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¾

Pages Pa

pers

Q

Y

o

u

Decide

Activity

Scenario Summary

You hav

e

been the Director of Operations for Middlefield Hospital for 2 and a half years and

finally resolved the workforce challenges

that

plagued the hospital, and in particular the mental

health unit. In a recent meeting, the chief financial officer (CF

O) indicated that the financial

performance of the hospital’s mental health unit has been deteriorating over the last 6 months.

The hospital is not meeting its budget and he is concerned about the future. The new facility

across town has continued to cut i

nto Middlefield’s market share by admitting more patients. The

number of admissions to Middlefield Hospital is declining each month, and more uninsured

patients are seeking services at your facility. You convene the Middlefield Hospital management

team and

discover a few interesting facts, which are identified below.

1.

The payer mix of Middlefield Hospital is comprised of more and more Medicare,

Medicaid, and uninsured patients, and

 

fewer patients have commercial insurance.

This is

reducing overall reimbursement and net income for the hospital.

2.

The nearby hospital

 

that competes with Middlefield has opened a wellness center

 that

offers

 

a comprehensive array of preventative and wellness services to the community.

This facility

is attracting young families to seek services at this location.

3.

Most of Middlefield’s managed care contracts are more than 2 years old. There

 

are little

reliable utilization and reimbursement data available. No one at Middlefield Hospital is

assigned to m

anage these contracts or maintain ongoing relationships with managed

care companies.

4.

The Joint Commission survey is scheduled for next year, and there are significant

problems with the hospital’s quality improvement program.

5.

The health plan offered to empl

oyees is getting more expensive each year. In fact, the

costs are increasing at a rate of 20% each year. This is adding significantly to the

hospital’s operational costs.

6.

The inpatient mental health services and neonatal intensive care unit continue to los

e

money for the hospital.

Your Role/Assignment

The board of directors has asked that you provide a 750

word report (double

spaced in APA

format) detailing your strategies and recommendations to improve the financial performance of

the hospital by focusing

on the mental health unit. The strategies and recommendations should

be as specific as possible and include identifying resources that are necessary to implement the

strategies. Also, describe the outcomes expected from implementing your recommendations.

Y

our primary text and journal and website research must be used as a reference to support your

analysis. Use at least three references.

Available Resources

Review the points of view of the following people to obtain further insight on this assignment.

Key Players

Dr. McCrae: Psychiatrist

I am a psychiatrist and admit my patients to the mental health inpatient unit at Middlefield. It is the only psychiatric inpatient unit available in the community, and the care provided is excellent. I understand the program loses money, but the hospital has a community obligation to offer services to patients who need mental health care.

Aretha Holly: Pharmacy Technician

I love the health plan offered by Middlefield Hospital. The plan really meets the needs of my family. The copays and deductibles are so low and I get my prescriptions for free. Also, I can go to any provider I choose. I hope they don’t make any changes to the plan, because I am worried that I may not be able to afford it.

Barbara Seville: Director of Quality Improvement

Middlefield’s quality improvement activities are not effective anymore. We do lots of data collection and reporting, but there is little improvement in the quality of care. Most staff members believe that we already provide quality patient care and don’t see why we are putting resources into this function. I think we are relying too much on our past reputation.

Notes:

¾

Pages Pa
pers

Q

Y
o
u
Decide

Activity

Scenario Summary

You have been the Director of Operations for Middlefield Hospital for 2 and a half years and

finally resolved the workforce challenges that plagued the hospital, and in particular the mental

health unit. In a recent meeting, the chief financial officer (CF
O) indicated that the financial
performance of the hospital’s mental health unit has been deteriorating over the last 6 months.
The hospital is not meeting its budget and he is concerned about the future. The new facility
across town has continued to cut i
nto Middlefield’s market share by admitting more patients. The
number of admissions to Middlefield Hospital is declining each month, and more uninsured
patients are seeking services at your facility. You convene the Middlefield Hospital management
team and

discover a few interesting facts, which are identified below.

