WORK BREAKDOWN STRUCTURE
Project Title: Date Prepared:
1. Project
1.1. Major Deliverable
1.1.1. Control Account
1.1.1.1. Work package
1.1.1.2. Work package
1.1.1.3. Work package
1.1.2. Work package
1.2. Control Account
1.2.1. Work package
1.2.2. Work package
1.3. Major Deliverable
1.3.1. Control account
1.3.2. Control account
1.3.2.1. Work package
1.3.2.2. Work package
Page 1 of 1
Running Head: EVALUATING PHYSICIANS AND NURSES PERSPECTIVE ON FACTORS CONTRIBUTING TO READMISSION OF OPHTHALMIC DISCHARGED PATIENTS AND POTENTIAL ONLINE FOLLOW-UP STRATEGIES TO REDUCE THEIR READMISSION IN A GOVERNMENT HOSPITAL OF RIYADH
[Type text] [Type text] [Type text]
EVALUATING PHYSICIANS AND NURSES PERSPECTIVE ON FACTORS CONTRIBUTING TO READMISSION OF OPHTHALMIC DISCHARGED PATIENTS AND POTENTIAL ONLINE FOLLOW-UP STRATEGIES TO REDUCE THEIR READMISSION IN A GOVERNMENT HOSPITAL OF RIYADH
Evaluating Physicians and Nurses Perspective on Factors Contributing to Readmission of Ophthalmic Discharged Patients and Potential Online Follow-Up Strategies to Reduce Their Readmission in a Government Hospital of Riyadh
CHAPTER I
Introduction
Annually, unplanned readmissions cost 15-20 billion dollars, and preventing such readmission will potentially improve the quality of life for patients and decrease the financial pain of health care systems, (Alper,2017). The existing precedence of many healthcare facilities is to reduce readmissions using post-discharge follow-up practices. The definitive objective of health care providers is to deliver high-quality health care services to patients using transitional care models. The methodologies encourage the use of appropriate outpatient follow-up appointments implemented through Medicare incentives to promote the reduction in hospital readmissions (Adib-Hajbaghery, Maghaminejad & Abbasi, 2013). Comment by Editor: Setting of margins required
Many of the researchers analyzing the outcome of follow-up on outpatients in reducing hospital readmissions majors on particular illnesses in a state; hence it is shallow. The review indicates that outpatient follow-ups decrease sickle cell anemia, pediatric asthma, and heart failure patient readmission (Hasan et al., 2010; Alper, 2017). However, there is an indication of mixed results obtained from examinations on hospitalized individuals. One study carried out by the Medicare Payment Advisory Commission demonstrated that there is no relationship between the timing of outpatient follow-up, and 30-day readmission rate in discharged patients from medical facilities (Ferrandino et al., 2017).
Statement of the Problem
According to Ferrandino et al. (2017), the readmission of roughly a half of the Medicaid receivers countrywide is within 30 days of discharge, and they fail to get a follow-up on outpatient before readmission. Equally, patients readmitted for chronic illnesses recorded a decrease in outpatient follow-up. It implies that the use of timely follow-ups to decrease the rates of readmi.
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, DioneWang844
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS
Page | 1
Quality
Nearly fifteen years ago, the Institute of Medicine published the “To Err Is Human” report, which exposed the substantial impact of medical errors in the US healthcare system and called for a dramatic system change, including an improved understanding of those errors (McCarthy, Tuiskula, Driscoll, & Davis, 2017). Medical errors are considered to be failure to achieve the original goal or plan of action, and these errors may range from a patient falls to a mistake in the operating room. Not only do medical errors cause harm to the patient and jeopardize the patient’s trust, but they also cause a financial strain for the health system (“To Err is Human,” 1999). One of the contributing factors to medical errors is the lack of effective communication between doctors who are treating the same patient. This results in healthcare providers overprescribing medications for patients as well as increases the possibility of a patient having unnecessary tests or procedures performed. The report’s four-tiered approach includes:
· Focusing on creating a stronger foundation of education on patient safety
· Mandating a nationwide reporting system to encourage timely reporting of errors
· Increasing the standards of performance for healthcare providers
· Taking advantage of the security that safety systems offer (“To Err is Human,” 1999)
Creating a strong educational foundation for patient safety is most important. Healthcare personnel are much more likely to actively participate in reporting systems, encourage one another to perform at a higher level, and take advantage of safety systems when they are well educated on patient safety and the implications of medical errors. The reporting system seems to provide the least amount of impact on patient safety as they can result in losing patient trust in certain healthcare systems. The healthcare system as a whole has made progress in establishing a safe environment for patients when they are in need of care.
