Food Processing Plant Hygiene
Food production factories produce many products that sustain and feed the world community. Growing demand for processed foods has led to the intensification of processing and preservation methods that have an insignificant impact on either the nutritional qualities of products. Attributable to the use of little preservation technologies to processed products, sanitary processing devices and a hygienic practice atmosphere are necessitated to keep off bacterial, chemical, and other contaminants from influencing these products while preventing food contact to dust and contaminated areas. Incorporation of sanitary atmosphere and procedures into a food processing factories assists to deter the intensification of microbes and microorganism areas, avoid food infection with substances and particles, help in sanitation, and preserve clean conditions before and subsequent to production (Baş, Yüksel & Çavuşoğlu 2007). This document supplies information concerning food processing plant layout and zoning requirements for high, medium and low risk foods. It as well outlines several elements of organizing a factory sanitation program and provides Irish operational guidelines concerning food processing factory hygiene.
Operational Irish Legislation on Factory Hygiene
The Irish law on factory hygiene describes the operational conditions that food processing plants are required to abide by. Compliance with Food Safety Authority of Ireland (FSAI) guidelines on sanitation and hygiene is significant for all food processing factories in Ireland. The Food Safety Authority of Ireland as well notes that all food plants, whether working from a business areas, in the home or from a food stand, should be mindful of the legislation concerning food sanitation and safety. Food Safety and Hygiene Regulations 2013/2996 regulate the processing and selling of processed food products in Ireland (Egan et al., 2007). The guidelines partly implement European Commission Regulation 853/2004, on certified regulations on factory hygiene. They do this by setting the hygiene regulations to signify the 2013 Regulations in conjunction with the European Commission Regulation (Garayoa, Vitas, Díez-Leturia & García-Jalón 2011). This stipulation provides regulation on all the operational obligations about different classes of food production concerns. Moreover, any plant should abide by the pertinent conditions of Regulation 2013/2996 in their production processes, in addition to other supplementary health provisions. The Food Safety Act performs regular inspections of certified processing plants in Ireland. In Northern Ireland, these reviews are performed by the Department of Agriculture and Rural Development (DARD) for the Food Safety Act (Baş, Yüksel & Çavuşoğlu 2007).
Suitability, Application and Effectiveness of Disinfection Agents
An efficient cleaning and disinfection program in food processing zones of a Good Manufacturing Practice (GMP) factory is vital to guarantee the safety of the products. Producers are being held to a high benchmark when it pertains to product safety and hygiene by regulatory authorities who are progressively demanding legalization proof to support cleaning and disinfection processes. Regulatory agencies nowadays demand proof of the effectiveness of disinfection agents against ecological isolates (Egan et al., 2007). The Food Safety Authority of Ireland directive for food processing posits that the suitability, effectiveness, and application of disinfecting agents and processes should be evaluated. The efficacy of these sanitizers and practices should be assessed by their capability to certify that possible pollutants are sufficiently isolated from plant surfaces.
Basic knowledge regarding the effectiveness of different chemical agents against ecological bacteria, fungi, and spores will aid in choosing disinfection agents. Requirements for food processing zones entail readily cleanable surfaces, floors, and roofs that have smooth, non-permeable floors; temperature, and moisture regulations; sanitation and cleaning practices to create and sustain sterile conditions. These conditions, together with cautious and comprehensive assessment of the disinfection agents applied for sanitation and disinfection strategies should result to attaining the particular hygiene standards and regulation of microbial pollution of food products (Garayoa, Vitas, Díez-Leturia & García-Jalón 2011). In current years, the application of antiseptics in food processing plants, clinical installations, and related regulated settings has been the topic of inspection by regulatory authorities.
It is imperative to understand that disinfectants do not commonly eliminate all the microbiological niches with which they touch and do not sanitize against all microorganisms uniformly the same. Some decontaminators do not destroy microorganism spores. A cleaning agent that is efficient against microorganisms may not be as efficient against viruses. There are numerous proprietary products obtainable and they differ in their efficiency against bacteria. Suitable disinfectants contain manufacturer’s guidance on the precise antimicrobial activity of the cleaning agent. The performances of good disinfectants are not affected by the availability of other materials in the areas to be cleaned. Materials such as detergents, heat, and the pH does not minimize the effectiveness of suitable disinfectants (Egan et al., 2007).
Organization of sanitation programs
Regardless of how big or small a business is, a food production plant should consider food hygiene and the interest of public hygiene as its first precedence. Starting recalls can be expensive and exhaustive, thereby minimizing production and output. Generally, it requires some years for an organization to pick up from a food borne infectious epidemic that has emerged from its factory. However, some organizations never even recover. It also requires several years to formulate a productive product and win customer allegiance, whereas it can take only minutes to demolish it. Successfully teaching workers assist to avert these unpleasant impacts and attain the company’s food hygiene and safety objectives. All food producers must contain a well-built food safety training program that comprises a broad program and responds to the questions of who, what and why related to food hygiene practices. A well-built training template assists guarantee food quality, a reliable product and a hygienic atmosphere under which foods are processed (Mensah & Julien 2011).
Shortage of suitable sanitation programs in food processing organizations can make the organization incur huge losses. Habitually, many companies do seem to recognize the impending dangers due to poor or lack of a proper sanitization program. This peril arises in terms of end users dissenting from the company, products, poor staff morale from frequent blames by the administration, hidden spoilage challenges and substandard food quality. The obvious sanitary dangers noted by food processing companies are frequent complaints and regulatory authorities’ involvement due to deteriorated sanitary conditions or public complaints (Mensah & Julien 2011). Poor hygiene results to increased refutations of products by customers, reduced product life, as well as losses to processing companies. Additionally, poor sanitary conditions on a company’s processing premises can attract the risk of possible plant closure by regulatory authorities. Appropriate sanitation programs established at the right time compensates more than it costs.
If executed efficiently, food hygiene, quality and cleanliness, education assist to guarantee a harmless product for consumers and eventually guards the company brand. Actually, without education, people and organizations are expected to form shocking practices that can be expensive and hard to rectify. It may be hard for some workers understand terms such as zero tolerance, fault action ranks or causative microorganisms. Even though most food plants contain competent administration knowledgeable in food hygiene, it is at times a setback to express the ideas they identify and comprehend to actual production workers: those who are directly involved and that deal with the production foods. It is important, therefore, for a good organization to establish which ideas will be incorporated in teaching, and the precise approach regarding how to communicate these concepts (Penna, Mazzola & Martins 2007). This task should be customized for each single institution because the variables and academic levels of workers vary among organizations and within businesses. Food hygiene program should commence with the essentials. This implies basing the program on Good Manufacturing Practices regulations. The GMP program should be performed at any rate yearly and entail education for workers and administrative staff. The GMP program should encompass all elements of modern GMPs named in the Code of Federal Regulations. It is also advisable to put exceptional prominence on the worker sanitation features of this regulation in any food sanitation program (Egan et al., 2007).
Putting on uncontaminated garments assists to avert the generation of microorganisms. By demanding that things like clean dust coats and aprons be supplied to every worker at the factory, the company can facilitate to avoid the transfer of dangerous microorganisms. Building hygienic and well-kept changing areas considerably eliminates the dangers of cross infection within the factory. The organization should present a place for employees keep private things. Training should concentrate on keeping public regions, particularly hygienic. Throughout the day, more workers will go in and leave public regions, comprising the changing room, washrooms, disinfectant storage areas, food-processing and non-food-processing zones, escalating the possibility for contamination. When more workers touch possible pollutants, there is greater the threat of shifting them to food processing surfaces. A stringent rule on hand washing should be in position, and the entire staff should be provided with training concerning good hand washing practices.
Plant Layout and Segregation Requirements for High, Medium and Low Risk Foods
Plant layout denotes to the general plan of a processing project facility. It progresses through a number of levels before it is concluded. The stages involved are recognition and choice of food to be processed, viability study and assessment, design description preparation, purchase of equipments comprising apparatus and machinery building, and fitting. The design should take into account the technical and hygienic aspects, different unit operations concerned, available and prospective sanitary conditions to mention a few. Several aspects of factory design for food factories are similar to other factories, especially those producing industrial compounds. The design and arrangement of the food processing plant should be tailored to the sanitary stipulations of a particular procedure, packaging or warehousing area. A processing factory’s interior should be designed to ensure there is a flow of material, employees, air and garbage in the proper route (Aarnisalo, Tallavaara, Wirtanen, Maijala & Raaska 2006). Nevertheless, there are numerous noteworthy variations, essentially in the fields of hygienic conditions and working area layout.
Battling food infection may take place not only at the apparatus level, but as well at the plant level. Integration of the sanitary plan into a food production plant can avert the growth of bugs and microbiological populations; prevent food pollution with chemicals (such as disinfection agents, oils, and peeling tint.) and particles (such as broken glass, sand, iron.); help disinfection and cleanliness and safeguard sterile situations both before and after processing. The plant infrastructure can be so planned and built that it cannot infect food products, openly or not directly. Several food processors only use the typical food conservation technique to ensure food hygiene. In the last twenty years, nonetheless, the European Hygienic Engineering and Design Group have established that the sanitary layout of food process equipment and plants can considerably lead to improved food hygiene (Ansari-Lari, Soodbakhsh & Lakzadeh 2010). Zoning and the institution of barricades to guarantee that food of satisfactory hygienic value is processed should only be used where their application will assist extensively to guard products. Planning the whole plant as a Cleanroom is not the rationale of food region segregation to shield both food and user. Zoning and barricade technology should be used in a suitable and regular manner, thus preventing unneeded investment. To maintain a plausible increase of processing activities in the factory, in years to come, the factory layout has to be designed in a manner in which the factory can be enlarged (Van Donk & Gaalman 2004).
