The inability to eliminate preventable medical errors is a major healthcare issue that undermines the nations health and does not allow medical facilities to provide effective and quality services. Therefore, it is essential to finally address the issue of medical errors and find a way to educate medical workers about how to prevent them.
According to researchers, in 2019, preventable medical errors were responsible for 250,000 to 440,000 deaths a year in the United States, making them the third leading cause of death after heart disease and cancer (Luciano, 2019, para. 2). Their financial cost is also extremely high, which has adverse effects on the countys economy.
These are the reasons why the support of the legislator is essential:
to increase peoples awareness of the severity of the problem;
to make sure that the necessary steps aimed at preventing medical errors are taken (Luciano, 2019);
to find more legislators who are ready to help address the issue.
Solving the problem and reducing the number of preventable medical errors has many implications for the nursing profession and patients. For example, it can reduce mortality and improve patient safety because the staff will know exactly what to do in order not to make a mistake (Rodziewicz et al., 2021). Further, the elimination of errors can strengthen teamwork and collaboration in hospitals (Luciano, 2019). Finally, patients will begin to trust the professionals and their treatment plans, which will ensure that they follow them and avoid self-medication.
It is desirable to see two recommendations happen related to the discussed issue. First, there needs to be a special program that provides ongoing training for medical workers and educates them on how to avoid an error or what to do after a mistake is made. Second, it is vital to propose proprietary names for medications to eliminate confusion among drugs (U.S. Food and Drug Administration, 2019).
Patients in the acute care facility, in most cases, present a challenge to nurses because the workload and the amount of attention required for each patient may be overwhelming. The most challenging issue, however, concerns making sure that the patients health condition is stable. Since I work in the Nephrology division, the cases of acute care are not frequent, as the majority of cases are detected at the early stages. However, during the first months of working in the division, I faced a case of critical nephrology care when a 50-year-old woman was admitted to the hospital with an acute kidney injury.
Discussion
When the patient was admitted, her medical record included no information on the previous history of kidney disease or any chronic health conditions, as she had not been to a medical check-up for several years until she was admitted to the facility. The woman was admitted to the ER with an AKI, but she was soon stabilized and transferred to the Nephrology division. I was assigned to the patient and found out that the woman had a history of substance abuse for several years. She was diagnosed with chronic kidney disease and hypotension.
Two years after her first attack, her blood pressure began to reduce rapidly, and she vomited several times. At the time when it happened, I was in her room and the doctor had just left, and I beeped the attending doctor immediately, but the doctor came in some minutes later. I realized that during those several minutes before the doctor comes, I needed to make sure she was stable but I was not to administer any kind of drug without the instructions from a doctor. But I made an on-the-spot decision to administer 10mg of Phenylephrine IV because the patient demonstrated the signs of dysautonomia. Just when I was about to administer the drug the doctor stepped in he was shocked but looking the patients signs he gave me a go ahead. For five minutes after the injection, her BP stayed at the rate of 55-60/40 mmHg.
Then, BP suddenly increased to 85/40 mmHg, and her skin color became less yellow since she stopped vomiting bile. I also noticed that she had not urinated for most of the day, and I realized that bladder blockage could be one of the reasons for a sudden failure, so I also installed a urine catheter. At the time, those fifteen to twenty minutes before the doctor could come seemed like an eternity because I was afraid to act without the clinicians directions. Later, the patient was prescribed medications to control blood calcium and potassium and dialysis to remove blood toxins. Currently, she continues her treatment yet is unwilling to stop drinking alcohol.
This experience has taught me to take responsibility in critical situations, as a rapid response is a key to success in acute care. I felt considerable pressure throughout the whole scenario, and nearly half of my actions were automatic. It should be admitted that the sense of fear and uncertainty adversely affected the speed of my problem-solving, and this is an aspect I should work on.
In the Nephrology division, we always have a number of patients with progressive kidney failure who require a kidney transplant. In most cases, someone from the family is eligible to become a donor, and the decision to help a fellow relative is quick, and we have no problems with securing the transplant. However, one time during my job as a nephrology nurse, I had to resolve a challenging situation concerning the unwillingness to transplant a kidney. A 12-year-old boy with kidney failure required a kidney transplant, and his 21-year-old cousin could become his donor. Since the patient could not legally make a decision for himself, I asked the childs parents to sign a formal agreement for a transplant.
Their response was negative, and their primary argument was that their religion did not accept such an unnatural intervention to a human body. They told me that the church they went to was very strict about sacrificing ones body for the sake of saving others. I told about this situation to the patients doctor, and together, we decided to talk to them about their options and tell them the worst-case scenario that could happen to their child. I realized that we could by no means convince the family to abandon their religion. The solution was found was to ask the familys permission to contact their mentor from church so they could meet with the family and talk about this complex situation. The situation was rather urgent, so we asked them to make a decision until the following day.
They wanted their pastor to come to the hospital and talk to them, their son, and us. The pastor came to the hospital the same day and had a long talk with the patients parents. During our conversation, the pastor asked about the potential outcomes in both scenarios and wondered about the risks for the potential donor. In the end, the family agreed to the transplant, and their child survived.