Challenges for Patient Safety and Steps for Improvement
Despite continuing evidence of problems in patient safety and gaps between the care that patients receive and the evidence about what they should receive, efforts to improve quality in healthcare show mostly inconsistent and patchy results.
Tap each image to know more.
Data Collection and Monitoring Systems
This always takes much more time and energy than anyone anticipates. It is worth investing heavily in data from the outset. Assess local systems, train people, and have quality assurance.
Tribalism and Lack of Staff Engagement
Overcoming a perceived lack of ownership and professional or disciplinary boundaries can be very difficult. Clarify who owns the problem and solution, agree roles and responsibilities at the outset, work to common goals, and use shared language.
Convince People That There's a Problem
Use hard data to secure emotional e ...
BENCHMARK 1
Evidence-Based Practice Project: PICOT Paper
Daysha Y. Polk
NUR 550
Grand Canyon University
June 1st, 2021
Evidence-Based Practice Project: PICOT Paper
Generally, a high level of patient satisfaction for the clients in the emergency department (ED) is vital, especially at this time when the healthcare system is shifting towards patient-centered care. Prakash (2010) notes that patient satisfaction levels significantly impact on medical malpractice claims, patient retention, and clinical outcomes. That is, it affects quality healthcare’s timely, efficient, and patient-centered delivery, making it both a proxy but a very effective key indicator for measuring the hospitals and doctors’ success. Consequently, supporting the improvements of patient satisfaction levels can positively affect several healthcare organizations’ components, such as preventive possible malpractice lawsuits, securing a positive local reputation, and enhancing patient retention rates. Thus, there is an increased need to develop strategies to improve ED patient’s satisfaction with the provided care services. Increasingly, the use of real-time location systems (RTLS) by hospitals to track patients, instead of relying on the traditional, manually-entered status updates, is increasingly being viewed as a better strategy to decrease the number or rate of Left Without Being Treated (LWBT) patients, and thus, improve ED patient’s satisfaction levels and hospital’s revenue collection (Boulos & Berry, 2012). Thus, the paper will explore whether the utilization of RTLS in the hospital’s ED, compared to manually-entered status updates to tract patients, help decrease the rate of LWBT and to raise revenue collection within 6 months, for ED patients with decreasing satisfaction levels with the provided healthcare services.
A wide array of factors is responsible for the decreased rate of satisfaction levels amongst ED patients. The current delays, long waits, leaving without being treated, decreased revenue collection from the ED unit, and reduced patient satisfaction scores have negatively portrayed the hospital's reputation to the public. As a result, the daily patient visits have continued to decrease as people attribute the facility to poor emergency care services delivery. All these complications result from the use of combined data resources and manual entry status updates when tracking patient records. This manual tracking cannot meet the demand for many patients and leads to overcrowding due to and reduced patient flow in the ED. Therefore, there is a need to install an automatic patient tracking system to increase the flow.
Patient satisfaction level, especially for hospital’s emergency department (ED) is increasingly becoming a key health quality indicator. Patient satisfaction regards the degree to which patients are happy with their healthcare (Heath, 2016). Patient satisfaction levels is a care quality measure and gives healthcare providers infor ...
15 April 2013Page of 1 ProQuest___________________________.docxhyacinthshackley2629
15 April 2013
Page of 1
ProQuest
_______________________________________________________________
_______________________________________________________________
Report Information from ProQuest
April 15 2013 10:30
_______________________________________________________________
Table of contents
PLEASE RIGHT CLICK HERE AND SELECT "Update Field" TO UPDATE TABLE OF CONTENTS.
1. Thirty-Day Readmission Rates as a Measure of Quality: Causes of Readmission After Orthopedic Surgeries and Accuracy of Administrative Data/PRACTITIONER APPLICATIONDocument 1 of 1
Thirty-Day Readmission Rates as a Measure of Quality: Causes of Readmission After Orthopedic Surgeries and Accuracy of Administrative Data/PRACTITIONER APPLICATION
Author: McCormack, Richard; Michels, Ryan; Ramos, Nicholas; Hutzler, Lorraine; Slover, James D, MD; Bosco, Joseph A, MD; Khan, Arby
Publication info: Journal of Healthcare Management 58. 1 (Jan/Feb 2013): 64-76; discussion 76-7.