Segregation Requirements for High, Medium and Low Risk Foods
Zoning of a food processing plants in several controlled regions helps uphold the sanitary conditions of the plant. These restricted areas have different sanitary requirements and stipulations regarding the admission of persons in the zone. The restricted areas predominant in various food plants entails high, medium, and low risk food regions. High risk food region refers to an area where the greatest level of sanitation is essential. A high risk food zone, which, in food processing is the similarity of a Cleanroom, has to be entirely out of bounds to unnecessary individuals. High risk food region represents an open area processing, where even minute contact of food with the atmosphere causes a food safety hazard (Reij & Den Aantrekker 2004). Foods and constituents produced in these restricted food zones are used to feed extremely susceptible user group such as newborn babies who consume foods produced under strict hygiene conditions. The types of food processed in these zones must be kept in cold conditions, to prevent contamination by of microbial microorganisms (Kletz & Amyotte 2012). Utility piping in the passageways of high risk food zones should be fitted into wall cubicles or the roof. When this is not practical, open racks can be attached to the ceiling and walls and near the ceiling.
Nevertheless, adequate space should be left between pipe layout and adjacent areas in order that they are easily reachable for cleaning and repair. The pipe layouts in this zone should be planned hygienically to reduce the existence of flat ledges, gaps, or slits where unreachable filth can build up. Food processing piping should be openly laid from service areas to process zones and should at all times be consistent and uncomplicated (Byrne, Lyng, Dunne & Bolton 2008). Because utility and process piping can have an effect on or interrupt the air circulation in a high risk food zone, a fog trial can manage airflow designs. Exhaust pipes should have enough capability to eliminate surplus heat, dirt, steam, aerosols, and smells from processing areas. Conversely, a positive overpressure should constantly be preserved. Lighting should light up parallel and perpendicular working areas uniformly, without inducing glare. Partitions and ceilings must be light-painted to allow fast discovery of dust and dirt on their surfaces. The objective of these food zones is to prevent any form of food contamination threats and to protect food processing equipments from contact with atmospheric air.
Medium risk food zones require a normal level of sanitation. These zones include process areas in which easily containable foods are produced, but whose end user is not predominantly vulnerable and where no extra bacteria growth is feasible in the food supply chain. Foods processed in medium risk areas may be exposed to the external surroundings, for instance, during selection and transport to other processing areas. Medium risk food areas endeavor to adjust the increase of injurious microorganisms from reaching other food sensitive areas (David, Graves & Szemplenski 2012). These zones are relatively spacious and have a complex layout design since the level of processing and sanitation in these areas are average. Their primary objective is to protect the interior of food production equipments from contact with microbes in the air.
Low risk food area is the last form of food plant segregation. These are areas that require an average standard of sanitary conditions. These are areas outside the processing rooms within the factory premises that provides general support and security to the processing zones (Lehto, Kuisma, Määttä, Kymäläinen & Mäki 2011). Examples of low risk areas are storehouses that is warehouses and power stations. They have a plain layout plan, which simplifies cleaning, and maintenance operations.
As the existing international obligations support HACCP operations, it is vital that the food processing plants lay a solid groundwork towards this obligation, with the intention that they can contend in the global market. Similar to utility piping, the food production support channel should flow one-way, with the support channel flowing from the northeast zone toward the least clean zones. Processing systems should convey a certain procedure aid initially in the high-risk area and last in the lowest risk area. Incorporation of sanitary atmosphere and procedures into food processing factories assists to deter the intensification of microbes and microorganism areas, avoid food infection with substances and particles, help in sanitation, and preserve clean conditions before and subsequent to production. This assists to avoid production losses and serve to improve food hygiene.
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A dental specialist’s obligations could incorporate judging the problem with one’s sensitivity issues or treating them for it, but most dentists are concerned basically with deterrent consideration. He or she teaches patients on the correct approaches on how one should regularly brush and use floss on their teeth and offers direction on the best over-the-counter items to utilize while doing so (Dental Hygienist, 2014).
As a rule, hygienists additionally evacuate the remove the pluck and junk on our teeth that is hard to remove just by brushing and flossing, for example, tartar, stains and plaque – when we try for a routine dental specialist visit. As feared as an outing to a dental specialist’s office can be, a significant number of us may evade the more obtrusive and frightful dental methods by taking after a hygienist’s recommendation and training (ExploreHealthCareers.org, 2014).
Work obligations can fluctuate somewhat by state – for instance, there are areas in the nation where dental hygienists may put fillings – and not all in this profession work in private practices. Some decide to utilize their abilities as a part of examination centred work, or venture into clinical practice in a school or general health project (American Dental Association, 2013). A number of the highly remunerated hygienists work in dental specialists’ business locales, however outpatient consideration focuses and wandering social insurance benefits likewise pay well. The calling’s best-paying metropolitan regions range from San Francisco on the West to Miami on the East (NHS Careers, 2012).
Functioning as a dental hygienist is not all about scratching plaque and giving fluoride medicines. Quinones says a decent hard working attitude, uplifting disposition, critical thinking abilities and solid relational abilities will advantage somebody planning to enter the position. “Having a wide exhibit of capacities and abilities expands the range of a dental cleanliness degree, permitting entry into areas beyond private dental practice,” she includes. (Bureau of Labor Statistics, 2013)
“Need breeds imagination, and this allows dentists to consider unheard of options, take a gander at their abilities and apply them to another profession way,” she says.
While dental practitioners focus on treating tooth and gum conditions, the dental hygienist (now and again otherwise called an oral wellbeing professional) has an indispensable part in serving to keep issues from emerging. As a dental hygienist, you would complete methodology, for example, scaling and cleaning teeth, and applying topical fluoride and gap sealants. On the off chance that you are situated in a healing centre, you would likewise help patients who are having surgery or entangled orthodontic treatment or those with specific restorative conditions to keep up a solid mouth. Dental hygienists work in healing centres and in group dental administrations, yet most habitually all in all dental practice. Five GCSE subjects reviewed A – C or comparable, in addition to two A levels or a perceived dental nursing capability.
To practice as a dental hygienist you have to have attempted a suitable course affirmed by the General Dental Council (GDC). This will permit you to enlist with the GDC, which is a required necessity. The course is generally two years (or up to 27 months) in length on a full-time premise and is offered by dental schools furthermore the Defense Dental Services Training Establishment. Subjects considered incorporate life systems and physiology, preventive dentistry, dental wellbeing instruction, dental pathology and the administration and consideration of patients (American Dental Association, 2013).
Dental hygienists are preventive oral wellbeing experts who have moved on from an authorize dental cleanliness program in a foundation of advanced education, authorized in dental cleanliness to give instructive, clinical, research, managerial and remedial administrations supporting aggregate wellbeing through the advancement of ideal oral wellbeing.
Clinical systems commonly incorporate evacuation of plaque and stains from the teeth; uncovering and handling dental X-beams; applying cavity preventive specialists, for example, fluorides and pit and gap sealants; and directing antimicrobial operators. In a few states, they additionally control nearby sedatives and nitrous oxide; place and cut filling materials, impermanent fillings, and periodontal dressings; evacuate sutures; perform root-planning as a periodontal treatment; and shine rebuilding efforts. Also, they can give clinical and lab symptomatic tests for translation by other wellbeing experts (Indeed, 2011).
American Dental Association. (2013). Dental Hygienist Education and Training Requirements. Retrieved from Education/Training & Admission Requirements: http://www.ada.org/en/education-careers/careers-in-dentistry/dental-team-careers/dental-hygienist/education-training-requirements-dental-hygienist
Bureau of Labor Statistics. (2013). Dental Hygienists. Retrieved from Dental Hygienists : Occuptional Outlook Handbook : U.S. Bureau of Labor Statistics: http://www.bls.gov/ooh/healthcare/dental-hygienists.htm
Dental Hygienist. (2014). Dental Hygienist. Retrieved from Dental Hygienist Job Overview | Best Jobs | US News Careers: http://money.usnews.com/careers/best-jobs/dental-hygienist
ExploreHealthCareers.org. (2014, November 13). Dental Hygienist. Retrieved from Dental Hygienist |explorehealthcareers.org: http://explorehealthcareers.org/en/Career/2/Dental_Hygienist#Tab=Overview
Indeed. (2011). Dental Hygienist Slary. Retrieved from Dental Hygiene: http://www.indeed.com/salary/Dental-Hygienist.html
NHS Careers. (2012). Dental hygienist. Retrieved from http://www.nhscareers.nhs.uk/explore-by-career/dental-team/careers-in-the-dental-team/dental-hygienist/
Patient Physical Communication
Communication in hospital affects in a great way the health of the society. Many people in the world especially those with no knowledge of the medical world miss out a lot when doctors use medical terms to explain health conditions. In fact, many people cannot device a personal prevention plan because they do not know the exact issues with their health conditions. The problem arises with doctors using jargon words to address patients something that leaves patients amused but in total ignorance. Ideal communication between doctors and patients can go a long way in improving the general health of the society. Doctors have the mandate to inform patients of their condition in the simplest words possible to help them take care of themselves while at home. Cases have been reported where misdiagnosis occurred because the patients did not understand the questions the doctors asked thus giving false information. Hospitals are about communication, therefore, there must exist clear communication between doctors and patients to achieve success in healthcare (Ha and Longnecker 39). This evaluation will aid in determining the kind of questions doctors pose to patients and the level of understanding among the patient. In connection to this, the evaluator will design communication tools that can enhance communication between patients and doctors for better healthcare delivery.
Prior Evaluation and Their Limitation
A lot of research has been done on this topic of patient-physician communication to help establish the issues affecting communication between doctors and patients. Evidence based practice has become part of healthcare operations especially in nursing practices. However, regardless of the positive results that evidence based practices have shown in nursing and clinical activities, less has been done to include the same approach in other areas of healthcare. The traditional functioning of a doctor required him or her to provide medical solutions to patients without having any relationship with the client, besides, it is the nurses and other physicians who interact one on one with patients. Communication on doctors part did not seem that important in the past hence the issues in doctor-patient communication (Heisler et al. 244).