Conclusion
Although this story has a happy end, I sometimes wonder how I would feel if the parents eventually refused a transplant. Respecting ones religious affiliation is extremely important, but it becomes ethically challenging when the childs life is on the line. From the above, it seems clear that this religious factor impacts the treatment to a great extent because it does not align with medical principles and approaches. Despite this, during the case, I felt confident in delivering the necessity of the transplantation to the parents anyway, as the child was responding well to all the inquiries and expressed a desire to live.
Social isolation has become a normal state of living for the worlds population in recent years. For many people, confinement has become a highly stressful situation, triggering their mental health issues, while for others became an opportunity to learn and grow. The recent article reviewed explores the impact of social isolation on a person, providing reliable data on the exact effect of such a notion on people and coping mechanisms to reduce its influence. This essay will summarize the story, adding relevant scientific evidence to ensure the credibility of the article.
Peterson, the author of the article, focused on the challenges the world faced with the pandemics restriction on social isolation, inviting Emilie Kossick, the manager of the Canadian Institute of Public Safety Research and Treatment, to talk about the notion from a doctoral perspective. The expert proceeded to state that social desolation has been a significant problem long before the lockdowns, providing examples such as the conditions of astronauts and older adults loneliness in care facilities, explaining that it did not receive much attention from researchers until COVID-19 (Peterson, 2021). For that reason, there are currently many available pieces of research that can help facilitate people endure the effects of communication limitations.
Among the physiological consequences of long-term isolation, Kossick indicates sleep pattern impairments and personality changes, in particular, the development of anxiety and depression. Indeed, multiple studies confirm the risks of mental health decrease, especially among children and adolescents who are constantly in need of socialization (Loades et al., 2020). The expert explains such impact to be caused by a decrease in brain activity in areas responsible for social skills and emotions. Therefore, social isolation negatively affects brain functions, causing multiple mental shifts.
Not only social functions are impacted by long-term confinement, but there is also a high possibility of developing chronic diseases as a result of low physical activity and the lack of socialization. Kossick offers the theory that the emergence of a higher likelihood of stroke, dementia, and heart diseases from isolation is attributed to human evolution as social creatures (Peterson, 2021). People continually interact with others, whether they want it or not, and instant depravity from such socialization radically affects mental and physical health.
Since the brain is not accustomed to functioning without interaction, people experience unpleasant consequences. Studies with certain participants confirmed that isolation evokes frustration, distresses the routine, and causes boredom (Brooks et al., 2020). Therefore, the authors advice is to create a coping strategy to reduce the negative impact of isolation. She proposes to constantly plan ones day, including hobbies and physical activities in daily life, as well as to keep in touch with friends and family (Peterson, 2021). Even though self-isolation is challenging for each person during the pandemic, as Kossick stated in the article, it is necessary to learn from such experience.
The article by Peterson is of utmost importance for all people who have experienced a decrease in their mental or physical health during the pandemic. It explains the most essential factors that influence a persons state and why such a thing happens. Moreover, the author offers strategies that can facilitate coping with isolation and reduce its negative impact. Although the articles on the pandemics evolution can be frequently encountered, they rarely focus on the condition of healthy individuals. Mental and physical health must become a general priority during the lockdown, and to this end, Petersons article helps explain the symptoms people might experience and suggests the mechanisms to remain sane.
The app is called MediCalc, standing for Medical Calculator System.
The app was created, developed, and maintained by ScyMed, Inc. The author is known from the app publisher, though the publisher can be a hired professional apps developer approved by Apple Inc. However, the originator of the idea is considered the creator of the app, as they know the exact purpose of the application. In this case, the app is developed by board-certified physicians in the United States of America.
Endorsement
According to the information provided in App Store, the app is developed by a team of board-certified physicians in the USA. This indicates that the app is endorsed by medical practitioners in different fields who may have contributed their discipline-specific knowledge in developing the app features to meet the intended needs. Any professional body does not endorse the app since medical attention is a complex activity that cannot be left to nonprofessionals to pursue as they choose.
Operation
The app is currently available in app store only and can be accessed by all users in the world who can access the platform. According to the app store details about the application, medicalc can be operated on supported mobile and desktop devices. However, the app is only effective if a user has the latest version installed since previous versions are likely to have outdated information or lack current solutions to some medical issues.
Aesthetics
The app is simple to use from the design and features having core functionalities. For instance, a person looking for a specific solution to a medical problem can check a screen where all the diseases and medical conditions are listed and explore the preferred one. A patient suffering from renal disease can click the renal and explore different areas where the specific disease has been highlighted. This results in the user clicking a particular choice and selecting calculate, which determines the patients fluids to manage or treat the malady affecting them. Consequently, the app is designed such that the user does not need any more instructions to use the app.
Purpose
Medicalc has unique features that allow patients to calculate the average amount of fluids or drugs their bodies need for a specific disease affecting them or people they know. In particular, updates such as the integration with McAlx enable users to customize their medical calculations based on patient-specific numerical determinations. This allows the users to add equations and determined scores available in the ad library to a single Interface or panel and then calculate the final fluids or drug concentration in the body at a given time.
