels. Use examples that show which entities are working on the issue and what they are doing. For example, what federal and local agencies and/or not-for-profit entities are involved, and what are their roles in the response?

B. Explain the specific public health subdisciplines involved in understanding and responding to the issue, including what their roles are. Examples of public health subdisciplines include biostatistics, epidemiology, maternal and child health, and disaster-response planning.

C. Explain the public health services involved in the response to the issue. What types of services, programs, or campaigns have been offered by organizations in response to the problem? Be sure to provide examples.

(Public Health On Hiv/Aids)

V. Current Directions: Based on your understanding of the health goals and interventions, identify gaps in the response and draw connections to the broader field of public health.

A. Explain the overall effectiveness of the public health response to your issue, based on any gaps between its goals and the current information and strategies. In other words, given what you understood about the distribution of the public health issue and the strategies that have been undertaken to address it, what are the obstacles to this public health response meeting its goals?

B. Discuss the unique perspective that public health theoretical  frameworks provide in addressing this issue. In other words, how is the public health approach different from the way other medical models might address this issue, and what advantages do public health frameworks have in terms of promoting positive health outcomes with regard to the issue?

C. Reflect on the connections between the public health response to this issue and broader ethical questions of social justice, poverty, and systematic disadvantage. Specifically, how does the response help to improve conditions for people in their communities? Keep in mind ethical theories and principles studied in this course

 
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Analyzing Sun Coast Data

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Analyzing Sun Coast Data

(Analyzing Sun Coast Data)

Correlation And Regression Analysis Using Sun Coast Data Set

Sun Coast Remediation Course Project Guidance

Background

To help make a connection between business research and its use in the real world, this course will use an iterative course project. Throughout the term, you will serve as the health and safety director for Sun Coast Remediation (Sun Coast).

Sun Coast provides remediation services to business and governmental organizations. Most of their contracts involve working within contamination sites where they remove toxic substances from soil and water. In addition to the toxicity of the air, water, and soil their employees come into contact with, the work environment is physically demanding and potentially contributory to injuries involving musculoskeletal systems, vision, and hearing. Sun Coast genuinely cares about the health, safety, and well-being of their 5,500 employees, but they are also concerned about worker compensation costs and potential long-term litigation from injuries and illness related to employment.

Health and Safety Director Task(Analyzing Sun Coast Data)

Sun Coast hired you last month to replace the previous health and safety director, who left to pursue other opportunities. This is a critical position within the company because there are many health and safety-related issues due to the nature of the work. The former health and safety director was in the midst of analyzing these issues through the implementation of a research project when she left the organization.

Throughout the term, you will use your knowledge of research methods to bring the research project to fruition. You will conduct a literature review, develop research questions and hypotheses, create the research design, test data, interpret data, and present the findings. Each unit will accomplish one of these tasks. It has already been decided that the business problems will be best addressed using a quantitative research methodology. You will not collect any data for this project. The former health and safety director had already collected the data, which is provided for you in an Excel spreadsheet.

Statistical Tools

You will conduct the data analysis using Microsoft Excel Toolpak. View these links for information: https://support.office.com/en-us/article/load-the-analysis-toolpak-in-excel-6a63e598-cd6d-42e3-9317-6b40ba1a66b4 and https://www.excel-easy.com/data-analysis/analysis-toolpak.html

Sun Coast Remediation Course Project Sections

Since this is a quantitative research study, there are specific steps that should be followed. The following is a template that will help you develop your project. (It is also provided as a template in Unit VII.) Use this information to guide your completion of the course project.

Table of Contents

Include the table of contents here. There is a tool for creating a table of contents in the References tab of the Microsoft Word tool bar at the top of the screen. Remember to delete this text and the instructions from the previous page before you begin.

Executive Summary

The executive summary will go here. The paragraphs are not indented, and it should be formatted like an abstract. The executive summary should be composed after the project is complete. It will be the final step in the project. Delete this text before you begin.

Sun Coast Remediation Course Project

Introduction(Analyzing Sun Coast Data)

Note: The following introduction should remain in the research project unchanged. Delete this note before you begin.

Senior leadership at Sun Coast has identified several areas for concern that they believe could be solved using business research methods. The previous director was tasked with conducting research to help provide information to make decisions about these issues. Although data were collected, the project was never completed. Senior leadership is interested in seeing the project through to fruition. The following is the completion of that project and includes the statement of the problems, literature review, research objectives, research questions and hypotheses, research methodology, design, and methods, data analysis, findings, and recommendations.

Statement of the Problems

Note: The following statement of the problems should remain in the research project unchanged. Delete this note before you begin.

Six business problems were identified:

Particulate Matter (PM)

There is a concern that job-site particle pollution is adversely impacting employee health. Although respirators are required in certain environments, PM varies in size depending on the project and job site. PM that is between 10 and 2.5 microns can float in the air for minutes to hours (e.g., asbestos, mold spores, pollen, cement dust, fly ash), while PM that is less than 2.5 microns can float in the air for hours to weeks (e.g. bacteria, viruses, oil smoke, smog, soot). Due to the smaller size of PM that is less than 2.5 microns, it is potentially more harmful than PM that is between 10 and 2.5 since the conditions are more suitable for inhalation. PM that is less than 2.5 is also able to be inhaled into the deeper regions of the lungs, potentially causing more deleterious health effects. It would be helpful to understand if there is a relationship between PM size and employee health. PM air quality data have been collected from 103 job sites, which is recorded in microns. Data are also available for average annual sick days per employee per job-site.

Safety Training Effectiveness(Analyzing Sun Coast Data)

Health and safety training is conducted for each new contract that is awarded to Sun Coast. Data for training expenditures and lost-time hours were collected from 223 contracts. It would be valuable to know if training has been successful in reducing lost-time hours and, if so, how to predict lost-time hours from training expenditures.

Sound-Level Exposure

Sun Coast’s contracts generally involve work in noisy environments due to a variety of heavy equipment being used for both remediation and the clients’ ongoing operations on the job sites. Standard ear-plugs are adequate to protect employee hearing if the decibel levels are less than 120 decibels (dB). For environments with noise levels exceeding 120 dB, more advanced and expensive hearing protection is required, such as earmuffs. Historical data have been collected from 1,503 contracts for several variables that are believed to contribute to excessive dB levels. It would be important if these data could be used to predict the dB levels of work environments before placing employees on-site for future contracts. This would help the safety department plan for procurement of appropriate ear protection for employees.