Research indicates that ideal communication between patients and doctors acts as a therapeutic mechanism that helps patients deal with their specific conditions effectively. One of the proposed ways that doctors can use to enhance communication with patients is through decision-making. Research indicates that involving patients in decision-making helps in achieving effective healthcare delivery on the hospitals part and improved health on the patient’s part. Partnership in decision-making takes care of patient needs and ensures that doctors are not all in control of the situation. Patients have become quite knowledgeable in the 21st century and people have different ways in which they desire to be served. Failing to incorporate their ideas in the treatment process can bring about resistance, which can be detrimental to the health of the patient. Communication shows that doctors appreciate the patient’s desires regardless of how irrelevant they may be for that particular situation (Silverman et al. 91). Additionally, communication helps both doctors and patients come to a clear understanding of various norms that may hinder healthcare delivery if not resolved between the two parties.
Regardless of the many researches done on this topic, only a few have been done on the kind of language that can enhance communication between doctors and patients. Very few program evaluations regarding the kind of questions that can enhance communication between doctors and patients as well as the ideal communication mechanism have been carried out. Much has been done on breaking bad news while ignoring the rest of different levels of communication that exist between these two groups. The main limitation of most of these studies is that program evaluation regarding healthcare takes long thus making it hard to generalize results.
The evaluation will employ the use of four-phase logic model including input, activities, output and outcome phases. The four phases will help in assessing the effectiveness of suing simple language, simple questions, and collaborative communication between patients and doctors. The purpose of this evaluation is to establish how effective alternative new communication mechanism can improve the health of the society. In this evaluation, the evaluator will observe the communication between doctors and their patients and note the kind of language and questions answered. To evaluate the intervention, the same process will be repeated only this time making use of the new communication techniques as suggested by the evaluator, which include collaborative communication, use of specific rather than general questions, and relationship development between the doctors and the patients (Ha and Longnecker 41).
The input part of the model will include the doctors, patients, the hospital administration, and the community. These are the major players in this evaluation hence the input. Each of these must be willing to participate for the evaluation to be effectively evaluated. The results of the program depend highly on the willingness of each party. The patients and doctors will carry out the major part of the program. They are expected to have a normal conversation as they do in a normal work environment to allow the evaluator to gather the correct information. Again, the doctors will be expected to make use of the new suggested techniques for purposes of program evaluation. The hospital administration and in this case the administration of Genesys hospital in grand Blanc Michigan must allow the changes within the institution for easy evaluation of the program. The activities involved in the program include doctors and patients having a conversation either for purposes of treatment, or follow up. Doctors will use an interactive nature while questioning the patients rather than the one-way communication that is mostly experienced in hospitals. The patients will have a chance to ask the doctor some questions to clarify what they do not understand concerning their situation. Additionally, doctors will use questions that are more specific. For instance, rather than asking if a patient is having a bloody discharge, the doctors will ask something like the color of the discharge. This will take care of the many misdiagnosis issues that arise from doctors assuming that patients have the right medical and health knowledge (Silverman et al. 143).
The outputs in the evaluation will include better understanding of ones health condition on the part of the patient, easy treatment of the patient on the doctor’s part, good use of medication among patients and the willingness to share with doctors about personal issues affecting the patient. Additionally, improved communication will help patients follow doctor’s instructions especially something that many patients do not do for lack of knowledge. Clear communication will make patients understand the importance of certain procedures thus improving on the health of the society. The outcome is improved healthcare in the society, which will benefit both the hospital and the community.
The evaluation will be carried out at Genesys hospital in Grand Blanc Michigan. Ten doctors will be used for the study where the researcher will devise surveys for the ten doctors to establish the kind of questions and the language they use in questioning the patients. Additionally, twenty patients will be given the same survey to see of they understand the questions. This will enable the evaluator to specifically note the hard terms used by doctors as well as get patients opinion on how that kind of language affects their health care reception. Knowledge of the gaps that exist in communication between patients and doctors is the first step towards and effective intervention and the use of evidence based practice in Medicare.
Process Evaluation Design
To evaluate the process, the evaluator will make use of the interrupted time series design with a single group commonly known as the simple time series. The evaluation design is ideal for this intervention because the purpose of the research and the evaluation is to improve on the program rather than compare its results with other programs (Silverman et al. 82). Additionally, communication evaluation takes time to establish the real outcomes; therefore, the repetitive nature of the design will help the evaluator come up with unbiased outcome at the end of the study. As such, the evaluation will make of use of observation, interviews, and questionnaires. The evaluator will observe all doctors as they communicate with patients and make note of the patient’s responses to different communication techniques. Additionally, both patients and doctors will be engaged in an informal interview where the evaluator will ask various questions concerning the communication sessions. Lastly, questionnaires will be used to gather information necessary for this study from the doctors, patients and the hospital administration. The same will be done with different communication approaches repeatedly to establish clear process outcome.
Outcome Evaluation Design
Due to the nature of the expected outcome, the evaluation will make use of expert judgment design. The design is quite suited for interventions that produce long-term outcomes thus making it suitable for this particular program evaluation. Surveys for both the patients and the doctors will be used to analyze the outcomes of the new communication techniques (Heisler et al. 250). Additionally, outcome evaluation will help inform the hospital management of the ideal communication skills to instill to their doctors for effectiveness in healthcare and Medicare service delivery.
Benefits for Stakeholders
The key stakeholders in this intervention include the community, the patients, the doctors, and the entire hospital. The patients will benefit from the intervention through improved knowledge of their health conditions. As a result, the community will benefit from a health society where people are well informed on both treatment and preventive measures. Additionally, the mortality rates will reduce because people will be willing to present their health issues to the doctors without expecting any negativity. The health institution will benefit through the achievement of the institutional goal, which is improved health of the society. Doctors will enjoy good relationship with patients, which will help in making work easier on their part. The hospital will also benefit financially since many people will be willing to visit the institution for any health issue because of the new levels of understanding between the doctors and patients (Heisler et al. 251). Lastly, issues of drug misuse will diminish and this will benefit both the society and the healthcare institution.
Ha, Jennifer and Longnecker, Nancy. “Doctor-patient communication: a review.” The ochsner journal, 10.1 (2010): 38-43. Print.
Heisler, Michele, Reynard, Bouknight, Rodney, Hayward, Dylan, Smith, Eve, Kerr. “The Relative Importance of Physician Communication, Participatory Decision Making, and Patient Understanding in Diabetes Self-management.” J Gen Intern Med 17.4 (2002): 243–252. Print.
Silverman, Jonathan, Suzanne M. Kurtz, and Juliet Draper. Skills for communicating with patients. London New York: Radcliffe Publishing, 2013. Print.
Medicare Fraud: The History, Incidence, Costs and Institutional Remedies
Medicare is health insurance for the elderly in the U.S. The term Medicare fraud is used to refer to companies or individuals who look for means of dishonestly obtaining Medicare health reimbursement. Individuals and companies that engage in Medicare fraud use different techniques to achieve their objective, which is obtaining money fraudulently. Giving an accurate estimate of the amount of money that is lost because of Medicare fraud has been difficult. However, according to the Office of Management and Budget, it is estimated that 47.9 billion dollars was lost in 2010. During the same year, the total amount spent on Medicare, according to the Congressional Budget Office amounted to approximately 528 billion dollars. This paper seeks to discuss the history, incidents, costs and institutional remedies for Medicare fraud.
History of Medicare Fraud
Medicare is a health program created in 1965. During the first ten years of its operation, there were no mechanisms put in place to control fraud. State and federal law enforcement agencies charged with the responsibility of investing criminal activities within the Medicare program were also nonexistent (National Association of Medicaid Fraud Control Units , 2014). Fraud in the Medicare program was first noted when the Congress and the public realized that there were many patients in nursing homes that were being retained by some Medicare workers in order to obtain regular funds from the program. This led to the formation of National Association of Medicare Fraud Control Units (MFCU) (National Association of Medicaid Fraud Control Units , 2014).
The U.S Congress started hearing cases of healthcare fraud in the early 1970s. The governor of New York, Hugh L. Carey together with the attorney general Louis J. Lefkowitz decided to appoint a Special State Prosecutor for Nursing Homes, Health and Social Services (National Association of Medicaid Fraud Control Units , 2014). The governor and the attorney general undertook this measure as a response to the widespread fraud in New York’s nursing home industry. In 1977, Congress also implemented measures to curb Medicare fraud by passing the Medicare-Medicaid Anti-Fraud and Abuse Amendments (National Association of Medicaid Fraud Control Units , 2014).
Incidents of Medicare Fraud
One recent incident of Medicare fraud is evident in the case of Doctor Jacques Roy, arrested and charged with fraudulently certifying hundreds of Medicare reimbursements. Doctor Roy obtained millions of dollars for services that were never provided to patients. Doctor Roy fraudulently obtained money from Medicare by recruiting homeless people as fake patients, and then making claims for reimbursements (Thomas, 2012). If Roy is found guilty of the charges against him, he could be sentenced to life. The Medicare Fraud Strike Force has termed doctor Roy’s fraud case as the largest healthcare fraud ever committed. Doctor Roy and his co-perpetrator ran an efficient fraud scheme for years, and managed to make millions (Thomas, 2012).
Roy was hiding most of his fraud money in foreign bank accounts especially in the Cayman Islands. According to the charges brought against him, Doctor Roy was planning to change his identity and leave the U.S in order to avoid prosecution. Another incident of Medicare fraud that was being investigated in February this year is the case of a concord doctor, Spencer Wilking. Doctor Wilking pleaded guilty to taking part in activities that defrauded 27 million dollars from Medicare. Doctor Wilking aged 65 years was the head of Waltham home health agency in the capacity of medical director (Ailworth, 2014). Wilking was accused of conspiring with two others to commit fraud by forwarding bills to Medicare for services that were never offered to patients. Wilking can be sentenced up to a maximum of ten years in prisons if found guilty of charges brought against him (Ailworth, 2014).