ProQuest document link
Abstract: The rate of unplanned 30-day readmissions to the hospital after discharge is being used as a marker to compare the quality of care across hospitals and to set reimbursement levels for care. While the readmission rate can be reported using administrative data, the accuracy of these data is variable, and defining which readmissions are unplanned and preventable is often difficult. The purpose of this study was to review readmissions to a single orthopedic hospital to identify the causes for readmission and, in particular, which readmissions are planned versus unplanned. Using that hospital's administrative database of patient records from 2007 to 2009, we identified all patients who were readmitted to the hospital within 30 days of a previous hospitalization for a procedure. Readmissions were broadly categorized as planned (a staged or rescheduled procedure or a direct transfer) or unplanned. Unplanned readmissions were defined as either surgical or nonsurgical complications (medical conditions not directly related to the procedure). Almost 30 percent of readmissions were planned. Of the unplanned readmissions, close to 60 percent were triggered by an infection or a concern for an infection. Nonsurgical complications accounted for 18.2 percent of unplanned readmissions. This study highlights the importance of careful data collection and abstraction when calculating early readmission rates. Preventing surgical site infection and better coordinating care between orthopedic surgeons and primary care and medical subspecialty physicians may significantly reduce readmission rates. [PUBLICATION ABSTRACT]
Links: Linking Service
Full text: Richard McCormack, MD, chief resident, New York (N.Y.) University Hospital for Joint Diseases; Ryan Michels, medical student, New York University School of Medicine; Nicholas Ramos, medical student, New York University School of Medicine; Lorraine Hutzler, quality project manager, New York University Hospital for Joint Diseases; James D. Slover.
Unit 1Emergency Department Overcrowding Due to L.docxwillcoxjanay
Unit 1
Emergency Department Overcrowding Due to Lack of Access to Primary Care
Teresa Cochran
November 12, 2015
Emergency Department Overcrowding Due to Lack of Access to Primary Care
Emergency Department overcrowding related to patients seeking care for non-emergent conditions is an increasing concern for hospitals across the country. In rural areas, this issue is of concern not only for patient care but also has an impact economically on hospital financial viability.
Current Situation
Emergency Departments are designed to provide expedient care for individuals with emergent, life-threatening situations. However, in the current state, emergency departments are increasingly serving as a source of providing primary care. The resulting inappropriate use of the emergency department for non-emergent visits has been shown to increases cost, impact patient safety and quality.
Healthcare organizations must find and development innovative methods to provide quality patient care while maintaining low cost and maximum efficiencies. While demand for Emergency Services grows in part due to an aging population, the volume also has grown due to lack of primary care physicians and patient preference. The financial pressures faced by hospitals due to reductions in reimbursement necessitate a restructuring of the standard model of healthcare care delivery.
Problem Statement
As the population continues to grow emergency departments will continue to see not only acute illness but more chronic illness. It is essential for health care systems to continue in developing new and innovative means related to optimization of care delivery. Specifically this will identify factors that affect overutilization of the emergency department by individuals that are more appropriately treated in the primary care setting. Therefore, the increasing use of emergency departments will impact overall patient care due to lack of continuity that is provided in the primary care setting for chronic illness.
Research Objective
This research proposal will evaluate the feasibility of incorporating a medical home into the emergency department setting, therefore, reducing overcrowding in the Emergency Department. This increased access to primary care will ultimately increase access to quality care in the most appropriate cost-effective setting
Research Question
The intended purpose of this research proposal will examine the concept volume and acuity of patients seen in the Emergency Department. The following questions will be addressed. What measures can be implemented to reduce the overutilization of the ED yet offer the appropriate level of care for the patient? What barriers are associated with accessing sustained primary care?
Hypothesis
In order to improve outcomes, healthcare organizations must evaluate the feasibility of healthcare redesign related to the delivery of care. By restructuring how and where care is delivered will reduce the number of non-eme ...