New Employee Training

All new Sun Coast employees participate in general health and safety training. The training program was revamped and implemented six months ago. Upon completion of the training programs, the employees are tested on their knowledge. Test data are available for two groups: Group A employees who participated in the prior training program and Group B employees who participated in the revised training program. It is necessary to know if the revised training program is more effective than the prior training program.

Lead Exposure

Employees working on job sites to remediate lead must be monitored. Lead levels in blood are measured as micrograms of lead per deciliter of blood (μg/dL). A baseline blood test is taken pre-exposure and postexposure at the conclusion of the remediation. Data are available for 49 employees who recently concluded a 2-year lead remediation project. It is necessary to determine if blood lead levels have increased.

Return on Investment

Sun Coast offers four lines of service to their customers, including air monitoring, soil remediation, water reclamation, and health and safety training. Sun Coast would like to know if each line of service offers the same return on investment. Return on investment data are available for air monitoring, soil remediation, water reclamation, and health and safety training projects. If return on investment is not the same for all lines of service, it would be helpful to know where differences exist.

Literature Review

After providing a brief introduction to this section, students should include the literature review information here. Important Note: Students should refer to the information presented in the Unit I Study Guide and the Unit I Syllabus instructions to complete this section of the project. Delete this before you begin.

Research Objectives

After providing a brief introduction to this section, students should include research objectives here. Students should compose short, direct statements about the objectives of the study. Research objectives should relate to the problems that have been identified above, and there should be one objective for each problem as shown in the example below. Important Note: Students should refer to the information presented in the Unit II Syllabus instructions to complete this section of the project. Delete this before you begin.

Example:

RO1: Determine if a person’s height is related to weight.

RO2:

RO3:

RO4:

RO5:

RO6:

Research Questions and Hypotheses(Analyzing Sun Coast Data)

After providing a brief introduction to this section, students should state the research questions and hypotheses. Each research objective should have a corresponding research question and a null and alternative hypothesis as shown in the example below. In total, there should be six research questions and twelve hypotheses. Important Note: Students should refer to the information presented in the Unit II Study Guide and the Unit II Syllabus instructions to complete this section of the project. Delete this before you begin.

Example:

RQ1: Is there a relationship between height and weight?

H01: There is no statistically significant relationship between height and weight.

HA1: There is a statistically significant relationship between height and weight.

Research Methodology, Design, and Methods

After providing a brief introduction to this section, students should detail the research design they have selected and why it is an appropriate research approach for addressing the business problems. Use the following subheadings to include all required information. Important Note: Students should refer to the information presented in the Unit III Study Guide and the Unit III Syllabus instructions to complete this section of the project. Delete this before you begin.

Research Methodology

Explain the research methodology chosen for this research project and provide rationale for why it is appropriate given the problems.

Research Design

Students should explain whether the research design is exploratory, causal, or descriptive. Provide rationale for the choice.

Research Methods

Students should describe the research methods used for this research study based on the research methodology, research design, and research questions, and provide a rationale as to why they were chosen. They might include a combination of experimentation, descriptive statistics, correlation, and causal-comparative methods.

Data Collection Methods

Students should specify how the data were most likely collected to test the hypotheses. Data collection methods include, but are not limited to, survey, observation, and records analysis.

Sampling Design

Students should briefly describe the type of sampling design that was most likely used for the data that were collected. Choices include, but are not limited to, random sample, convenience sample, etc. Explain your rationale for your sampling design selection(s).

Data Analysis Procedures

Students should specify the statistical procedures used to test each set of hypotheses from among correlation, regression, t test, and ANOVA. They should explain why each procedure was the most appropriate choice.

Example:

Correlation is the preferred procedure to use to test the RQ1 hypotheses since the interest is whether a relationship exists between an independent variable (IV) and dependent variable (DV). Correlation will indicate if there is a relationship between height (IV) and weight (DV), the strength of the relationship, and the direction of the relationship.

Data Analysis: Descriptive Statistics and Assumption Testing(Analyzing Sun Coast Data)

After providing a brief introduction to this section, students should provide the Excel Toolpak results of their descriptive analyses. Frequency tables, histograms, and descriptive statistics tables should be cut and pasted from Excel directly into the final project document. Important Note: Students should refer to the information presented in the Unit IV Study Guide and the Unit IV Syllabus instructions to complete this section of the project. Delete this before you begin.

Correlation: Descriptive Statistics and Assumption Testing

Students should include this information here. Include frequency table, histogram, and descriptive statistics table. Evaluate and discuss the descriptive statistics and make an explicit statement about whether the assumptions for parametric statistical testing were met or not met. Delete these statements before you begin.

Simple Regression: Descriptive Statistics and Assumption Testing

Students should include this information here. Include frequency table, histogram, and descriptive statistics table. Evaluate and discuss the descriptive statistics, and make an explicit statement about whether the assumptions for parametric statistical testing were met or not met. Delete these statements before you begin.

Multiple Regression: Descriptive Statistics and Assumption Testing

Students should include this information here. Include frequency table, histogram, and descriptive statistics table. Evaluate and discuss the descriptive statistics and make an explicit statement about whether the assumptions for parametric statistical testing were met or not met. Delete these statements before you begin.

Independent Samples t Test: Descriptive Statistics and Assumption Testing

Students should include this information here. Include frequency table, histogram, and descriptive statistics table. Evaluate and discuss the descriptive statistics, and make an explicit statement about whether the assumptions for parametric statistical testing were met or not met. Delete these statements before you begin.

Dependent Samples (Paired-Samples) t Test: Descriptive Statistics and Assumption Testing

Students should include this information here. Include frequency table, histogram, and descriptive statistics table. Evaluate and discuss the descriptive statistics, and make an explicit statement about whether the assumptions for parametric statistical testing were met or not met. Delete these statements before you begin.

