Todd Park and Jonathan bush were pivotal in the formation of Athenahealth in 1997. The success of the company is, however, attributed to the effort of hired consultants from other companies. Training medical claims underwriters in the country were the primary vision of the company. This proved futile due to the nature of the healthcare environment and forced the company to diversify into software development (Udell, 28). This software enhances practice management services by physicians through the provision of an an-easy-to-use interface. After a series of frustrating failures, the company reinvented itself to focus on software products for healthcare facilities in the United States (Udell, 29).
Missions and visions of Athenahealth
As stated in the mission statement of Athenahealth, the company endeavors to be the most trusted service provider in the healthcare sector. According to the chairman of the company, innovative technology and the commitment of the people enabled the company to provide crucial assistance to physicians. Athenahealth envisions an institution with a strong foundation and the ability to offer support services to physicians across the country and beyond (Adler-Milstein and Robert, 351).
Objectives of Athenahealth
Athenahealth seeks to provide high quality, state of the art electronic health record software to hospitals in the country. It also endeavors to enhance the management and leadership abilities of physicians and healthcare professionals through quality training opportunities. Finally, the company seeks to provide a connection between the physicians and the patients to enhance service delivery (Udell, 27).
Issues facing Athenahealth
Despite the progress made by the company in the provision of the management healthcare system to healthcare facilities, it has faced a number of challenges. The inability of hospitals to upgrade their information technology systems limits the companys entry into new markets. The Einhorn saga also affected the reputation of the company after it was implicated (Gold, 358).
Works Cited
Adler-Milstein, Julia, and Robert Huckman. The Impact Of Electronic Health Record Use On Physician Productivity. American Journal of Managed Care 19.1 (2013): 345-352. Print.
Udell, Melody. 10 Minutes with Rob Cosinuke. Marketing Health Services 34.3 (2014): 28-31. Print.
According to the UAE Department of Health and Preventive Medicine report, health care refers to the diagnosis, treatment, and prevention of illnesses. The public depends on medical professionals coming together in order to deliver modern effective care services. These professionals include public health care practitioners and community health workers, among others (Sathish, 2012, para. 13). Public health care practitioners, in particular, deal with the general preventive and curative care services.
They deal with all forms of acute and chronic physical health issues. Consequently, a certified health practitioner must possess extensive knowledge in many areas, including a thorough understanding of food poisoning (Sathish, 2012, para. 15). In reference to the two articles discussed above, this report aims at analysing how the media portray health care-related topics. Additionally, it points out the challenges that health care systems undergo while working with the media.
Body
A report issued by the UAE Department of Health and Preventive Medicine defines food poisoning as a complication characterised by stomach infections or pain, vomiting, a general body weakness, and fever. The report further shows that food stored at incorrect temperatures is the major cause of poisoning.
This is for the reason that bacteria thrive well and multiply faster in hot and humid temperatures. The two families purchased food that was not preserved at the right temperatures, leading to food poisoning. The infection kills fast, as demonstrated by the two cases.
Sathish (2012) reports that Anthony was admitted to a private clinic in the neighbourhood. However, due to lack of sufficient equipment and expertise of health care professionals, he was admitted to another facility, the Al Qasmiya Hospital, where he died. The death of the siblings in Dubai and the narrow escape by their mother are also instances where the media have negatively publicised the health care system.
The death of five-year old Nathan and subsequent death of his sister in the ICU openly show the negligence of the health care system. Convectional advertising has been likened to the manner in which media news on health care issues work. Messages in various media sources that promote specific desirable behaviours have the potential to persuade the public to change behaviours (Saberi, 2009, para. 7).
It has been shown that negative news about health care issues greatly impact the public. The more the public is influenced by health messages they receive, the more they would also be affected by how the media portrays the roles and conduct of health professionals (Saberi, 2009, p. 6). It makes little sense to think that people would learn something about the causes and effects of food poisoning from the media, but that they would form no opinions about a health professional who is presenting the information in that source (Sathish, 2012).
It is quite evident that the health care system has been negatively handling urgent cases, such as those of food poisoning, but keeps on referring patients to other facilities, yet time is running out, implying that their conditions would be worsening. The medical practitioners lack widespread knowledge to handle advanced medical complications.
This acts as a challenge to health representatives with the media houses concentrating on the details. Sathish, the reporter on the case of the three-year-old boy who died of food poisoning, gets his information from a source close to the family. The level of truth and originality of this information cannot be substantiated. The health care system and the medical practitioners end up being victimised and negatively portrayed (Sathish, 2012).
There have been concerns that some stakeholders in the health care sector aim at influencing media firms with regard to reporting health care matters across the world. In fact, it is evident that some health care personnel adopt some corrupt measures to ensure that media houses do not publicise their professional misconduct. An example reported is tactics used by the tobacco industry since the 1970s to minimise negative reports in the media, but maximise positive ones (Sathish, 2012, para. 12).
Conclusion
In conclusion, this report has shown that the media have critical roles to play in relation to reporting health care news. On the other hand, health care professionals need to know the duties and the required professional ethics of media practitioners. The media are used to reflect practices in the health care sector, and to let the public know various issues that might negatively or positively impact their care outcomes.
In fact, they are a reflection of the larger culture they represent. From a health care system perspective, media need to be viewed like advertising tools since they communicate the positive contributions of the health system in society. From a personal perspective, the mass medias way of portraying health care issues is not fair and balanced.
The media should adopt better approaches to ensure that their reporting is not always aimed at negatively impacting the health care sector. As noted in this report, some reporters are not competent enough to report health issues. In fact, they need to undergo some special forms of training.
References
Saberi, M. (2009). Dubai siblings die of suspected food poisoning. Web.
What geographic or international health equity issues exist within and between countries participating in or attempting to establish regulations for the global medical tourism market?
Health equity implies the absence of unjust health differences among different social groups on different levels of the social ladder. Inequity in health isolates people on the basis of gender, poverty level, religion, and race. It is an ethical issue and is associated with human rights policies (Cattan & Tilford, 2006). The medical tourism market involves the provision of medical services to international patients.
Countries that practice medical tourism enhance their economic development though there is a certain risk. The risk involves sabotaging projects aimed at improving health equity both inside and outside the country. The rise in global health care systems has reduced their capability of meeting the goals of Health for All stated in the WHO Declaration of Alma Ata and safeguarding peoples rights to health.
