Final Project: Risk Management Plan

Final Project: Risk Management Plan

Objective:

For this assignment, you will create a Risk Management Plan for a Community Health Center of your choosing, The Risk Management Plan is designed to support the mission and vision of the Facility you choose as it pertains to clinical risk and patient safety as well as visitor, third party, volunteer, and employee safety. You are encouraged to choose any Health Care Facility: Hospital, Doctor Office, Emergency Care Center, etc. The project will be 8-10 pages long including title page and reference page.

 

ASSIGNMENT GUIDELINES ( 20 points/ 10%):

Students will generate Risk Management Plan for a Community Health Center to support the mission and vision of the Health Care facility as it relates to clinical risk and patient safety as well as visitor, third party, volunteer, and employee safety. The paper will be 8-10 pages long (including title page and reference page). You need to apply all the concepts studied in this plan. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA format when referring to the selected articles and include a reference page.

 

EACH PAPER SHOULD INCLUDE THE FOLLOWING:

 

 

1. Introduction (50 points / 25%) Provide a brief synopsis of Importance of the Risk management as an integral component of a healthcare (not a description), in your own words.

2. Your Risk Management Plan (10 points / 50%)

a. Presentation Page:

ORGANIZATION NAME

BUSINESS ADDRESS

CITY, ST, ZIP

TELEPHONE NUMBER

FACSIMILE NUMBER

WEBSITE ADDRESS

EMAIL ADDRESS

b. MISSION STATEMENT : Mention the organization’s mission. New Page.

c. Purpose of your Risk Management Plan: The purpose of your risk management program is to protect patients, staff members and visitors from inadvertent injury. New Page

d. Authority and Role of the Risk Manager: Mention and state the major functions and responsibilities of the Risk Manager in your organization. Job’s description.

e. Scope of your Risk Management plan : Under the direction of the risk manager, the risk management program provides for collaboration among all departments, services, and patient care professionals within the organization. Mention the departments will be influence by this Risk management plan.

f. Objectives of the Risk Management Program

g. Specific Components of the Risk Management plan

The risk management program will include the following components:

g.1 Event/Incident/Occurrence reporting

g.2 Educational activities

g.3 Management of patient and family complaints/grievances

g.4 Patient satisfaction

h. CLAIMS MANAGEMENT: In some organizations, claims management is a function outside the risk management program and may have a separate staff with unique policies, procedures and protocols. If the claims management function is included in the risk management plan, you should constitute of their elements.

i. REPORTS TO THE GOVERNING BODY

j. ANNUAL EVALUATION OF THE RISK MANAGEMENT PROGRAM.

3. Conclusion ( 20 point/ 15%)

Briefly recapitulate your thoughts & conclusion to you Risk Management plan. How did this Management plan impact your thoughts on Health Care Administrator?

Evaluation will be based on how clearly you respond to the above, in particular:

a) The clarity with which you consolidate, stablish and apply your knowledge to generate the Risk Management Plan;

b) The depth, scope, and organization of your paper; and,

c) Your conclusions, including a description of the impact of the Risk Management plan on any Health Care Setting.

Final Project: Organizational Management Proposal for Quality and Performance

Florida National University

HAS-6185 Management of Health Care Organizations

Final Project

Final Project: Organizational Management Proposal for Quality and Performance

Objective:

For this assignment, you will create an Organization management proposal for quality and performance that will be used in a Community Health Center of your choosing. The proposal is designed to improve quality and provide a good customer service such as Patient Treated with courtesy, respect, tolerance and serenity. You are encouraged to choose any health care facility: Hospital, Doctor Office, Emergency Care Center, etc. The paper will be 8-10 pages long including title page and references pages. APA style 7th edition format.

ASSIGNMENT GUIDELINES (2 points /10%):

The proposal is designed to improve quality and deliver a virtuous customer service: Patient Treated with courteousness, reverence, acceptance and tranquility. You need to apply all the knowledge obtains during this class to create an organizational proposal that will improve the quality and performance of the Health Care Setting you desire. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA format when referring to the selected articles and include a reference page.

