PHE 5005 Week 6 Healthcare Project Report Summary

2 Oct No Comments

Healthcare Project Report Summary

Name:

Course:

Date due:

Healthcare Project Report Summary

There are few things that concern cut across whatever divides we may have created for ourselves as much as health care do. The quality , access and cost of healthcare is something that concerns all of and it is the best way that proper measures are put in place to ensure that health care is taken as seriously as it is supposed. This paper looks at partnerships and collaboration in health sector and their impact on the quality and access of care, health reform, and community based care and evidence-based research and the impact that these factors have on health.

Successful partnerships

The partnership and the collaborations that Utica have identified in Davis and Gross article is that public partnership recommend an alternative example for pharmaceutical innovation in every difficult disease parts where there are significant public need and commercial interests. These areas have the ability to reduce the huge waste of ineffective drug development and try to support the necessary knowledge of pharmaceutical improvement. For instance, the article mentions how they need partnership plan that will work in competitive collaboration areas. The article includes that an affected patent may use to drive the pharmaceutical business to collaborate with the public and private determinations to act faster for certain disease cures. For example, the national data concerning asthma study the method the insurance coverage and the value of the disease care. The other way is that the children who are suffering with severe asthma will receive coverage faster than children with less forms of the condition. (Coker, Kaplan, and Chung, 2012). Another successful partnership is care management and Housing caring. It is extremely important due to the fact that a lot of helpless patients are really in demand of more extreme management. A study shows that “housing and care management program was associated with a substantial decrease in emergency room visits and hospital admissions. This partnership was also associated with societal cost-savings, providing a strong rationale”. These works offer support that human services plan can make a difference in improving great help. ( Basu et Al, 2012).

Research can also generate important data to guide policy-making, providing a new perspective on important health issues. Bharmal et al. “explored racial disparities in life expectancy, and found marked variation across states in the magnitude of racial differences in health”. ( Bharmal et al., 2012) The leadership qualities that made the partnerships successful are for example the application from Jacobs and Rathouz, they assess and change the value for the patient by having the telephonic interpreting instead of only having face to face meeting. They created the telephonic interpretation for Spanish speaking clients. They also provide video interpretation in the emergency department as well which can help the bilingual Spanish speaking patient in order to understand all the significant information for their health care. According to Jacobs “That video-based interpretation might provide a valuable combination of strengths of the current modes and permit more timely and effective interpretation services for patients in emergent care settings”. (Jacobs, 2012). Describe the leadership qualities the parties possessed that made these partnerships successful. The other example to demonstrate the leader qualities is by providing a “population-based perspective” which can notify to the patients a way to make great efforts on evaluating effective and significant area of health by allowing patient to have medal home. Because they found that considerable practices are lacked in patients’ registry tracking and these principals insinuation should provide better self-management and improvement. The scholars and graduates show their creation on how to notify the policy before they apply to their work. The PPACA states regarding great health care that patients are able to afford and they have the right to eliminate any financial obstacles that may help them to provide health care for many Americans. They have discovered that many Americans may suffer from nonfinancial obstacles and they will not be able to have access to any health care providers. In the 2010 the National Collegiate Atlantic Association (NCAA) examines to screen every division athletes for the sickle cell trait disease. The policy instructed that they provide a screening for each student athletes at the schools to classify if they are diagnose with sickle cell trait. The supporters of the program discuss that they will inform any athletes who are at risk for life-threatening events. There are many critics that the program may lead to judgement, Tarini et Al stated on the critics and let the NCAA know that about its own data and the perception of the program, because they saved many lives over the years of screening. Grudzen et Al define their partnership between University of California and Los Angeles County Emergency medical Services Agency. Their affiliation ascended from a foundation of research to translate certain concerns into action. Such as having the emergency medical technicians to resuscitate all patients even when there is a low benefit risk of physical harm also the disrespectful of patient preferences. They demand to change such actions and concerns; they change the issues by asking all of the patient’s family to honor any written and verbal requests not to resuscitate.