The Costs of Medicare Fraud
As stated earlier, it is difficult to determine the exact amount of money that is lost in Medicare related fraud. Some estimates have placed the figure at 850 billion, 100 billion, and others 60 billion. However, the federal government has stated that it loses 60 billion of taxpayers’ money in Medicare fraud every year (Mcfadden, 2010). Fraudulent clinics, medical supplies firms and pharmacies are the major perpetrators of Medicare fraud. Medicare fraud has become a lucrative venture that has even attracted former criminals and drugs dealers. For example, in Florida, fraudsters buy pharmacies that have Medicare licenses and patient databases. Such pharmacies are sold for just 45,000 dollars (Mcfadden, 2010).
The owners of these fraudulent pharmacies would then bill Medicare for services that were never offered; and the patients do not exist. In 2007, the Medicare Fraud Strike Force visited some 1,600 businesses offering health care services in Miami and found that 481 of these businesses did not exist, and yet they billed Medicare for 237 million (Mcfadden, 2010).
Institutional Remedies to Medicare Fraud
One of the institutional remedies for Medicare fraud is for states to make eligibility requirements for an institution to vend Medicare services more stringent. For example, the state of Illinois has already implemented such a measure, and it requires that small firms that are more likely to engage in fraud to undergo criminal background checks and have their workers’ fingerprints checked before being approved. After losing 250 million over a period of years, the state of California now requires that new Medicare vendors be placed on probation for at least 18 months (Malanga, 2014).
Investing in advanced technologies that can monitor Medicare program for suspicious activities can also be effective in curbing the rampant fraud. For instance, the state of Texas has hired a group of computer scientists from the University of Texas to implement their latest mapping software of Texas’ Medicaid database. This technology enables authorities in Texas to identify doctors and pharmacists who source for patients far away from their location. This can be a sign of a possible fraud (Malanga, 2014).
Another remedy that has the potential of curbing Medicare fraud is integrating Medicare billing data with state Medicaid database. The two sets of records can then be examined by advanced computer software at once. It has been observed that healthcare providers that defraud Medicare are also more likely to try to defraud Medicaid (Malanga, 2014). For example, a pilot computer program in California can examine the amount of time a doctor takes in providing certain medical procedures. Doctors with Medicare and Medicaid bills that average to 24 hours, in all workdays, are more likely to be cheating. The most technologically advanced method that can be used in curbing Medicare fraud is the use of biometric data and fingerprint at the doctor’s office. Texas is currently running a pilot program on the possibility of using this technology (Malanga, 2014).
Ailworth, E. (2014, February 26). Concord doctor pleads guilty to Medicare fraud. Retrieved February 28, 2014, from Boston Globe Media Partners, LLC: http://www.bostonglobe.com/business/2014/02/26/concord-doctor-pleads-guilty-medicare-fraud/PaSeDjA7PFlpCsu4s972DK/story.html
Malanga, S. (2014). How to Stop Medicaid Fraud. Retrieved February 28, 2014, from City Journal: http://www.city-journal.org/html/16_2_medicaid_fraud.html
Mcfadden, C. (2010, March 17). Medicare Fraud Costs Taxpayers More Than $60 Billion Each Year. Retrieved February 28, 2014, from ABC News: http://abcnews.go.com/Nightline/medicare-fraud-costs-taxpayers-60-billion-year/story?id=10126555
National Association of Medicaid Fraud Control Units . (2014). History. Retrieved February 28, 2014, from http://www.namfcu.net/about-us/namfcu-history
Thomas, A. C. (2012, February 28). Biggest Medicare Fraud in History Busted, Say Feds. Retrieved Febraury 28, 2014, from ABCNews: http://abcnews.go.com/Blotter/biggest-medicare-fraud-history-busted-feds/story?id=15809129
Ethical Code of Conduct for a Long-Term Care Facility
The ethical code of conduct for long-term-care facility refers to procedures and guidelines that will govern the personal conduct of all employees working in the facility. Long-term care facilities develop and implement ethical code of conduct here after referred to as the code, as a way of ensuring that they achieve the highest level of care using ethical and integrity standards. It is the duty of employees across all levels of the organization to ensure that they follow all the ethical codes, particularly, those included in the facility`s code of ethics. According to Darr (2002), patients look for care in different healthcare facilities and long-term care facility is one of them. Each healthcare organization operates differently and as a result, each has a different code of conduct. A long-term care facility operates differently from a surgery center or a specialty hospital (Joint Commission, 2008). The majority of healthcare organizations have a code of conduct that all their employees are expected to follow. The code provides a set of behavior standards for all people within the facility. The code includes particular standards of behavior that governs the relationship between the employers and their employees, and stipulates how they interact professionally with their customers and the general public (Bardetti & Moriarty 2009). A professional code of ethics is important for a long-term care facility and its employees because of their access to protected and confidential financial and medical information that the facility`s employees are privy to. Consequently, all long-term care facility workers are required to abide by the code fully, which brings integrity in the field of healthcare delivery. This paper will focus on the on a long-term care facility. The code will cover employees at all levels of the organization including but not limited to professionals, support staff, and those in managerial roles.
2.0 Background of the Facility
A long-term-care facility refers to a healthcare organization that offers both medical and non-medical services to patients with chronic illnesses or with disability. Similarly, some long-term-care facilities take care of aged patients who by the virtue of their age no longer have the ability to look after themselves. As a result, such populations require around the clock expert care from professionals (U.S. Department of Health and Human Services, 2014). Compared to other specialties, a long-term-care facility offers more to its patients and clients. For example, in a long-term care facility, employees assist patients in their day-to-day life tasks such as bathing, dressing, and in some cases feeding (Boulding, 2000). In addition, long-term care may also include provision of medical care requiring professional skills to address issues related to persistent diseases that come with old age. In the United States, a significant number of long-term care facilities are located in formal places that provide services such as living quarters for patients in need of around-the-clock medical care and other types of care like personal care and meals. In some instances, long-term care can be offered in a patient`s home. In this paper, we discuss long-term care in the context of a nursing home-a formal long-term care facility. For many countries across the globe, there has been a significant increase in life expectancy in the past few decades, and with the increase in elderly population, chronic diseases have increased too. In some cases, the old lack the capacity to look after themselves and have to depend fully on others` care. According to the World Health Organization (2014), with the rapid increase in elderly populations, there is an urgent need to for effective and customer-centered long-term care. World Health Organization (2014) estimates that approximately 12 million people over 65 years of age will require long-term care by 2020. In the U.S., four in every 10 people who will attain 65 years will require long-term care in the course of their lives.
3.0 Organization Structure
The structure of a long-term facility differs from that of other healthcare providers. To begin with, all long-term care facilities, particularly nursing homes are private entities. The organizations structure for this nursing home includes the owner, the medical director, and the administrator at the management level. At the operational level, we have the medical service department comprising of a physician assistant, nurse practitioner, attending physician, pharmacist, and a clinical nurse specialist. The nursing services department includes the director of nursing, assistant director of nursing, in charge nurses for all shifts, and division supervisors. Below the division supervisors are the Licensed Practical Nurses who perform a supervisory role over all the certified nurse assistants. In addition, the facility has other skilled healthcare workers including speech therapists, dentists, physical therapies, occupational therapist, and podiatrist (Pattison, 2001). Other important employees that form part of the organization`s structure include the business director, admissions director, and dietary supervisor.
4.0 Duties and Responsibilities of Management and Professional Staff
There are various duties and responsibilities for the different employees in a long-term health facility. We evaluate the duties and responsibilities for skilled and professional staff and those of upper management. The responsibilities and duties of upper management vary. Management is directly involved in planning, supervision, monitoring, and ensuring the highest standard of care are maintained across supervision, monitoring, and ensuring high quality of care is maintained across all the departments in the facility. Effective management of a long-term care facility requires good communication flow between management and staff. In addition, the management team must have business acumen and effective leadership. Those in managerial positions are responsible for the planning and directing of all activities in the facility using the framework set by the facility`s board of directors. These activities include effectively monitoring the operations of various groups that include medical, nursing, social services, technical, and clerical teams. On the other hand, the duties and responsibilities for skilled and professional staff include making sure that all the facility`s patients and clients are taken care of in a professional manner and that they receive their prescribed medication on time and as scheduled. The facility`s doctor has a responsibility of ensuring that all customers are examined on a regular basis.
5.0 Two Possible Ethical Dilemmas
An ethical dilemma refers to a situation involving an ethical or a moral conflict between doing something right or wrong. Ethical dilemmas are a common phenomenon in long-term care facilities and they may involve situations such as terminating an individual`s life, decision making on hospitalization, and use of sedation (Bardetti & Moriarty, 2009). In healthcare setting, ethical dilemmas normally require healthcare providers to arrive at decisions that may conflict with the ethical norm (Pozgar, 2011). Numerous ethical dilemmas may happen to both the management and professional staff in a long-term care facility.
The first example is when medical team in the facility are given special orders of Do-Not Resuscitate in a patients chart, yet they get conflicting views from the patient`s family. For example, a patient in urgent need of hospitalization has mild dementia and has difficulties in breathing. The facility`s personnel are convinced that hospitalizing the patients under short-term intubation can improve his chances of survival. However, the patient`s wish is that he should be given no life support if he has a terminal condition. The dilemma here is that this patient is lucid and has not reached the fatal state. The facility`s medical staff are in a dilemma on whether to go by the patient`s wishes or ignore the of Do-Not Resuscitate orders on the chart and hospitalize this patient with an intubation? Similarly, given that this patient and understands the conditions in which he is under, should the doctors ask him if he wishes to be hospitalized under intubation?
The second ethical dilemma that licensed practical nurses and registered nurses in a long-term care facility can face relates to applying restraints on patients suffering from dementia. A number of dementia patients are often hostile and combative and as a result, they require special attention as a way of ensuring their own safety. The most popular way to achieve this is through using restraints. However, this practice has come under heavy criticism on grounds that it may cause physical harm to patients and infringe on their independence, freedom, and respect. The employees at this facility have to make a fine distinction on situations that warrant restraint and how it should be applied without violating the autonomy and freedom of the patients. These are examples of dilemmas that both management and medical staff at the facility are likely to encounter. According to Numminen, Van der Arend, & Leino-Kilpi (2009), long-term health facilities are often understaffed unlike tertiary care centers that have sufficient clinical ethicists. However, even with fewer professionals at their disposal, the employees have to ensure that their actions are in the best interest of the patients and that they are consistent with the ethical guidelines set by the facility.