 

EACH PAPER SHOULD INCLUDE THE FOLLOWING:

 

 

1. Introduction (5 points / 25%) Offer an abstract that provide a brief outlook of the proposal and explaining in your own words what is meant by a good customer service through effective performance management and organization.

 

2. Your Organizational Management Proposal for Quality and Performance Plan (10 points 50%)

a. Presentation Page:

ORGANIZATION NAME

BUSINESS ADDRESS

CITY, ST, ZIP

TELEPHONE NUMBER

FACSIMILE NUMBER

WEBSITE ADDRESS

EMAIL ADDRESS

b. MISSION STATEMENT : Mention the Health Care Setting’s mission. New Page.

c. Purpose of the Organizational Management Proposal for Quality and Performance Plan : The purpose of this plan must be base in support and promote accomplishment of a health care organization mission, goals and also quality customer’s service and good performance.

d. An effective Organizational management proposal :

Should include the following elements designed with customer satisfaction as the focus:

1. Setting individual and team goals that are aligned and associated with the health care setting :

Goal setting is the first element of an effective Organizational proposal plan. Individual and team customer service goal should be aligned, discussion and remark.

*Research in goal setting:

*Who are your customers? Internal and external customers.

* Setting Goals and standards for Quality and performance

 

2. Establish a measurement system.

Measuring or quantifying customer needs, expectations and satisfaction is a basic requirement. Effective customer research for setting goal centers on measuring the issues that are truly important for the customers: Good quality service.

These are the steps for developing a Measurement system to by apply at the Health Care Organization you choose:

* Identify the goals that need to be measure.

* develop performance indicators to measure the service stablish in the goal setting.

* Involve employees, they will be more likely it accepts and be committed to reach the goal.

The following are suggestion and possible measurement system you can acquired and adapted to your health care facility:

1. Post-incident surveys by channel. Following an interaction, asking customers about the agent’s customer service skills, technical knowledge, completeness of solution provided, time to respond and resolve and satisfaction to measure both effectiveness and consistency across channels.

2. Self-service and/or community experience. Asking customers if they found the answers they needed and if they have suggestions to make the site or its content more useful.

3. Relationship surveys. Quarterly or annual surveys that ask about overall support experience, satisfaction with products and value received.

 

4. Customer loyalty. Questions that should put your customer retention team into action if answered negatively include: Do you intend to continue purchasing products from this vendor? Would you recommend the brand to your peers?

 

3. Providing adequate, timely feedback.

Feedback is a very important component of a successful Organizational Management Proposal. Individual who receives a feedback on performance relative to their goals will more commit to their goals. Characteristic of the feedback: Specific (Goal by Goal), Timely (Day-to-day, Week-to-week) Appropriate (Correct manner that will help improve performance best.)

 

4. Rewarding and recognizing desired performance.

Organizational Management Proposal should provide built-in incentives that will promote high-quality customer service; some examples: Monetary Incentives, Nonmonetary Recognition.

 

 

3. Conclusion (3 points / 15%)

Briefly recapitulate your thoughts & conclusion to you Organizational Management Proposal plan. How did this Organizational Management Proposal plan impact your thoughts on Health Care Administrator?

Evaluation will be based on how clearly you respond to the above, in particular:

a) The clarity with which you associate, relates, stablish and apply your knowledge to generate the Organizational Management Proposal Plan.

b) The Complexity, depth, scope, Profundity, and organization of your paper; and,

c) Your conclusions, including a description of the impact of the Organizational Management Proposal Plan on any Health Care Setting.

ASSIGNMENT DUE DATE:

The assignment is to be electronically posted in the Assignments Link on Blackboard no later than noon on Wednesday, February 24, 2021.