The agencies that were not mentioned in Davis and Gross article include the United Nations Development program (UNDP); UNDP is the global development system that is mostly focused on resolving many obstacles such as crisis prevention, recovery, poverty reduction, HIV/AIDS, democratic governance etc. This organization also arranges global and nationwide plan to overcome these obstacles especially reduction of poverty. For instance, it has helped Liberia to prepare nationwide for the elections of the first woman president by the name of Ellen Jonson-Sirleaf in Africa. This agency also helped Thailand construct water pumping places, as well as the Pakistan during the earthquake damaged. It also promotes the Human Development report every single year. The other agency that was not mentioned in the article is United Nations Children’s Fund (UNICEF). It has reached out to a lot of countries when they going through hard time. It is available to help and care for mothers and children. For instance, they provide immunization for more than million children in Angola. They encourage girls to stay in school in many different countries in Africa. I am very familiar with this organization, because I have made a few donations on several occasions

Training programs for medical students

According to Sultz “The adequacy of the supply of primary care physicians and the number of training programs for medical students, which had appeared to meet population needs for primary care in years past, have recently been reexamined during the current era of health care delivery reform”. ( Sultz & Youn, 2011). It is extremely important to understand the history of healthcare delivery organization, the way it operates, the legal and ethical issues that arise, who participates, and figure out the problems that are continued to outbreak the healthcare system. In many instances, training beneath a physician stayed as a mutual technique of physician training in the mid-18th century. The hospital sensed that it is necessary to adjust the training technique and start a program that will have the physician to pay to the hospital a fee to the institution for a period of years. Heath centers became the areas of education and training for physicians and other health care workforces. Today the training provides by the hospital of health care foundations are the main providers for patient care. The hospitals also provide major care for the inexpensively population in the regions, the efforts to lower unnecessary hospital admissions have helped hospitals attentiveness on delivering well care than before, by helping the patients’ knowledge and educating on the patients release plan. “The teaching hospitals of the 126 academic health centers represent only 6% of the nation’s hospitals; they provide more than one-half of the nation’s care to indigent and underserved populations”. ( Shultz & Youn, 2011). One of the ways that partnerships will achieve the goal of reducing hospital readmissions is to focus on reducing transitions from one care location to another efficient care which require thoughtful collaboration among health care providers, social services providers, hospitals etc. The goal of the community-based care programs is to improve transitions of beneficiaries from hospital setting to other care setting. Moreover, document savings to the care program, to improve the experience of excellent care, to improve the healthcare population, and to reduce readmissions for extreme risk of Medicare beneficiaries. “Changes in physician medical practice will be far reaching as reimbursement transitions from the individual patient fee-for-service model to models that are population based”. ( Sultz & Youn, 2011) . Patient must be able to understand their data accessed in order to prepare a plan of care, and physician must complete all the forms that are required as well as insurance filing, manage correspondence, and supervise the providers. “The ultimate goal is to combine the intuitive strengths of humans and data retention strengths of computers to create a hybrid system that is intuitive with a tireless data processing capability”. ( Sultz & Youn, 2011). The systems changes can include a large number of training of hospital staff to guarantee proper data fields across different systems. Workers required to be protected emotionally, psychologically and physically to guarantee strong workers. ( Stephen, 2 012).

Evidence-based research

It is not brainer that research and healthy policy should go hand in hand because there is a very clear connection that exists between the two. Research is not rigorous and straightforward and can help in not only shaping short-term change but long term progress. This obvious connection has not been appreciated by all due competing interests and contrasting priorities have frustrated efforts of translating research into actionable policy.

There are several example of evidence based research can be translated into polices. For instance, Spatz et al (2012) not only did research on barriers to accessing specialty care but went ahead to translate the research into actionable points and policy based solution to addressing those barriers. They describe the formation of team in New Haven that worked Project Access; comprising of researches, health care providers and advocates to identify and overcome challenges to access of specialty care. This partnership was formed on the principles of community-based participatory research, various specialty providers and numerous hospitals were involved in this partnership that resulted in funding for special care and formulation and modification of policies in the local health care system to facilitate access.

Another example that is similar to the above is the partnership between the University of California-Los Angeles and the Los Angeles emergency medical service agency (Grudzen et al, .2012). The partnership developed against the backdrop of research by the university that stated the emergency medical agency staff were performing resuscitation on all patients even resuscitation may not be of any help to them or where the patients has a different preference or where there is danger of physical harm to the patient. To put the research into actionable policy some specific indicators were developed that entailed issues such as asking family members or honoring written or verbal requests against resuscitation.

