Question

The case of the unhealthy hospital:

What are the issues facing the hospital. Briefly summarize the key issues facing the hospital and then make recommendations based on reading and evidence from literature.

Answer 1

A healthy nation they say is a wealthy nation. Healthcare is important to the society because people get ill, accidents and emergencies do arise and the hospitals are needed to diagnose, treat and manage different types of ailments and diseases. Many of people’s aspirations and desires cannot be met without longer, healthier, happy lives. The healthcare industry is divided into several areas in order to meet the health needs of individuals and the population at large. All over the world, the healthcare industry would continue to thrive and grow as long as man exists hence forming an enormous part of any country’s economy.

Most Americans are well aware of the many problems with the current health care system in the United States. Lack of access to affordable health insurance and rising health care costs is of great concern to many Americans. Many working families worry about getting sick or injured because they cannot afford health insurance or basic health care. Many individuals are turned away from insurance companies because of a pre-existing medical condition or illness. Others lose their health insurance when they are laid off from work or change jobs.

The dire health care situation can be seen in the numbers. More than 47 million people in the United States do not have health insurance and about 9 million of them are children. Over 40 million people a year do not get medical care when they need it, even if insured, because they can’t afford it. More than 8 out of 10 uninsured people are from working families. Thousands of deaths every year are attributed to lack of health insurance.

Health Care–Social Issues is an interdisciplinary minor designed to enhance students’ competence in analyzing the complex social and ethical implications of health care controversies, policies, and delivery systems.

The issues to address in the reform of the health care system:

Affordability

The cost of health insurance and health care is rising at a pace faster than wages and inflation. Most of the uninsured are working Americans who cannot afford the cost of health insurance. Many Americans are able to afford health insurance only because it is subsidized by their employer. The average health insurance premium for a family, provided through an employer health benefit program, was $11,480. Of this amount, the employee paid an average of $2,973 towards the premium.

Not only does employer-sponsored health insurance make it possible for many people to afford coverage, but group plans are generally less expensive than individual plans. This makes health insurance coverage very expensive for people who have to purchase health care insurance individually, either because they work at jobs that don’t offer employment health benefits or are self-employed.

Of the 84% of Americans with health insurance, approximately 60% get their health insurance through their employer, while only 9% of the insured purchase their own policies (the remaining insured get health coverage through the government; Medicaid, Medicare, or Military).

Portability

In our current health care system, the majority of health insurance coverage is tied to employment. When health insurance is tied to employment status, it can be very disruptive and inefficient. It is estimated that about 24% of the uninsured are without insurance because they lost their job or had a change in employment. People should not have to worry about what will happen to their health insurance or health care needs if they lose their job, change employers, take time off to raise a family, retire, become injured or disabled, or any other reason that affects employment. Health insurance should follow a person, not a job.

Accessibility

While the primary reason individuals do not have health insurance is because of cost, there are also many people who cannot get insurance because of pre-existing medical conditions. For some, their health insurance is actually cancelled and bills left unpaid due to their illness or injury. Under the current private health care system, insurance companies are profit-driven. If an applicant is considered high risk, they can refuse to sell them a health insurance policy.

For the uninsured, the lack of health insurance limits access to medical care such as preventative healthcare, check-ups, immunizations, dental care, prescriptions, eye exams, eyeglasses, and mental health care. Many of the uninsured have to live without proper medical care, even when it is needed, unless it is an emergency. This often causes smaller health problems to become even more serious, treatable health conditions are left untreated, more situations are treated in emergency rooms, and some may even die from preventable conditions.

The lack of accessibility to health care also affects children. Studies show that uninsured children are more likely to be sick, miss more school days, and perform more poorly in school than children with insurance. Many children suffer from asthma and cannot afford the treatment that will benefit their health and education. Many children cannot afford the recommended immunizations. Many children get ear infections that are not treated, leading to hearing loss.

While many low-income children qualify for Medicaid or the State Children’s Health Insurance Program (SCHIP), many families are unaware of these benefits and are not enrolled in the program. For these children, it is important to get the word out, increase enrollment, and help the families access the health care coverage available.