ANOVA: Descriptive Statistics and Assumption Testing

Students should include this information here. Include frequency table, histogram, and descriptive statistics table. Evaluate and discuss the descriptive statistics, and make an explicit statement about whether the assumptions for parametric statistical testing were met or not met. Delete these statements before you begin

Data Analysis: Hypothesis Testing(Analyzing Sun Coast Data)

After providing a brief introduction to this section, students should provide the Excel Toolpak results of their hypothesis testing. The statistical output tables should be cut and pasted from Excel directly into the final project document. For the regression hypotheses, the students should display and discuss the predictive regression equations. Important Note: Students should refer to the information presented in the Units V and VI Study Guides and the Units V and VI Syllabus instructions to complete this section of the project. Delete this before you begin.

Correlation: Hypothesis Testing

Students should include this information here. Restate the null and alternative hypotheses, cut and paste the statistical output from Excel Toolpak, discuss the p-value in relation to alpha and explicitly accept or reject the null and alternative hypotheses. Delete these statements before you begin.

Simple Regression: Hypothesis Testing

Students should include this information here. Restate the null and alternative hypotheses, cut and paste the statistical output from Excel Toolpak, and interpret and explain the simple regression analysis results below the Excel output. Your explanation should include: multiple R, R square, alpha level, ANOVA F value, accept or reject the null and alternative hypotheses for the model, statistical significance of the x variable coefficient, and the regression model as an equation with explanation. Delete these statements before you begin.

Multiple Regression: Hypothesis Testing

Students should include this information here. Restate the null and alternative hypotheses, cut and paste the statistical output from Excel Toolpak, and interpret and explain the simple regression analysis results below the Excel output. Your explanation should include: multiple R, R square, alpha level, ANOVA F value, accept or reject the null and alternative hypotheses for the model, statistical significance of the x variable coefficients, and the regression model as an equation with explanation.

Independent Samples t Test: Hypothesis Testing

Students should include this information here. Restate the null and alternative hypotheses, cut and paste the statistical output from Excel Toolpak, discuss the p-value in relation to alpha and explicitly accept or reject the null and alternative hypotheses. Delete these statements before you begin.

Dependent Samples (Paired Samples) t Test: Hypothesis Testing

Students should include this information here. Restate the null and alternative hypotheses, cut and paste the statistical output from Excel Toolpak, discuss the p-value in relation to alpha and explicitly accept or reject the null and alternative hypotheses. Delete these statements before you begin.

ANOVA: Hypothesis Testing

Students should include this information here. Restate the null and alternative hypotheses, cut and paste the statistical output from Excel Toolpak, discuss the p-value in relation to alpha and explicitly accept or reject the null and alternative hypotheses. Delete these statements before you begin.

Findings(Analyzing Sun Coast Data)

After providing a brief introduction to this section, students should discuss the findings in the context of Sun Coast’s problems and the associated research objectives and research questions. Important Note: Students should refer to the information presented in the Unit VII Study Guide and the Unit VII Syllabus instructions to complete this section of the project. Restate each research objective, and discuss them in the context of your hypothesis testing results. The following are some things to consider. What answers did the analysis provide to your research questions? What do those answers tell you? What are the implications of those answers? Delete these statements before you begin.

Example:

RO1: Determine if a person’s height is related to weight.

The results of the statistical testing showed that a person’s height is related to their weight. It is a relatively strong and positive relationship between height and weight. We would, therefore, expect to see in our population taller people having a greater weight relative to those of shorter people. This determination suggests restrictions on industrial equipment should be stated in maximum pounds allowed rather than maximum number of people allowed.

RO2:

RO3:

RO4:

RO5:

RO6:

Recommendations(Analyzing Sun Coast Data)

After providing a brief introduction to this section, students should include recommendations here in paragraph form. This section should be your professional thoughts based upon the results of the hypothesis testing. You are the researcher, and Sun Coast’s leadership team is relying on you to make evidence-based recommendations. Delete these statements before you begin.

References

Include references here using hanging indentations, and delete these statements and example reference.

Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Thousand Oaks, CA: Sage.

 
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Strategic Consensus Organizing Principles

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Strategic Consensus Organizing Principles

(Strategic Consensus Organizing Principles)

The Strategic Principles of Consensus Organizing

Can you teach people how to be strategic? It’s a question that trainers and teachers often ask as they approach a new training program or a classroom full of eager faces. Thinking strategically and pragmatically is the hallmark of a good consensus organizer. Consensus organizing is based on several key strategic principles that are the fundamental beliefs and values that guide the implementation of the model and its activities. These principles also express the philosophy and the attitude behind the consensus organizing approach. As consensus organizers begin to enter a community, these principles are at the forefront of their minds as their organizing strategy takes shape. This chapter explains these principles and why they are important to consensus organizing.

Table 3.1 summarizes the five core strategic principles of consensus organizing (Consensus Organizing Institute, n.d.).

Table 3.1 Strategic Principles of Consensus Organizing

Strategic Principle Key Strategies Example
Solutions to local problems should come from affected communities.
  • Strategies and objectives are set by the community.
  • Incorporate community’s existing social networks.
  • Analyze and identify individual self-interests and mutual community interests and build relationships based on those interests.
 Residents bring recent crime problems to the attention of the local police and ask for assistance in developing a crime watch program. The local police work with residents to develop a neighborhood watch. Relationships are built between residents and the police.
Pragmatic leadership is present in communities, though not always recognized.
  • Identify trusted, respected, behind-the-scenes leaders.
  • Position leaders to take responsibility for effort.
  • Build leaders’ skills and confidence to succeed.
 An older woman to whom young mothers turn for parenting help.
A teacher who stays after school hours to help his students with their studies.
Self-interest can be harnessed as a motivation for improving the welfare of communities.
  • Analyze and identify the interests of members of external power structure (e.g., government, philanthropy, corporate, social service).
  • Position them to make genuine contributions aligned with their and the community’s interests.
 A local foundation director who has $1 million to improve housing in local distressed neighborhoods, but who does not have relationships with community-based organizations located in those neighborhoods.
If a project achieves its short-term goals without positioning the participants to make even greater gains in the future, then an opportunity has been missed.
  • Position community leaders to take the lead on projects.
  • Use short-term projects to build community’s skills and relationships with power structure to lay the foundation for more comprehensive efforts.
 A neighborhood cleanup that builds relationships among residents and between residents and the city can lead to new opportunities, such as improved code enforcement and the rehab of dilapidated housing in cleanup area.
Building relationships and strategically positioning leaders to make a program work requires time, care, and finesse.
  • Understand and gain trust of leaders of the community and power structure.
  • Break down stereotypes and misperceptions that community and power structure have of one another.
  • Invest the time up front to position leaders of the community and power structure to develop genuine strategic partnerships.