 

ASSIGNMENT RUBRICS

Assignments Guidelines20 Points/ 10%
Introduction50 Points / 25%
Your Organizational Management Proposal Plan10 Points / 50%
Conclusion20 Points / 15%
Total100 points / 100%

 

ASSIGNMENT GRADING SYSTEM

A90% – 100%
B+85% – 89%
B80% – 84%
C+75% – 79%
C70% – 74%
D60% – 69%
F50% – 59% Or less.

 

 

 

 

 

 

Dr. Gisela LLamas

An Overview of U.S. Health Care Delivery

Chapter 1

An Overview of U.S. Health Care Delivery

 

 

1

Learning Objectives

Understand the nature of the U.S. health care system.

Outline the key functional components of a health care delivery system.

Get a basic overview of the Affordable Care Act.

Discuss characteristics of the U.S. health care system.

Emphasize importance for practitioners and managers to understand the health care delivery system.

Get an overview of health care systems in selected countries.

Point out global health challenges and reform efforts.

Introduce the systems model as a framework.

 

2

Introduction

The U.S. has a unique health care delivery system.

Americans are not automatically covered.

A true system does not exist.

The health care system is fragmented.

It continues to undergo periodic changes.

 

3

Overview of the Scope and Size of the System

The health care workforce employs over 16.4 million people.

838,000 active MDs

70,480 DOs

2.6 million nurses

5,795 hospitals

15,700 nursing homes

1,375 health centers

180 medical and osteopathic schools

1,500+ nursing programs

 

4

A Broad Description of the System (1 of 4)

Characteristics of the U.S. system

Multiplicity of financial arrangements

Numerous insurance agencies/MCOs that employ various mechanisms for insuring against risk

Multiple payers that make their own determinations about the cost for each service

Diverse settings where services are delivered

Numerous consulting firms offering expertise in planning, cost containment, electronic systems, quality, and restructuring of resources

 

5

A Broad Description of the System (2 of 4)

Little standardization, missing dimensions in system

Planning

Direction

Coordination from a central agency

Inefficiencies created

Duplication

Overlap

Inadequacy

Inconsistency

Waste

 

 

6

A Broad Description of the System (3 of 4)

Cost control

Financial manipulation

Two primary objectives

Enable all citizens to obtain needed health care services

Ensure cost-effective services and meet quality standards

 

 

7

A Broad Description of the System (4 of 4)

Leads the world in

Medical technology

Medical training

Research

Sophisticated institutions, products, and processes

 

 

8

Financing and Insurance Mechanisms

Employer-based health insurance (private)

Privately purchased health insurance (private)

Government programs (public)

State Employees Group

Employees

Medicare

Elderly and certain disabled people

Medicaid and CHIP

Indigent, poor (if meet eligibility criteria), children

9

 

Insurance and Health Care Reform

Medicare, Medicaid, and Children’s Health Insurance Program (CHIP)

Reasons employment-based system left some uninsured

Small businesses cannot get group insurance at affordable rates and are unable to offer insurance.

Participation in insurance programs may be voluntary.

Affordable Care Act

Required all U.S. citizens and legal residents to be covered by public or private insurance

 

10

Major Characteristics of the U.S. Health Care System

Political climate

Economic development

Technological progress

Social and cultural values

Physical environment

Population characteristics (demographics, health trends)

Global influences

 

11

Figure 1-2: External forces affecting health care delivery.

 

12

Ten Basic Characteristics Differentiate the U.S. Health Care Delivery System (1 of 2)

No central agency governs the system.

Access to health care services is selectively based on insurance coverage.

Health care is delivered under imperfect market conditions.

Third-party insurers act as intermediaries between the financing and delivery functions.

The existence of multiple payers makes the system cumbersome.

 

13

Ten Basic Characteristics Differentiate the U.S. Health Care Delivery System (2 of 2)

The balance of power among players prevents any single entity from dominating the system.

Legal risks influence practice behavior of physicians.

Development of new technology creates an automatic demand for its use.

New service settings have evolved along a continuum.

Quality is not accepted as an unachievable goal.

 

14

1. No Central Agency (1 of 2)

Most developed nations have national health care.

To control costs, use global budget to determine total health care expenses.