Clinical decision making
The clinical decision is a crucial decision, which the app does not consider giving as the decision relies on the users accuracy. The app only allows users to calculate the fluids or drug concentrations associated with the type of medication they May require for a particular disease (Milani ET AL., 2017). Therefore, the information provided in the app does not replace professional advice when a non-medical user utilizes the app to determine such values.
Safety
The app is safe to use by anyone who wishes to utilize its functions without compromising the users safety. For instance, the app does not collect users information, except in certain situations where the users May wish to disclose their information. Since no data can identify a particular user, there is no direct harm associated with using the app.
Privacy/Security
According to the information provided on the app store, the app creators did not give any privacy policy statements. This can be attributed to the fact that the app does not share any information that can identify its users and does not allow them to communicate. Moreover, since there is no sign-in required, the app does not connect with other social media accounts where it can collect users information. Moreover, there is no need for a statement of encryption of data since the app only allows users to determine the costs associated with the kind of medical attention they May require.
Users
Medicalc is mainly available for users who have devices supported by app store, such as iphones.
Distribution
Moreover, the app can be accessed from across the world as Long as the user has such devices that are correct to the technological requirements.
Credibility
The credibility of the information cannot be determined precisely since it is not endorsed by designated bodies that license medical provisions in any country. However, since board-approved physicians developed the app from different fields in the medical sector, the information within the app has a greater extent of credibility. However, a significant challenge occurs when various health providers charge differently for the services they provide, which is mostly the case.
Relevance
The app is regularly updated to accommodate new information and current trends in the medical sector. For instance, version 10.2, which is the latest version, was updated on October 16, 2020. This version captures information that has not changed much. However, the app and its functionality do not correspond to any literature or standards. This happens because different patients have different medical needs based on human diversity and age differences.
The app can be used in a real-case scenario where, for instance, a diabetic patient may have experienced an issue at home and would like to understand the kind of medications to take or the amounts of fluid needed to balance the body. In this case, the app would provide inputs that the user has utilized and the new quantities needed for optimal body functionality.
The same case can also be used practically by a nurse who wishes to know the number of fluids they need to administer to the patient based on the available information. The caregiver will enter information such as age, history of the disease, fluid administered previously, the fluid excreted or voided, and any other those taken by the patient. With this information, the app can calculate the amount of fluid remaining in the body and the volume needed depending on the time of day (Milani et al., 2017). The information obtained at the point of care by the nurse can help the caregiver provide quality health care, hence speeding up the healing process. However, the nurses should also know what is expected of them. Moreover, the caregivers must understand how to administer different fluids without relying on the calculations obtained from the app.
Conclusion
The implementation and the use of the app make it possible for caregivers to be consistent with health care administration. A nurse who understands how the app works and the calibrations of various medical equipment can consistently use the app and attain continuously accurate information.
Reference
Milani, G. P., Groothoff, J. W., Vianello, F. A., Fossali, E. F., Paglialonga, F., Edefonti, A., Agostoni, C., Consonni, D., van Harskamp, D., van Goudoever, J.B. and Schierbeek, H. (2017). Bioimpedance and fluid status in children and adolescents treated with dialysis. American Journal of Kidney Diseases, 69(3), 428-435.
Casanove et al. (2022), in their article Development of a Workflow Process Mapping Protocol, attempted to resolve the issue of efficient patient treatment management. Timely, not delayed care is essential in the resulting patient well-being, especially in the case of oncology. Limited care access is the most notable barrier to efficient and equal healthcare delivery. Thankfully, it can be easily addressed with an effective navigation process that will allow for greater service accessibility. Unfortunately, there are many requirements for the navigation protocol to be truly efficient.
A lack of standardization in tools that integrate workflows and reduce treatment gaps for oncology patients presents a significant issue in the implementation of city-wide patient navigation processes. In the effort to standardize them, the authors developed a protocol that allows workflow mapping and, thus, improves the navigation process. They state this protocol will significantly enhance the design and delivery of streamlined care coordination in a metropolitan area.
Ultimately, the provided protocol does not seem easily implementable for several reasons. First, it was designed within a single breast cancer treatment modality, which implies limitations outside; in addition, the current research indicates a gap in interdisciplinary streamlining processes (Casanova et al., 2022). Second, the whole protocol proved to be resource-intensive, which often becomes an issue due to the financial differences in regions (Casanova et al., 2022). Finally, the two mentioned reasons invoke skepticism on the actual acceptability and adoption since the data on implementation outcomes are yet to be received.
In my opinion, the issue of workflow mapping does need to be addressed; thus, the conducted research raises the right questions. Among its strengths, I can name the effort of implementing theoretical concepts in practice, which is constantly subjected to challenges. However, the main weakness resides in the resulting protocols overall complexity and costs. Moreover, the process did not incorporate the patient perspective, which is crucial to the effectiveness of healthcare delivery.
The efficiency of a workflow mapping protocol depends on many factors. Casanova et al. (2022) managed to grasp the root of the problem in the lack of standardization. However, the scope of the final protocol concerned only one treatment modality, with the protocol itself proving to be resource-intensive. Overall, the research goes in the right direction; thus, there is strong confidence in the future study success.