1.

The payer mix of Middlefield Hospital is comprised of more and more Medicare,
Medicaid, and uninsured patients, and

fewer patients have commercial insurance.

This is
reducing overall reimbursement and net income for the hospital.

2.

The nearby hospital

that competes with Middlefield has opened a wellness center

that
offers

a comprehensive array of preventative and wellness services to the community.
This facility

is attracting young families to seek services at this location.

3.

Most of Middlefield’s managed care contracts are more than 2 years old. There

are little
reliable utilization and reimbursement data available. No one at Middlefield Hospital is
assigned to m
anage these contracts or maintain ongoing relationships with managed
care companies.

4.

The Joint Commission survey is scheduled for next year, and there are significant
problems with the hospital’s quality improvement program.

5.

The health plan offered to empl
oyees is getting more expensive each year. In fact, the
costs are increasing at a rate of 20% each year. This is adding significantly to the
hospital’s operational costs.

6.

The inpatient mental health services and neonatal intensive care unit continue to los
e
money for the hospital.

Your Role/Assignment

The board of directors has asked that you provide a 750

word report (double

spaced in APA
format) detailing your strategies and recommendations to improve the financial performance of
the hospital by focusing
on the mental health unit. The strategies and recommendations should
be as specific as possible and include identifying resources that are necessary to implement the
strategies. Also, describe the outcomes expected from implementing your recommendations.
Y
our primary text and journal and website research must be used as a reference to support your
analysis. Use at least three references.

Available Resources

Review the points of view of the following people to obtain further insight on this assignment.

Notes: ¾ Pages Papers

Q You Decide Activity

Scenario Summary

You have been the Director of Operations for Middlefield Hospital for 2 and a half years and
finally resolved the workforce challenges that plagued the hospital, and in particular the mental

health unit. In a recent meeting, the chief financial officer (CFO) indicated that the financial

performance of the hospital’s mental health unit has been deteriorating over the last 6 months.
The hospital is not meeting its budget and he is concerned about the future. The new facility

across town has continued to cut into Middlefield’s market share by admitting more patients. The

number of admissions to Middlefield Hospital is declining each month, and more uninsured
patients are seeking services at your facility. You convene the Middlefield Hospital management

team and discover a few interesting facts, which are identified below.

1. The payer mix of Middlefield Hospital is comprised of more and more Medicare,

Medicaid, and uninsured patients, and fewer patients have commercial insurance. This is

reducing overall reimbursement and net income for the hospital.

2. The nearby hospital that competes with Middlefield has opened a wellness center that

offers a comprehensive array of preventative and wellness services to the community.

This facility is attracting young families to seek services at this location.

3. Most of Middlefield’s managed care contracts are more than 2 years old. There are little

reliable utilization and reimbursement data available. No one at Middlefield Hospital is

assigned to manage these contracts or maintain ongoing relationships with managed

care companies.

4. The Joint Commission survey is scheduled for next year, and there are significant

problems with the hospital’s quality improvement program.

5. The health plan offered to employees is getting more expensive each year. In fact, the

costs are increasing at a rate of 20% each year. This is adding significantly to the

hospital’s operational costs.

6. The inpatient mental health services and neonatal intensive care unit continue to lose

money for the hospital.

Your Role/Assignment

The board of directors has asked that you provide a 750-word report (double-spaced in APA

format) detailing your strategies and recommendations to improve the financial performance of

the hospital by focusing on the mental health unit. The strategies and recommendations should

be as specific as possible and include identifying resources that are necessary to implement the
strategies. Also, describe the outcomes expected from implementing your recommendations.

Your primary text and journal and website research must be used as a reference to support your

analysis. Use at least three references.

Available Resources

Review the points of view of the following people to obtain further insight on this assignment.

NO

TE:

Write a

response

/ reply for Q1

to

Q6

Q1.