Government controls proliferation of health services.

U.S. has mostly private financing and delivery.

Financing via employers 52% and government 48%.

Private health care, hospitals, and physicians are independent of government.

 

15

1. No Central Agency (2 of 2)

No one monitors total expenses through global budgets and utilization.

U.S. determines public-sector expenses and reimbursement rates for Medicare/Medicaid/CHIP.

Government sets standards of participation.

Providers must comply with standards to be certified to provide care for Medicaid and Medicare patients.

Regarded as minimum standards of quality.

 

16

2. Partial Access (1 of 2)

Access is the ability to obtain health care when needed.

Americans can access health care services

Through their employers

Under a government health care program

By buying insurance using private funds

By paying for services privately

By obtaining charity or subsidized care

Health insurance helps ensure access.

 

17

2. Partial Access (2 of 2)

Uninsured Americans

Able to obtain medical care for acute illness

Form of universal catastrophic health insurance

Usually forego basic and routine care

Universal access

Countries with national health care programs provide universal coverage.

The ability of all citizens to obtain health care when needed is mostly a theoretical concept.

 

18

3. Imperfect Market (1 of 3)

The U.S. has a quasi-market where health care is partially managed by free markets.

In a free market, multiple patients and providers act independently.

Providers do not collude to fix prices.

Prices are set by the interaction of supply and demand.

Inverse relationship between quantity of services demanded and price of services.

Equilibrium is achieved without interference.

 

19

3. Imperfect Market (2 of 3)

Unrestrained competition.

Patients must have information about the availability of different services.

Consumers are seizing some measure of control.

Internet as a source of medical information.

Patients must bear cost of services received.

Moral hazard.

 

20

3. Imperfect Market (3 of 3)

Two factors limit patients’ decisions:

Need

Demand

Item-based pricing

Fees charged for service (surgeon’s price)

Phantom providers

Bill for services separately

Package pricing

Bundled fee for a group of related services

 

21

4. Third-Party Insurers and Payers

Patient is first party.

Provider is second party.

Intermediary is third party.

A wall of separation between financing and delivery.

Quality of care is a secondary concern.

 

22

5. Multiple Payers (1 of 2)

Single-payer system.

A national health care system that is usually the primary payer, the government

The United States has many payers; company can choose different plans.

A billing and collection nightmare

 

23

5. Multiple Payers (2 of 2)

System becomes more cumbersome.

Difficult for providers to track various health plans.

Providers must hire claims processors.

Payments can be denied for not following requirements, which necessitates rebilling.

Some plans allow providers to balance bill whereas others do not.

Providers must engage in collection efforts.

Government programs have complex regulations.

 

24

6. Power Balancing

Multiple players

Key players

Physicians, administrators, insurance companies, large employers, and the government.

Have own economic interests to protect.

Self-interests are often at odds.

 

25

7. Litigation Risks

The United States is a litigious society.

Private health care providers are increasingly susceptible.

Risk of malpractice lawsuits.

Practitioners engage in defensive medicine.

Prescribe diagnostic tests, return checkups, documentation

 

Information updated

26

8. High Technology

The U.S. is a hotbed of research and innovation in new technology.

Creates demand for new services despite high costs

With capital investments, must have utilization

Legal risks for providers denying new technology

 

Information updated

 

27

9. Continuum of Services

Three categories of medical care services:

Curative

Restorative

Preventative

Health care is not confined to the hospital.

Additional settings.

 

Information updated

 

28

Table 1-2: The Continuum of Health Care Services

 

29

10. Quest for Quality

Definition and measurement are not clear-cut.

Increased pressure to develop quality standards

Demonstrate compliance

Higher expectations.

Continuous quality improvement.

 

Information updated

 

30

Figure 1-4: Trends and direction in health care delivery.

 

31

Trends and Directions

The U.S. health care delivery system continues to undergo fundamental shifts.

Promotion of health while reducing costs.

Focus is changing from illness to wellness.

Providing more effective and efficient quality care.