However, Pollack et al. (2012) points out a different story from the community by examining various practice patterns by different urologists. He combined the cancer registry data Medicare data. He found out that different communities use different patterns but when a patient receives care from a given physician or group of physicians he becomes part of that community whether he knows it or not. This distinct patterns by various urologists affect populations that use this services and payers such as Medicare. This differences that exist among various providers bring into sharp question the need for standardization of clinical approaches

On the other hand, evidence-based research has been known to have influence on health policy even at the national level. For instance, value-based insurance design (VBID) is based on price elasticity and demand; it holds that utilization of a service is inversely related to the cost of that service (Fendrick et al.2012). They observed that service such as VBID that are targeting many insured patients should have incentives to make them more successive such as by reducing out- of pocket expenses while those service that are less effective the cost should go higher to discourage patients. To promote uptake of this research and translate it into policy Fendrick et al.(2012) observes that there is need for continued engagement and interaction between purchasers and policy makers. There is also need to promote and explain the concept to many people so that it can be taken up. The research bore some fruit because as early as 2008 almost 30% of employers were using some form of VBID that culminated in it being incorporated into the national policy by being enshrined in the People’s protection and Affordable Care Act (PPACA).

Downey et al. (2012) on the other hand targets the inpatient safety indicators and how the standards of health have changed over the years between 1998 to 2009.Over this period of time there are some an unprecedented changes that were witnessed in the health sector especially as it related to enhancing the safety of patients. Downey et al. (2012) analyzed more than 69 million hospitalizations and they found that although there were remarkable improvements but also worsening measures were identified. This research proves that although progress has been made to ensure that inpatients are safe but this should not be a reason for complacency. The formulators of health policy need to use this research to identify those areas that have not been completely addressed that be a causes for alarm as far inpatients’ safety is concerned and work toward developing measures to address those concerns.

Coker, Kaplan and Chung (2012) looking at the issue of childhood cancer that has implications both at the national policy level as it relates to insurance coverage and clinical level as it concerns the practice patterns. Their research focused on how insurance cover and quality of asthma care are concerned as it relates to diagnosis and controller medications and their appropriateness. They found out that children have severe cases of asthma are more likely to have some form of insurance coverage compared to children with mild forms of asthma.

A policy implemented in 2010 by National Collegiate and Athletics Association(NCAA) to have all Division 1 players to be screened of sickle cell anemia trait prompted Tarini et al. (20120 to carry out a study to examine this policy. The policy was implemented against prior research about screening of the sickle cell trait. The concerns were that the policy might not help the students but could lead to further discrimination while proponents of the policy held that it will help to identify students in danger of life long health risks. The focused on the concerns raised by those opposed to the policy and the views of the proponents of the policy so that t help the NCAA make an informed decision.

Quality of care

Quality healthcare can be defined as the extent to which health services for both individuals and population can increase the possibility of desired health outcomes consistent with the professional knowledge and practice. When all the available evidence is used and applied in the evaluation of various options before reaching a decision in clinical management and practice and policy making. This can be termed as evidence-based medicine (Sultz&Young, 2011). The use of academic research in formulation of polices and improvement of quality of care is important because the evidence provided by research is vital for accountability purposes. For instance, practices that have been found to improve the health status and quality of care and life for those participating then there is no reason why such evidence should support and lead to change in policy and how we care for the patients.

According to Spatz et al (2012) people who are insured or under insured have a great challenge as far as accessing health screening, preventive and specialty care is concerned. Their only hope is to depend on the national health care safety net system. The patients who have no insurance or underinsured have to depend on community health centers to get specialized care but these centers are themselves overwhelmed because of the many clients they are required to serve and they also have fewer specialists physicians attending to vulnerable population and in turn this has caused; overwhelming of emergency services and hospitals, fragmented health care plans, disease advancement and long wait times for patients before they can see a doctor.

These problems however have been taken care of by project Access, implemented in New Haven to overcome challenges to access of specialty care by the help of researchers, health care providers and advocates. This project is aimed at creating a network of hospitals and specialists willing to provide free or donate care to both uninsured and underinsured patients by integrating this care through patient navigation. The fundamental aim of the project is to have a patient-centered approach that is characterized by scheduling of medical appointments, negotiating language and literacy barrier, access to free or discounted medication that have been prescribed and connecting with health-related resources. In addition under this approach patient navigators are empower patients to be more proactive to participate in primary care and engage with specialty care. The results have been, improved or quality care for patients in terms of timely access to specialty care, satisfaction for both patients and physicians and finally reduction in number of visits to emergency department (Spatz et al,.2012) .