 

 Going to churches, agencies, and community organization meetings, and meeting residents one-on-one in their homes. Attending local housing symposiums, city council meetings, and chamber of commerce meetings, as well as meeting one-on-one with members of the e
 
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Transforming Hospital Organizational Effectiveness

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Transforming Hospital Organizational Effectiveness

(Transforming Hospital Organizational Effectiveness)

Case Study Essay

Read the below case and then write a paper.

you must have a minimum of 3 scholarly sources (peer-reviewed journal articles). Please ensure that you follow standard APA formatting. Your paper must have a title page and a reference page. You must have a minimum of five (5) in-text citations.

During the paper, answer these questions. DO NOT put this in a question and answer format. Make sure there is an introduction and conclusion, and some parts of the questions as headings and subheadings and follow the recommended outline to ensure that all questions are answered.

Respond to the following questions in an essay (3 page minimum).

1. Assemble the diagnostic data into a framework and prepare feedback to the senior administrators of the hospitals. What’s your sense of the organization’s current structure and employee involvement issues?

2. What changes would you recommend? Is a total quality management intervention appropriate here? What alternatives would you propose?

3. Design an implementation plan for your preferred intervention.

Be sure that you describe the most common organization structures used today as well as their strengths and weaknesses.  Describe the employee involvement and how it relates to performance. Consider whether there should be a sociotechnical systems work design.

Selected Cases THE SULLIVAN HOSPITAL SYSTEM

PART I(Transforming Hospital Organizational Effectiveness)

At the Sullivan Hospital System (SHS), CEO Ken Bonnet expressed concern over market share losses to other local hospitals over the past six to nine months and declines in patient satisfaction measures. To him and his senior administrators, the need to revise the SHS organization was clear. It was also clear that such a change would require the enthusiastic participation of all organizational members, including nurses, physicians, and managers.

At SHS, the senior team consisted of the top administrative teams from the two hospitals in the system. Bonnet, CEO of the system and president of the larger of the two hospitals, was joined by Sue Strasburg, president of the smaller hospital. Their two styles were considerably different. Whereas Bonnet was calm, confident, and mild-mannered, Strasburg was assertive, enthusiastic, and energetic. Despite these differences, both administrators demonstrated a willingness to lead the change effort. In addition, each of their direct reports was clearly excited about initiating a change process and was clearly taking whatever initiative Bonnet and Strasburg would allow or empower them to do.

You were contacted by Bonnet to conduct a three-day retreat with the combined management teams and kick off the change process. Based on conversations with administrators from other hospitals and industry conferences, the team believed that the system needed a major overhaul of its Total Quality Management (TQM) process for two primary reasons. First, they believed that an improved patient care process would give physicians a good reason to use the hospital, thus improving market share. Second, although the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) had enacted policies some time ago encouraging hospitals to adopt continuous improvement principles, SHS’s system was sorely behind the times. The team readily agreed that they lacked the adequate skills and knowledge associated with implementing a more sophisticated TQM process. This first meeting was to gather together to hear about how TQM, engagement, and other strategic change processes had advanced and the issues that would need to be addressed if more sophisticated processes were to be implemented. During the meeting, you guided them through several exercises to get the team to examine methods of decision making, how team-based problem solving had advanced, and explored their understanding of the hospital’s current mission, goals, and strategies.

Although you were concerned about starting the process with a workshop that explored a solution rather than understanding the problem, you remembered Roger Harrison’s consulting rule, “Start where your client is at,” and agreed to conduct the workshop. You were assured by Bonnet that the hospital system was committed to making substantive changes and that this was only the first step. In addition, and in support of this commitment, Bonnet told you that he had already agreed in principle to begin a work redesign process in a few of the nursing units at each hospital and had begun to finalize a contract with a large consulting firm to do the work. The workshop was highly praised and you convinced the team to hold off on the work design implementation long enough to conduct a diagnosis of the system.

Following the retreat, your diagnosis of the SHS organization employed a variety of data collection activities including interviews with senior managers from both hospitals as well as a sampling of middle managers and staff (for example, nurses, ancillary professionals, and environmental services providers). Questions about the hospital’s mission garnered the most consensus and passion. There was almost unanimous commitment to the breadth of services provided and the values that played a prominent role in the delivery of those services by a Catholic-sponsored health care organization, such as SHS. A mission and values statement was clearly posted throughout the hospital and many of the items in that statement were repeated almost verbatim in the interviews.

From there, however, answers about the organization’s purpose and objectives became more diverse. With respect to goals and objectives, different stakeholder groups saw them differently. Senior administrators were fairly clear about the goals listed in the strategic plan. These goals included increasing measurements of patient satisfaction, decreasing the amount of overtime, and increasing market share. However, among middle managers and supervisors, there was little awareness of hospital goals or how people influenced their accomplishment. A question about the hospital’s overall direction or how the goals were being achieved yielded a clear split in people’s perceptions. Some believed the hospital achieved its objectives through its designation as the area’s primary trauma center. They noted that if someone’s life were in danger, the best chance of survival was to go to SHS. The problem, respondents joked, was that “after we save their life, we tend to forget about them.” Many, however, held beliefs that could be labeled “low cost.” That is, objectives were achieved by squeezing out every penny of cost no matter how that impacted patient care.

Opinions about the policies governing the hospital’s operation supported a general belief that the organization was too centralized. People felt little empowerment to make decisions. There also were a number of financial policies that were seen as dictated from the corporate office, where “shared services” existed, including finance, marketing, information systems, and purchasing. Further, several policies limited a manager’s ability to spend money, especially if it wasn’t allocated in budgets.

In addition to the managerial sample, a variety of individual contributors and supervisors were interviewed either individually or in small groups to determine the status and characteristics of different organization design factors. The organization’s policy and procedure manuals, annual reports, organization charts, and other archival information were also reviewed. This data collection effort revealed the following organization design features:

(Transforming Hospital Organizational Effectiveness)

· • The hospitals’ structures were more bureaucratic than organic. Each hospital had a functional structure with a chief executive officer and from two to five direct reports. Both hospitals had directors of nursing services and professional services. The larger hospital had additional directors in special projects, pastoral care, and other staff functions that worked with both hospitals. Traditional staff functions, such as finance, procurement, human resources, and information services, were centralized at the corporate office. There were a number of formal policies regarding spending, patient care, and so on.

