Health Care Delivery System

Health Care Delivery System

HLT-314V

Grand Canyon University

Health Care Delivery System

The health care delivery system in the United States consists of many clinicians, hospitals, and other health care facilities such as nursing homes, insurance plans, and purchasers of health care services which all operates in groups, networks, and independent practices (The Future of…, 2003, ch.5, pg.212). These health care delivery systems can either work in the public sector or private sector as profitable or non-profitable (The Future of…, 2003, ch.5, pg.212-213). Each health care delivery systems have missions for care and these missions have similarities and differences. Three health care delivery systems that everyone knows about are the hospitals, nursing home, and HMOs. They all have missions for care that are similar and different.

There are many hospitals in the United States. All the hospitals have many floors that house different types of patients from the elderly to the injured, to infants. The have many allied health professionals such as doctors, therapists, technicians, nurses, certified nurse’s assistants (CNAs), and many more. The jobs description varies from profession to profession but all professionals are to give quality and accurate care to their patients. The mission of the professionals at the hospitals is to demonstrate excellence in clinical care by using evidence-based practice and delivering culturally competent patient care in a caring-healing environment. They also promote innovation in clinical practice, programs, and technology through many active decision-making and research meetings. The hospitals also provide a compassionate and respectful environment for all the members of the hospitals (Valley Health System, n.d). The philosophy of the hospitals is that they believe that health care is a human right, and that patients have the right and are encouraged to participate in their own care, whether the goal is quality of life of dignity of death. That the hospital staff makes a commitment to delivery compassionate, holistic care to the patient in a competent, ethnical, and caring manner. That the description of the nursing care includes the promotion, maintenance, and restoration of body, mind, and spirit for individually defined health. They also believe the nursing staff to be qualified through licensure, demonstrated competent, and a commitment to professional development through lifelong learning (Valley Health System, n.d).

There are many nursing homes in the United States. Each nursing home have many allied health care staff with different job titles such as CNA’s, nurses (LPN’s and RN’s) DON’s, Administrators, dietary, and many more. It takes many types of people to run a nursing home. They must be caring, patient, and love the elderly. A nursing home can house many patients from rehab only (they go home once they are released from rehab) to total patient care (they usually stay to live in the nursing home). Each nursing home has their own mission statement that goes something like this: Continuously improve the quality of life and well-being of residents and to provide leadership to achieve the vision of making their community a better place in which to live, work, raise a family, and enjoy life (Oaklodge Nursing Home, n.d). Most nursing homes philosophy statements states that empowering people and providing the knowledge to make them active partners responsible for maintaining their health and making decisions about their care and treatment (Oaklodge Nursing Home, n.d).

Health Maintenance Organization (HMO) is a type of health insurance plan that usually limits coverage to care from doctors who work for of contract with the HMO. HMOs generally won’t cover out of network care except in an emergency (Health Maintenance…, n.d). Some HMOs may require people to live or work in its service area to be eligible for coverage. HMO providers provide integrated care and focus on prevention and wellness (Health Maintenance…, n.d). The mission for the HMOs is to promote the health and wellness of their members and communities through accessible, cost-effective, quality health care. The philosophy is to provide products and services of the highest quality and value with a direct focus on meeting the needs of customers (BCBSIL Provider…, 2008). HMOs have different types of allied health care professionals such as insurance agents. The insurance agents are there to help with the cost of the patients’ health. The agents are supposed to follow the mission and philosophy of the company.

These three health care delivery systems have many similarities and differences. The similarities are that they promote to provide accurate care and services to their patients. Their mission and philosophy statements basically state the same things about providing compassionate care and letting the patient have a say in their treatment and care. They all have allied health care professionals to help with the care of their patients and customers. Their allied health team varies from CNAs to insurance providers. They also have some differences too. Hospitals can house many patients like nursing homes but most of their patients can recover and go home. Nursing home patients are there to live but that have a few that are there for rehab and they can go back home. “HMOs are very different from hospitals and nursing homes because they are health insurance companies. They cover most of the cost of health care and treatment. HMOs are there to help with any health expenses that their customer have depending on the health policy they have. There is always a deductible for the patient to pay after that the insurance will cover.” (Health Maintenance…, n.d)

A good mission statement would be that the health care team as a professional community will provide a compassionate and caring environment for the patients and their families. That the staff will provide accurate care for the patients. The community will have decision making groups to help with innovation ideas to make the patients and their families more comfortable in the staff’s care. That the members of the professional community are licensed and will constantly be learning new and important ways to care for the patients. This is a great way to put a mission statement. Compassionate and caring environment should be in the statement because the members of the community should be compassionate and caring when in the health field. There should always be innovation to create better environments and care for the patients. All the staff should be licensed for the care they give. A great philosophy statement should go like this: all the professionals at this facility believe that the patients have a right to have a say in their care, that they should be treated with care and respect, and the families should be treated with the same care and respect as the staff would want to be treated. The staff also believe that everyone should be treated as equals no matter their age, race, sex, or ethnics. They also believe in leaving their problems at the door because for the next 8 hours or more they are here it is not about them it is about the patients. The reasons these should be in the philosophy is because the staff should always treat their patients and the families with respect because that is how they would want to be treated. A mission and a philosophy statement should always be a part of the facility, so the staff can know what they are supposed to do as professionals and human beings taking care of human beings. It shows their patients that they will be taking care of by the best ability that the professionals can do. They will have a say in their own care and treatment because it is the patients’ health and know what is wrong with their health. The patients see the mission statement as a promise to take the best care of them. That the staff are there to help and give quality care to them.

In conclusion, there are many health care delivery systems in the United States. Hospitals, nursing homes, and HMOs are some health care delivery systems. They all have allied health professionals such as nurses and doctors or insurance agencies. Their missions are all similar with a few differences. They all promote a good work environment for their staff and a caring environment for their patients and their families. Hospitals and nursing homes can house many patients at one time. They give accurate care and a professional environment for their patients. The HMOs are insurance companies that help service patients with medical expenses. A great mission statement and philosophy statement should always have in it the quality of care the patients will receive when in their care. It should also have in them the rights of the patients. HMOs all have allied health professionals to help with the patient need and to make sure they are getting the best care for the right price. Every allied health care professional must follow a mission and philosophy for the place they are employed and to be professionals on and off the job. They should be caring and compassionate in the career that they choose because they are human beings taking care of human beings whether it is for an injury or to help pay for the treatment and care.

References

BCBSIL Provider Manual. (2008). HMO Quality Improvement. BlueCross BlueShield of Illinois. Retrieved on April 1, 2017 from: http://www.bcbsil.com/PDF/providermanual/hmo_quality_improvement.pdf

Health Maintenance Organization (HMO). (n.d). Retrieved on April 1, 2017 from: http://www.healthcare.gov/glossary/health-maintenance-organization-HMO/

Oaklodge Nursing Home: Adding Life to Years and Years to Life… (n.d). Retrieved on April 1, 2017 from: http://www.oaklodgenursinghome.ie/mission.htm

The Future of the Public’s Health in the 21st Century. (2003). Chapter 5. The Health Care Delivery System. PG. 212-267. Retrieved on March 31, 2017 from: http://www.nap.edu/read/10548/chapter/7#228

Valley Health System. (n.d). Nursing’s Mission, Vision, and Philosophy Statements. Ridgewood, New Jersey. Retrieved on March 31, 2017 from: http://www.valleyhealth.com/NursingAtValley.aspx?id=4902