The promotion of medical tourism may motivate the distribution of public resources to the private sector in order to support medical tourism (Hodges, Kimball & Turner, 2012). More so, medical tourism may lead to a transfer of professionals to the private health sector. This may result in a scarcity of health professionals in public health systems. Medical tourism also encourages the training of health professionals for more expensive and complex procedures, which attract medical tourists. This may reduce the provision of affordable and appropriate health services to local inhabitants. Medical tourism questions the credibility of health systems in the departure countries (Cattan & Tilford, 2006). This is because of the deviation of resources that are employed to take care of the sick in other countries at the cost of less privileged.
Do you believe that mental health is receiving an equal amount of attention as physical health worldwide?
Mental health is not receiving sufficient attention globally. Very few resources are allocated to the treatment of mental health as compared to physical health (Cattan & Tilford, 2006). Moreover, less funding is provided to do research in this sphere. This underfunding worsens during a recession because of the absence of a national tariff for mental health.
Mental health is not receiving much focus because of the stigma. Stigma is caused by heightened negligence among the general public and media about mental disorders. This is linked to fear of the mentally ill and the image painted by the media regarding associated risks and dangers. In addition, a bias against mental health exists in various medical centers.
People with mental disorders have low access to advanced treatment. More so, mental patients often have to wait for long months and years to get appropriate treatment. The long wait for medical care may cause the disease to advance to more severe stages, which can be difficult to treat. There is enough evidence that people with mental sickness are rejected on the basis that they are not severely sick to get emergency treatment.
The choice and ability to make decisions are not available for patients with mental health problems as they have little say on issues pertaining to their treatment (Cattan & Tilford, 2006). Admittedly, mental patients (and sometimes their caregivers) do not get sufficient (or adequate) attention and support from consultants as well as healthcare professionals on the best choices to make regarding their treatment.
Reference List
Cattan, M., & Tilford, S. (2006). Mental health promotion: A lifespan approach. New York, NY: McGraw-Hill International.
Hodges, J., Kimball, A., & Turner, L. (2012). Risks and challenges in medical tourism: Understanding the global market for health services. Santa Barbara, CA: ABC-CLIO.
Find the mission and values statements for four different hospital types. Do their missions and values reconcile with your expectations for the type of organization? Look at a religiously based organization. Do their mission and values reflect their religious teachings and mission? Now examine a for-profit hospital. Do their mission and values include the need to increase their owners value and maximize their earnings? Why do you think the missions and values are structured as they are?
Valley General Hospital: Working together, we exist to serve the changing health care needs of our community. We will provide personalized patient care known for quality and excellence with a healing environment through caring relationships. This mission statement identifies its competitive edge as personalized care but does not state how it will achieve it. It does not also state the boundaries that it intends to operate under, as well as uses vague terms such as caring relationships. For a public institution, the statement does well in stating the intention to collaborate with others to offer service that meets changing community healthcare needs.
Stony Brook University Medical Centre: Stony Brook University Medical Centre improves the lives of our patients, families, and communities, educates skilled healthcare professionals, and conducts research that expands clinical knowledge. Precise and states the objectives of the hospital, the market segment that it intends to serve, and how it intends to serve it. It, however, fails to mention the institutions values. As a medical center, the institution clearly states its commitment to medical research.
Novartis: To improve patients lives by providing customers with innovative science and differentiated healthcare solutions delivered by diverse and engaged talent with integrity, passion, and focus on performance. The statement precisely states how it intends to deliver its service to the community. It also identifies the market segment it intends to serve. The company values are talent, integrity, and passion for work. As a pharmaceutical company mission statement is clear on the companys intentions to provide healthcare solutions.
St. Vincent Charity Medical Centre: Faithful to the philosophy and heritage of the Sisters of Charity of St. Augustine, the St. Vincent Charity Medical Centre family is committed to the healing mission of Jesus. As Caregivers, we serve with: a deep respect for the dignity and value of all persons; our practice of quality care; our dedication to the poor; and, our commitment to education. It identifies the values and objectives of the institution it intends to meet.
It is also clear on the market segments it intends to serve. However, it fails to identify how it intends to achieve those objectives. As a catholic based hospital, the institutions are very clear on its intentions to include Christian faith and philosophy as part of its healthcare solutions. The mission statement also focuses on the teachings of Sisters of Charity of St. Augustine as the basis of its doctrine.
Tenet Healthcare Corporation: Quality is our mission, and it shows. At Tenet, our business is health care. Our mission is to improve the quality of life of every patient who enters our doors. Being a for-profit organization, the mission statement mentions its intentions of making quality healthcare as a business. However, it does not state how it intends to achieve its business objectives. It also does not identify its market segment it intends to serve. It also fails to show how it intends to maximize profits from its healthcare services.
Health care in the United States has been traditionally a mixture of not-for-profit and for-profit organizations. Do you think that markets where more for-profit firms exist would be inherently more competitive? Why or why not?
In the United States of America, healthcare is varied with for-profit and not-fro-profit organizations being set up to offer healthcare. For-profit healthcare organizations were established in the 1980s. These types of institutions are advantageous over nonprofit organizations to the country for several reasons. For-profit organizations have a strategic advantage and positioning in the market. As compared to not-profit organizations, for-profit organizations are established on a win-loose basis.
In this case, they have to compete effectively with competitors or lose market share. Suffice to say that such completion results in specialized services and further research, which leads to the advancement of healthcare services. Furthermore, any organization must generate profit from its activities to sustains its operations.
Business models describe four components of how an organization is organized. They can show comparative differences in a competitive analysis. What is the relationship between strategy and business models?
A business model is a strategy that comprises the key components of any organization. In healthcare organizations, business models constitute key elements such as customer value, inputs, profitability, and business processes. With time healthcare organizations have to change their business model components to accommodate new industry challenges most of which are brought about by new technologies. For healthcare organizations to be strategically placed in the market, they must keep changing their business model components to help them gain market advantage.
An important aspect of strategic planning is analyzing the internal and external environments. Recently, a large organization completed its environmental analyses only using a very extensive SWOT process. They then used the strengths, weaknesses, opportunities, and threats generated by this process as their environmental analysis. What would be the value of using this technique only? Should other methods also be used? How could data trends be used?