Reference
Casanova, N. L., LeClair, A. M., Xiao, V., Mullikin, K. R., Lemon, S. C., Freund, K. M., Haas, J. S., Freedman, R. A., Battaglia, T. A. & Consortium, T. R. I. P. T. (2022). Development of a workflow process mapping protocol to inform the implementation of regional patient navigation programs in breast oncology. Cancer, 128, 2649-2658.
Increased physician efficiency. The interaction between the specialist and the Clinical Decision Support System (CDSS) increases productivity, makes work more accessible, and provides additional time for other tasks and responsibilities. This system will benefit young physicians who have not yet gained sufficient experience.
Negative impact on the physician. If the specialist is not correctly trained to work with such a system, it can result in professional burnout, insecurity, and erroneous conclusions that he is unqualified.
Storing large amounts of information. It is difficult for a physician to keep a colossal amount of formed medical knowledge in his head and constantly remember the small details. The volume of patient data is overgrowing, and it is more reliable to store it on a digital medium.
A long learning process. The CDSS is always lengthy, complicated, and requires retrospective studies. For the systems proper operation and productive interaction between the doctor and the machine, long-term and high-quality personnel training are necessary.
Quick analysis. No doctor can analyze as much data in a short period as modern technology provides. In addition, the more data is accumulated, the more accurately the tool will work.
Shifting responsibility. It is necessary to understand that no artificial intelligence can solve all problems. The physician manages the treatment, bears the responsibility, and makes the final choice.
Clinical Decision Support Systems (CDSSs) and telemedicine and electronic health records are critical sectors in developing digital health. CDSS is designed to help various medical professionals make clinical and physician decisions (Sutton et al., 2020). However, it is essential to understand that machines cannot solve all problems. The doctor directs the treatment and makes the final choice. The clinical patient and disease scenario was created to explore this topic more deeply and consider the main points.
Clinical Patient and Disease Scenario
The case of the pandemic is still relevant today and, more importantly, not fully understood; new information is being discovered by scientists all the time. Currently, there are less data on the effect of COVID-19 coronavirus infection on pregnancy, childbirth, fetal state, and the postpartum period (Yang et al., 2020). This paper describes a clinical case of severe COVID-19 coronavirus infection in a thirty-year-old pregnant patient. She was transferred to an infectious diseases hospital from the maternity hospital on the fourth day of her illness with a referral diagnosis: twenty-nine-week pregnancy threatened preterm labor and right-sided pneumonia. The client complained of general weakness and infrequent cough; the patients medical history showed an increase in body temperature to 37.90 C four days ago. Pain in the lower abdomen appeared on the third day of the disease. The ambulance team hospitalized her in the maternity hospital, where she received symptomatic antibacterial therapy.
Necessary Measures
The aim of treatment is the patients recovery and preservation of pregnancy. The disease can develop acutely, with a reasonably rapid extensive damage to the respiratory tract (Tsang et al., 2021). Accordingly, it is necessary to act immediately in this case. It is required to examine the patient by an infectious disease doctor and an obstetrician-gynecologist, continue symptomatic therapy and make a chest CT scan. It is crucial to monitor the pregnancy, so an ultrasound scan should be done. If the disease worsens, the patient should be transferred to the ventilator. The CDSS has not collected much data on coronavirus now (McRae et al., 2020). Accordingly, this system is not a suitable option, as competent specialists need urgent action to help the patient.
Conclusion
CDSS is a developing field, but it is still understudied, and there is a long way to go before real successes are achieved. The medical staff needs to act rationally, think critically about the situation, and rely not on a general scenario but on the patients specific case. Every health care provider should understand that they have a personal responsibility to clients. Artificial intelligence is not always able to find the necessary solution quickly. Meanwhile, gathering information and putting it into the system is vital because it can improve patient outcomes.
Care coordination is often seen as a key to addressing healthcare system issues. The current policy statement by the American Academy of Pediatrics and denes CC as a patient and family-centered, assessment-driven, team-based activity created to meet the needs of children while enhancing the caregiving capabilities of families. It interrelated medical, social, developmental, behavioral, educational and nancial needs to achieve optimal health and wellness outcomes (Ruggiero et al., 2019). Care coordination is a critical element within the pediatric healthcare system, and it has been defined as a collection of actions that take place in the area between providers, visitors, and entities and is becoming increasingly important to evaluate the effect it has on health outcomes.
The study conducted by Ruggiero, K., Pratt, P., & Antonelli, R. seeks to examine the role of Nurse Practitioners in the care coordination system. Its primary purpose is to assess the role and possible influence of Nurse Practitioners through the quantitative study conducted in two clinics. The study problem is viewed with an eye on the current development of the health care system when it, with its integral complexity, attempts to move into the community settings, such as infusion settings. At the forefront of the growing demands for quality care coordination stand Nurse Practitioners, who support several infusion programs.