6.0 Ethical Standards for the Facility`s Staff
Every organization requires an ethical code of conduct that not only directs behavior between the field of healthcare and management, but also governs the relationship between various stakeholders including patients, employees and the society. The fundamental function of a code of ethics is to help those performing managerial and professional duties to sustain a system that enhances the quality of life and improves the wellbeing and dignity of all patients and clients in need of healthcare services (Gordon & Rosenberg, 2001). Those in management positions have to conduct themselves in a manner that instills respect, trust, and confidence to the healthcare profession. Prior to implementing an ethical code of conduct, the codes should contain the values of the organization, its culture and mission statement. The long-term care facility should choose the type of values that are vital to the organization`s long-term survival. The following ethical code of conduct will work well for the long-term care facility:
- Undertake all medical and professional activities in good faith and with integrity, honesty, and respect.
- Comply with all the regulations and laws relating to long-term care while promoting and sustaining transparency and proficiency.
- Work toward the implementation of procedures and processes that will safeguard the privacy and confidentiality of all patients and clients.
- Practice care that advances compassion, while delivering the best quality of care to both patients and their family members.
- Ensure that all care services provided at the facility are consistent with existing regulations and care at all times.
- Promote the education and training of all employees on the code of conduct and implement measures to deal with emerging concerns.
- Treat all patients with dignity regardless of their racial and cultural backgrounds
- Remain truthful in organizational and professional communication and report all negative financial information in a prompt manner to authorities to prevent deceptive or misleading information.
- Give utmost respect to the wishes and rights of individuals in the facility even when they conflict with popular norms.
- Report all cases of abuse or suspicions of abuse
- Provide accurate and reliable information to potential customers to help them make informed decisions on long-term care.
- Develop and promote a culture that does not discriminate based on ethnicity, race, age, religion, gender, disability, or sexual orientation.
The ethical code of conduct listed above is useful in the effective management of the long-term care facility. However, it is worth noting that the code of ethics and conduct will work only if the leadership fully supports the regulations and enforces them with rewards for compliance and sanctions in case they are violated. The facility`s management have a responsibility to the patients and their family members to act in a manner that inspire trust and confidence.
7.0 Methods of Implementing the Code to Achieve Compliance
The majority of healthcare facilities and particularly long-term care facilities have ethical code of conduct for their organizations. However, the major problem is how to execute the code of conduct and ensure that all employees across all levels of the organization comply. The facility can use numerous ways to implement the code across the organization. The first step in implementing the code of conduct has already been developed-the development of the ethical code of conduct. The following subsequent procedures will ensure that the code of conducted is fully implemented across the organization and ensure that they are fully complied with. They include:
- Hire compliance officers who will be provide guidance and synchronize the code`s implementation. The officer will be further responsible for establishing training and communication on all subject matters related to ethics and code of conduct.
- The facility should put in place mechanisms to supervise and audit the process and put in place anonymous methods that employees can use to blow the whistle on non-compliance
- The facility should undertake an in-house survey as a way of identifying which areas stakeholders believe might cause ethical dilemmas. The areas identified should then be discussed and employees at all levels should find ways of tackling the problems beforehand.
- The code of conduct should not only be visible but also readily available to all employees. Management should ensure that they print, post and display code of conduct, with every department head given parts of the code appropriate to the department`s employees.
- As a way of ensuring that all employees know what is important to the organization, all workers ought to be informed on the goals of the facility, their specific roles and responsibilities, and the expectations and priorities of their positions.
- It is impossible to implement the code successfully if the facility does not live up to its corporate values. As a result, employees at all levels have to be empowered on decision making in a manner consistent with the corporate values. In addition, the facility should also be strict in compliance and pursue a zero tolerance policy toward those who fail to comply with the laws.
A code of conduct incorporates all behaviors that the long-term care facility will not tolerate and the consequences that will follow if they are not followed. The code will help the facility in keeping the organization and its employees safe from both real and imaginary unethical practices. It permits the employees to know which types of conduct are harmful to the facility and the likely consequences that will follow from those types of conduct.
8.0 Consequences in the Event of Violation
The majority of long-term care facilities have a zero tolerance policy toward employees who violate their code of conduct, particularly those relating to patient rights. Numerous disciplinary measures can be taken against any employee who contravenes the ethical code of conduct. The punishment used depends on the type and extent of the violation. Sanctions may include written warnings and in extreme cases, they may be fired. Long-term care facilities are expected to offer high quality of care to their clients. As part of quality, they are expected to provide service with the highest ethical, legal, and business standards (Noelker & Harel, 2001). These standards are applicable in the daily interactions with others in the facility including family members, patients and the public. For many businesses in the long-term care specialty, complying with the ethical code of conduct is a prerequisite for employment and any person found in breach of the ethical code of conduct has to face severe disciplinary action. In some cases, they are dismissed from employment. The facility should make use of numerous corrective measures to discipline those who disobey the codes. Corrective measures may include offering addition training to the offender, refund of copayments in the case of bills paid, and providing written warnings. Disciplinary measures against offending employees should be based on which code of conduct violated and the nature of the individual employee to prevent discrimination and unfair sanctions.
The ethical code of conduct for the long-term care facility offers a procedure and guideline for the organization`s employees on how they should conduct themselves. The code of conduct provides a set of behaviors to be followed by all in the facility. It governs the relationship between the employees, employer, and their professional interaction with the patients and the public. The facility`s structure as a long-term care facility is quite different from other healthcare organizations. The structure is comprised of the owner, the medical director, and the administrator. The facility has numerous duties and responsibilities for the different positions in the facility. Ethical dilemmas involve ethical and moral conflicts between doing the right thing and doing the wrong thing. The fundamental function of an ethical code of conduct is to help the management team and professional staff to sustain a system that enhances the quality of life, dignity, and wellbeing of all persons in need of care services.
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Interview with an Older Adult
Old people play a fundamental role in society, as they offer free guidance to the younger generation on various issues, which include relationships, health, finance, as well as political issues. However, old people usually encounter several challenges when they retire because society may isolate them, or they do not make good plans about it. The major challenge among older adults is health, where majority of them suffer from chronic illnesses. I decide to conduct an interview with Johnstone Pillemer, one of my grandfather’s closest friends, to understand his past life’s situation, his current, as well as his plan for the future. Pillemer is a retired banker, aged 71 years. He is now a retiree, who spends most of the time in his resident, with her wife, who is 67 years old. Their children, who are now adults, live away from their home, and they only come to visit them whenever they are free. This has made the family to hire a house-help, who undertakes the household chores, in addition to facilitating their medical attention in case they fell ill.
Report on the interview with Mr. Pillemer
I asked Mr. Pillemer about his childhood days in my first day’s visit, and he was eager to explain that he was raised in the urban setting, where all facilities were within a few kilometers from their home. Pillemer had grown as a healthy boy without suffering from serious illnesses that could demand spending some time in hospital beds. The environment was conducive, with minimum polluters. Just like any other child, he was fond of playing with his toys, as well as his pet dog, which he nicknamed Boyd. He was the last born in a family of three, which include two brothers and a sister. Pillemer claimed that his father was a wise man, who kept on reminding him of showing respect to elderly people because one day, he will be at the same situation as them, and he would demand respect from young people. He advised him that society has a role to play on the life of the older people. As a part of the society, he should visit the elderly people in hospitals, or in their homes, and assist them in any way that he deemed appropriate. Pellimer grew up knowing the essence of taking care of the old people, who are not even family members.
During my second day in Mr. Pillemer’s house, I decided to probe on how he spent his young adult life until the retirement age. Pillemer has worked in various banks with the borders of the US, and whenever he was transferred to a given branch, he moved with his family to the new city. Having a health insurance cover was a necessity in the banking sector, thus, Pellimer was enrolled in a private insurance cover that covered for him and the family members. Pellimer was also involved in community programs that offered voluntary services to older people in his home area, where he learned a lot from counselors and health care providers who joined the course. Inadequate facilities to cater for the elderly people, as well as financial constraints, were the major problems in the provision of health care to older people (de Guzman et al 309).
When Pillemer attained 45 years, has diagnosed with chronic lower respiratory ailment, a disease that made him spend several days in the hospital bed. Luckily, he has a health insurance card, which assisted him to cover all the medical requirements. Although he recovered at that time, the disease kept on disturbing him even after his retirement. Now that the bank cannot pay for his medical needs, Pillemer had prepared for such a time by enrolling in Medicare, the federal social insurance program that caters for the health needs of people over the age of 65 years. Pillemer is glad that Medicare has helped him to recover from his ailment, as well as assuring his family of his survival.
My third day with Mr. Pillemer focused on his future, as well as the role of society in taking care of the elderly people. He vividly explained how society could assist in taking care of the elderly people through various community-based programs. He emphasized that community is a place where people live in harmony, socialize, and undertake their daily responsibilities, and community-based programs should assist elderly people to face their future with ease through meeting their physical and mental needs. Although he has two sons and a daughter who are working, he feels lonely, and sometimes, depressed. He misses the time that the family used to live together. He hopes that they would learn from his noble deed and invest on their future.
Pillemer underlined the essence of community programs in facilitating for good health among the elderly people in society. He mentioned about senior centers that handle elderly people with disabilities. According to Stanhope and Lancaster, senior centers provides education, recreation, counseling, case management, therapies, among other services, to a group of older people who opt to remain independent in the community (368). These programs are capable of facilitating treatments of those who are severely affected by various illnesses and offer high quality care to the old people.