SWOT analysis is the most effective tool that helps the members of the organization understand and assess all the aspects of the organizations performance. Other than helping the organization identify its opportunities for growth, SWOT techniques are also useful because they are easy to set off and are all-inclusive (involve many participants and stakeholders). There are other strategies that are available for use by healthcare organizations. They include generic strategies that involve the establishment of low-cost services and products as well as the differentiation of these products and services. Healthcare can also use data trends effectively to improve its healthcare services. This can be attained by using demographic data to strategize how to meet cultural and demographic healthcare needs.
There are many firms that have positioned part or all of their products at a low cost. Low costs are also commonly thought to equal low prices. Are low costs necessarily the same as low prices? Could a firm have low costs and still have high prices?
One of the strategies for establishing organizations effectiveness is low costing. Healthcare organizations, concerned with healthcare needs, have to combine low cost with quality services. Healthcare organizations that position themselves as low-cost providers find themselves not attracting desirable clients for profitability as healthcare consumers connect low cost and low quality. However, low cost should not be confused with low pricing. Healthcare service maybe low cost yet not be low priced. Consumers of healthcare products who have insurance policies are cushioned from the high cost of these services. As such firms could still have a low costs but high products and services such as plastic surgery.
Large pharmaceutical companies have prospered by owning their discovery, production, and marketing assets and have traditionally made significant portions of their profits from a small number of blockbuster drugs. How is the pharmaceutical companies business model predicted to change? What are the forces that are influencing this change?
The current business model in pharmaceutical involves undertaking all activities involved in its line of business. This involves doing everything from scientific research, marketing, trials of drug prototypes among others. The model resulted in pharmaceuticals releasing blockbuster drugs, which generated the company enormous profits. However, this type of business model is changing as there have emerged multiple drug companies resulting in multiple drugs, for any significant profit.
In the future, pharmaceuticals will have to limit their activities to any of the core activities. Furthermore, profit generation will not be through direct sales but negotiated deals, especially with healthcare insurance companies. The change in business model has been influenced by the latest technological changes that allow easier access to services. Furthermore expanding the number of pharmaceuticals has played a major role in the change of business model.
Porter recommends generic strategies of low cost or differentiation. Is it possible to obtain both at the same time? In health care, is low cost a reasonable strategy? If so, in what circumstances might this be an acceptable strategy?
Differentiation in healthcare provision involves offering unique products and services to consumers. Low costing involves offering a multitude of services at a low cost. In healthcare, it has been proven that most of the consumers of healthcare prefer quality at a high price. It is therefore not necessary to obtain the two simultaneously. Low cost is usually seen as a reasonable strategy in the provision of healthcare services. Low cost does not attract the most desirable clients because of quality issues connected with low-cost healthcare. However, it is reasonable as it enables the provision of a wide variety of healthcare services. Furthermore, low-cost healthcare is affordable to the majority of consumers as it is supported by health insurance.
To sustain a competitive advantage, an organization must have valuable resources, endure over time, are hard to imitate, and are difficult to find substitutes for. What are some of the common resources in health care that could convey a sustained competitive advantage? How do these differ for the different segments of the health care industry: For hospitals, Insurance companies, Pharmaceutical companies, Equipment manufacturers?
A fully competitive health care institution normally has at its disposal several resources. They include tangible assets (building, equipment, personnel) and intangible assets such as organizational culture and tacit knowledge. While tangible assets are can be replaced with ease, intangible resources cannot. Organizational culture helps a healthcare organization to build a set of unique products and services which result in a healthcare organization gaining a competitive advantage. These resources differ from one segment of healthcare to another. Pharmaceuticals can gain a competitive advantage if they use new and patented drugs. Hospitals may gain an advantage by employing specialists in various fields that offer unique services.
Under what circumstances would you agree with someone who said that alliances are very risky?
Establishing an alliance between healthcare providers is encouraged. However, in certain circumstances such alliances are risky. Links through which these alliances are established are very delicate. They expose parties to major risks that other collaborating partners will be hard-pressed to collaborate effectively. When organizations that have entered in an alliance fail to disambiguate their basic comparisons, this exposes them to risk.
What dimensions would you use to classify the various types of strategic alliances? Why those dimensions?
Alliances can be classified into several dimensions. They include several member alliances where two or more members are involved. This type of alliance encourages diversity where more members for the alliances. Another dimension is governance structured collaborations. Governance structures of different alliances form an alliance of their own by incorporating a member from each of the individual alliances. This type of alliance is crucial in philanthropic work. There are also mandated versus voluntary alliances where organizations are compelled by an external legal authority to ally. This type of alliance is useful as it ensures legal compliance amongst members.
Which alliance motivations do you think are the most compatible with each other?
Organizations intending to establish alliances must understand their strategic intentions to make the alliances effective. Several motivations must be present to ensure that the partners are compatible with each other. These include an in-depth understanding of ones owns allied partner. For compatibility, an alliance must be motivated by an explicit mission statement as well as understanding the intentions of each of the collaborating partners. Organization forming alliances must also be motivated to attain the purpose of that alliance.
What do you consider to be the likely stages of strategic alliance development? Does every alliance have to go through each stage?
A successful alliance is developed through a series of strategies. Alliance formation begins by finding alliance partners. Organizations with similar ideals and intentions must be identified to be incorporated into the alliance. The transition stage follows, where the alliances establish the most effective mechanism for making decisions. Partners are allocated their share of control. If the alliance successfully goes through the transition stage, it enters into the maturity stage. This is the stage through which the attainment of objectives is the major preoccupation of such organizations. This is coupled with keeping members committed to the alliances. After maturity alliances move on to critical crossroads, a point where they become too independent and individual partners start to feel the weight of alliance. At this point, it is usually crucial to maintain a mechanism for establishing collaboration while maintaining individual autonomy. This is intended to strengthen the alliance.
What is the difference between an alliance problem and an alliance symptom, and what does this difference mean in terms of managerial intervention?
Most of the alliances fail because they do not differentiate between a problem and a symptom. An example of a problem in healthcare alliances includes a situation in which a partner fails deliberately to collaborate with others to benefit alone. Another example of problem may involve the inability of an alliance to form a set of rules and norms that govern that alliance. Symptoms are signs that the alliance is not progressing well. In this scenario a symptom may involves explicit exhibition of non compliance with other members. Alliance managers must move with speed to intervene to save the alliance by clearly establishing the boundaries between the symptom and the problem and dealing with the problem rather than the symptom.
