PROPOSAL TO INTRODUCE VETERAN CLINIC IN TEXAS Carrington Sherman THERESA MC CLELLAND HCS/525 Leadership December 19, 2016 Introduction and summary of research The paper gives descriptions of a proposal intended to introduce a New (VA) Veteran Affair clinic in Houston TX. The decision to introduce the clinic is based on numerous factors. First, a study conducted by the Department of Veterans Affairs (DVA) reveals that the current supply of VA health care services in Texas is not optimally aligned to meet veteran health care needs. The veterans who live in Texas are forced to travel several distances seeking for the medical services. The study further reveals that the demand for specialty outpatient services (clinic stops) is expected to increase. The widening gap in specialty outpatient care has implications for the service delivery options. There is also a rising demand for specialized outpatient treatment of Post Traumatic Stress Disorder (PTSD). The study further reveals that the existing clinics do not offer some of the emerging specialty needs. Veterans, for example, are facing several pressures managing their social life, and hence most of them experiences stress, which often lead to adverse health consequences. The report by U.S. Department of Veterans Affairs (VA) reveals that most of the veterans experience mental problems. Consequently, the number of veterans requiring mental health services in Texas has increased significantly and will continue to rise. It is also revealed that many veterans living in rural areas do not have easy access to healthcare services offered by the federal government or state government. Most veterans, according to the study, have mobility problems. This bar them from seeking regular and recurrent care at VA facilities. The study also reveals that there is generational gap between modern veterans and the past veterans. This implies that most of the veteran hospitals and clinics do not meet the emerging needs. The gap is attributable to various deployment and introduction to unfriendly conditions, for example, urban battle, extemporized unstable gadgets, and suicide bombings. In addition, some veterans received “other than honorable” discharge from military due to small issues related to misconduct. Such veterans often have difficult accessing benefits. They find it hard accessing VA help, incapacity pay and state services, or nonprofit programs funded by government grants. Most of such veterans are homeless and often opt to drug abuse. Type of services offered in local community The federal government works with state government of Texas to offer basic veteran healthcare services. Some of the services include health benefits, funds, subsidies and inpatient services. Other services include VA help, incapacity pay and state services, or nonprofit programs funded by government grants. Description of facility selected The proposed facility intends to fill the gap related to veteran’s access to healthc.

1. PROPOSAL TO INTRODUCE VETERAN CLINIC IN TEXAS
Carrington Sherman
THERESA MC CLELLAND
HCS/525 Leadership
December 19, 2016
Introduction and summary of research
The paper gives descriptions of a proposal intended to introduce
a New (VA) Veteran Affair clinic in Houston TX. The decision
to introduce the clinic is based on numerous factors. First, a
study conducted by the Department of Veterans Affairs (DVA)
reveals that the current supply of VA health care services in
Texas is not optimally aligned to meet veteran health care
needs. The veterans who live in Texas are forced to travel
several distances seeking for the medical services. The study
further reveals that the demand for specialty outpatient services
(clinic stops) is expected to increase. The widening gap in
specialty outpatient care has implications for the service
delivery options. There is also a rising demand for specialized
outpatient treatment of Post Traumatic Stress Disorder (PTSD).
The study further reveals that the existing clinics do not offer
some of the emerging specialty needs. Veterans, for example,
are facing several pressures managing their social life, and
hence most of them experiences stress, which often lead to
adverse health consequences.
The report by U.S. Department of Veterans Affairs (VA) reveals
that most of the veterans experience mental problems.
Consequently, the number of veterans requiring mental health
services in Texas has increased significantly and will continue