Focused more on delivery of services.

Mid-level health professionals, health coaches, and health information technology

 

32

Trends and Directions: Challenges

Managing costs

Focusing on care delivery

Adopting technologies

Delivering new operating models

Meeting various federal and state regulations

 

33

Significance for Health Care Practitioners

Understanding of the health care delivery system

Can attune health professionals to their relationship with the rest of the health care environment

Can help understand changes and the impact of those changes on their practice

Adaptation and relearning

34

 

Significance for Health Services Managers (1 of 2)

Positioning the organization

Know organization position in the macro environment

Handling threats and opportunities

Proactively deal with any threats to their institutions profitability and viability

Evaluate implications

Understand relevant issues

35

 

Significance for Health Services Managers (2 of 2)

Planning

Strategic planning of which services should be added or discontinued

Capturing new markets

Know emerging trends before market is overcrowded.

Complying with regulations

Following the organizational mission

36

 

Health Care Systems of Other Countries

Three basic models

National health insurance

Quad-function model

Financing

Insurance

Payment

Delivery

National health system

Socialized health insurance

37

 

Information updated

Health Care Systems of Other Countries: Australia

Switched from a universal national health care program to a privately financed system

Returned to a national program called Medicare

Philosophy of everyone contributing to the cost of health care according to their capacity to pay

Developed health service delivery models to contain costs, and provide quality and accessible care

Developed a National Primary Health Care Strategy

 

38

Health Care Systems of Other Countries: Canada

Medicare consists of 13 provincial and territorial health insurance plans sharing basic coverage

Nearly all Canadian provinces (except Ontario) have resorted to regionalization

In 2004 created the 10-Year Plan to Strengthen Health Care

Transitioning to patient-centered care

 

39

Health Care Systems of Other Countries: China (1 of 2)

Evolved from a public insurance system (government or public enterprise) to a multipayer system.

Facing the growing problems of a large uninsured population and health care cost inflation.

Three-tier referral system has been largely abolished.

 

40

Health Care Systems of Other Countries: China (2 of 2)

Health reform initiatives in five major areas

Health insurance, pharmaceuticals, primary care, public health, and public/community hospitals

Establishment of an essential drug system

In 2015 announced a five-year plan

 

41

Health Care Systems of Other Countries: Germany and the UK

Germany

Health insurance mandatory for all citizens and permanent residents since 2009

Pharmaceutical Market Reform Act

Act to Strengthen SHI Health Care Provision

United Kingdom

National Health Service (NHS)

Better Care Fund in 2013

Five Year Forward View plan in 2014

 

42

Health Care Systems of Other Countries: Israel and Japan

Israel

Universal coverage based on German SHI model

Employer tax and individual income-based contributions

National health information exchange in 2014

Japan

Providing universal coverage with two main insurance schemes

Employer-based and national insurance program

Japan Primary Care Society will run a training program

 

43

Health Care Systems of Other Countries: Singapore

Had a British-style NHS program.

Medisave provides universal coverage.

Chronic Disease Management Program.

 

44

Systems Framework

System foundations

System resources

System processes

System outcomes

System outlook

Figure 1-4: Trends and direction in health care delivery.

 

45

Summary

The U.S. has a unique health care delivery system.

Through private and public financing

Through private health insurance and public insurance programs

Not governed by free-market principles.

No country has a perfect health care insurance system.

Health care managers must understand how the health care delivery system works and evolves.

 

46

 Examine health care disparities in the Jewish Culture.

 Examine health care disparities in the Jewish Culture.

This paper is an examination of culture on health disparities, health-related practices, healthcare outcomes and transcultural theories

350 words minimum..

please provide in-text citing and references no more than 5 years old.

no more than 5% PLAGIARISM. Please provide plagiarism report.

must provide two references less than 5 years old.

 Submit your project presentation (including self-introduction) and notes pages here.  Review the  Project Guidelines and Grading Criteria Project Guidelines and Grading Criteria (uploaded)  – Alternative Formats to assure you have met expectations.

