What examples of public health and prevention can you identify in your daily life? How do you believe they have affected your health?
Complete the readings and video then consider and respond to these ideas:
Why can’t public health do more to achieve its goals? Name some of the political, legal, logistic, and resource challenges. How can we overcome these challenges?
What level of governmental is appropriate when it comes to population interventions (for example helmet laws, seatbelt laws, smoking restrictions) in order to achieve public health goals? Why? What about the consequences of those actions; who would be responsible for paying for related health care issues?
Tell us about a population that you think is ‘vulnerable’ in regards to getting health care. Why do you consider them vulnerable? Do you encounter this vulnerable group in your daily life? Do you provide any services to your identified group of vulnerable people?
Now that you have read the materials for this week, do some research of your own and discuss the following:
How have programs and interventions for promoting healthy behavior changed over the past 40 years? Do you think they are more successful or less?
How have personal health behaviors impacted public health and as a consequence impacted the cost of health care in the United States? (Identify specific health behaviors in your discussion).
Recommend and discuss ways that we, as a nation, can improve delivery of health care services to vulnerable populations? Support your ideas with the textbook, and any of your own discovered resources.
In general, would you characterize the delivery of health care in the United States as imperfect or just about right for our society? Are there certain types of services that are more imperfect than others? How so? Think about the positive and detrimental external forces affecting delivery as you discuss with each other.
Now applying what you have learned from the readings and videos, let’s go through the rest of the discussion together, one question at a time.
Discuss how the focus on wellness and preventative care might affect the delivery of care? How will it affect the population? What types of preventative care might become high priority?
We are facing key shortages in the health care work force. Confer with your classmates how you believe the characteristics of the health care system and other key determinants of physician and nursing requirements will change over the next two decades.
In your opinion, what complications are caused by our insurance system to individual consumers?
Complete the readings and review the websites, then consider and respond to these prompts:
What complications does our current financing system cause for care providers?
What are some of the promising new approaches to changing our health system so that it has incentives to provide more efficient care?
What are your suggestions for this organization to prepare for P4P?
How do you envision this preparation affecting work with/for other stakeholders?
Consider the roles of health care quality management entities as you prepare to engage in this discussion. For this discussion, let’s focus on a few major organizations that have a regulatory, oversight, and/or funding function: Centers for Medicare and Medicaid Services (CMS), The Joint Commission (TJC), and your state health department.
Use the following case study as the basis of this discussion. Following the case study is a set of questions to discuss.
You have just completed your first week employed as assistant executive manager in a 180-bed skilled nursing facility, named Sanctuary Nursing Home. On your first day, the facility CEO gave you a tour of the facility, introducing you to staff and residents. Throughout the week, you have been observing and getting to know your staff and residents.
Now, as your first full week on the job winds to a close, you are dismayed to notice a pattern of care indicative of some organizational deficiencies. Some of these problems are so serious that, were an inspection to happen today, Sanctuary would likely receive a number of citations. Most of these issues have the potential to cause at least minimal harm.
The list of problems you have noticed includes:
There is urine and/or feces on the bathroom floors of several incontinent patients.
Less than 40% of staff and 70% of residents received an influenza vaccine this year.
Medication patches ordered “discontinued” for a resident were found on the resident’s shoulder one day after the discontinuation order was placed in chart.
Four activities scheduled on the Recreation Calendar were cancelled within your first week without notice, leaving residents sitting in front of the television in the activity room.
As a new manager, you recognize a need to: 1) engage in an in-depth assessment of quality of care being provided at Sanctuary, and 2) develop a plan to proactively improve care quality and prevent citations or sanctions from external oversight entities.
First, let’s start with a question based on your opinion (to be posted by Wednesday):
Do you think that the situation as described here at Sanctuary is typical of skilled nursing facilities, or do you think that nursing homes suffer from poor, inaccurate press based on a few isolated situations?
For the rest of the questions you will need to read the text, articles, and Module Notes so you can meaningfully integrate into your posts what you are learning.
How do you think that oversight entities, such as the CMS, TJC, and your state health department, inspecting your facility would react to the problems at Sanctuary? What penalties might they impose and what would the impact of the penalty/penalties be on your nursing home? How could they be helpful in improving quality?
How could you/your team incorporate quality improvement tools described in your readings? What barriers do you anticipate and how might you overcome them? What would your first steps be?
The various issues discussed in this module center on how our health care system will be reformed, no longer on whether it should be reformed. As you engage in discussion, think about what needs to happen for Americans to buy into a philosophical framework for reform, and how a philosophical framework leads to advances in such areas as heightened use of advanced health care technologies. Keep in mind all we have learned to date in terms of our health care system in general and The Affordable Care Act.
Consider and respond to the following, starting with the first question which is opinion based (begin discussion before Wednesday):
What major trends affecting health care delivery do you believe will be important over the next five years? How so?
Complete the readings and videos, then consider and respond to these ideas:
Three principal drivers of change in the health care system have been discussed in this week’s reading. How do you think they will impact care from a patient perspective? From a provider prospective?
Explore the new technologies being discussed in health care (electronic medical records are not considered ‘new’ at this point). What will these bring to our health care system in terms of benefits? Challenges? Added costs? (Include web links as you use examples of technology.)