2. to rise. It is also revealed that many veterans living in rural
areas do not have easy access to healthcare services offered by
the federal government or state government. Most veterans,
according to the study, have mobility problems. This bar them
from seeking regular and recurrent care at VA facilities. The
study also reveals that there is generational gap between modern
veterans and the past veterans. This implies that most of the
veteran hospitals and clinics do not meet the emerging needs.
The gap is attributable to various deployment and introduction
to unfriendly conditions, for example, urban battle,
extemporized unstable gadgets, and suicide bombings. In
addition, some veterans received “other than honorable”
discharge from military due to small issues related to
misconduct. Such veterans often have difficult accessing
benefits. They find it hard accessing VA help, incapacity pay
and state services, or nonprofit programs funded by government
grants. Most of such veterans are homeless and often opt to
drug abuse.
Type of services offered in local community
The federal government works with state government of Texas
to offer basic veteran healthcare services. Some of the services
include health benefits, funds, subsidies and inpatient services.
Other services include VA help, incapacity pay and state
services, or nonprofit programs funded by government grants.
Description of facility selected
The proposed facility intends to fill the gap related to veteran’s
access to healthcare needs. The facility will be designed based
on evidence-based design principles. This means that the design
of the facility and the services that shall be included will differ
significantly from the existing veteran clinics. A number of
areas or services would be introduced. First, the number of beds
will be increased to accommodate high influx of patients.
Second, the number of beds per room will be reduced. Multi-bed
rooms has been associated with lower discharge rate.
Minimizing the number of beds per room may increase the
healing process.

3. Based on the findings from the research, it is indicated that
some veterans do not access VA help, incapacity pay and state
services. The proposed facility is expected to offer such
services at a subsidized amount. To achieve this, a proposal
would be designed justifying why those veterans who received
“other than honorable” discharge should be given equal rights
like others. The proposal would then be send to the non-
governmental institutions for grants and support. Then the
facility will use such grants to come up with cheap and
affordable services for veterans who received “other than
honorable” discharge. The facility will also introduce wellness
program where veterans can join and engage in wellness
activities such as physical exercises, dancing, gym and
socialize. The facility would be based on Blue Zone principles
proposed by Dan Buettner. The principles reveals that the way
the different people eat, interact with each other, shed stress,
heal themselves, avoid disease, and view their world yields
them more good years of life. The wellness program will be
used to teach veterans on what they should do to shed stress. It
will also be used to inform them of existing services and
benefits.
Justification for the building
As indicated, the proposed building is meant to fill the existing
gaps. The research reveals that there are many gaps related to
veteran’s access to healthcare. Filling such health gap is
therefore a noble move. Consequently, it is clear that the
proposed building is feasible.
References
U.S. Department of Veterans Affairs, 2013 Performance and
Accountability Report, accessed December 19, 2016, at
http://www.va.gov/budget/docs/report/2013-
VAPAR_FullWeb.pdf.
Department of Veterans Affairs, “Post-Traumatic Stress
Disorder: Implications for Primary Care,” Veteran Health
Initiative, (March 2002), 80.

4. Learning Activity 1 – Theme One: Understanding the nature of
leadership helps to frame the viewpoint of a leader.
View: Drew Dudley:
And I've come to realize that we have made leadership into
something bigger than us; something beyond us. We've made it
about changing the world. We've taken this title of "leader" and
treat it as something that one day we're going to deserve. But to
give it to ourselves right now means a level of arrogance or
cockiness that we're not comfortable with. And I worry
sometimes that we spend so much time celebrating amazing
things that hardly anybody can do, that we've convinced
ourselves those are the only things worth celebrating. We start
to devalue the things we can do every day, We take moments
where we truly are a leader and we don't let ourselves take
credit for it, or feel good about it. I've been lucky enough over
the last 10 years to work with amazing people who've helped me
redefine leadership in a way that I think has made me happier.
In conjunction with the opening comments in the week 1 course
schedule, the readings for week 1, theme 1, consider the point
stated by Drew Dudley in Everyday Leadership. Then, reflect
on your experiences with leaders, and in your own words, define
leadership. How does your definition differ from what you
read and viewed and explain why.
Learning Activity 2 Theme Two: The evolution of leadership
theory can help to explain what makes a good leader today.
Explain the meaning behind theme two and describe the GDD
leader of today based on the evolution of theory. What you will
need to do is look at the different leadership theories and apply
the theories to support your reasoning.
Running Head: EVIDENCE-BASED DESIGN
EVIDENCE-BASED DESIGN