When can you tell if your partner is not likely to have a cooperative orientation?
In forming an alliances there are a various types of partners involved in. The success of alliance depends on the ability to identify if the partner has competitive tendencies or not. To establish the partners corporative orientation, one needs to critically analyse the partners behaviour early on during the emergence stage. Early characteristic must be noted to establish the intentions of the type of an alliance that the partner is interested in. These signs include evaluating the partners strategic goals. Vigilance must be established throughout to identify if cooperative orientation partners orientation shifts.
The paper explores methods that can be used to improve service delivery in a surgical ward facility through business process re-engineering. In order to understand the best strategies for improving efficiency in surgical wards, a case study was developed as part of the research approach, methodology and design. The study also considered factors that may minimise patient convenience in surgical ward (Khodambashi, 2013).
The latter is often caused by unscheduled operations. However, scheduled operations may also lead to patients inconvenience especially if carried out in a less proper manner. From the findings, it is possible to identify a number of areas that need improvement in selected wards.
For instance, the number of sessions required to operate patients demanded a major improvement. This was replicated across several wards. The operation rooms also lacked adequate preparation before patients could be given attention. Surgical instruments for operations were yet another area that required additional attention. The best management choices for surgical wards were established through the discrete event simulation.
At the stage of gathering information, Delphi methodology was employed. It is interesting to note that this was a unique method not available in other sources of literature. This proved the originality of the research study. One of the profound strengths of the methodology adopted in the study was that it offered frameworks to develop standards that could be used in major clinical settings.
Recommendations and conclusions
Apart from the methods used to undertake the above study, there are still a number of recommendations that can be adopted to improve patient care delivery services in sensitive facilities such as surgical wards. Delivery models for patient care should be diversified as much as possible so that the needs of different patients are addressed substantially.
The workforce management practices in healthcare organisations should be examined critically so that the needs of patients are understood. For example, cost reduction measures in surgical wards should be a major consideration for healthcare institutions. If the cost of operation is not affordable for patients, satisfaction in care delivery can hardly be attained.
Surgical operations demand a lot of financial spending for both patients and healthcare institutions. Other challenges faced by healthcare institutions include increased patient demand, staff shortages, and increased financial pressure. This explains why providers often find it cumbersome to navigate viable operating models and re-engineering optimal processes.
These challenges are mainly faced by large healthcare systems that are eager to centralise their systems and consolidate or merge their processes. Hence, it is highly advisable for healthcare providers to develop workforce insight. Even in cases where there are inadequate operational standards for surgical wards, improved processes and workflows can indeed alleviate inevitable weaknesses. The most important labour management functions should be restructured in order to construct a sustainable framework.
Workforce management is a crucial undertaking for healthcare organisations that perform sensitive services such as surgical operations. Benchmark comparisons and gap analysis are two major methods that can be employed alongside the Delphi methodology to boost practices, guidelines and processes.
Several industries across the board utilise information technology in their daily practice. A case in point is medical knowledge analysis that assists in decision-making. Hence, substantial information science based on process control can be suitably applied in medical applications.
Technology-based systems that rely on information technology can be used to achieve set goals, reduce medical errors, enhance decision support systems, undertake report writing and create systematic entries (Bevilacqua, Ciarapica & Giacchetta, 2011)
From the Delphi research study on business process re-engineering, the system objectives were identified using the As-Is analysis. The latter was necessary in the process of setting up a proper analytical approach. The health sector can significantly benefit from the As-Is analytical tool. However, some scholars argue that the incremental approach is more reliable and effective than the As-Is analysis because it takes care of the capacity needs and ability of individual healthcare organisations.
Poor process modelling has led to high rate of failure in software products used in healthcare settings. The traditional process modelling methods face a major shortcoming in regards to a direct model feature that can be used to verify certain facts. When automatic analysis simulation is used, it eliminates the verification challenge posed by the conventional methods. The same method has been proposed and supported by scholars.
Moreover, verification and execution processes have also been made more successful by researchers through semantics assigned to personal computers. An interactive approach was once suggested by researchers. The unofficial model and regulations were reduced and then validated. Regardless of the interpretation used, both the correct and incorrect constructs are obtained. Hence, the Delphi process was used to overcome the operational challenges associated with the traditional models (Champy & Greenspun, 2010).
Perhaps, it is vital to inquire and explore the importance of re-engineering in healthcare. As already discussed in the essay, healthcare organisations can hardly separate themselves from the ideals of information technology. Modern applications in healthcare (such as surgical operations) require articulate use of medical engineering in order to meet the needs of both caregivers and patients.
References
Bevilacqua, M., Ciarapica, F. & Giacchetta, E.G (2011). Business process reengineering in healthcare management: a case study. Business Process Management Journal 17 (1), 42 66.
Champy, J. & Greenspun, H. (2010). Reengineering Health Care: A Manifesto for Radically Rethinking Health Care Delivery. Upper Saddle River: Pearson Education Inc.
Khodambashi, S. (2013). Business Process Re-Engineering Application in Healthcare in a relation to Health Information Systems. Procedia Technology 9 (1), 949 957.
This has the response to your grant of proposals for the economic, environmental, and social causes. Our trust is engaged in looking after the wellbeing of the aged people of our community. We have been successfully managing an old age home for the past 10 years. We would like to further enhance our services in providing medical aid to the senior citizens of our community.
Our trust proposes to concentrate on the chronic health problems of the aged. We are inclined towards providing healthcare facilities to the aged because issues such as heart attacks, cancer, arthritis, and diabetes demand costly treatments. Moreover, the aged people, being at the last stage of their lives, dont have much to spare for their treatment. The number of aged people suffering from such ailments is increasing each year. Reports suggest that during the year 2009-2010, 31.5% of aged Americans suffered from heart ailments, 55.5% from hypertension, 8.5% from heart stroke, 21% from arthritis, and 11.5% from asthma. Therefore, we aim to minimize the pain and agony experienced by aged Americans by making available suitable medical aid.
Our trust is well equipped to execute such a project because we already have been in this field for the last couple of years and adding to our strength is the fact that our members include prominent people from the society from different professions such as doctors, lawyers, administrators, engineers, etc. We even have an in-house clinic for catering to any emergencies.