First; ————

Submit your project presentation (including self-introduction) and notes pages here.  Review the  Project Guidelines and Grading Criteria Project Guidelines and Grading Criteria (uploaded)  – Alternative Formats to assure you have met expectations.

Your presentation must be on PowerPoint.

Attach to this discussion a copy of your presentation with audio or notes. If you added “notes” with each slide, you do not have to attach a separate notes page.

You will not be able to see the post of others until you create and upload your own project materials.

You must also comment/post on the presentation materials of at least 2 classmates to receive full credit!

Knowing that others will see your work creates a little bit more encouragement to make sure you submit something you are proud of, is edited for typos and is of high quality!

This project is to help you think outside the box next time you have to do a presentation to a governing board, the community, coworkers or employees.  I look forward to seeing these!  Don’t forget your introduction at the beginning and comments on two classmates!

Second; —

Submit your Project paper summary/overview here.

  • must follow apa requirements
  • a cover page, abstract and references page (minimum of 2 references) are all required
    • be sure to use and cite your sources at least once WITHIN your paper

HCA 543 Project, Guidelines and Grading Criteria

HCA 543 Project, Guidelines and Grading Criteria

Guidelines:

Purpose: The objective of this assignment is to allow the student an opportunity to learn a more challenging yet effective way to present materials, providing a more engaging platform for communication and retention of quality practices in healthcare organizations.

PechaKucha’s 20×20 presentation format shows your 20 chosen images, each for 20 seconds. In other words, you’ve got 400 seconds to tell your story, with visuals guiding the way. PechaKucha means “chit chat” in Japanese. This creative outlet began as nighttime get-togethers in Tokyo in 2003 by two renowned architects. Since then, three million people have attended PechaKucha events worldwide. https://www.pechakucha.com/

The following items MUST be included in the paper . Failure to adhere to these guidelines will result in a failing grade.

1. Presentation Slides, PechaKucha style:

a. Go to: https://www.pechakucha.com/about

b. Minimum of 10 slides, maximum of 15

c. Use Powerpoint only (if this is an issue for you, email me)

d. Add a self-introduction at the beginning – be fun and creative!

e. Either maximum 20 seconds of recorded audio OR a notes page provided with each slide (notes page at the bottom of each slide would detail the information you would discuss/talk about that would be approximately 20 seconds per slide)

f. No words on slides except

a) Your Introduction Video

b) Title slide, References slide at end, references/footnotes throughout as needed

g. All other slides must be pictures only (clip art, actual photos, link to video or audio file, etc)

2. Paper/Written Summary:

a. A two to three (2-3) page maximum brief summary/overview of your presentation. The maximum 3 pages does not include cover page, Abstract or References page (minimum of 2 references required).

b. Must follow APA format to include cover page, running header, page numbers, Abstract page, Times New Roman 12 point font, 1” margins, appropriate Level 1 headings, double-spaced, References page.

c. Depending on your topic and presentation, some of the following sections may not be applicable to your particular topic and therefore would not be in your paper summary.

i. Methodology: Please describe how you gathered your information (personal experience, literature review, interviews, secondary data, reports, etc.)

ii. Literature Review (if applicable): The narrative should be comparative (compare and contrast what different researchers and writers have to say). You also need to identify any gaps in the literature.

iii. Major Findings and Recommendations (as applicable): Please describe the major findings and then present appropriate recommendations to address the overall issue/challenge. If applicable, also detail ways in which the recommendations can be implemented.

iv. Conclusion: For this section you will summarize your overall presentation. Evaluate your sources, focusing on major flaws or gaps in any information you provided in your presentation, inconsistencies in theory and findings, and areas or issues applicable to future studies.

v. References page: This is the last page of your document. All items in APA format.

 

 

3. Presentation Topic: It can be on ANYTHING you choose as long as it is professionally done, has some references (minimum of 2) and meets the modified PechaKucha criteria stated above. Ideas:

a. Process to make a favorite dish

b. Travel tips to a specific destination

c. An ideal patient experience

d. How to groom a dog

e. Whatever appeals to you – if you are concerned about your topic of choice, simply ask me.