Alexandra

Accreditation

organizations have the difficult task of ensuring that every person and hospital

they give

accreditation

to is still functioning properly per their

guidelines

. As medicine continues

to grow and change, so does the accreditation programs involv

ed with keeping these physicians,

medical professionals and hospitals in check. Often, we see physicians sharing information with

one another in order to grow and learn. Many accreditation organizations have physicians

voluntarily share information about a

specific case that had an adverse or unexpected outcome

(O’Leary). In sharing important information about these specific cases, other physicians that are

either inexperienced or have not seen cases like that will be able to learn and be better prepared

to

treat something like this in the future (O’Leary). Year after year, the standards that are being

upheld grow higher and higher, which helps keep these physicians in line. Accreditation

organizations are also not opposed to susepnding or revoking a license

if the performance of the

physician is unsatisfactory. Ancillary healthcare institutions have implemented similar standards

while also helping to make the community more aware of the standards that need to be upheld.

We see a reducation in the “blame game

” while also holding people accountable for their actions

in a very appropriate manner (Rodziewicz).

 

Often those that are blamed repeatedly for mistakes

may stop reporting, but in a field like mental health that is so underreported and

underappreciated in

the first place, something like this cannot happen (Rodziewicz). When we

reduce the blame game but still hold physicians accountable, it becomes a more honest and open

practice where everyone wants to get better and give better care to patients. I think th

is is a very

excellent and effective strategy because of the good outcomes and the learning that ultimately

comes out of a system like this.

 

Rodziewicz, L. Thomas et al. (

2

021).

 

Medical Error Reducion and Prevention

. NCBI. Retrieved

from

 

https://www.ncbi.

nlm.nih.gov/books/NBK499956/

O’Leary, S. Dennis. (2000).

 

Accredidation’s Role in Reducing Medical Errors

. NCBI. Retrieved

from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117749/

Q.

2

Jose

classmates, it has been noted that Medical errors are the th

ird

leading cause of death in the

United States, right after heart disease, cancer, stroke and Alzheimer’s disease according to the

British Medical Journal. According to Martin Makary of John Hopkins University, it is

estimated

 

that 251,000 Americans die

each year from medical errors. Lately Hospitals have

taken steps to improve patient safety by implementing new technology in digital systems. The

federal government and the Joint Commission have started to set safety

related standards that

hospitals must m

eet. In this case effective use of electronic health records has helped medical

professionals not make the mistake of giving a patient a medication that he/she might be allergic

to. It also keeps a log of the time a medication was given so they won’t overd

ose the patient. I

believe that communication is key in keeping patients safe and reducing medical errors. Having

accessibility to patients treatment and records by the medical professionals that are taking care of

the person goes a long way in making sure

that everyone knows what has been going on with the

patient. word of mouth or even writing things down can easily cause miscommunication, but entering information on the electronic health record as the care is being given will go a long way into keeping everyone informed about the patients care. 

https://www.pewtrusts.org/en/research-and-analysis/issue-briefs/2020/07/hospitals-can-take-key-steps-to-improve-safe-use-of-digital-systems (Links to an external site.)

https://www.apa.org/monitor/2016/09/preventing-errors

Q.3 Nenobia

The accreditation process has the potential to influence quality through a series of three mechanisms: coherence, organizational buy-in and collective quality improvement action. Internal and external contextual factors, including individual characteristics, influence an organization’s experience of accreditation. The 5 major healthcare accreditation organizations are: Accreditation is a process by which an impartial organization will review a company’s operations to ensure that the company is conducting business in a manner that is consistent with national standards. The top three strategies that were reported the most, included strategies to empower families, carers and patients; integration of care or collaborative interventions; and e-health interventions. Prevention is concerned with avoiding disease while promotion is about improving health and well being. By identifying the positive aspects of mental health, one can highlight or target the
areas to promote and the goals to be attained. It is important to target the positive aspects of
mental health, together with targeting the illness. Preventive and promotional elements can be
present within the same programme and hold different meanings for two groups of the targeted
population.