· • The basic work design of the hospitals could be characterized as traditional. Tasks were narrowly defined (janitor, CCU nurse, admissions clerk, and so on). Further, despite the high levels of required interdependency and complexity involved in patient care, most jobs were individually based. That is, job descriptions detailed the skills, knowledge, and activities required of a particular position. Whenever any two departments needed to coordinate their activities, the work was controlled by standard operating procedures, formal paperwork, and tradition.

· • Information and control systems were old and inflexible. From the staff’s perspective, and to some extent even middle management’s, little, if any, operational information (that is, about costs, productivity, or levels of patient satisfaction) was shared. Cost information in terms of budgeted versus actual spending was available to middle managers and their annual performance reviews were keyed to meeting budgeted targets. Unfortunately, managers knew the information in the system was grossly inaccurate. They felt helpless in affecting change, since the system was centralized in the corporate office. As a result, they devised elaborate methods for getting the “right” numbers from the system or duplicated the system by keeping their own records.

· • Human resource systems, also centralized in the corporate office, were relatively generic. Internal job postings were updated weekly (there was a shortage of nurses at the time). There was little in the way of formal training opportunities beyond the required, technical educational requirements to maintain currency and certification. Reward systems consisted mainly of a merit-based pay system that awarded raises according to annual performance appraisal results. Raises over the previous few years, however, had barely kept pace with the cost of living. There also were various informal recognition systems administered by individual managers.

PART II(Transforming Hospital Organizational Effectiveness)

This diagnostic data was discussed and debated among the senior team. A steering committee composed of physicians, managers, nurses, and other leaders from both hospitals was convened, and creating a vision for the system and the change effort became one of their first tasks.

The steering committee spent hours poring over vision statements from other organizations, discussing words and phrases that described what they thought would be an exciting outcome from interacting with the hospital, and trying to satisfy their own needs for something unique and creative. When the first draft of a statement emerged, they spent several months sharing and discussing it with a variety of stakeholders. To their dismay, the initial version was roundly rejected by almost everyone as boring, unimaginative, or unreal. The group discussed the input gathered during these discussions and set about the task of revising the vision. After several additional iterations and a lot of wordsmithing, a new and more powerful vision statement began to emerge. The centerpiece of the vision was the belief that the organization should work in such a way that the patient felt like they were the “center of attention.” Such an orientation to the vision became a powerful rallying point since many of the hospitals’ management teams readily understood that there was an existing perception of poor service that needed to be turned around.

The three months spent working and adapting the vision statement was well worth it. As it was presented to people in small meetings and workshops, each word and phrase took on special meaning to organizational members and generated commitment to change.

 
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Health Insurance Case Scenarios

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Health Insurance Case Scenarios

(Health Insurance Case Scenarios)

Health Insurance Basic Questions

1. Mrs. Washington was involved in a traffic accident. She saw Dr. Grace because of pain in her right knee. She explained that this pain was the result of her knee hitting the dashboard on impact. Mrs. Washington has a history of arthritis in both of her knees. Dr. Grace listed her diagnosis from this visit as bilateral degenerative joint disease. What are the consequences of this diagnosis on Mrs. Washington’s case?

2. Anthony is 17 years of age and attending college in Maine. One day while skiing, he broke his leg and was taken to the emergency room of the local hospital. When filling out the necessary paperwork, whom should Anthony name as the party responsible for the charges incurred?

3. Mrs. Cassidy called her physician’s office complaining that her insurance company was billed twice for her office visit on November 19. Carole pulled Mrs. Cassidy’s file and verified that this was true. She apologized for the error and assured Mrs. Cassidy that she would correct this error. What steps should be taken to avoid duplicate billing

4. Mrs. Ellison called her doctor’s office and spoke with Lorraine about a bill from her recent visit. Mrs. Ellison has been Dr. Johnson’s patient for many years, although prior to her recent visit it had been some time since she saw Dr. Johnson. Mrs. Ellison was sure that there was a billing error because she was billed for a new patient visit. How should Lorraine handle this patient’s inquiry

5. Allison was working at the reception desk during a department staff meeting. She normally worked in medical records and therefore had an understanding of the importance of patient confidentiality. When a caseworker from a workers’ compensation case arrived and asked to discuss a patient’s case with the physician, Allison explained that she would need a signed release form from the patient before that was possible. Did Allison handle this situation correctly?

6. Jamie is reviewing Mr. Murphy’s medical file to process his insurance claim. She has difficulty reading the doctor’s notes, but rather than flag the file to check with the doctor, Jamie makes an educated guess and completes the insurance form. What are some possible consequences of Jamie’s actions?

 
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Navigating Ethics in Healthcare

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Navigating Ethics in Healthcare

(Navigating Ethics in Healthcare)

HEALTHCARE ETHICS

ASSIGNMENT 2

HA570-1: Critique the need for and role of ethics in the American healthcare environment.

Instructions:

As you have learned, differences exist between morality, ethics, and the law. Morality refers to an individual‘s moral compass or belief system based on their individual perspective. Ethics refers to the standard of action that should be performed, irregardless of an individual‘s perspective, opinion, or ideology. Law simply refers to any legal requirements involved.

In an ethical dilemma, varying perspectives exist. Oftentimes, these perspectives include the patient, provider, caregiver, family member, or staff member. Every person has a unique perspective and it is these unique experiences that form our belief system. As a future leader in healthcare administration, it is important to identify and understand how these varying perspectives act as a foundation for individual morality and influence our decisions. Likewise, it is also important to understand that despite personal morality, providers are required to abide by the ethical standards present in the field.

In this unit, you will explore the differences between morality and ethics by examining a scenario and its implications from varying perspectives. By the end of this unit, you will be able to proficiently discuss the need for and role of ethics in the American healthcare environment.