Another example of evidence-based research and how it has contributed to quality care is the partnership between the University of California-Los Angeles and the Los Angeles emergency medical service agency (Grudzen et al, .2012).This collaboration led to development and changes as it relates to cardiopulmonary resuscitation of patients. This collaboration was created against a background of a research that had been done and found that the EMS agency was carrying out resuscitation on all patients regardless of the personal preference of the concerned patient, how the resuscitation might help them and the challenges and physical harm associated with the process.

The community-patterned research approach comprised of community members, health experts and practice group, the Los Angeles emergency medical service agency to come up with guidelines to decrease harmful and unnecessary and potentially harmful cardiopulmonary resuscitation attempts. Because of this research all six perquisites and standards related to do no attempt resuscitation (DNAR) were include in the practice guidelines. This has improved the quality of care given to patients in emergency situations and thus greatly benefiting them in return by reduction of exposure to unnecessary and harmful resuscitation.

According to Jadad (2000) the internet can be great tool in generation, synthesis, dissemination and exchange of health research .The internet is providing unprecendetn opportunities to access information by health care professionals that can help in making that affect them and their clients by using evidence-based research.

A good example is the Cochrane collaboration that people to make informed decisions about their health by making sure that there is access to up-to-date reviews and analyses about the potential risks and benefits of health care interventions professional organizations and governments have also been involved in the use of the internet to facilitate dissemination and access to evidence based clinical guidelines. For instance, National Guideline Clearinghouse that offers access to evidence-based clinical practice guidelines form various organizations in North America. This enhances quality care by providing evidence-based clinical care for patients according to their circumstances. Doctors or healthy specialists can find out what other doctors have written and research available to help them improve the quality of care for patients.

There are some branches of health that are still resistant to change and utilization of evidence based research in proving health care such as pediatric nursing.Persisence of myths, bias ,tradition in pain management of pain in infants and children has greatly limited the application of research based practices. However, there is a shift with hospitals putting much more emphasis on patient safety and prioritizing making sure that the hospitals are safe for patients and especially children. This together with other measures that support evidence-based practices in the delivery of quality care (Hughes, 2008).

In conclusion, to ensure that patients are getting the best care there is need to incorporate evidence based research and not be stuck in the past and the old way of doing things as far quality care is concerned.

Summary

Partnerships are important in the provision of healthcare and going forward they will an extremely important role in the provision of healthcare. Utica has identified in the Davis & Grossman (2012) public partnership can help in the process of pharmaceutical development. Pharmaceutical companies always have a desire to get profit by making as many sales as possible but with the promotion of partnership between these companies and other public and private players in the health sector they are likely to consider other petininent interests and see how they can balance between various competing interests. Another key area of partnership is housing and care management that has a crucial role to play as far as quality of care is concerned.

Housing and care management have ability to cut on societal health costs and give a great boost to the quality of care. Partnerships can result can between healthcare providers and research institutions such as the as the example of partnership between University of California and Los Angeles County Emergency medical Services Agency. There had been complaints that the latter perform on routine cardiovascular resuscitation on patients including those who might a different preference and notwithstanding the risks associated with it.

Communication with patients is equally important and great strides have been made in terms of improving the health communication for instance, the patients’ registry tracking to provide better self-management and improvement. Besides telephonic interpretation has been developed especially for the Spanish speaking students. Video interpretation complements this by assisting both doctors and patients in emergency situation by helping them to understand everything that helps patients to understand everything as it relates to their health.

Just like communication and partnership, research has a crucial role to play in health care related issues; research is both straightforward and direct and it can help to shape policies and how things are done. Research is important for both short term change and long term progress. For instance Spatz et al (2012) researched on the difficulties that can be faced by people looking for specialty care but he did not stop there. The research was developed into policy and some actionable points put in place. Most of these patients have challenges accessing screening, and preventive care due to either being an uninsured or underinsured and thus they depend on community health centers to get specialized care but these centers are themselves overwhelmed because of the many clients they are required to serve and they also have fewer specialists physicians attending to vulnerable population and in turn this has caused; overwhelming of emergency services and hospitals, fragmented health care plans, disease advancement and long wait times for patients before they can see a doctor.