The study design can be described as quantitative since the studys goal is to find out how individuals believe, behave, or feel in a particular manner. Quantitative research uses vast sample sizes and focuses on the number of replies rather than the more focused or emotional understanding that qualitative research seeks. The clinic sample used in the research was the two clinics, which are part of the childrens hospital (Ruggiero et al., 2019). The study sample was limited to the children who were receiving infusion therapies. The sample set can be identified as medium-sized since the data amount was collected only from two clinics.
The instrument used in the study was the modified version of the care coordination measurement tool. During the research, the care coordination activities were investigated, the interactions by Nurse Practitioners were measured, and the results were thoroughly documented and analyzed (Ruggiero et al., 2019). With regard to the modification of the original care coordination measurement tool, initially adapted for pediatric care coordination, the authors managed to include other settings, such as pediatric neurology, perioperative ambulatory clinics, etc. (Ruggiero et al., 2019). Within these settings, several improvements were made, mainly concentrating on the incursion of the specific settings relevant to the Nurse Practitioners. As mentioned in the study, after 80% agreement on the modifications by the panel of experts, it served as the primary instrument for data gathering and analysis for this research (Ruggiero et al., 2019). Thus, the initial care coordination measurement tool was adopted by the authors to conduct the analysis based on specifically Nurse Practitioners impact.
It should be mentioned that the instrument used for the study is relevant and reliable. After a two-staged assessment of the authors modifications to the care coordination measurement tool, it was approved by an expert panel of Nurse Practitioners, patients, and expert clinicians (Ruggiero et al., 2019). Therefore, to achieve the stated research objectives, this tool was best suited. Moreover, these modifications can be used in further studies on the topic, which increases the significance and justification for its usage.
The statistical analysis used for the studys data shows that more than 250 interactions related to care coordination were investigated and analyzed. In most cases, Nurse Practitioners were providing primary care concerns, such as family needs, concerns (more than 70 percent), and the advocation for the patient/family (more than 50 percent) (Ruggiero et al., 2019). The other set of data was focused on the outcomes that were prevented by the efforts of Nurse Practitioners. In most cases (almost 100 entries, nearly 40 percent), it was the delay in treatment (Ruggiero et al., 2019). The last set of statistical data aims at the evaluation of the time needed to complete care coordination procedures. The data analyzed in the research shows that the most common encounters with Nurse Practitioners lasted from 10 to 19 minutes (Ruggiero et al., 2019). These sets of statistical data are implied to analyze the involvement of Nurse Practitioners in the care coordination system and evaluate their performance.
The reliability and validity of the study should be assessed carefully due to the studys limitations. Since it is based on self-reports, reliability cannot be described as objective in any case (Ruggiero et al., 2019). Every respondent has his own subjective understanding of care coordination; therefore, the study can not be hundred percent valid and reliable. In further research, this should be considered and noted.
A similar issue arises when trying to assess the generalizability of the study. As it was mentioned in the article, the project was limited in scope to two clinics within one hospital, which implies the inability to generalize the outcomes and apply them to the other settings (Ruggiero et al., 2019). However, the study aims at further research which intends to be more global and with more degree of possible generalization.
Aside from demographics, the research assesses the role of Nurse Practitioners in the field of care coordination and concludes that the understanding of it is critical in terms of the future of the health management of CMC. Nurse Practitioners seem to be in the midst of the shifting priorities of the healthcare system; moreover, they can influence and improve the care coordination system. The primary study outcome is that Nurse Practitioners are in the perfect position for the adaptation and development of care coordination.
The study investigated how the role of Nurse Practitioners enhances care coordination and their importance in general. This article was the first to analyze the activities performed by nurse practitioners in the ambulatory practice setting (Ruggiero et al., 2019). Within this, the authors suggested that the next of the research would be to evaluate the cost savings of the nurse practitioners in relation to care coordination. Based on the foundation of this study, this aim is seen to become the next step in the development of this project.
Proceeding from the aforementioned, this project can be considered an important one in terms of the future of Nurse Practitioners practice developments. The role of care coordination is crucial for the healthcare system, and Nurse Practitioners are one of the main parts of enhancing care coordination capabilities. Based on the future assumptions of the authors, this study can be identified as of extreme relevance and importance in the field.
Reference
Ruggiero, K., Pratt, P., & Antonelli, R. (2019). Improving outcomes through care coordination: Measuring care coordination of nurse practitioners. Journal of the American Association of Nurse Practitioners, 31(8), 476-481.
Understanding the expectations of the various divisions and personnel within the organizations determines the healthcare outcomes. Each organizational division influences the reimbursement procedure regarding the schedules and amount of capital directed toward the process. One key element to track financial components is the Medical billing software, which determines copayments and verifies the insurance coverage, sending the claims digitally to the third-party payers. In a healthcare setting, a supervisor within a patient financial services (PFS) department should elaborate on how reimbursement affects other healthcare departments.