As your good self would agree, this kind of initiative needs a sizeable amount of investment. So we are approaching your good office for financial assistance that would enable us to start this humanitarian project in the Texas State.
Thank you for your valuable time and kindness.
Yours sincerely
MNO
Chairman
Problem statement
It is understood that pain from chronic diseases is unbearable, especially when the patients are aged (more than 65 years of age). In such conditions, the patients need immediate medical attention. Due to the fast life that we have, we dont have time for our loved ones, especially our parents and other aged people in the community. The aged are left on their own or in nursing homes to tackle their problems with health. Is this what they had expected? They didnt leave us on our own when we, as children, needed them the most. So why is it that once our parents grow old, we stop taking care of them? The aged people in America and elsewhere are a pitiable lot that needs immediate support and medical aid.
There are other issues about the medical aid for the aged that need to be tackled. At times of immediate needs, lack of suitable transportation is seen as one of the major constraints for transferring patients to the hospitals. There is a lack of proper health insurance. The major hindrance in providing medical aid to the aged is the lack of clinics or hospitals that are specialized in treating the aged. Treating the aged requires specially trained nurses who have the patience to deal with their unresponsiveness. It has been observed and it has become a usual practice of the nurses to administer the basic medicines for elderly people having pain. They are not concerned about the variations of pain or its intensity. In other words, the medications given to elderly people having pain is never customized.
Further, pain assessment in elderly people becomes all the more difficult due to their other health issues and their compassion towards pain-relieving prescriptions. A variety of other problems like the patients viewpoint and attitude towards pain and pain-relieving prescriptions, nurses insufficient information and understanding of chronic pain, and certain professional hurdles intensify the complications and the role of nurses.
Review of secondary literature
Pain, being a personal experience, is very complicated to prove. In elderly people, where verbal communication has become restricted, the expression of pain becomes very difficult. As such, the pain assessment becomes all the more difficult. In such circumstances, likely, the patient might not get the required treatment and as a result, the patient might not get the expected relief.
During the past couple of years, there has been a major increase in the percentage of elderly people in the population of the world. It is estimated that by the year 2050, the percentage of elderly people (more than 65 years of age) in the world population will be 36.3%, and that of the elderly people who are more than 80 years of age will be tripled. Pain is a very commonly experienced ailment by elderly people. Persistent pain, like chronic pain, affects more than 50% of elderly people residing in the community and 80% of those residing in nursing homes. Elderly people are more prone to chronic pain than the younger population. The pain experienced by elderly people is persistent and is of normal to a rigorous intensity that may continue for several years.
Gauging and categorizing pain is the most crucial aspect of pain management. Even today, the researchers report paucity in pain detection. Several scholars believe that elderly people dont express their pain verbally. They keep on tolerating their pain. Until recently, there had not been any serious efforts or studies on the topic of pain management in elderly persons. Considering the severity of the issue of pain in the elderly people, The British Pain Society and the British Geriatrics Society, jointly made public some guidelines for managing pain in elderly persons. The main purpose of such guidelines is to educate healthcare professionals about the changes that appear in human beings due to old age. Professor Pat Schofield believes that elderly people hesitate to report their pain and even if they report it, the healthcare professionals are not able to apply the pain management techniques efficiently.
There have been several serious legal cases against nurses who have neglected to treat elderly patients having pain. Certain guidelines clearly state the instances where adult abuse is committed. There may be various kinds of elderly abuse such as, bodily abuse, overlook, or a lack of care that amounts to bodily harm, pain, or mental torture of elderly people. Some scholars believe that incompetence in treating pain or under-treatment might also be categorized as elderly abuse.
The solution to the problem
The solution to such problems lies in providing proper healthcare facilities to the aged people. Providing healthcare services is a vast term that includes various steps and measures that have to be taken. As an initial step towards starting the project, it is proposed that community resource mapping will be conducted. On average, 40 resources will be spotted in every community. The surveyors, from among society, will gather the required data from various families. Such data will be compiled and used as a resource index by way of a website. A mapping, targeting the nurses, will also be conducted. Nurses are also an important part of this project because ultimately, they are the ones who will be responsible for administering proper medication according to the pain management guidelines. By the data, the required training will be provided to the nurses. In addition to the awareness about our responsibilities towards the aged people, the training will also include information about the various acts of the aged people.
Since the lack of proper transportation is considered as one of the major hindrances in providing proper and immediate medical aid to the aged people, it is proposed that a separate department will be created for this purpose. Depending on the data, a certain number of ambulances shall be made available. A unique telephone number will be assigned to the ambulance service so that anyone will be able to call for assistance anytime. This particular telephone number shall be suitably publicized through various media.
It is also proposed to appoint specialized doctors and nurses for our in-house clinic. This will enable us to take care of aged patients who cannot afford the costly treatments of chronic diseases. An ambulance will be ready 24 X 7 to bring in emergency cases.
Necessary equipment required to treat emergency patients will also be arranged by the trust so that immediate first aid may be provided and the patients may experience some relief by the time they are transported to the proper healthcare institution.
All the information about the community mapping, available healthcare facilities, and other details will be made accessible to people by installing computers at various hospitals and other healthcare facilities where people will be able to access the details.
Budgetary details
The project director will be responsible for maintaining the budgetary requirements, hiring people, marketing the venture, preparing news articles, addressing the audience, arranging training schedules, organizing the various reports, and other things that might be required from time to time. Other staff members will perform their respective allocated duties with complete dedication.
The remuneration for employees will be as follows:
Designation
No.
The hourly rate in US $
Number of hours for the first year
Number of hours for the second year
Total hours for each person
Amount in US $
Project Director
1
Full time
Full time
Full time
Full time
60,000
Consultant
1
35
400
200
600
21,000
Training Coordinator
2
20
300
100
400
16,000
Surveyors
5
15
500
100
600
45,000
Doctors
5
60
200
200
400
120,000
Nurses
12
25
600
600
1200
360,000
Total (1)
622,000
Table 1: Salaries.
In addition to the salaries, other expenses (for two years) are as under:
Account head
@
Amount in US $
Training schedules
30 schedules
700 each schedule
21,000
Traveling expenses
9375 miles
$0.64 per mile
6,000
Office supplies, including postage, printing, etc.
5,000
Computers for hospitals
3 nos.
700 each computer
2,100
Telephone charges
1,000
Ambulances
4
100,000
Necessary equipment for providing immediate first aid
100,000
Total (2)
235,100
Table 2: Other expenses.