Q.4 Tetro

Professor and classmates, personally I see that one of the biggest challenges ahead in improving the quality of our healthcare delivery system is to reduce healthcare costs while improving the quality of care. Healthcare costs are rising at a fast pace in the U.S. according tot he Centers for Medicare and Medicaid Services. The country’s national health spending is projected to increase at an average annual rate of almost 5.4% between 2019-2028 and reach $6.2 trillion by 2028. Physicians need to buy and upgrade technology on a continuous basis to provide better quality care to their patients as well as to stay competitive. However due  to rising costs, lesser number of patients that are visiting clinics and physicians are registering low revenue growth, implementing some cost-saving initiatives can help in such scenarios. Reducing staff on a already short medical staff or increasing office hours to generate more money is not always the correct way to tackle costs of operating a medical business. Keeping up to date with technology goes a long way in improving quality care for patients. As medical costs increase so does the rise of keeping up with technology that will help offset some of these costs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193522/

Q.5 Jordan

Professor and class, some challenges arising in healthcare delivery would be slow adoption of information technology that are needed and required to provide care, personel shortages, and poor designs of systems, policies, and processes. With telehealth being a newer way to deliver care, we have to shift our focus from previous treatment options and focus on what we can do remotely that constitutes as high quality care. Personel shortages are due to the lack of education and resources available, and in all honesty interest lost in the field. Clinical staff have high stress work conditions in certain positions, which isn’t appealing to certain people entertaining them idea of entering healthcare. Designs of system can go hand in hand with technology innovations; we have to rewire day to day workflow. Adapting to new environments and circumstances is a first step in the right direction.

 

https://www.ncbi.nlm.nih.gov/books/NBK221522/

Q.6 Constance

High-quality health services involve the right care, at the right time, responding to the service users’ needs and preferences, while minimizing harm and resource waste. Quality health care increases the likelihood of desired health outcomes and is consistent with seven measurable characteristics: effectiveness, safety, people centredness, timeliness, equity, integration of care, and efficiency.  It is essential to ensure that care is effective, safe, and in keeping with the preference and needs of the people and communities being served. In order to enhance health care quality, we must first determine what it is that requires improvement, develop a process for advancement, and then evaluate the success or failure of the process. We also need to offer the necessary incentives to improve the quality of health care services.

References:

https://ebrary.net/13611/health/major_challenges_facing_health_care_delivery

NO
TE: Write a

response
/ reply for Q1 to Q6

Q1.
Alexandra

Accreditation

organizations have the difficult task of ensuring that every person and hospital
they give
accreditation

to is still functioning properly per their
guidelines
. As medicine continues
to grow and change, so does the accreditation programs involv
ed with keeping these physicians,
medical professionals and hospitals in check. Often, we see physicians sharing information with
one another in order to grow and learn. Many accreditation organizations have physicians
voluntarily share information about a

specific case that had an adverse or unexpected outcome
(O’Leary). In sharing important information about these specific cases, other physicians that are
either inexperienced or have not seen cases like that will be able to learn and be better prepared
to

treat something like this in the future (O’Leary). Year after year, the standards that are being
upheld grow higher and higher, which helps keep these physicians in line. Accreditation
organizations are also not opposed to susepnding or revoking a license

if the performance of the
physician is unsatisfactory. Ancillary healthcare institutions have implemented similar standards
while also helping to make the community more aware of the standards that need to be upheld.
We see a reducation in the “blame game
” while also holding people accountable for their actions
in a very appropriate manner (Rodziewicz).

Often those that are blamed repeatedly for mistakes
may stop reporting, but in a field like mental health that is so underreported and
underappreciated in
the first place, something like this cannot happen (Rodziewicz). When we
reduce the blame game but still hold physicians accountable, it becomes a more honest and open
practice where everyone wants to get better and give better care to patients. I think th
is is a very
excellent and effective strategy because of the good outcomes and the learning that ultimately
comes out of a system like this.