 

***You are NOT recording a video of yourself doing this presentation.

**You are simply creating the slides, adding either recorded audio to each slide or a notes page for each slide

***Your presentation must begin with an introduction about you – it can be pictures or video – and is not included in the 10 slide minimum.

 

Grading Criteria:

GRADING CRITERIAPossible

Points

Points Awarded
Draft  
Provides evidence of work in progress5 
Addresses feedback, if applicable, in final product5 
Presentation Content/Information (Weight 55%)  
Main idea about the topic is clear10 
Critical elements of the topic are addressed and developed10 
Follows modified PechaKucha format requirements15 
Self-introduction is provided5 
Audio or notes provided with each slide, excluding intro10 
Quality of Paper/Written Summary  
Clarity of sentences and paragraphs10 
Zero spelling and grammar errors. Demonstrate proper use of English5 
Organization and coherence of ideas, fluency, sequencing10 
Appropriateness of terms and concepts5 
References and use of Credible Sources (Weight 15%)  
Use of scholarly/peer reviewed references as needed (no blogs!)5 
Proper APA formatting5 
Total100 

 

Grading comments from course Instructor:

Page 1 of 2

What does Performance Improvement in Healthcare mean to you as a leader, potential leader and to you as a beneficiary of care?*Double-spaced  * 12 font *APA or MLA formatting required*Use of references to support fact and opinion of subject matter *Cover page, 

Please answer this question now with a professional response with supporting references and your last paragraph representing your opinion.

Minimum 3 page, double-spaced paper.

What does Performance Improvement in Healthcare mean to you as a leader, potential leader and to you as a beneficiary of care?*Double-spaced  * 12 font *APA or MLA formatting required*Use of references to support fact and opinion of subject matter *Cover page, 

3 page minimum, and a reference page

Provide three real world examples in a healthcare organization of under-use, overuse, and misuse for both quality and cost.  

Question:

Provide three real world examples in a healthcare organization of under-use, overuse, and misuse for both quality and cost.

What are the implications for effectiveness, efficiency, and the patient for each of your examples.

*Basically, provide an example of underuse, overuse, and misuse. Then, for each example, list the implications or what could be wrong with the effectiveness, efficiency, and the patient in your examples. *help answering this question look at chapter 7 of the attached textbook**

Your response should be a minimum of 1000 words, and include a minimum of 3 scholarly sources.

Overuse, Underuse and Misuse of Medical Care

FACT SHEET

Overuse, Underuse and Misuse of Medical Care

 

Across America, there are dangerous gaps between the health care that people should receive and the care they actually receive. These variations in care result in major costs in both lives and dollars. Delivering the best care to every person every time will only happen when we understand the scope and depth of the problem. Poor-quality care comes in three forms: overuse, underuse and misuse. We give people care they do not need, we fail to give people care that we know works, and we make mistakes that hurt or kill people. We must address all three problems to create a more efficient, equitable and high-value health care system in America.

What is overuse?

 

Overuse occurs when a drug or treatment is given without medical justification. It includes treating people with antibiotics for simple infections – or failing to follow effective options that cost less or cause fewer side effects. For example, antibiotics are prescribed inappropriately for children’s ear infections 80 percent of the time despite the finding that these infections get better within three days without antibiotics. In health care, more is not always better. More spending and treatment does not translate into better patient outcomes and health. For example, when used appropriately, MRI’s and other imaging exams are valuable. But MRI’s often don’t change the treatments prescribed or a patient’s outcome, in which case the technology is an unnecessary cost.

What is underuse?