Reimbursement and the Revenue Cycle
Reimbursement Meaning to a Healthcare Organization
Reimbursement is the payment of the cash that has been allocated for utilization. In the United States, reimbursement policies constantly change since federal lawmakers amend them almost daily. Nevertheless, insurance companies are mandated to create a blueprint on how the financial system operates in the healthcare sector. The charges are made when a physician provides services to the patients, which forms the basis of a reimbursement claim. Significantly, reimbursement is essential in healthcare as it offers the much-needed capital to operate a medical facility (Harrington, 2019). Notably, if no payments are received after providing services to the clients, the healthcare would face monetary challenges, resulting in closure. At the same time, the revenue cycle entails sufferers collecting databases to facilitate reimbursement and involves three key players: payers, patients, and insurance providers.
The Flow of the Patient Via the Revenue Cycle
Figure 1. The Flow of Patients ( Find a Doctor , 2022)
To a greater extent, medical facilities, including the Northeast Georgia Medical Center, constant reimbursements guarantee their operations. Notably, when a healthcare center does not acquire such refunds, it risks bankruptcy. In the United States, approximately 23 hospitals face a monetary obstacle, leading to liquidation to a lack of repayments (Harrington, 2019). Figure 1 illustrates the flow of patients from initial contact to the final destination of making payments at Northeast Georgia Medical Center. The payments made by the victims for the services offered enable the healthcare facilities to derive reimbursements.
The process commences when the medical entity officials communicate with the client in the admission division by making contact via online enrollment or calling the physician to schedule a hospital appointment. After the patients give their database, the hospital staff begins the authentication process to verify the insurance and demographics information (Wang & Wang, 2021). Afterward, an individual victim account is created to facilitate payment and treatment. The accounts division representatives prepare a charge entry in a coded system which is delivered to the client after the discharge. The medical facility accountants create a bill forwarded to an insurance firm if no conflict exists from the charges.
Departmental Impact on Reimbursement
Utilization of Reimbursement Data
Several diverse departments deploy reimbursement data in a healthcare organization. For example, Northeast Georgia Medical Center is a reputable non-profit healthcare facility that delivers cardiac care services to patients and receives approximately $2.8 billion from patient revenue ( Find a Doctor , 2022). Notably, the medical center has large and small hospital branches that offer multiple benefits, including family care, internal medicine, pediatrics, and emergency services. The healthcare entity divisions management handles reimbursement data with great care to ensure the hospitals success (Harrington, 2019). The lack of monitoring of such data makes the hospital to financial difficulties, resulting in bankruptcy. Considerably, the gathering of reimbursement data is crucial for pay-performance inducements. The internal audit assists in evaluating the hospitals reimbursement effect on departments. The audit entails an independent appraisal process, giving insights into the firms financial and operational controls. The Northeast Georgia Medical Center utilizes the pay-for-performance payers system, ensuring the healthcare providers get rewarded grounded on exceptional victim outcomes due to quality of care, and penalizes those insurers that underperform.
Activities Within a Healthcare Organization
The Northeast Georgia Medical Center has four core departments that may influence reimbursement, including patient accounts, administration, healthcare information management, and clinical services. The victims accounts division is responsible for gathering the clients data and recording it to the chargemaster to produce the reimbursement bill. On the other hand, the administration department reviews all the transactions for the healthcare facility that could transition its financial position (Wang & Wang, 2021). In addition, the department adjusts the budget accordingly when errors in the revenue cycle cause a profit decline. The clinical services department is mandated to verify the patients insurance and registration details and examine whether the services rendered to the client were effectively billed. Clinical services management elaborates to the sufferer the type of services offered and determines whether correcting mistakes is necessary ( Find a Doctor , 2022). The health information department in a medical facility can impact reimbursement. Therefore, the divisions duty is to soft code of clients medical database and ensure the accuracy of the data being reviewed.
Responsible Department for Ensuring Compliance
At Northeast Georgia Medical Center, the division that is in charge of ensuring conformity with the policies for coding and billing is the healthcare information department. Significantly, the subdivision personnel assesses whether the medical facility adheres to the existing coding guidelines, and it must be familiar with the financial obligation of the clients to the healthcare providers (Harrington, 2019). However, each department should outline the procedures for policy application to their respective locations of care settings.
Conclusion
The reimbursements help medical facilities, such as Northeast Georgia Medical Center, to avoid bankruptcy and continue providing healthcare services to patients. The flow of patients from the initial contact to the last point of making the payment is crucial in tracking the reimbursement data. The vital departments influencing the repayment include patient accounts, healthcare information, clinical services, and administration divisions. The health database department is mandated to ensure that the healthcare organization complies with the available policies.
References
Find a doctor. (2022). Northeast Georgia Medical Center. Web.
Harrington, M. K. (2019). Health care finance and the mechanics of insurance and reimbursement (2nd ed.). Jones & Bartlett Learning.
Reflective practice is a significant ability for nurses. With systematic reflection, the nurses are able to manage their professional and personal influences of addressing patients health and wellbeing. This paper will cover the definition of reflective practice, its importance in the nursing field, two models of reflective practice and the obstacles of reflective practice in the nursing profession. Reflective practice can be described as the procedure of analyzing circumstances or the ability to reflect and make sense of ones actions; this helps individuals or nurses in continuous learning. Nurses have a substantial part in addressing the needs of their patients and colleagues on a regular basis, reflective practice is therefore important for them.