The total expenses amount to the US $857,100. This is the amount that is being requested as grant aid to enable us to initiate this important project. Other recurring and maintenance expenses are proposed to be covered by way of donations from other charitable organizations and individuals. This project will be executed by the National Public Charitable Trust (NPCT). NPCT is a charitable organization engaged in the resurgence of the aged people. NPCT has, in the past, made its presence felt in many developing countries. The trust has effectively executed various development ventures based on grants.
Evaluation
There is a dire need for healthcare facilities for the aged people in Texas State. Considering the incessant increase in the population of the aged people, it is eminent that such needs will keep on increasing in the coming years. The recent increase in suicidal deaths in America is a clear indication that the aged are dissatisfied with their lives. The major factor responsible for such dissatisfactions is pain from chronic ailments. So if proper and timely medical aid is provided to the aged patients, the suicidal deaths of our elders can be reduced substantially.
Our proposal aims at minimizing the suffering of aged people by providing them with the required treatment at the right time. We think that this endeavor of ours will contribute towards a healthy future in American society. We request your good self to kindly consider our proposal with a view of sympathy and respect towards the elderly people. Thank you.
Since the beginning of the 1990s, Acibadem Healthcare Group has been in place to deliver high-quality care using the latest innovations and technology (MedRetrieat par. 1). Acibadem Healthcare Group currently occupies a leading place in the Turkish healthcare sector due to its advanced equipment (Trilogy, GammaKnife, CyberKnife, Truebeam STx, Rapidarc), highly-qualified staff, and bold and innovative projects ( About Acibadem par. 1; MedRetrieat par. 1; Technology par. 3). Acibadem Healthcare Group can be considered as one of the moving forces in the Turkish healthcare that is focused on the ongoing development and improvement of the service excellence.
Hospitals of the Group such as Acibadem International Hospital specialize on the provision of health care services specifically for the patients who arrive in Turkey as medical tourists; the hospital is staffed with the professionals who can speak many foreign languages such as Russian, English, Spanish, Kyrgys, and the languages of the Balkans ( International Hospital, Istanbul, Turkey par. 1). Besides, Acibadem hospitals have been accredited by the JCI (Joint Commission International) global standards for the sector of healthcare (Turkey Health Advisor par. 1). In addition, Acibadem Labmed now has ISO 15189 accreditation level which makes it one of the most influential labs in the region (Turkey Health Advisor par. 1). The Group does not only provide a wide range of high-quality services but also delivers the excellent patient experience and a high level of the client satisfaction.
Acibadem Healthcare Group currently includes 17 hospitals and 13 outpatient centers; the combined size of all the facilities of the Group equals 402000 square meters; it hires 13000 professionals (the number of physicians is 2500) (Acibadem Healthcare Group 7; Patients Beyond Borders par. 1). Moreover, the number of beds in the hospitals is 2146, and there are 98 ORs; further, according to the data of 2013, Acibadem Healthcare Group could accommodate 408660 inpatients (with 110000 surgical patients) and provide care to over 3 million outpatients; it also conducted about 6 and a half million lab tests and over 650000 of radiology tests (Acibadem Healthcare Group 7). Acibadem network spreads to 8 different countries such as Singapore, Brunei, Malaysia, India, and Macedonia among others ( Why Acibadem? par. 2).
To compare healthcare sectors of the United States of America and Turkey, it is important to identify the overall public health indicators in these countries. For instance, according to the data of 2007, life expectancy at birth in the USA (78.1) is higher than that in Turkey (73.2); however, throughout over three decades since 1970, this number has changed significantly for Turkey (from under 50 years old) and remained almost unchanged for the USA (from over 70 years old) (OECD 6). Life expectancy at 65 is twice higher in the USA population (OECD 16). Infancy deaths are 3.5 times more frequent in Turkey than in the USA (If It Were My Home par. 1). Also, the number of practicing physicians in the USA is 2.4 per 1000 people, while in Turkey it is 1.5, which indicates that the Turkish healthcare is understaffed and the population underserved (OECD 11). The overall healthcare expenditures are more than twice as high in the USA as they are in Turkey (Anderson and Squires 3). At the same time, the residents of Turkey are almost 84% less likely to become exposed to HIV/ AIDS during the course of their life (If It Were My Home par. 1).
Greenland Healthcare Clinic offers a range of home-based health care services coupled with community based social services to the people of South Carolina. It has been revealed through market research that the region is in dire need of not only the quality healthcare, but also the need for better social services. And as such, it is our belief that by employing well educated and competent staff coupled with organized management, we can become one of the best healthcare agencies in South Carolina. Greenland Healthcare Clinic will be created as a Charleston Limited Liability company based in Charleston County. The office will be based on Main Street in Charleston, Southeastern State of South Carolina.
Greenland Healthcare Clinics services will mainly target the individuals who will require the home-based healthcare service providers at their convenience. Our agency will be licensed by the state of Columbia. Currently, there are only two home healthcare clinics in South Carolina which do not offer services to all our target regions. Greenland Healthcare Clinics is integrated as a partnership.
The core founder of Greenland Healthcare clinic, Clement Nitzch, is a renowned health administrator coupled with his social work skills with enormous expertise in social services. The partnership will also incorporate, a non-managing partner, Gustavo Brandao, who will assist with the start-up funding. Greenland Healthcare Clinic will be managed by the clinical directors Veronica Tadivo and Roberto Rodriguez. All the Greenland Healthcare Services will be set in accordance with the existing Medicare Insurance regulations of Columbia.
Company Description
Greenland Healthcare Clinic is an upcoming Home-based healthcare and social service agency. The premise will be based in the heart of South Carolina and will provide the following services: Skilled Nursing, Social Work, Personal Injury Case Management, Nursing Aide and Speech therapy (Home Health Care Services Business plan, 2013).
Market Analysis
The Greenland Healthcare Clinic customer base will be largely drawn from the patients referred by healthcare facilities, physicians and other healthcare professionals. The patients seeking personal Injury Case Management will be basically those who get injured either at work place or those involved in other forms of accident within an organizational structure. The referrals will basically emanate from attorneys in search of case management services for their clients (Home Health Care Service Business Plan, 2013).