To begin, select one (1) of the following stories from your textbook from which to address the assignment requirements:

· The Story of the Harvey Family and the Interprofessional Care Team (p. 3)

· The Story of Pat Jackson, the Interprofessional Care Team, and Mr. Sanchez (p. 29)

· The Story of Bill Boyd and Kate Lindy (p. 53)

· The Story of Elizabeth Kim, Max Diaz, Melinda Diaz, and Michael Meary (p. 73)

· The Story of Michael Halloran and Amrou Croteau (p. 106)

In a 5-7 page paper (excluding title page and reference list), address the following:

· Summarize the story briefly providing the ethical dilemma and parties involved.

· Discuss the varying perspectives from the parties involved. Be sure to discuss potential reasoning for the varied perspectives. Please note that you may need to include fictitious information to complete this.

· Discuss ethical standards relevant to the unique scenario.

· Identify possible personal moral convictions which may influence the direction of the story.

· Foreshadow potential events in the story of what could happen if ethical standards did not exist.

Report your findings noting the following standards:

· Current APA formatting (e.g. title page, citations, conclusion, reference page, etc.) should be used.

· Proper grammar, spelling, and punctuation are expected.

· Plagiarism, self-plagiarism, unoriginal work, and unattributed content is not permitted and will result in action pursuant to the University’s Plagiarism Policy and Procedures.

Navigating Ethics in Healthcare

HA570-2: Assess national regulations regarding confidentiality and ethical considerations of confidentiality laws.

Instructions:

As you have learned, regulations and laws exist to protect patient privacy and uphold confidentiality. Especially in a technological advanced setting, such as healthcare, maintaining these standards can prove challenging as a result of new, ethical issues not previously experienced. As a future leader in healthcare administration, it is important to understand national regulations relative to confidentiality, privacy, and informed consent.

In this unit, you will compare ethical issues of confidentiality by examining a scenario and its implications of various regulations and laws. By the end of this unit, you will be able to assess national regulations regarding confidentiality and ethical considerations of confidentiality laws.

To begin, select one (1) of the following stories from your textbook from which to address the assignment requirements:

· The Story of Twyla Roberts and Mary Louis (p. 203)

· The Story of Beth Tottle, Mrs. Uwilla, and the Uwilla Family (p. 229)

· The Story of Jack Burns and Cecelia Langer (p. 250)

· The Story of Meg Perkins and Helen Williams (p. 279)

In a 5-7 page paper (excluding title page and reference list), address the following:

· Summarize the story briefly providing the ethical dilemma and parties involved.

· Discuss the varying perspectives from the parties involved. Be sure to discuss potential reasoning for the varied perspectives. Please note that you may need to include fictitious information to complete this.

· Discuss ethical standards relevant to the unique scenario.

· Identify national regulations and laws pertinent to the story.

· Using the six-step process, explain a practical, ethical solution to your story.

Report your findings noting the following standards:

· Current APA formatting (e.g. title page, citations, conclusion, reference page, etc.) should be used.

· Proper grammar, spelling, and punctuation are expected.

· Plagiarism, self-plagiarism, unoriginal work, and unattributed content is not permitted and will result in action pursuant to the University’s Plagiarism Policy and Procedures.

Navigating Ethics in Healthcare

3: Evaluate other healthcare industry regulations that protect patients and providers and best practices for assuring that they are followed.

Instructions:

As you have learned, the role of the ethical professional in the healthcare field requires conscious decision-making and consideration for all parties involved. As a future leader in healthcare administration, it is important to understand various industry regulations that protect patients and providers in an effort to make an appropriate decision with a caring response.

In this unit, you will use the six-step process to work through an ethical issue in healthcare to make an appropriate, caring response. By the end of this unit, you will be able to identify various healthcare industry regulations that protect patients and providers. Likewise, as a result, you will be able to discuss the proper moral limits of intervention.

To begin, select one (1) of the following stories from your textbook from which to address the assignment requirements:

· The Story of Mitch Rice, Gail Campis, the Belangers, and the Botched Home Visit (p. 123)

· The Story of Maureen Gudonis and Isaias Echevarria (p. 153)

· The Story of Simon Kapinsky and the Interprofessional Ethics Subcommittee to Implement a Green Health Plan (p. 179)

In a 5-7 page paper (excluding title page and reference list), address the following:

· Summarize the story briefly providing the ethical dilemma and parties involved.

· Discuss three healthcare rules, regulations, or laws relevant to the story (in additional to national laws, you will need to research industry-specific regulations based on your story selection).

· Thoroughly discuss each phase of the six-step process relative to your story selection.

· Recommend an appropriate, caring response that aligns with industry-specific regulations and ethical standards.

Report your findings noting the following standards:

· Current APA formatting (e.g. title page, citations, conclusion, reference page, etc.) should be used.

· Proper grammar, spelling, and punctuation are expected.

· Plagiarism, self-plagiarism, unoriginal work, and unattributed content is not permitted and will result in action pursuant to the University’s Plagiarism Policy and Procedures.

Navigating Ethics in Healthcare

4: Analyze the effect ethics has on day-to-day operations as well as long-term policy and procedure in a healthcare environment.

Instructions:

As you have learned, the population segment aged 65 and older is rapidly aging in the United States. As a result, new ethical challenges are emerging in the field, specifically in long-term care (i.e. skilled nursing facilities including those with post-surgical short-term rehabilitation services).

One area of concern is the challenge of providing adequate healthcare services to a growing (and aging) population with limited resources. This dilemma is expected to increase as the population continues to increase. As a result, the demand for medical services increases; however, with finite healthcare resources, providing services to everyone who requires care is not possible.

This will present a unique challenge for nursing home administrators because they are responsible to ensure that resident needs (including receiving healthcare services) are being met. Determining who should receive the necessary care that is available will be an interdisciplinary challenge indeed.

Scholars have posited a variety of allocation methods; however, these principles have not been without controversy. One of the most recent principles introduced is the Complete Lives System. This method is unique, because unlike its predecessors that relied on a unilateral perspective, the Complete Lives Systems takes a multi-allocation system approach.

In this unit, you will combine your previous knowledge obtained throughout the course and apply clinical reasoning to evaluate moral action and its relevance to ethical-decision making in long-term care. Using ethical decision-making, you will determine the best method of allocating limited medical resources to a growing and aging population. By the end of this unit, you will be able to analyze the effect ethics has on day-to-day operations as well as long-term policy and procedure in a healthcare environment.