During this week of practicum, I help nursing student on the simulations lab, I was giving them scenarios with different patients to see if they able to follow instructions and figure out what was wrong with the patients. Problems that occurred were that the students were not able to follow instructions and they got overwhelmed with the orders that they were receiving.
The experience of performing this assignment was enhanced by the true Nurse Educator course, which was mainly applied in the process. As such, I used a revalidation technique that has been used to establish continued competence in the healthcare sector. The approach ensures that the ethical and professional code of healthcare practitioners is enhanced with the primary aim of improving quality care. Continuous professional development (CPD) is a significant way through which healthcare practitioners can achieve a holistic commitment in their practice to allow them to enhance their professional skills throughout their careers (Bristol, Hagler, McMillian-Bohler, Wermers, Hatch & Oermann, 2019). CPD practices, therefore, enable healthcare learning to become proactive and conscious and also influences professional development among medical practitioners.
I think I did a good job teaching them and giving them tips on how to be more organized and have more critical thinking when it comes to follow orders. Throughout this assignment, I was guided by three principles, but first, it is vital to note that I am passionate about organizing. I wanted to succeed no matter what the cost; I also did not want to let my superiors down; this influenced other driving principles within me in many different ways. I was honest with myself regarding my strengths and weaknesses, and this ability helped me develop a system that incorporated people to build compensating strength. Secondly, I was motivated through the entire process. This action drove productivity as well as empowerment, which I passed down the group. I also kept the team members motivated through being supportive and encouraging (Williams, 2019). Lastly, I was focused on the main objective of the team, and I kept the entire team focused as well. I kept track of our progress in order not to diverge off from the main course. By the end of the project, all the staffs, including the medical professional, had understood their core responsibilities; we established new and clear guidelines toward patients care. We did this by making the guidelines easy to digest, making the guidelines clear, and writing the process includes. Finally, we celebrated the teams success through rewarding the champions and all the team players; it compelled the team players to work hard and achieve their recognition. I learned that leadership takes courage, and the people who are courageous enough to lead are often the best leaders.
The best method of improving clinical skills is through practice, setting specific career goals to improve weak areas will improve the overall job performance and the quality of output. It was important for me to help students to adapt to the educational environment, so I tried my best to be able to communicate the assignment, leave feedback and answer students questions when required. The provision of quality health care through standardized practices and self-assessment ultimately improved the services provided by the nursing professionals (Halstead, 2018). Hence, the assessment and evaluation strategies were applied as well.
References
Bristol, T., Hagler, D., McMillian-Bohler, J., Wermers, R., Hatch, D., & Oermann, M. H. (2019). Nurse educators use of lecture and active learning. Teaching and Learning in Nursing, 14(2), 94-96.
Halstead, J. (2018). NLN core competencies for nurse educators: A decade of influence. Lippincott Williams & Wilkins.
Williams, C. A. (2019). Nurse educators meet your new students: Generation Z. Nurse Educator, 44(2), 59-60.
Ashford Childrens Clinic will be located in Houston municipality to focus on providing immunizations and screenings for conditions such as lead poisoning, developmental delays, and hearing or vision problems. Ensuring all children in Houston receive recommended immunizations and screenings is vital to protecting their health and well-being. Immunizations and screenings are some of the common ways used to prevent childrens deaths. People need to know about the new clinic; therefore, some of the available marketing strategies include advertising, personal selling, sales promotion, direct marketing, and public relations. Ashford Childrens Clinic is a health organization that will be marketed to provide healthcare services to minimize childrens deaths.
Background
City Profile
Houston is the fourth most populous city in the United States, with a population of 2.3 million, and it is growing rapidly. The city is racially and ethnically diverse, with more than one hundred and fifty languages spoken; roughly forty percent of Houstonians are foreign-born (Ellickson et al., 2020). A few factors contribute to the lack of accessible healthcare in Houston. First, Houston has a large population of low-income residents who may not have the resources or transportation necessary to get to clinics (Haidar et al., 2021). Second, many healthcare facilities in Houston are understaffed and underfunded, making it difficult for them to provide adequate care to all patients.
Services Profile
Ashford Childrens Clinic will focus on providing children immunization services in the Houston municipality. Immunization of children refers to administering vaccines to young children to build up their immunity against infections and diseases (Martin et al., 2017). A screening is a process or test used to identify individuals with a particular disease or characteristic. Screenings are important because they allow for the early detection of health conditions and diseases in children.
Immunizations are one of the most effective ways to protect children from diseases such as diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib), hepatitis B, measles, mumps, rubella (MMR), varicella (chickenpox) and rotavirus. Similarly, the clinic will likewise provide other preventive care services, such as screenings. The screenings will include lead poisoning, anemia, tuberculosis, immunization status, and hearing and vision screenings. It will be important to screen children for these conditions as they can all lead to serious health problems if left untreated.