Due to the fact that a good number of people living in Charleston, South Carolina are elderly, it therefore prudent for them to stay at home most of the time and get treatment from a nearby healthcare provider, this will avoid continuous movement sometimes for longer distances in search of healthcare services. Greenlands primary market segment will therefore include those patients who are in their old age; thereby requiring home care services (Washburn Small Business Development Center, 2013)
Organization and Management
Greenland Healthcare clinics starting team will consist of a Clinical Director, an Administrative Director and five other employees. Due to the fact that Clement Nitzch is a licensed social worker, he will therefore provide all social health services for the start up stage of the plan, coupled with that, he will also provide most of the administrative directions within the premise. Veronica Tadivo being a registered nurse, she will provide the nursing services and supervising the nursing staff during the initial stages of the business (U.S. Small Business Administration, 2013).
References
Home Health Care Service Business Plan (2013). Executive Summary. Web.
U.S. Small Business Administration, (2013). How to Write a Business Plan. Web.
Washburn Small Business Development Center. (n.d.). Business planning to profits. Web.
Creation of different types of medical care is encouraged by the rising need to optimize American health care system so that it can satisfy the needs of patients and be affordable. Experts foresee a quick development and implementation of Accountable Care Organizations (ACOs) system, as it has a great potential. ACOs are the networks of health care providers, where physicians can unite their efforts to improve the quality of services and lower the health care costs.
Better quality and visible positive outcomes of provided care are considered the main goals of ACO model. The topic of this paper is main goals of ACOs model. Summers, Lisle, Ness, Birchfield Kennedy, and Muhlestein explore the issues related to the effectiveness of ACOs in their report How Accountable Care Impacts the Way Consumers Receive Care (2015).
The main objective of this paper is to analyze the evidence of the ability of ACOs approach to provide better care and healthier outcomes presented by the authors of the report and determine if ACO approach will accomplish the goals.
How Does the Report Demonstrate the Ability of ACOs Approach to Help Consumers Experience the Better Care and Healthier Outcomes?
The authors of the report believe that ACOs approach will help consumers experience the better care and healthier outcomes and prove their argument by presenting the advantages of the ACO model. To support the argument, the authors begin the report with an extended explanation of what is an ACO. The authors emphasize that in an ACO, payments are focused on the outcome, such as value and quality of the provided care, not volume (Summers, Lisle, Ness, Birchfield Kennedy, & Muhlestein, 2015, p. 2).
The main difference between ACOs and other models of care delivery is defined as the focus on delivering patient- and family-centered care. ACOs encourage partnerships with patients and their involvement in the process of practice improvement.
The next part of the report explores the main benefits of ACOs for consumers. Improved care coordination is regarded as one of the main advantages of ACOs, which brings numerous benefits to the patients. Improved care coordination is aimed at fixing the fragmented nature of the current health care system (Summers et al., 2015, p. 3).
It should bring together all parts of the health care delivery system (primary care, laboratories, urgent care, hospitals, etc.) and ensure they work in the most efficient way. Another privilege of ACOs indicated in the report is the maximized use of health information technology (HIT) tools, such as electronic health record (EHR).
EHRs help to avoid duplicative procedures and present all necessary patient data to every specialist involved in the delivery of care. Another HIT tool, a patient portal, helps to have continuous access to medical information by both patients and health care providers. Different types of ACOs are also identified and explained to show how each of the types contributes to providing the better care.
The final part of the report discusses how ACOs can help consumers experience the better care and healthier outcomes. The improvement of the way the patients receive care is the first point considered contributing to the delivery of better services. It is based on the innovative care integration and promotion of patient and family engagement. Another goal of ACOs is ensuring that patients receive the right care at the right time and providing appropriate prevention for common diseases.
The conclusion of the report indicates that though ACOs exist for only several years, certain positive results have already been observed. Such organizations help to move the healthcare system from inefficient and fragmented structure to more effective and integrated structure. However, the authors point to some of the issues that should be considered for providing continuous development of ACOs. They include improving consumer access to quality and cost information and informing the patients how ACO model functions.
The analysis of the report demonstrates that the authors believe that ACOs approach will help consumers experience better care and healthier outcomes because of the orientation of the approach towards providing the integrated health care services and efficient patient and family engagement. The motivation of the practitioners involved in ACOs to provide a high level of quality of work instead of the volume is considered another important reason to find ACOs approach helpful for providing better care.
Will ACOs Accomplish the Goal?
Though the history of employing ACO model is rather short, I believe in its great potential to accomplish the goal of helping consumers experience the better care and healthier outcomes. ACOs can achieve this goal by improving patients health and well-being, mitigating the anticipated shortage in primary care providers , and lowering the costs for healthcare (Tallia & Howard, 2012, p. 2388).
In my opinion, the main reason ACOs appear to be able to achieve the declared goals is their orientation towards prevention of diseases. I believe that prevention is the key to providing healthier outcomes. While traditional model in medical care involves focusing on providing care to the patient while the patient is in the office, ACO model is determined to provide continuous care for patient throughout his life paying attention to all aspects of the patients life outside the office.
It includes analyzing predispositions, conditions of life, habits, etc. to provide an integral examination of the health state and find solutions needed to eliminate risks of developing certain diseases and promote the patients health. Such strategy appears to be very useful for providing great health outcomes and can reduce the cost of healthcare. Camargo, Camargo, Deslich, Paul III, and Coustasse (2014) conducted a research that demonstrates a vital importance of providing more coordination and preventive services for decreasing health care spending (p. 114).
Another factor that appears to contribute to achieving the goal of helping consumers experience excellent care is encouraging patients to participate in the creation of highly customized products. As ACOs approach emphasizes the importance of patient and family involvement in the process of improving health care services, ACO model has a potential to collect patients opinions and based on them create heath care products.
Macfarlane (2014) claims that such approach can help to reduce the waste incurred in the production of non-competitive products and services (p. 270). I believe that ACO model can provide an efficient level of care by using its methods for encouraging patients to be a part of the process of improving the services.
Another distinctive feature of ACOs that contributes to achieving their goals is flexibility. Patients are not obliged to receive care only from the doctors inside the ACOs network and can choose the practitioners outside the network in compliance with their preferences, without paying extra money. Therefore, ACOs are supposed to put much effort in getting a good feedback from patients, as they can lose their contracts. Such circumstances result in stronger motivation for the participants of ACOs to be competitive and strive for improving the performance.