The impact of nurse practitioner regulations onpopulation acdaniatrappit
The impact of nurse practitioner regulations on
population access to care
Donna Felber Neff, PhD, RN, FNAPa,*, Sul Hee Yoon, PhDb, Ruth L. Steiner, PhDc,
Ilir Bejleri, PhDb, Michael D. Bumbach, PhD, FNP-BCd, Damian Everhart, PhD, RNe,
Jeffrey S. Harman, PhDf
a College of Nursing, University of Central Florida, Orlando, FL
b Department of Urban and Regional Planning, University of Florida, Gainesville, FL
c Center for Health and the Built Environment, Department of Urban and Regional Planning, University Of Florida, Gainesville, FL
d College of Nursing, Department of Family, Community, and Health System Science, University of Florida, Gainesville, FL
e Centers for Medicare and Medicaid Services, University of Central Florida, Palm City, FL
f Department of Behavioral Sciences & Social Medicine, College of Medicine, Florida State University, Tallahassee, FL
A R T I C L E I N F O
Article history:
Received 15 November 2017
Accepted 5 March 2018
Available online 8 March 2018.
Keywords:
Nurse practitioner scope of
practice
Population access to care
Drive time
State NP practice regulations
A B S T R A C T
Background: By 2025, experts estimate a significant shortage of primary care pro-
viders in the United States, and expansion of the nurse practitioner (NP) workforce
may reduce this burden. However, barriers imposed by state NP regulations could
reduce access to primary care.
Purpose: The objectives of this study were to examine the association between three
levels of NP state practice regulation (independent, minimum restrictive, and most
restrictive) and the proportion of the population with a greater than 30-min travel
time to a primary care provider using geocoding.
Methods: Logistic regression models were conducted to calculate the adjusted odds
of having a greater than 30-min drive time.
Findings: Compared with the most restrictive NP states, states with independent
practice had 19.2% lower odds (p = .001) of a greater than 30-min drive to the closest
primary care provider.
Discussion: Allowing NPs full autonomy to practice may be a relatively simple policy
mechanism for states to improve access to primary care.
Cite this article: Neff, D. F., Yoon, S. H., Steiner, R. L., Bejleri, I., Bumbach, M. D., Everhart, D., & Harman,
J. S. (2018, JULY/AUGUST). The impact of nurse practitioner regulations on population access to care. Nursing
Outlook, 66(4), 379–385. https://doi.org/10.1016/j.outlook.2018.03.001.
Background
The benefits of an adequate supply of primary care pro-
viders on patient health have been well documented in
the scientific literature, including improved care coor-
dination and better overall patient outcomes (Macinko,
Starfield, & Shi, 2007; Starfield, Shi, & Macinko, 2005).
However, a shortage of primary care physicians (MDs)
in the United States is estimated to exceed 52,000 by
2025 (Petterson et al., 2012), most notably in key geo-
graphic locations, including medically underserved and
health professional shortage ...
A few months ago I wrote an article entitled Unplanned Readmissions: Are They Quality Measures or Utilization Measures? It explained the Hospital Readmissions Reduction Program (HRRP) that began in October 2012 as part of the Affordable Care Act (ACA). That article explained the program and its results over the past 5 years. However, more and more healthcare leaders and organizations are beginning to question whether HRRP is a valuable program or whether it is time to move on to something that focuses on quality of care and clinical outcomes, rather than cost savings. This article will address those issues. (In this article “readmissions” mean unplanned or preventable readmissions).
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996). For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000). Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013). The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019). The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996).
For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000).
Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013).
The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019).
The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
Work Breakdown Structure (WBS)Project Name Massive Solutions .docxlefrancoishazlett
Work Breakdown Structure (WBS)
Project Name: Massive
Solution
s International Data Center ExpansionDate: 1/19/19
Prepared by:
1.0 Current state analysis 1
1.1 Complete an inventory of all physical and virtual servers.
1.2 Complete an inventory of all software applications currently being provided, and critical index factor (CIF) for each.