Research also has been found to have impact at the federal level as it relates to formulation of policy. As Fendrick et al. (2012) value-based insurance design (VBID) is based on price elasticity and demand; it holds that utilization of a service is inversely related to the cost of that service They observed that service such as VBID that are targeting many insured patients should have incentives to make them more successive such as by reducing out- of pocket expenses while those service that are less effective the cost should go higher to discourage patients. To promote uptake of this research and translate it into policy. It is good to note that continued engagement and interaction between purchasers and policy makers and this will benefit the health sector as a whole.

We had also observed that is important that patients receive good care and their demands and wants are met. Health that is likely to satisfy is one that patients enhances their chances of being and leading healthy lifestyles. Such indicators at the quality of healthcare, access to health centers, availlalbity of competent doctors, emergency services and availability of medicine. All these factors and many more are important in determining whether a patient would be satisfied or not. Health is a product and the patients are the recipients hence it is important to make sure that the product (healthy) being dispensed is of good quality.

Health reform has a great impact on provision of healthcare in terms of widening the reach and scope while at the same time cutting on the cost of healthcare. For instance the change in training technique for healthcare professionals to pay a given fee to a hospital and then they are trained. The hospitals also provide major care for the inexpensively population in the regions, the efforts to lower unnecessary hospital admissions have helped hospitals attentiveness on delivering well care than before, by helping the patients’ knowledge and educating on the patients release plan. This reforms have opened up hospitals to teaching and learning and this widens knowledge and expertise that becomes beneficial in the long run for all parties involved; patients and physicians.

With more people reaching the medical care age and the increase in prevalence and severity of illnesses it would be impossible for all sick people to be hospitalized that is why there has been a shift in the recent few years to look for alternative ways of hospitalization. Home –based care of the sick with constant supervision may be their right way to be adopted because it enables a sick person to remain in touch with family and other relatives while at the same time getting the best counsell and services from the health professionals.

In conclusion, health is a great determinant of many other sectors in the country and it is only obvious that proper attention and seriousness is given to it.

References

Coker, T. R., R. Kaplan, and P. Chung. 2012.The Association of Health Insurance

and Disease Impairment with Reported Asthma Prevalence in U.S. Children.”

Health Services Research 47 (1, part II): 425–439

Davis, M. M., Gross, C. P., & Clancy, C. M. (2012). Building a bridge to somewhere better:

Linking health care research and health policy. Health Services Research, 47(1pt2), 329–

336.

Downey, J., T. M. Hernandez-Boussard, G. Banka, and J. M. Morton. 2012. Is Patient

Safety Improving? National Trends in Patient Safety Indicators: 1998-2007.”

Health Services Research 47 (1, part II): 408–424.

Fendrick, A. M., A. E. Weiss, and J. J. Martin. 2012. Value-Based Insurance Design:

MoreHealth at Any Price.” Health Services Research 47 (1, part II): 398–407.

Grudzen, C., L. D. Richardson, W. J. Koenig, J. R. Hoffman, K. A. Lorenz, and S. M.

Asch. 2012.Translation of Evidence-Based Clinical Standards into a New Prehospital

Reususcitation Policy in Los Angeles County.” Health Services Research

47 (1, part II): 363–373.

Jadad, A. (2000). The Internet and evidence-based decision-making: A needed synergy for efficient knowledge management in health care. J Med Internet Res Journal of Medical Internet Research.

Spatz, E. S., M. S. Phipps, O. J. Wang, G. I. Lucas, S. Lagarde, L. A. Curry, and M. S.

Rosenthal. 2012. Expanding the Safety net of Specialty Care for the Uninsured:

A Case Study.Health Services Research 47 (1, part II): 344–362.

Stephen M. Petterson et al., “Projecting US Primary Care Physician Worforce Needs: 2010–2025,” Annals of Family Medicine, Vol. 10, No. 6 (November/December 2012), pp. 503–509, and Kathleen Sebelius, “ACA Gets Care to Those in Most Need,” Albuquerque Journal, September 19, 2012,. Retrieved from: http://www.heritage.org/research/reports/2014/03/the-impact-of-the-affordable-care-act-on-the-health-care-workforce

Tarini, B. A., M. A. Brooks, and D. G. Bundy. 2012. A Policy Impact Analysis of the

Mandatory NCAA Sickle Cell Trait Screening Program. Health Services Research

47 (1, part II): 440–455.




Click following link to download this document

PHE 5005 Week 6 Healthcare Project Report Summary.docx