Individuals can also plan for their future by joining Medicaid or Medicare, depending on their levels of income. According to Pillemer, these programs are essential to cater for the health of individuals in their current life, as well as during their retirement, when they are unable to earn a living. Pillemer regrets that he has not saved enough to live the way he would have liked to. He thinks that children should reciprocate and provide their parents with resources that they lack, especially at this era of technology, so that they can eradicate loneliness. However, he is happy that he has laid a health foundation for his children, who have emulating his deeds.
Living a health life is fundamental in the life of retirees and elderly people in society. A big lesson that the young generation should learn from Mr. Pillemer is that they should be prepared to face the retirement by investing on health insurance, as well as good relationship with their family members, who can assist them in such a crucial time. Old people should not be perceived as a burden, as they still hold an essential part in the community. Children should take the responsibility of ensuring that their elderly parents receive the health care that is appropriate to their survival. Apart from individual efforts in catering for the health of the elderly people, the state and community has the capacity to identify, as well as execute appropriate strategies to promote the health of the aged people.
de Guzman, Allan B., et al. “Concept of Care, Caring Expectations, And Caring Frustrations of the Elderly Suffering from Chronic Illness.” Educational Gerontology 38.5 (2012): 299-313. Academic Search Premier. Web. 22 Nov. 2014.
Stanhope, Marcia, and Jeanette Lancaster. Foundations of Nursing in the Community: Community-oriented Practice. St. Luis, Mo: Elsevier, 2014. Print.
Stress and Coping Theory
Lazarus and Folkman Stress and Coping Theory
Lazarus and Folkman proposed a model that stresses on the transactional characteristics of stress. Based on their model, transaction occurs between an individual and the setting. Stress is a result of imbalance between demands and resources (Oxington, 2005, P. 54). Therefore, individuals get stressed when their demands exceed their resources (individuals’ ability to cope and mediate stress) (Oxington, 2005, P. 54). According to Lazarus and Folkman stress is “particular relationship between an individual and the environment that is appraised by the individual as a taxing or exceeding his/her resources and endangering his/her well- being” (Lazarus & Folkman, 1984; Hobfoll, 2004). This association is described by two main phases; Cognitive appraisals and coping.
This is a method of classifying an experience and its different features, based on its necessity for well-being (Lazarus & Folkman, 1984, P. 31). It is important to cognitively evaluate a situation as being potentially stressful, before coping with it. Cognitive appraisal is mental course where by two key factors are considered; whether individuals’ demand endangers their well-being and whether an individual considers that he/she has the resources to meet the demands of the stressor. There are two main types of appraisals; the primary appraisal and the secondary appraisal ( Bartlett, 1998).
- Primary Appraisal
This is a review of what is at risk. At this phase, individuals seek answers to the meaning of a situation regarding their well-being. For instance, individuals may ask themselves whether they are in trouble, or they are benefiting now or in the future and in what ways? If the answers to these questions are positive, then the situations can be classified as being a threat, a challenge, or a loss. Loss appraisal entails an injury or mischief that has already occurred. Threat and challenge appraisals describe occurrence in the past or the ones that are anticipated. Threat describes a potential danger to an individual’s well being, while challenge suggests that one concentrates on the success that a situation might bring about. Threat and challenge are known to be negatively correlated, however, there are instances where they can occur simultaneously. For instance, Lazarus and Folkman demonstrated that students waiting for an examination appraised the forthcoming event as mainly threatening and challenging (Lazarus & Folkman, 1984).
- Secondary Appraisal
This is normally occurs at the same occasion as the primary appraisal. It is an evaluation of the coping resources and solution to the question of whether an individual is able to cope with a situation. It demonstrates confidence in an individual’s ability to cope with a situation because of the availability of resources to do so. Resources may be corporeal, societal, emotional or material. Secondary appraisal is a review of the perceived resources, deal with a danger. Individuals who are considered affluent, healthy, and optimistic are regarded as resourceful and thus less vulnerable towards a stressful situation (Driskell & Salas, 1996). For example, a research was once carried out concerning the association between self-efficacy and precise health consequences, such as recuperation from a surgical treatment or the process of adapting to a chronic illness. The result of the research was that patients with high self-efficacy beliefs were found out to be better able to cope with pain than the patients with low self-efficacy. Self-efficacy is considered to have an effect on blood pressure, heartbeat, and serum catecholamine levels in coping with incidents that are regarded as a challenge or a threat (Schwarzer, 1998; Schwarzer & Fuchs, 1996).
This is the cognitive and behavioral efforts to understand, minimize or endure the inner and the outer demands that develop as a result of the stressful operation (Lazarus & Folkman, 1984). Lazarus and Folkman stated that coping serves two main functions; the regulation of sentiments and distresses that lead to stressful situations and the management of an issue that causes stress by directly altering the factors of a stressful situation. These forms of coping are based on the way individuals appraise a situation and the antecedents of the model. Lazarus and Folkman identified two main classifications of antecedents, which directly influence the way individuals appraise and cope with situations; the ones associated with the nature of an individual and those associated with the nature of the event. Early researchers investigated the relationship between stressful situation and individual distress. The result was that stressful situation accounted for ten percent of the changes in distress. The coping behavior of a person may contribute to the evaluation of the amount of distress one experiences (Robert-McComb, 2001).
Lazarus and Folkman classified coping into two main categories; Problem focused and emotional focused, where problem focused entails efforts to manipulate a situation that causes stress. Conversely, emotionally focused entails the demonstration of the emotional responses that are as a result of a situation that causes stress (Fridenberg, 2004, P. 281). For example, to understand the determinants of life of a cancer patient, numerous treatments are required, which should contain the cognitive appraisals and the coping strategies. In this case, the cognitive appraisals include the recognition of threat occurrence and self-efficiency in the adaptation of health behavior recommendations. The coping strategies may include motivational messages as well as coping abilities, training practices (Glanz & Viswanath, 2008; Lyon, 2000).
Lazarus and Folkman Stress and coping theory is a system for assessing the process of coping with stressful experiences. Stressful encounters are interpreted as individual-environment transactions, which are dependent on the impact of the external stressor. This is arbitrated by an individual’s appraisal of the stressor and the social as well as the cultural resources at one’s disposal. The model by Lazarus and Folkman is mainly helpful for health learning and support as well as disease deterrence. Stress affects individuals differently and may cause illness and bad experiences. Coping with stress is thus a fundamental issue.
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New Jersey Health Insurance Benefit Analysis
According to the National Conference of State Legislature, on the mandated health insurance benefits, there are regulations that New Jersey State is yet to meet in basic healthcare provision. Moreover, based on the insurance mandate, New Jersey’s state not for profit healthcare services is not adequately covered. The law does not provide clear guidance on how to apply the rule in states that offer subsided healthcare. The challenge arises when hospitals in states such as New Jersey seek tax exemption in the disguise of not-for-profit healthcare providers. However, such hospitals have been associated with for-profit activities such as liaising with for-profit subsidiaries run by for-profit physicians.
According to the universal health care mandates in the United States, it can be concluded that New Jersey does not necessarily have better health insurance mandates as compared to other states. In fact, according to Schencker, the unique non-profit plan used in the state has contributed to the aggressive debt collection used by state mechanism on patients.
The Affordable Care Act (ACA) plays a significant role in the mandates by providing for standard coverage rates across all states in the United States. In simple terms, the ACA will make sure citizens can access any form of healthcare despite their geographical location as this will be cost effective and time management considered. On the same note, insurance providers will cover certain mandated benefits without any additional charges. Finally, the ACA plays a significant role in setting the requirements needed for one to qualify for state and federal healthcare insurance benefits. Nonetheless, every state has the liberty to restrict, repeal, or modify the mandates that had been passed before the enactment of the Affordable Care Act.
NCSL. “State Insurance Mandates and the ACA Essential Benefits Provisions.” Ncsl.org. Web. 5 Apr. 2016.
Schencker, Lisa. “Not-For-Profit Hospital’s Tax Exemption Case Could Signal Trouble for Others.” Modern Healthcare 2015: N.p. Web. 5 Apr. 2016.
There has been increasing demand, production, and consumption of energy drinks in many countries worldwide. The energy drink industry has been able to produce a sophisticated variety of products to suit the ever-changing consumer demands. This has resultedin the creation of various brands, such as Red Bull, Monster, Shark, Mountain Dew, Lucozade, Mother, and LiquidX among others. This paper will discuss the advantages and disadvantages of Red Bull, and find out whether it is recommended or its consumption may affect the consumer.
Red Bull was invented by Dietrich Mateschitz in the year 1987 after partnering with Chaleo Yoovidhya in Thailand. Dietrich drew the inspiration to create this product from an energy drink that already existed in Thailand known as Krating Daeng. He wanted to create such a drink for the Western countries.Dietrichmade some modification of the ingredients used to manufacture Krating Daeng and finally came up with Red Bull as a new product. Today, the product is being sold by Red Bull GmbH, an Australian company, packed in a tall slim blue-silver can, and it has penetrated the industry market to become the highest-selling energy drink globally. Red Bull has maintained its visibility in the world market through adverts, celebrity endorsements, sports team ownership, and Red Bull-sponsored events (Alford &Wescott, 2001).
There have been continuous claims associating energy drinks with health-related risks. Some claims are that repeatedly consuming, or excessively consuming it could lead to psychiatric and cardiac conditions. Others say that there could be intoxication if such energy drinks are taken with alcohol. Red Bull, however, is meant to provide the body some extra vital nutrients and energy, especially to those who engage in physical activities requiring a high level of energy, such as outdoor sports. Its ingredients are taurine, sucrose, glucose, caffeine and B vitamins (B3, B5, B6, and B12). Even with such claims of health risks, EFSA (European Food and Safety Authority) indicates that the amount of caffeine contained in Red Bull cans is not likely to interact adversely with alcohol or other constituents of energy drinks.