Rodziewicz, L. Thomas et al. (2021).

Medical Error Reducion and Prevention
. NCBI. Retrieved
from

https://www.ncbi.
nlm.nih.gov/books/NBK499956/

O’Leary, S. Dennis. (2000).

Accredidation’s Role in Reducing Medical Errors
. NCBI. Retrieved
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117749/

Q.
2

Jose

classmates, it has been noted that Medical errors are the th
ird

leading cause of death in the
United States, right after heart disease, cancer, stroke and Alzheimer’s disease according to the
British Medical Journal. According to Martin Makary of John Hopkins University, it is
estimated

that 251,000 Americans die
each year from medical errors. Lately Hospitals have
taken steps to improve patient safety by implementing new technology in digital systems. The
federal government and the Joint Commission have started to set safety

related standards that
hospitals must m
eet. In this case effective use of electronic health records has helped medical
professionals not make the mistake of giving a patient a medication that he/she might be allergic
to. It also keeps a log of the time a medication was given so they won’t overd
ose the patient. I
believe that communication is key in keeping patients safe and reducing medical errors. Having
accessibility to patients treatment and records by the medical professionals that are taking care of
the person goes a long way in making sure

that everyone knows what has been going on with the

NOTE: Write a response / reply for Q1 to Q6

Q1. Alexandra

Accreditation organizations have the difficult task of ensuring that every person and hospital

they give accreditation to is still functioning properly per their guidelines. As medicine continues

to grow and change, so does the accreditation programs involved with keeping these physicians,

medical professionals and hospitals in check. Often, we see physicians sharing information with
one another in order to grow and learn. Many accreditation organizations have physicians

voluntarily share information about a specific case that had an adverse or unexpected outcome

(O’Leary). In sharing important information about these specific cases, other physicians that are
either inexperienced or have not seen cases like that will be able to learn and be better prepared

to treat something like this in the future (O’Leary). Year after year, the standards that are being

upheld grow higher and higher, which helps keep these physicians in line. Accreditation

organizations are also not opposed to susepnding or revoking a license if the performance of the

physician is unsatisfactory. Ancillary healthcare institutions have implemented similar standards
while also helping to make the community more aware of the standards that need to be upheld.

We see a reducation in the “blame game” while also holding people accountable for their actions

in a very appropriate manner (Rodziewicz). Often those that are blamed repeatedly for mistakes

may stop reporting, but in a field like mental health that is so underreported and

underappreciated in the first place, something like this cannot happen (Rodziewicz). When we

reduce the blame game but still hold physicians accountable, it becomes a more honest and open

practice where everyone wants to get better and give better care to patients. I think this is a very

excellent and effective strategy because of the good outcomes and the learning that ultimately

comes out of a system like this.

Rodziewicz, L. Thomas et al. (2021). Medical Error Reducion and Prevention. NCBI. Retrieved

from https://www.ncbi.nlm.nih.gov/books/NBK499956/

O’Leary, S. Dennis. (2000). Accredidation’s Role in Reducing Medical Errors. NCBI. Retrieved

from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117749/

Q.2 Jose

classmates, it has been noted that Medical errors are the third-leading cause of death in the

United States, right after heart disease, cancer, stroke and Alzheimer’s disease according to the
British Medical Journal. According to Martin Makary of John Hopkins University, it is

estimated that 251,000 Americans die each year from medical errors. Lately Hospitals have

taken steps to improve patient safety by implementing new technology in digital systems. The

federal government and the Joint Commission have started to set safety-related standards that

hospitals must meet. In this case effective use of electronic health records has helped medical

professionals not make the mistake of giving a patient a medication that he/she might be allergic

to. It also keeps a log of the time a medication was given so they won’t overdose the patient. I

believe that communication is key in keeping patients safe and reducing medical errors. Having
accessibility to patients treatment and records by the medical professionals that are taking care of

the person goes a long way in making sure that everyone knows what has been going on with the

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