The Healthcare Effectiveness Data and Information Set (HEDIS) and The Joint Commission grew out of a movement, which recognized the need to identify and measure quality health care in the United States. The origins of HEDIS and the Joint Commission may be traced to the establishment of “a minimum standards for hospital care” adopted by the American College of Surgeons as a part of the Hospitalization Standardization Program. The ACS directly linked quality medical care with a quality patient record. The concept of quality measurement came to light when statistician Walter A. Shewhart identifies good processes equal a good product.
a. According to Yoder-Wise (2015) complexity, formalization and centralization are characters that classifies a organization.(p. 141) All of these characteristics apply to Health care organization, but to what degree does a healthcare organization use each of these characteristics? In today 's Health Delivery organization I see a vision or movement toward shared governance. With this being said Health organization are more focused on decreasing hierarchies or complexity and using decentralization; Magnet Recognition Program is an example. (Yoder-wise 2015 p. 149) I have choice these to component because I have noticed a lot of hospitals achieving or wanted to achieve Magnet status. With the shared governance model management and administration
Education, empowerment, social change, support, advocacy and medical are government strategies set out for health promotion and there are health promotion models that are linked to these strategies: Becker model (1974), Caplan and Holland (1990), Beattie (1991), Tannahill and Downie (1996), Tone and Tilford (1994). Becker Model (1994) Is one of the wellbeing advancement models called wellbeing conviction model communicated that whether she/his ' conduct as capacity of the individual 's appraisal of benefits and danger of that activity, his/she conviction about danger reality to strength of not making a move and how far she/his acknowledges the action will alter or settle the risk. Caplan and Holland model (1990) this model is hypothetically decided and is more unpredictable. It tries to investigate what achieves incredible wellbeing and debilitated wellbeing and the activities to be utilized to address wellbeing issues.
The Biomedical model of health has influenced the provision and delivery of healthcare for over a century (Wade, 2004). This conceptual model was founded on the belief that the mind and body are separate and that all diseases and disorders can be explained (Sarafino, 2008). Ergo, this approach concentrates predominately on the physical processes and looks at biochemistry, pathology and physiology to explain illness or disease (Placeholder3). As a consequence, medical intervention is the primary method used to diagnose, treat and return the health of an individual to a pre-illness state (Wade, 2004).
The first individual right under the health care system is "rights related to receiving services provided under healthcare, health financing, or health insurance laws. An example of this right is the Patient Self Determination Act. This act is a federal law that requires health care organizations, such as hospitals and nursing homes to provide information on advance directives, must ask you whether you have an advance directive, and provide information of your rights under state law, such as the right to refuse treatment. This law ensures that a patient 's right to self-determination in health care decisions is communicated.
Health care in many parts of the world is considered a basic right that should be given to people. Access is crucial in order to ensure the efficient delivery of basic health care services. In general, health care systems are organized in order to provide treatment of diagnosed health care problems and these systems are usually government-run, meaning they utilize the people's taxes. Though most of the health care systems differ, they share common goals and outcomes as well as features that identify them with the universal health standards. Since the end of the Second World War, universal health coverage remained a contentious public issue in the United States.
I was shocked when the Cleveland Clinic Foundation announced that they were no longer accepting Caresource insurance which is part of the Medicaid program. I knew that this was going to affect a lot of people who count on Cleveland Clinic Foundation for their care. Also, our advancements in technology have been astonishing but still present as a concern because of the cost to purchase, operate, and maintain the equipment is a huge investment in which sometimes the federal government provides financial coverage. In summary, these predicted increases in health care costs must be looked at in terms of prevention and/or cure and effective planning for the the future must start
Patients in different healthcare settings are vulnerable due to their conditions and sometimes lack the ability to share their challenges such as poor quality treatment and hospital-associated infections. There are cases when hospitals undermine ethics and ignore their patients’ values and interests. Healthcare professionals therefore have a responsibility to empower their patients with information on important medical decisions. However, some nurses ignore the need to communicate the risk of hospital-associated infections leading to undesirable outcomes. In cases when a hospital records a higher rate of HAI, it is important to inform a patient of the risk.
In the article “Medical Technology and Ethical Issues” by William E. Thompson and Joseph V. Hickey give the pros and cons of medical technology deciding patient outcomes instead of a doctors instincts. Critics and ethicists are against the RIP system. According to the authors, the program makes informed decisions about life saving treatments. “In emergency rooms across the world, this program is helping doctors make life–saving treatments or simply allow patients to die. Using statistical probability, the program analyzes all of the input on a particular patient and makes a prognosis on the likely hood of survival”.
HIPAA policy is divided into several titles. The title 1 of HIPAA will secure health insurance for various employees and their relevant families when the employees lose or change their specific jobs. The title II of HIPAA is also known as Administrative Simplification Specification (AS), which will require the standardization of various national standards for secured electronic healthcare data transactions and national identifiers for various providers, health insurance plans and organizations. The official HIPAA privacy rule was first published on April 14, 2003 that had one-year validity with certain schemes.
They are as a result treating more patients, are under more pressure and thus reducing the quality of care for patients. A recent AOTA article describing the current PPS in SNFs concluded that need for the Centers for Medicare and Medicaid Services (CMS) to implement a new system of therapy payment is crucial because patients are not being given quality care they need due to dictated frequency of therapy (Red Flags, 2015). It further suggests that the focus of new payment method should be on patient characteristics rather than the quantity of therapy delivered (Red Flags, 2015). Therapists also have to guess what services they are going to deliver to a patient rather than in the past when itemized bills or actual costs were sent to insurance companies after the services were provided (cost-based reimbursement, retrospective payment plan). Current and future occupational therapists should have an understanding of the Medicare A PPS system and be aware of annual PPS rule changes if working in a skilled nursing facility or related inpatient setting.
CPT codes were developed and maintained as a collection of codes that represents procedures, supplies, products and services. That is acceptable to Medicare and Medicaid beneficiaries, as well as private health insurance programs . Level 1 codes were developed and maintained by the AMA. The CPT primary coding system is used in the out-patient setting to code professional services provided to patient 's . Level 2 codes are National codes that are a five-positioned alphanumeric codes representing physician and non-physician services and supplies that are not represented in the Level 1 codes.
Second, the medical apps endanger the privacy of personal and medical information of the patients. For some people easy access to care is more important and on the contrary, for some privacy is the priority. Health care managers need to reassure that the application of eMedicine will not increase the chances of fraud and misuse of the confidential information. Third, high-cost patients like dual-eligible- both enrolled in Medicare and Medicaid- consume most of the health care resources. Also some patients wait till their health problem reaches emergency situations and their visit to to the emergency department is noticeable.
Most of the US health policy revolves around insurance companies (payors), hospitals and doctors (providers), and the government in shape of Center for Medicare and Medicaid Services (CMS). The corporatization, rationalization (via Managed Care), and technological advances have been a blessing and a curse for health care delivery. The continued push for new gadgets without clear benchmarks, need gap analysis, or its correlation to the health care quality has led to the exponential growth in health care costs while our politicians have been busy wrapping themselves with the US Constitution and debating whether health care is a right. However, it is well documented that very little was known of medical science in 1776, let alone the imagination to cement health care as a right in the Constitution at that time. In the words of Hanoura of T.C. William High School, “Now, when the founding fathers were drafting the constitution, the idea of someone two hundred years later not being able to pay for their chemo treatments most likely did not cross their minds” (Hanoura, Is Healthcare a Right?