Therefore, this topic was chosen to critically research and examine the advantages of consuming such drinks, in this case, Red Bull, the disadvantages of using it, and find out if it is recommended or if its consumption may affect the consumer or benefit them health wise. This is a detailed study ranging from the ingredient analysis, analysis of provisions of authorities responsible for health products regulation, the parties that have benefited or have been negatively affected by consuming the product, and the media influence among many other variables.
Arguments in Support of Red Bull Consumption
Since Red Bull is a product that touches on the health of individuals, it has received mixed reactions from its market, some in support for, and some against it. However, why is it still very popular in the global market? It is clear that anything of no good, or any product that puts lives at risk can never receive the attention of such a large number of consumers, especially when there are many other competitor products in the same market. Hence, since in 2013, Red Bull saw a massive sale of 5.387 billion cans.There have to be positive reasons behind such love for the product.
Firstly, as indicated before, Red Bull contains a lot of important nutrients in form of ingredients. Such nutrients are needed not only by physically active persons, but also everyone uses them. The combination of all these ingredients make up the energy drink.
Caffeine has been proved through scientific studies to improve human performance in endurance sports and activities by as much as 19 per cent. The United States Department of Health and Human Services conducted a study with the United States Department of Agriculture to reveal that consuming the amount of caffeine contained in 3 to 5 coffee cups on a day-to-day basis is safe and can reduce the risk of cardiovascular diseases and type 2 diabetes in adults. Evidence from the research also showed the ability of caffeine to protect the body against Parkinson’s disease (Candow & Grenier, 2009). The caffeine contained in the energy drinks like Red Bull is the main reason behind the increased attention, increased reaction to speed, and overall improved cognitive performance in the people who take the drinks.
Athletic and performance have also been proved to be increased by some percentage after taking the Red Bull. In prolonged driving, for instance, such energy drinks have been seen to improve the performance, and that is why energy drinks are used by most sports drivers, Red Bull and Formula 1 being the most accurate example. Other tests indicated that the Red Bull drink increased power and endurance on those who took the energy drink. Repeated Red Bull tests were conducted on young adults in Wingate and found out that it increased the endurance of the upper body muscles significantly in young adults, which is a very positive effect of the taking the drink (Ragsdale & Batool, 2010). The amount of caffeine and the sugar level in Red Bull energy drink is almost the same as those contained in coffee and fruit juices. Therefore, there is no cause for alarm when taking Red Bull, as long as a person does not consume it repeatedly and frequently.
Additionally, Taurine is among the constituents used in making different energy drinks. Despite the fact that taurine is efficiently available in healthy humans, some may lack the adequate amount due to issues, such as kidney problems, liver problems, and heart failure among others. Certain diets may also inhibit its availability in enough quantity, such as the vegetarian diet. Taurine helps the body to improve hearing functions, electrolyte balance, insulin sensitivity immune modulation and cardiovascular health if it is in adequate amounts in the body. Red Bull uses taurine as an ingredient, hence, ensures such important functions of taurine to the body are taken care of.
Sucrose and glucose used in the manufacture of Red Bull is the main reason it is known as ‘energy drink’. Consuming adequate amounts of sucrose and glucose ensures the availability of optimal amount of energy needed by the body. Only excess consumption of these essential elements may lead to sugar-related diseases.Therefore, Red Bull has taken into consideration this fact, and the drink is made using the recommended amount for each can.The drink does not put the life of the consumer at risk (Astorino & Evans, 2012). This means that consuming a few cans of the drink a day may not disturb the general well-being of the body system, but it may have a positive impact on the energy and performance levels.
Red Bull’s Positive Representation in the Media
Red Bull has a very visible media image all over the world. It mainly targets young adults and those who engage in extreme sports ranging from snowboarding, windsurfing, cliff-diving, motocross, rally, Formula one and many others. It also uses video games like PlayStation 3 and Worms 3D, music and even celebrity endorsements (e.g. the Red Bull EmSee Battle Rap Championship sponsored by Eminem). Red Bull hosts various events including Red Bull Flugtag and other art shows, aside from its ownership of football teams in different countries like Germany, Austria, Brazil and the United States of America. Red Bull has so far established a market for well over 150 related kinds of merchandise.
Arguments Against Red Bull Consumption
As Red Bull celebrates its success regarding broad market acceptance and superior competitive advantage in its industry, there have been various concerns related to health impacts of the same product. However, it has come from a slight percentage of the consumers, and the company has continually reviewed the issues and produced safer products (Forbes & Chilibeck, 2007). There was a taurine concern raised by a French food safety agency since some people did not recommend the addition of the element to their body systems since it is right that a healthy body already has an adequate amount of the same. It was, however, easy for the Red Bull company as it introduced Red Bull without taurine. Regarding caffeine, glucose and sucrose in the product, there is no concern unless too much Red Bull is taken.
Therefore, it is clear that the positive impacts of taking Red Bull drink outweigh the adverse effects, which are very minimal and they only depend on excessive consumption of the product. The body needs extra energy at some point in time, for instance, when undertaking activities that require the addition of caffeine, taurine, glucose and sucrose as components of Red Bull. This is the cause of overwhelming demand and consumption of Red Bull by celebrities, sports stars, and the general population. I highly recommend the usage of Red Bull to an average young adult.
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Taming the Cost of Medicare Program
Healthcare administration across United States faces diverse challenges emphasizing urgent reforms are needed. According to Niall, Nicole, Lawrence, Aaron, Marisa, Nadia, Mark, and Reginald, approximately forty six million citizens in the country are not insured. Conversely, insured Americans have to deal with rapid increases in premiums which are often classified under out-of-the pocket costs. President Barrack Obama and the Congress have had to consider ways of investing in healthcare while reducing number of citizens suffering due to lack of insurance coverage. The president has always stated that, addressing shortfalls with regard to healthcare quality and efficiency ought to be undertaken simultaneously. This will ensure healthcare costs are also addressed and poor healthcare outcomes resolved. As a result, feasibility and sustainability of quality and efficient healthcare ought to ensure systems and facilities are reformed and reorganized (Niall, Nicole, Lawrence, Aaron, Marisa, Nadia, Mark, & Reginald, 2009).
The Patient Protection and Affordable Care Act was developed to achieve the primary goal of providing Americans and legal residents across United States with universal quality healthcare services. It was therefore fully implemented to ensure citizens access universal healthcare insurance including the uninsured and underinsured. Universal public healthcare systems aim at ensuring the reforms are undertaken for healthcare insurances to increase and costs to reduce to enhance affordability rates among Americans and legal residents in the country. For example, more than two trillion dollars were spent by Americans which was more than seventeen percent of the country’s Gross Domestic Product in 2009 on healthcare (Susan, 2012).
The amount has been rising with predictions affirming the trend will be observed for several decades if serious interventions and reforms are not undertaken. This led the healthcare administration to target thirty two million citizens by 2014 that ought to have healthcare insurance. Although it was a tipping point within the fiscally overblown healthcare system, the reform has increased number of people able to access and afford healthcare services. The changes however slow, have been promising. For example, spending on federal healthcare programs including Medicaid and Medicare as well as Children’s Health Insurance Program (CHIP) has enabled a larger number of citizens to be reached and assisted in accessing healthcare services. The growing and unsustainable federal debt should therefore be addressed to guarantee more people will qualify for healthcare insurance in the future. Consequently, they will be enabled to access and afford quality and efficient healthcare services across diverse healthcare systems in the country (Susan, 2012).
Current Issues Affecting Healthcare Administration, Systems, and Industry
Population Health Issues
According to Shannon, Molly, Heather, Emily, Ellie, and Tamara, there are at least ten challenges affecting healthcare systems and administration in the country. The population health has always been considered as the major idea to be applied in maintaining or gaining momentum in the nation’s healthcare administration. Population refers to the multidisciplinary concept shared among social institution, policymakers, and public healthcare agencies. As a result, hospitals are required to play the role of providing expertise healthcare services to the population. This role however has been overwhelming as population health is ranked among the hardest skills set to find across the broader healthcare field (Shannon, Molly, Heather, Emily, Ellie, & Tamara, 2014).
In 2014, American Hospital Associated conducted a survey during which more than fifty percent of the executives identified that, management of community and population health suffers from a talent gap. The survey therefore provided proof that the talent gap across healthcare systems are often filled through creation of new positions such as executive and chief population health managers. This further challenges the process of quantifying the population health as healthcare leaders need to creatively think and develop methods improving health qualities and efficiencies across geographic populations. The leaders are also required to maintain healthy senses of skepticism with regards to populations’ efforts towards achieving and sustaining quality healthcare systems. Thus, the act of oversimplifying issues while overinvesting solutions for positive healthcare outcomes is not sustainable in improving healthcare administration (Shannon, Molly, Heather, Emily, Ellie, & Tamara, 2014).
Challenges Experienced when Shifting from Volume-based to Value-based Reimbursements
The second issue witnessed in healthcare administration involves shifts from volume-based to value-based reimbursements. This issue is described as inevitable as it depends on how quickly healthcare providers are able to make it successfully. For example, some medical facilities move too fast in providing healthcare services. They however also increase the risk of losing revenues and putting into practice strategies that are neither practical nor supported by the market. Conversely, some healthcare facilities move too slowly in providing healthcare services. This enhances the risk of either building or loosing opportunistic partnerships comprising of experienced and qualified healthcare providers. More so, a lot of time is utilized providing the healthcare services rather than modifying and transforming medical services and practices. A national study was conducted in 2014 by McKesson. The findings revealed that, at least ninety percent of healthcare payers and providers have transitioned to value-based reimbursement. As a result, healthcare providers including accountable-care organizations are very reluctant to embrace value-based healthcare initiatives, systems, and programs. Thus, at least sixty percent of healthcare payers and thirty five percent of healthcare providers have developed and embraced the behavior of believing in value-based reimbursement as it has a positive financial effect (Steven, & Peter, 2010).