As hospital administrators know, perhaps better than anyone, hospitals are complex organizations. Communication is a constant challenge, and it can take several months to implement even the smallest process change. After all of the paperwork, training and follow-up reviews, you may begin to question whether your amendments are truly improving the workspace, or simply adding more madness to the mayhem.

However, while failure to comply with some procedures, such as organizing supplies, may be a source of frustration, other procedures, such as those focused on patient-centered care, can have a major impact on your hospital’s success.

Here are a few ways you can improve patient-centered care in your hospital environment, and make sure it sticks.

1. Make Sure Staff Members Understand their Roles

One of the biggest threats to achieving patient-centered care in the workplace is each employee believing it’s up to someone else. The front desk staff thinks it’s the responsibility of the floor nurses. The floor nurses think it’s the responsibility of the physicians. It’s an age-old game of “pass the buck.” However, for patient-centered care to be successful, everyone must take full responsibility. From treating patients with courtesy and respect to making sure all needs are met prior to discharge, everyone plays a crucial part. Your primary role is to make sure they understand theirs.

2. Set Department-Wide and Hospital-Wide Goals

There’s a reason nearly every company in every industry sets goals for employees: because they work. Objectives motivate staff members both individually and as a team. Hospitals are full of goal-oriented individuals. After all, you’ve got to hit quite a few benchmarks to achieve a career in the healthcare industry.

The best way to tie everything together is to create goals around HCAHPS responses. What score do you need to achieve as a floor? A unit? An organization? Set the bar high, and people will rise to the occasion.

3. Reward the Champions

In addition to setting goals, rewards are a powerful motivator. When an employee sees others receiving recognition, he feels compelled to work harder and achieve his own recognition. According to a study by the Aberdeen Group, 60 percent of Best-in-Class organizations rated employee recognition as “extremely valuable” in driving individual performance.

If an employee is consistently meeting goals, earning accolades from patients and their families, offering genuine emotional support, focusing on patient comfort and ensuring patients are fully educated before leaving the hospital, make an example of her!

4. Set Clear Guidelines

The best way to make sure your hospital staff follows new procedures is to make them easy to digest. Clarity is key. Write up processes, and include specific examples on how to accomplish the pillars of patient-centered care, such as involving approved family in case decisions, making physical comfort a top priority and educating the patient. For example, for patient comfort, suggest care providers make use of measures such as topical anesthetics.

Most importantly, though, ensure everyone has the opportunity to ask questions so you can quickly clear up misunderstandings.

5. Work Closely with Patient Advocates

Patient advocates live in patient-centeredcare. Their entire purpose is to ensure patients get the care they need, and so they spend plenty of time listening to patient concerns. Cooperating with these professionals will allow you insight into opinions and sentiments you may not otherwise be privy to. By taking this feedback, and applying it to your procedural changes, you can help make a real impact.

Patient centered care is not just better for patients, it’s crucial to success in today’s healthcare landscape. Although it may be challenging to change up processes within your organization, by using these measures you can empower your staff to take the right actions. By making it a priority for your entire staff, it will quickly become the norm.

Problem solving

Sometimes, it is not enough to just cope with the problems – they need to be solved.

Most people engage in problem solving every day. It occurs automatically for many of the small decisions that need to be made on a daily basis.

For example, when making a decision about whether to get up now or sleep in for an extra 10 minutes, the possible choices and the relative risks and benefits of obeying the alarm clock or sleeping later come automatically to mind.

Larger problems are addressed in a similar way. For example: “I have tasks that need to be done by the end of the week. How am I going to get them all done on time?”

After considering the possible strategies, 1 is chosen and implemented. If it proves to be ineffective, a different strategy is tried.

People who can define problems, consider options, make choices, and implement a plan have all the basic skills required for effective problem solving.

Sometimes following a step-by-step procedure for defining problems, generating solutions, and implementing solutions can make the process of problem solving seem less overwhelming.