 

Underuse is when doctors or hospitals neglect to give patients medically necessary care or to follow proven health care practices – such as giving beta-blocking drugs to people who have heart attacks. As many as 91,000 Americans die each year because they don’t receive the right evidence-based care for such chronic conditions as high blood pressure, diabetes and heart disease.1 There are countless, alarming examples of underuse of health care. For example:

• One study showed that only one in 20 women are consistently getting an annual breast cancer screening mammogram, despite the fact that regular mammograms are clearly associated with reduced risk of death from breast cancer.2

• Nearly 10,000 deaths from pneumonia could be prevented each year with a one time vaccination. Yet

in 2005 only 56 out of 100 adults age 65 and older received the shot.3

What is misuse?

 

Misuse is another way of describing medical errors. It occurs when a patient doesn’t fully benefit from a treatment because of a preventable problem – or when a patient is harmed by a treatment. Between 44,000 and 98,000 people die annually from preventable errors—more than from car accidents, breast cancer or AIDS combined.4 (See companion Fact Sheet on Medical Errors)

• Misuse includes avoidable medical errors like prescribing a drug the patient is allergic to, for example a patient who gets a rash after receiving penicillin for strep throat, despite having a known allergy to that antibiotic.

 

 

 

2

Do these problems affect everyone?

Poor quality care affects everyone, whether or not they have health insurance. A study published in the New England Journal of Medicine found that, on average, children received less than half (46.5 percent) of the care recommended by experts.5 Nearly all the children in the study had health insurance. Health insurance does not protect patients from poor quality care.

What can we do to reduce overuse, underuse and misuse?

Quality health care is a national issue. It’s a local issue. It’s everyone’s issue. Everyone who gives, gets or pays for care should be concerned with improving quality. There are three fundamentals to improving quality: performance measurement, quality improvement and consumer engagement.

1. We must measure and report information about the performance of health care providers to everyone who gives care, gets care and pays for care.

2. We must help doctors’ offices and hospitals improve their quality.

3. We must encourage people to act more like “consumers” when it comes to health care so we can

create demand for high-quality care. In the same way that consumers buying a new car compare prices and features to find the best value car, and then make their purchase from a place that provides good customer service, they must take similar action with health care.

4. We must design a system in which patients work in partnership with their doctors and other

providers to manage their own health care. As a consumer advocate, you can lend support for national and state policies that:

• Encourage health care performance measurement and public reporting, and use of these reports by consumers. Measuring performance shows doctors and hospitals if and when they are providing the right care to the right patients. Additionally, by publicly reporting the information, patients can make decisions about which doctor and hospital to see based on their track record of providing the right care at the right time for the right reason.

• Promote the practice of evidence-based medicine and preventive care. When doctors are making

treatment decisions based on existing research and data, they are more likely to give the right care to the right patient – and the likelihood of underuse, overuse and misuse decreases.

 

1 The Essential Guide to Health Care Quality. Washington: National Committee for Quality Assurance, 2007. (No authors given.) 2 Karen Blanchard et al. “Mammographic Screening: Patterns of Use and Estimated Impact on Breast Carcinoma Survival,” CANCER; Vol 1/Issue 3, 495-507. (August 1, 2004). 3 The National Health Care Quality Report 2007, US Department of Health and Human Services; Agency for Healthcare Research and Quality. Publication No 08-0040 (February, 2008) 4 Kohn LT, Corrigan JM, Donaldson, MS (eds). To Err Is Human: Building a Safer Health Care System. Washington: National Academies Press, 2000.

5 Rita Mangione-Smith, et al. “The Quality of Ambulatory Care Delivered to Children in the United States,” New England Journal of Medicine, 357, 1515-1523. (October 11, 2007).

 

 

The National Partnership for Women & Families is a non-profit, non-partisan advocacy group dedicated to promoting fairness in the workplace, access to quality health care and policies that help women and men meet the dual demands of work and family.

More information is available at www.nationalpartnership.org.

© 2009 National Partnership for Women & Families All rights reserved.

Describe the relationships among negligence, respondeat superior, and Ultra Vires Act.

Describe the relationships among negligence, respondeat superior, and Ultra Vires Act.

Give on example of each.

Write ONE FULL PAGE including at least one high-quality resource in your paper.