Ineffective Hospital Infection Control and Prevention Programs
The third issue refers to hospital infection control and prevention programs. In 2014 in light of Ebola, the programs discovered new fame as healthcare facilities across United States received more attention from people and organizations afraid of contracting the disease. United States borders have been steering the citizens towards healthcare providers in order to be treated for infections. The providers are also required to develop and implement control measures to reduce the rate at which Ebola as well as other medical conditions are spread in the country. These efforts however, led to a larger number of healthcare providers being infected with Ebola as more than one million healthcare-associated infections were reported in United States by the Centers for Disease Control and Prevention. These revelations are neither positive nor promising as they affirm the country’s infection, control, and prevention not strong or properly managed. Ebola infections have therefore acted as a way of enlightening the healthcare administration. They have raised awareness on the need to prevent infections. The healthcare administration ought to acknowledge, hospital infection control and prevention programs were developed to protect citizens from various diseases. More so, the programs reduce the number of Americans and legal residents likely to suffer from an infection or disease healthcare systems were required to prevent from spreading. Consequently, the amount of healthcare costs incurred the healthcare administration is reduced drastically as citizens are protected (Thomas, & Hoangmai, 2016).
Jumbled Healthcare Information Technology: Data Storage
Healthcare systems have often been described as jumbled collections of facilities operating under diverse cultures, strategies, campaigns, and reimbursement rates. Healthcare executives have been realizing the systems have not been successfully posting healthcare transactions. For example, a research conducted by Strategy and Booz Company affirmed healthcare transactions are not always successful. More so, a study was conducted among hospitals between 1998 and 2008. The findings affirmed that, only forty one percent were able to outperform peers with regards to operating income and margins. Thus, various healthcare facilities had failed to identify synergies required to make wise, practical, and manageable decisions. They therefore develop alliances and power bases making it hard to make difficult decisions within healthcare strategies (Fisher, Goodman, &Skinner, 2009).
The healthcare sector generates huge amounts of data on a daily basis. More so, the sector generates big buzzwords as the healthcare information technology supports innovation. It is also developed to operate under diverse healthcare disruptions while accessing big data and supporting bigger ideas that are either consumer or clinically driven. For example, the IBM supercomputer Watson was developed and tailored to suit treatment plans according to peoples’ genetics. The Telehealth is therefore applied in providing world class healthcare services to people located in the most remote areas across the country. In 2015, Apple, Samsung, and Microsoft among others participated in the launching of platforms dedicated in providing quality healthcare services to enhance wellness across the country. These organizations participated to ensure the process tracks the patient’s progress as they provided wearable consumer technology to the receivers. The advances witnessed across the healthcare information technology however have increased the rate at which data has been piling up as they have improved the speed. As a result, healthcare managers working in a healthcare system’s data warehouse have to work closely with other teams and stakeholders in delivering patient care under meaningful insights. This requires backdated systems to track without system-wide infrastructures to leverage the process. This issue has been a great challenge as making sense of data based on how it is stored and brought together for health managers to gain comprehensive understanding has been exigent (Shannon, Molly, Heather, Emily, Ellie, & Tamara, 2014).
This has encouraged healthcare managers to rely on descriptive and predictive analytics when analyzing big data. This helps them in understanding why patient return seeking further treatment. It also assists in predicting when a patient is likely to return. Consequently, healthcare givers have to understand the causes of a patient returning by being proactive with each patient in order to provide better healthcare attention. The experts within healthcare organizations therefore strive being proactive in provide medical care at reduced costs for improved outcomes. The data developed through this process however has to be integrated which has been challenging. Healthcare organizations relying on data warehousing have had either to move or leave some data (Shannon, Molly, Heather, Emily, Ellie, & Tamara, 2014).
Resolving the population health issue has to involve healthcare leaders. The leaders ought to reduce reliance levels on traditional programs. Conversely, the leaders should focus on establishing new partnerships with communities as well as private, public, and non-profit making organizations. More so, healthcare systems ignoring wealth associated with expertise and sufficient resource allocation in order to act autonomously will be reformed. Consequently, issues involving domestic violence, cases of sexual and elderly abuses and public healthcare crises will be identified and resolved by health managers and leaders with sufficient resources and qualified expertise. Accountability will also increase among healthcare organizations prompting them to develop and implement unique programs responding to issues affecting population health (Shannon, Molly, Heather, Emily, Ellie, & Tamara, 2014).
Consequently, resolving the issue associated with shift from volume-based to value-based reimbursement of healthcare services, a new model ought to be developed. The model ought to ensure healthcare payers and providers agree to replace the traditional program paying more attention on the amount of fees paid for a service. The new model should therefore focus on providing healthcare seekers and payers with quality and efficient services. For example, a mixed model that does not rely on the fee-for-service should be developed in order for the traditional program to be completely replaced by 2020. The pay-for-performance model has also been introduced in the market. Healthcare payers are required to make necessary transitions as worthwhile and efficient as possible for providers. Conversely, the healthcare providers ought to adjust their thinking from short-term to long-term. Healthcare leaders and executives should therefore build strategic plans detailing how healthcare organizations ought to develop in a period of at least five years. The plan however, ought to be detailed, flexible, and consistent with environmental changes (Bruce, Kosuke, Sara, & Kate, 2010).
Conversely, resolving the issue allied to infection control and prevention programs across various hospitals in the country sorely involves the healthcare industry undergoing reforms. Foremost, the government should invest in the programs in terms of human capital and medical resources. The government should therefore ensure qualified personnel with adequate skills and experience are tasked with the role of preventing citizens from various infections and diseases. Consequently, healthcare personnel should focus on performing day to day tasks crucial in controlling and preventing infections and diseases. They should undergo retaining to acknowledge the importance of donning and doffing personal protection gears properly. This will effectively and efficiently deal with infections and diseases while the prevention team collectively provides the much needed healthcare averting. Lastly, raising public awareness on the need to perform proper hygiene is vital as it will control and prevent other diverse infections. The culture of infection prevention should therefore be encouraged and supported as it can emphasize the need to develop and embrace programs among citizens, patients, and organizations as well as private and public sectors (Thomas, & Hoangmai, 2016).
In order to resolve the issue allied to integration of efficient healthcare systems, traditional integration approaches ought to acknowledge the need to merge assets. The process of merging and acquisition of healthcare systems and assets is bound to maximize synergy opportunities. As a result, a focus on footprint, operations, head counts, and cost reductions should be paid in order to enhance capabilities among healthcare systems in the country. Achieving true integration of healthcare systems however requires reevaluation and development of integration strategies. This will ensure stalled integrated healthcare systems with reserved mutually reinforcing capacities continue to achieve the benefits. Consequently, they can be gradually improved during integration process based on the strategy and objective roadmap. More importantly, the integrated healthcare systems should be utilized in setting and creation of milestones and temporary transformations. This will ensure difficult decisions and policies guaranteeing positive changes and efficient quality outcomes are formulated and implemented. This however requires a transformation office to be established to act as an unbiased third party driving the process of integrating healthcare systems. Lastly, healthcare facilities should recruit and train staffs with specific skills required in operating integrated systems (Brenda, & Jeanette, 2011).
The issue involving jumbled healthcare information technology with regards to data is closely associated with lack of interoperation in the sector and industry. Healthcare information technology lacking interoperation in the sector and industry should therefore be addressed as the incapability has been crippling the healthcare’s analytical capabilities. Although identifying easy solutions to this issue can also be challenging, advancing healthcare information technology should embrace population health based preventive analytics. They can be effective and impressive as healthcare experts can utilize them in identifying factors crippling particular patients’ healthcare strengths. Consequently, they can develop treatment measures to undertake in order to control and prevent healthcare risks in the future. Thus, the population health-based preventive analysis should be embraced as it will leverage health data while managing population health and pursuing value-based care (Shannon, Molly, Heather, Emily, Ellie, & Tamara, 2014).
In 2010, the government had to spend over eight thousand dollars per citizen on healthcare costs. The amount is more than twice the amount of medical care costs incurred by other advanced and developed nations such as Japan, Germany, and Canada. This revelation however, should not be applied in claiming or judging United States healthcare sector as either bad or ineffective. Instead, it should be applied in justifying that the healthcare administration within the country is expensive. The government is required to take responsibilities involved in payment of healthcare costs through Medicare and Medicaid which has been a burden especially for the poor. Addressing the issues affecting the healthcare sector in the country will therefore ensure future generations do not experience the current challenges (Thomas, & Hoangmai, 2016).
As a result, the first recommendation involves ensuring medical costs are reduced. They have been rising due to reasons beyond demographics of the aging nation. This has encouraged people as well as healthcare seekers and providers to opt for greater volume of healthcare services leaning towards volume-based reimbursement. This explains why Americans have been purchasing improved healthcare services as income levels increase. This however, does not guarantee improved healthcare outcomes even without making wasteful decisions. All levels of healthcare ranging between consumers’ co-payment to government spending has incurred eighteen percent of the nation’s Gross Domestic Product. This translates to the government incurring one dollar for every five dollars an individual is required to pay for medical care. The medical costs should therefore be cut down by at least thirty percent to resolve fiscal crises in the country. To achieve this objective, the following steps should be undertaken (Mark, 2013).
Foremost, traditional healthcare practices including Medicare payments indirectly in support of medical education should be declared obsolete. This will encourage and enable the government to invest in doctor training a process that can save the nation more than five billion on yearly basis. Several people that are Medicare beneficiaries often sped a lifetime contributing payroll taxes during their working years. They also continue to pay premiums after retiring. These hurdles however, do not guarantee that the beneficiaries will utilize the medical cover maximally. Thus, the entitlement bomb that is likely to increase by 2037 among beneficiaries ranging between fifty and eighty million is adversely affecting the federal budget. Consequently, social security claiming the nation’s financial resources for almost a decade will rise. The president and Congress should therefore make legislations reforming the entitlement claims among citizens. Fiscal crises will decrease prompting the national debt to decrease accordingly. Consequently, the government can focus on allocating funds, resources, and staffs in implementing the viable solutions discussed above to resolve the issues affecting United States healthcare sector (Fisher, Goodman, &Skinner, 2009).
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