Six step guide to help you solve problems

Step 1: Identify and define the problem

    State the problem as clearly as possible. For example: “I don’t have enough money to pay the bills.”
    Be specific about the behaviour, situation, timing, and circumstances that make it a problem. For example: “I need to pay the phone and gas bills, and I don’t have enough money to cover both this month.”

Step 2: Generate possible solutions

    List all the possible solutions; don’t worry about the quality of the solutions at this stage.
    Try to list at least 15 solutions, be creative and forget about the quality of the solution.
    If you allow yourself to be creative you may come up with some solutions that you would not otherwise have thought about.

Step 3: Evaluate alternatives    

    The next step is to go through and eliminate less desirable or unreasonable solutions.
    Order the remaining solutions in order of preference.
    Evaluate the remaining solutions in terms of their advantages and disadvantages.

Step 4: Decide on a solution    

    Specify who will take action.
    Specify how the solution will be implemented.
    Specify when the solution will be implemented. For example: tomorrow morning, phone the gas company and negotiate to pay the gas bill next month.

Step 5: Implement the solution

    Implement the solution as planned.

Step 6: Evaluate the outcome

    Evaluate how effective the solution was.
    Decide whether the existing plan needs to be revised, or whether a new plan is needed to better address the problem.
    If you are not pleased with the outcome, return to step 2 to select a new solution or revise the existing solution, and repeat the remaining steps.

Problem solving is something we do every day.

Some problems are small or easily solved - others are more complicated and can seem overwhelming.

One way of tackling problems is to use a specific and systematic problem solving procedure. If you’ve tried to solve certain problems without much success, try these steps out and see if they help.

Learning to solve problems effectively will help you to minimise the level of stress in your life and improve your overall sense of well-being.

The World Health Organisation (WHO) defines health policy as decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. The aim of health care policies is to define a vision for the future which in-turn helps to establish targets and points of reference for the short and medium term. It also outlines priorities and the expected roles of different groups; and it builds consensus and informs people.

The cultural differences and way of life of people have a great impact on the way they assess their health and well-being as well as their attitude towards healthcare. It affects their attitude and understanding of the cause of an illness and how to manage them as well as the consequences of medication and medical treatments. This also has an effect on people’s expectations on healthcare delivery.

For religious reasons people also have different beliefs and how they perceive healthcare delivery and sometimes how they react to medical practitioners. For instance, Muslim women do not allow male medical practitioners to attend to them especially when it has to do with the exposure of their private parts. Jehovah’s witnesses do not consent to the use of blood transfusion.

Political factors: a new government with new agenda and mission to fulfil their manifestos pass new laws about health and health reforms. With the government of the day wanting to cut cost; so many benefits of the citizens has been drastically reduced. These include a cut in energy allowance for the elderly, cut in healthcare allowance and so on.

Economic factors: the global economic downturn has made the government of the day to cut cost and introduce policies and agenda which has made people loss job and become unemployed. How well the government of the day react to these issues will determine the extent to which the health and well-being of its entire populations are protected. During these times, some people may become depressed, and become mentally ill.

Social factors (inequalities, discrimination): for instance, when people become depressed and mentally ill during recession, they become discriminated upon by colleagues, friends and sometimes close family members. The loss of a job too makes people to socialise less often and prefer to live in isolation most times and this can have a great impact on their health.

Technological advancement: this has drastically affected healthcare delivery in recent times. Diagnosis and treatment of diseases with the use of technological equipment have gone a long way in making things easier and faster for healthcare professionals and the patients as well. Treatment can be done faster and accurately too. For instance, the use of radiotherapy in the treatment and control of cancer. However, such treatments are sometimes rejected by the patient due because of the after effects it will have on them.

Environmental factors: a change in the weather e.g. snow, heavy rainfall and flooding also affect people’s attitude and spending towards healthcare. Many become very ill, catching a cold, having flu and fever in cold temperatures, making them to visit their local G.Ps more frequently, and spending more on medication as well. The government tend to spend more and healthcare professionals tend to be more engaged during these periods. Emergency services work round the clock saving people.