Competitive Landscape
There is stiff competition among clinics that provide immunization and screening services for children in Houston. Many parents are extremely diligent in finding the best possible care for their children and are willing to travel significant distances and incur costs to make sure their children are getting the best care available. It can be challenging to stand out in such a competitive landscape; Ashford Childrens Clinic will manage to differentiate itself by providing outstanding customer service and building relationships with parents and families. Similarly, it will offer a wider range of services such as immunization and screening since most hospitals are majoring in one service line. Indirect competitors offer substituted products that satisfy the same need, while direct competitors offer competing products for the same purpose (Downing et al., 2019). The clinic will have some direct and indirect competitors in the Houston area. Some of its direct competitors are Texas Childrens Hospital, Baylor College of Medicine, and Methodist Hospital. Conversely, its indirect competitors will include clinics such as Memorial Hermann Healthcare System, Kelsey-Seybold Clinic, and Houston Methodist Willowbrook Hospital.
Additionally, there are many immunization and screening services substitutes in Houston. Children in Houston have access to a variety of immunization and screening services through the local health department, as well as through private providers. The Harris County Health Department offers immunizations for children and adults, as well as screenings for tuberculosis and other communicable diseases; the department likewise provides health education and outreach services. Private providers alternatively offer a variety of immunizations and screenings for children. Major healthcare providers such as Methodist Hospital, Texas Childrens Hospital, and St. Lukes Episcopal Hospital offer children a wide range of services, including immunizations and screenings.
Marketing Communications Mix Recommendations
Advertising
Advertising is the process of marketing and promoting a product or service to potential consumers. For marketing communication, I recommend advertising for Ashford Childrens Clinic services to the Houston residents. Advertising will help to create awareness of the clinic and its services. This will be important because many people may not be aware of the clinic or its offerings unless they see advertising for it. Similarly, advertising can aid in generating interest in the clinic and its services to bring in new patients and families who may not have otherwise considered using the clinic. The four media houses that could be used for advertising in Texas are the Houston Chronicle, the Houston Chronicle Media Group, the Dallas Morning News, and The Texas Tribune. In terms of advertisement implementation, the clinic can sponsor childrens sporting events or other community-based activities to connect with parents and promote their services.
Personal Selling
Personal selling is the process of creating and building relationships with potential and current customers to persuade them to buy a product or service. There are a few reasons why I do not recommend personal selling as a marketing strategy for Ashford Childrens Clinic services. First, it can be very time-consuming to build relationships with potential customers one-on-one in the entire Houston. Second, it can be difficult to scale a personal selling operation as the organization grows. Third, the institution may have difficulty reaching potential customers who are not in its immediate network, or it may force the institution to employ many agents, which will increase its expenses.
Sales Promotion
Sales promotion is an important marketing tool to increase consumer demand, drive product awareness and encourage purchase. There are many different methods of sales promotion, but some of the most common include discounts, free services, and premium offers. By offering sales promotions, Ashford Childrens Clinic will increase brand awareness and drive traffic to its products or services. Additionally, sales promotion can stimulate customer demand and help overcome any hesitations potential customers may have about purchasing a product or service. In the implementation details, the discounts technique includes offering a percentage off of services or providing a set amount of money off services for a limited time. Another technique is using loyalty programs which will involve rewarding customers for their patronage by giving them incentives each time they visit the clinic. Finally, another common technique is providing free trials of services; this allows potential customers to try out the clinics services before committing to becoming regular patients.
Public Relations
Public relations are the strategic communication management between an organization and its public. I recommend Public relations because it will assist the clinic in building trust with its customers and shaping its image in a favorable light. There are several avenues the clinic can pursue regarding public relations. Traditional methods such as print, radio, and television advertising can generate awareness of the clinic and its services. A more modern approach would be to utilize social media platforms such as Twitter, Facebook, and Instagram (Key et al., 2017). In the implementation, these public relations platforms will inform the public about the cost-effective and efficient clinic packages offered by the clinic. The platforms will entail individuals testifying about their positive experiences with the clinic. The company will also hire bloggers to inform and answer online questions asked by potential or regular clients to ensure they get the clinics and instruction health information right. This online communication will similarly give Ashford Childrens Clinic an edge over its competitors due to quicker response and easier consultation online.
Direct Marketing
Direct marketing is a type of marketing that focuses on tackling marketing goals through directly communicating with target customers rather than using indirect channels such as mass media. This communication can take many forms, including mail, telephone, email, and face-to-face meetings (Key et al., 2017). I do not recommend this type of marketing because it may be annoying to some of the email recipients who may not be interested in the companys services. Similarly, some of the recipients may decide to ignore the marketing messages, while some may block the emails from Ashford Childrens Clinic company.
Conclusion
In conclusion, Ashford Childrens Clinic will be aiming at ensuring better healthcare in Houston. Indeed, the clinic has reasonable goals of boosting healthcare provision among children, but the company still has to market itself so that potential clients can beware of its services. As the marketing director, advertising, sales promotion, and public relations are my recommended marketing strategies. These three activities work well in the cycle to create a comprehensive marketing strategy. Advertising can introduce people to the clinic services; sales promotion drives them to purchase the services, and public relations can keep them coming back for more. By using all three of these activities together, the organization can effectively reach its target markets and achieve its desired results. Direct marketing and personal selling are not recommendable since they are cumbersome and slow in reaching the entire Houston residents.