Navigating Ethics in Healthcare

Read the following articles from our library:

· Krütli, P., Rosemann, T., Törnblom, K. Y., & Smieszek, T. (2016). How to fairly allocate scarce medical resources: Ethical argumentation under scrutiny by health professionals and lay people. Plos ONE, 11(7), 1-18. doi:10.1371/journal.pone.0159086

· Persad, G., Wertheimer, A., & Emanuel, E. J. (2009). Department of Ethics: Principles for allocation of scarce medical interventions. The Lancet, 373, 423-431. doi:10.1016/S0140-6736(09)60137-9

Please review the following resources and using specific information from these resources, your course materials, and additional research, address the tasks posed below.

Three individuals in town require a hip surgery, followed by extensive rehabilitative therapy. Physical and occupational therapy will be provided at the skilled nursing facility where the individual will reside until able to return home. Below are details of each individual.

· Donna Mueller is a 58-year old disabled widow with no children. She spent her career as a homemaker and taking care of her husband. Donna requires surgery after falling at home while washing windows. Prior to the accident, Donna was relatively independent, although a stroke a few years prior left her partially paralyzed. She lives alone and has minimal company over.

· Steve McDonald is 40-year old unemployed musician. He has a teenage son who lives with the son’s mother in a neighboring town. At the age of 19, Steve left college to pursue a career as a drummer. For the past two decades, Steve has worked odd jobs while pursuing his dream. Although his perseverance has not landed him national attention, he has performed with a few, known bands in the area. Recently, while exiting stage left from a nightclub performance, Steve tripped over the dark stairs and fractured his hip, ultimately leaving him unemployed as he is currently unable to perform.

· Chris Snider is a 73-year old entrepreneur and business owner. Never married, Chris spent his career in the fast-pace, produce or perish industry of nanotechnology where he employs over 5,000 workers ranging from maintenance technicians to senior research engineers. Chris requires surgery after being innocently hit with a runaway golf cart on the back 9 with his visiting, foreign affiliates. Chris was completely independent prior to the accident. He lives alone; however, his business requires travel.

In a 6-8 page paper (excluding title page and reference list), address the following:

· Considering the aging population and existing challenges, discuss the potential role of allocation principles in the American healthcare system.

· Discuss the potential implications these principles have on the aging population (consider potential violations of federal antidiscrimination laws and ethical principles about fair treatment).

· Based on the Complete Lives System, discuss which individual would most likely receive the surgery.

· Based on your moral compass, ethical standards, and healthcare laws, discuss which individual you would recommend for surgery.

· Recommend the one allocation principle you would prefer as the primary medical intervention for a growing (and aging) population.

Report your findings noting the following standards:

· Current APA formatting (e.g. title page, citations, conclusion, reference page, etc.) should be used.

· Proper grammar, spelling, and punctuation are expected.

· Plagiarism, self-plagiarism, unoriginal work, and unattributed content is not permitted and will result in action pursuant to the University’s Plagiarism Policy and Procedures. 

 
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Clinical Procedure Coding Practice

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Clinical Procedure Coding Practice

(Clinical Procedure Coding Practice)

ICD-PCS Coding

M132 Module 02 Coding Assignment

Find the correct code and explain your rationale for each case study below.

1. Case Study:

PREOPERATIVE DIAGNOSIS:

1. Gangrene right foot.

POSTOPERATIVE DIAGNOSIS:

1. Gangrene right foot.

OPERATION:

1. Right below the knee amputation.

ANESTHESIA: General LMA.

PROCEDURE: The patient was brought to the operative suite where a general LMA anesthesia was induced.

A Foley catheter was inserted. The right foot was s secluded in an isolation bag and the right lower extremity circumferentially prepped and draped in its entirety. Beginning on the right side the skin was marked with a marking pen 4 fingerbreadths below the tibial tuberosity anteriorly with a long posterior flap. The skin was incised circumferentially and the anterior musculature sharply divided exposing the tibia The tibia was cleaned with a periosteal elevator and then transected with the Stryker saw. The fibula was exposed and transected with the bone cutter and the amputation completed by sharply incising the posterior musculature. Bleeding vessels were ligated with 2-0 silk Ligature. There appeared to be adequate bleeding at this level for primary healing. The tibia was then cleaned with a bone rasp and the fibula with a rongeur. The wound was irrigated and ultimately closed without significant tension utilizing interrupted 2-0 vicryl sutures for reapproximation of the fascia and skin staples for reapproximation of the skin.

The right side was dressed with sterile gauze fluff dressings and a Kerlix roll. Estimated blood loss throughout the procedure was approximately 150 mL. The patient received one unit intraoperatively of packed cells because of preoperative anemia. She was transported in stable condition to the recovery room.

2. Case Study:(Clinical Procedure Coding Practice)

PROCEDURE: Open reduction and internal fixation of bilateral tibial plateau fractures.

INDICATIONS: This 23-year old was involved in a serious accident and sustained bilateral tibial plateau fractures

DESCRIPTION OF OPERATION: The patient was brought to the operating room and placed on the operating room table in the supine position. General anesthesia was induced, and after this both lower extremities were prepped and draped in the usual sterile fashion. Attention was first directed towards the left tibial plateau. A standard lateral procedure to reduce the lateral tibial plateau fracture was performed. After a submeniscal arthrotomy was performed, the joint was visualized via the lateral approach. The posterolateral fragments were reduced and the lateral tibial plateau was elevated, restoring the articular surface. K-wires were placed to provisionally hold this reduction. C-arm fluoroscopy was used to confirm good reduction of the joint surface. Next, a 6-hole lateral plateau locking plate from the Stryker sets was selected. This locking plate was advanced down the tibial shaft. Screws were placed to secre the plate to the bone. Four screws were placed in the distal shaft fragments and 4 locking screws in the proximal fragment. A kickstand screw was also placed in the locking mode. After all screws were placed, x-rays exhibited good reduction of the fracture, as well as good placement of all hardware. Next, the wound was thoroughly irrigated with normal saline. The meniscal arthrotomy was closed with the 0 PDS suture, including the capsule. Next, the IT band was closed with 0 Vicryl suture, followed by 2-0 Vicryl sutures for the skin and staples. Attention was then directed toward the right tibial plateau. A similar procedure was performed on the right side. Then, the lateral approach to the lateral tibial plateau was performed, exposing the fracture. The incision was approximately 4 cm on the right side. A 6-hole LISS plate was advanced down the tibial shaft. Four screws were placed in the distal fragments followed by four screws in the locking mode and proximal metaphyseal fragment. Excellent fixation was obtained. The C-arm fluoroscopy was used to confirm excellent reduction of the fracture on both the AP and lateral fluoroscopic images. Next, the wound was thoroughly irrigated and closed in layers. Sterile dressings were applied All wounds were dressed with sterile dressing and the patient was placed into knee immobilizers. The patient was then awakened from anesthesia, and transferred to recovery. The patient will be nonweightbearing for approximately three months on bilateral lower extremities. The patient will receive DVT prophylaxis during this time.