5. 2
EVIDENCE-BASED DESIGN
Carrington Sherman
HCS 529 – Contemporary Health Care Facility Design
December 19, 2016
Introduction
I am writing this letter to clarify why the proposed facility
should adopt evidence-based design. It is undisputable that the
competition in healthcare industry is growing as new facilities
enters the industry at high rate. In order to hold the competitive
edge, it is important to adopt some of the most competitive
strategies. One of these strategies is the evidence-based design.
The letter will give brief history of hospital design process,
description of evidence-based design, and reasons why the
evidence-based design should be adopted.
History
The way in which the hospitals are designed and built has
evolve over time. Traditionally, most of the healthcare
organizations are designed based on opinion, preference or
personal values. However, since the end of 19th century,
laboratory and field research on the relationship between
designs and organizational goals intensified. It was discovered
that the choice of design can influence the healthcare outcomes.
It was found that some designs are measurably safer, more
efficient and of higher quality. Consequently, most hospitals are
adopting a new approach called evidence-based design.
Description of evidence-based design

6. Evidence-based design is the process of using credible research
to make decision about the built environment in order to
achieve the best possible outcomes. EBD links building design
decisions with key performance outcomes that have been
systematically evaluated. If environment A, for example, has
been shown to result in an increased patient satisfaction, then a
new facility should be designed based on environment A design.
Similarly, an evidence-based design facility should possess
qualities of an architect associated with fewer nosocomial
infections or fewer falls (Marcus & Sachs, 2014). There is no
single model for achieving evidence-based design. However,
most of evidence-based design shares some features. First, they
depend on findings that has been collected thoroughly
throughout the design process to determine how design
decisions are likely to influence performance outcomes and
project-specific goals. They also use a variety of information
and information collection approaches to pick up a
comprehension of how design decisions are probably going to
influence execution results and venture particular objectives.
The most common sources of data is benchmarking. This
include talking with experts, clients, users, and observing how
your own designs have been used. In addition, the patient
satisfaction surveys such as HCAHPS (Hospital Consumer
Assessment of Healthcare Providers and Systems) give reliable
information concerning patient satisfaction towards the hospital
design (Marcus & Sachs, 2014). Each of these method should,
however, be evaluated in terms of the reliability and credibility
of the information it generates. Another feature that is common
in evidence-based design is that there is usually a
multidisciplinary design team that can examine a project from
different perspective. In addition, it is possible to hypothesize
or predict early about the possible effects of key design choices
on consequences.
The importance of evidence-based design is supported by vast
amount of literature. Most studies have revealed that there is a
close relationship between the physical, environmental design

7. of healthcare setting and patient, staff, and organizational
outcomes in healthcare. Citing the studies conducted by Ulrich,
Zimring, and colleagues, Harris, D. D. (2008) reveals that there
is clear evidence in many areas demonstrating how environment
affects outcomes in healthcare settings. The findings from the
study reveal that the design of hospital units alone may
contribute to higher-than-recommended noise levels, which in
turn affect sleep, communication, and healing. It has also been
demonstrated that hospital design characterized by multi-bed
patient rooms, poor air quality and lack of hand-washing
facilities contribute to higher rates of hospital-acquired
infections. One area that has not been studied extensively
concerns the impact of the environment on staff performance
and effectiveness.
Advantages of evidence-based design
There are a number of reason why I am proposing the use of
evidence-based design in the new facility. First, evidence-based
design increases healing process. For example, if it is
established that an environment with music system increase
healing, then the design will include music system in its
architectural consideration. The second reason why evidence-
based design is effective is that it increases patient satisfaction.
Through evidence-based design, an organization can choose a
design that has been found to foster patient satisfaction. The
third reason why evidence-based design effective is that it
reduces hospital-acquired infections. For example, if it is found
that single patient rooms, good air quality and presence of hand-
washing facilities reduces hospital-acquired infections, then the
healthcare facility will be designed in accordance with these
specification. This will reduces hospital-acquired infections.
The fourth reason why evidence-based design should be adopted
is that it is possible to predict the outcomes. This means that if
there is any deviation from the outcome, it would be easier to
diagnose the cause of the deviation.
References

8. Top of Form
Harris, D. D. (2008). A practitioner's guide to evidence-based
design. Concord, Calif: Center for Health Design.
Top of Form
Marcus, C. C., & Sachs, N. A. (2014). Therapeutic landscapes:
An evidence-based approach to designing healing gardens and
restorative outdoor spaces. Hoboken, New Jersey : John Wiley
& Sons
Bottom of Form
Bottom of Form