The adequate level of accountability for clinicians participating in ACOs is one of the keys to the success of such organizations. Fisher and Shortell (2010) indicate the effectiveness of organizing different levels of ACOs based on corresponding payment models (p. 1715). These payment models include shared savings with no risk, symmetrically shared savings with some risk for excess cost, and partial capitation (Fisher & Shortell, 2010, p. 1715).
I believe that such approach can help ACOs to accomplish their primary goals as it supports differentiated system of payments aimed at providing adequate level of accountability for health care workers and, thus, motivating them to provide the highest quality of care.
ACO model has already gained popularity among American health care providers due to its innovative approach to organizing the integrated cooperation of medical workers. In my opinion, more effort should be put in educating health care workers about ACO model and preparing the conditions necessary for employing it.
Auerbach, Liu, Hussey, Lau, and Mehrotra (2013) conducted a study that demonstrates the regional factors that are predictive of ACO formation (p. 1781). These factors include high percent of hospitals affiliated with a system and high percent of hospital revenue from risk-sharing contracts (Auerbach et al., 2013, p. 1786). These data should help to encourage popularization of ACOs by adjusting the factors mentioned above to their needs.
The analysis of the report and other academic sources studying the issues related to the ACOs approach helps to see a great potential of this approach and define its ability to accomplish its main goals, such as providing better care and healthier outcomes for patients. ACO model gives the physicians an opportunity to unite their efforts and provide integrated care bringing better results.
References
Auerbach, D. I., Liu, H., Hussey, P. S., Lau, C., & Mehrotra, A. (2013). Accountable care organization formation is associated with integrated systems but not high medical spending. Health Affairs. 32. 1781-1788.
Camargo, R., Camargo, T., Deslich, S., Paul, D. P. III, & Coustasse, A. (2014). Accountable care organizations: Financial advantages of larger hospital organizations. The Health Care Manager. 33. 110-116.
Fisher, E. S., & Shortell, S. M. (2010). Accountable care organizations: Accountable for what, to whom, and how. The Journal of the American Medical Association. 304. 1715-1716.
Macfarlane, M. A. (2014). Sustainable competitive advantage for accountable care organizations. Journal of Healthcare Management. 59. 263-271.
Summers, L., Lisle, K., Ness, D. L., Birchfield Kennedy, L., & Muhlestein, D. (2015). How accountable care impacts the way consumers receive care. The Impact of Accountable Care. pp. 2, 3. Web.
Tallia, A. F., & Howard, J. (2012). Innovation profile: An academic health center sees both challenges and enabling forces as it creates an accountable care organization. Health Affairs. 31. 2388-2394.
Crossing the Quality Chasm is a comprehensive report dwelling upon the quality of health care in the US, which calls for bridging the quality gap through a drastic redesign of the American health care system. The report provides principles for action that policymakers, health care managers, regulators, doctors, nurses, and other people responsible for patients well-being must follow in order to achieve the ultimate goal indicated in the document (Likosky, 2014). Moreover, the report not only criticizes the existing system and sets performance expectations for the century ahead but also suggests particular improvements in six dimensions: patient safety (reducing the possibility of harm), care effectiveness (preventing misuse or underuse of resources), patient-centeredness (improvement of customer service and taking into account patients preferences in care decisions), timeliness (reducing wait time), care efficiency (minimizing waste), and equity (eliminating racial and social inequality of health care) (Brilli, Allen, & Davis, 2014). Crossing the Quality Chasm analyzes the causes of the quality gap as well as limitations of the present-day system of health care to come out with a totally different framework for care. It claims that services should be performed at four levels: patient experience, care-giving microsystems, organizations that house and support them, and legal, financial, and educational environment this would promote evidence-based practice and improve quality that is currently impeded by a lot of adverse factors (Inoue, 2016).
Analysis
The Agency for Healthcare Research and Qualitys 2015 National Healthcare Quality and Disparities Report is an official document recording the countrys progress in eliminating various disparities that currently exist in health care. The major assumptions include the following ones (Radwin, Castonguay, Keenan, & Hermann, 2016):
there has been a considerable improvement in providing access to health care services to people who did not have any kind of health insurance before;
the quality of health care continues to become better;
the overall treatment has been improved with the gradual removal of disparities;
patient safety has been increased, although gaps remain;
care coordination is not given priority;
care affordability is still low;
racial and social care discrepancies persist.
This important information will render assistance in advocating for a disadvantaged patients population as it clearly shows the areas of health care that do not seem to improve in terms of bridging gaps. Thus, it shows the directions of further development. Besides, the report will guide me in the provision of culturally competent care and help initiate programs and campaigns aimed at increasing affordability of health care service to people of low economic status (Austin, McGlynn, & Pronovost, 2016).
The Institute of Medicines 2010 and 2016 Future of Nursing Reports are highly significant for re-evaluating the role of an advanced practice nurse in the health care system. Both documents encourage nurses to be more active, efficient, and decisive in the complex health care system and take an active part in the decision-making process. Such reassessment of an advanced practice nurses position implies that I would be able to take a leadership role in improving care provision. The system still has a lot of weak points that have to be addressed. Many recommendations from the documents are already reflected in the unceasing process of advancing the profession that is capable of opening new horizons to its representatives. The evidence-based recommendations provided in the report will be very useful not only in providing high-quality care to patients but also in policy-making (Grossman & Valiga, 2016).
References
Austin, J. M., McGlynn, E. A., & Pronovost, P. J. (2016). Fostering transparency in outcomes, quality, safety, and costs. Jama, 316(16), 1661-1662.
Brilli, R. J., Allen, S., & Davis, J. T. (2014). Revisiting the quality chasm. Pediatrics, 133(5), 763-765.
Grossman, S., & Valiga, T. M. (2016). The new leadership challenge: Creating the future of nursing. Philadelphia, PA: FA Davis.
Inoue, M. (2016). Improving quality of care through primary care research. Journal of General and Family Medicine, 17(4), 267-269.
Likosky, D. S. (2014). Clinical microsystems: A critical framework for crossing the quality chasm. The Journal of Extra-Corporeal Technology, 46(1), 33-37.
Radwin, L. E., Castonguay, D., Keenan, C. B., & Hermann, C. (2016). An expanded theoretical framework of care coordination across transitions in care settings. Journal of Nursing Care Quality, 31(3), 269-274.