3. Case Study:(Clinical Procedure Coding Practice)

PREOPERATIVE DIAGNOSES:

1. Pelvic pain.

2. History of previous pelvic surgery and ovarian cyst.

POSTOPERATIVE DIAGNOSES:

1. Pelvic pain.

2. History of previous pelvic surgery and ovarian cyst.

OPERATION PERFORMED: Laparoscopic adhesiolysis.

SURGEON: Susan Smith, MD

ANESTHESIA: General endotracheal.

ESTIMATED BLOOD LOSS: Less than 10 mL.

URINE OUTPUT: 70 mL.

IV FLUIDS: 750 mL.

DESCRIPTION OF OPERATION: After informed consent was obtained, the patient was taken to the operating room. She was placed in the dorsal supine position and general anesthesia was induced and prepped and draped in the usual sterile fashion. A Foley catheter was placed to gravity and speculum was placed in the posterior and anterior vagina and the cervix was grasped with a single-toothed tenaculum. A Hulka clamp was then inserted through the cervix into the uterus for uterine manipulations and the tenaculum was removed and attention was then turned to the abdomen.

A supraumbilical incision was made with a scalpel and elevated up with towel clamps. A long Veress needle was then placed and CO2 gas was used to insufflate the abdomen and pelvis. A 10-12 trocar and sleeve were then placed and confirmed via the laparoscope. The dense greater omental adhesions to the anterior abdominal wall were noted immediately. At this time, we were not able to see into the pelvic region. A second 5 mm trocar and sleeve were placed in the left mid quadrant under direct visualization. The ligature device was then placed developing a plane between the omentum and the anterior abdominal wall.

The adhesiolysis took place and it took approximately 25 minutes to release all of the omental adhesions from the anterior abdominal wall. We were then able to visualize the pelvis and a blunt probe was placed through the port. The ovary was visualized and photos were taken with no evidence of any ovarian cyst or ovarian pathology or of pelvic endometriosis. The uterus also appeared normal and the left tube and ovary were surgically absent. The appendix was easily visualized and noted to be noninflamed, normal in appearance, and there were no adhesions in the right lower quadrant. The upper abdominal exam was unremarkable. The procedure was terminated at this time. The ports were removed. CO2 gas was allowed to escape. The incisions were closed with 4-0 Vicryl suture. The Hulka clamp was removed. The vagina was noted to be hemostatic. The patient’s anesthesia was awakened from anesthesia, the Foley catheter was removed, and she was taken in stable condition to the recovery room.

 
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Ethical Conduct

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Ethical Conduct

(Ethical Conduct) Discuss nursing ethics based on the case study.

Ethical Conduct

Nursing Ethics in the Context of a Case Study

Nursing ethics is crucial in ensuring that patient care aligns with moral principles. A recent case study highlights the importance of ethical considerations in nursing. In this case, a nurse faced a dilemma when a terminally ill patient requested assistance in ending their life. This situation presents various ethical challenges, requiring a thorough understanding of nursing ethics to navigate effectively.

Respect for Autonomy

Firstly, respect for autonomy is a fundamental ethical principle in nursing. Autonomy refers to the patient’s right to make decisions about their own health care. In the case study, the patient expressed a clear desire to end their suffering through euthanasia. Therefore, the nurse must respect this wish while considering legal and professional boundaries. To support the patient’s autonomy, the nurse should ensure the patient fully understands their options and the potential consequences of their decision. (Ethical Conduct)

Beneficence and Non-Maleficence

Beneficence and non-maleficence are also critical in nursing ethics. Beneficence involves promoting the patient’s well-being, while non-maleficence means avoiding harm. In the case study, the nurse faces a conflict between these principles. Assisting the patient in ending their life may be seen as promoting well-being by alleviating suffering. However, it also involves causing harm. The nurse must carefully weigh these principles to determine the best course of action.

Legal and Professional Considerations

Legal and professional considerations also play a significant role in nursing ethics. The nurse must adhere to the laws and regulations governing their practice. In many jurisdictions, euthanasia is illegal, and assisting a patient in ending their life could result in severe legal consequences. Moreover, professional codes of ethics, such as the American Nurses Association’s Code of Ethics, provide guidelines for nurses. These codes often emphasize the importance of preserving life and prohibit actions that intentionally cause death. Thus, the nurse must balance ethical principles with legal and professional obligations. (Ethical Conduct)

Communication and Compassion

Effective communication and compassion are essential in addressing ethical dilemmas. The nurse should engage in open, honest conversations with the patient and their family. This approach helps to understand their perspectives and provide emotional support. By listening to the patient’s concerns and explaining the ethical and legal constraints, the nurse can build trust and provide compassionate care. Additionally, involving other healthcare professionals, such as physicians and ethicists, can offer valuable insights and support in decision-making.

Ethical Decision-Making Frameworks

Applying ethical decision-making frameworks can guide nurses in resolving complex ethical dilemmas. One such framework is the Four-Box Method, which considers medical indications, patient preferences, quality of life, and contextual features. By systematically evaluating these factors, the nurse can make a well-informed decision. In the case study, this approach could help balance the patient’s desire for euthanasia with the ethical, legal, and professional considerations involved.

Conclusion

Nursing ethics require a careful balance of respecting patient autonomy, promoting well-being, avoiding harm, and adhering to legal and professional standards. In the presented case study, the nurse faces a challenging ethical dilemma when a terminally ill patient requests assistance in ending their life. By applying ethical principles, effective communication, and decision-making frameworks, the nurse can navigate this complex situation. This approach ensures that patient care remains compassionate, ethical, and legally compliant.

References

https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/

 
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