1.2.1 Identify what an acceptable downtown would be for each application.
1.3 Determine the interdependencies between applications, servers, storage, and telecommunications.
1.4 Conduct a benchmarking of existing performance metrics of data center operations.
1.5 Determine viability of moving existing equipment or cost-benefit of procuring new equipment.
2.0 Planning and management 2
2.1 Identify potential costs.
2.2 Develop a budget.
2.3 Develop a process list of all anticipated move-related tasks.
2.4 Determine lessons learned from past moves.
2.5 Test move processes to identify problems or issues.
2.6 Obtain stakeholder approval to continue project.
3.0 Data center move strategy 3
3.1 Identify key personnel who will be involved with executing the move.
3.1.1 Determine if outsourcing of tasks is required.
3.2 Identify potential risks.
3.2.1 Develop risk mitigation processes.
3.3 Assign servers and applications to move bundles.
3.4 Prioritize the order in which bundles will be moved to the new data center.
4.0 Data center migration 4
4.1 Shift data center operations to a back-up site.
4.2 Verify operations are working properly.
4.3 Shut down current operations.
4.4 Procure/order new equipment required.
4.5 Uninstall existing equipment.
4.6 Prepare for shipment.
4.7 Track shipment.
4.8 Receive shipments at new data center.
4.8.1 New procurements
4.8.2 Existing equipment
4.9 Install equipment.
4.9.1 Test and verify.
4.10 Install software/applications.
4.10.1 Test and verify.
4.11 Migrate live data from backup site.
4.11.1 Test and verify.
5.0 Post-move verification
5.1 Ensure all installations are complete.
5.2 Conduct post-move benchmarks of performance, and compare with pre-
move benchmarks to determine delta (difference), if any.
5.3 Obtain stakeholder approval and accepatance.
.
work breakdown structureAssignment ContentCreate a Wor.docxlefrancoishazlett
work breakdown structure
Assignment Content
Create
a Work Breakdown Structure (WBS) and project schedule for the Learning Software Project.
Use
Microsoft® Project to list the components and breakdown of the project's WBS (i.e., project phases, grouping of tasks, resource assignments, etc.).
Develop
a Gantt chart with the following:
Project phase
Tasks
Resource names/titles
Duration
Start and finish dates
Predecessors
Milestones highlighted
Submit
your assignment.
.
More Related Content
Similar to WORK BREAKDOWN STRUCTUREProject TitleDate Prepared 1.Proje.docx
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, DioneWang844
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS
Page | 1
Quality
Nearly fifteen years ago, the Institute of Medicine published the “To Err Is Human” report, which exposed the substantial impact of medical errors in the US healthcare system and called for a dramatic system change, including an improved understanding of those errors (McCarthy, Tuiskula, Driscoll, & Davis, 2017). Medical errors are considered to be failure to achieve the original goal or plan of action, and these errors may range from a patient falls to a mistake in the operating room. Not only do medical errors cause harm to the patient and jeopardize the patient’s trust, but they also cause a financial strain for the health system (“To Err is Human,” 1999). One of the contributing factors to medical errors is the lack of effective communication between doctors who are treating the same patient. This results in healthcare providers overprescribing medications for patients as well as increases the possibility of a patient having unnecessary tests or procedures performed. The report’s four-tiered approach includes:
· Focusing on creating a stronger foundation of education on patient safety
· Mandating a nationwide reporting system to encourage timely reporting of errors
· Increasing the standards of performance for healthcare providers
· Taking advantage of the security that safety systems offer (“To Err is Human,” 1999)
Creating a strong educational foundation for patient safety is most important. Healthcare personnel are much more likely to actively participate in reporting systems, encourage one another to perform at a higher level, and take advantage of safety systems when they are well educated on patient safety and the implications of medical errors. The reporting system seems to provide the least amount of impact on patient safety as they can result in losing patient trust in certain healthcare systems. The healthcare system as a whole has made progress in establishing a safe environment for patients when they are in need of care.
Challenges for Patient Safety and Steps for Improvement
Despite continuing evidence of problems in patient safety and gaps between the care that patients receive and the evidence about what they should receive, efforts to improve quality in healthcare show mostly inconsistent and patchy results.
Tap each image to know more.
Data Collection and Monitoring Systems
This always takes much more time and energy than anyone anticipates. It is worth investing heavily in data from the outset. Assess local systems, train people, and have quality assurance.
Tribalism and Lack of Staff Engagement
Overcoming a perceived lack of ownership and professional or disciplinary boundaries can be very difficult. Clarify who owns the problem and solution, agree roles and responsibilities at the outset, work to common goals, and use shared language.
Convince People That There's a Problem
Use hard data to secure emotional e ...
BENCHMARK 1
Evidence-Based Practice Project: PICOT Paper
Daysha Y. Polk
NUR 550
Grand Canyon University
June 1st, 2021
Evidence-Based Practice Project: PICOT Paper
Generally, a high level of patient satisfaction for the clients in the emergency department (ED) is vital, especially at this time when the healthcare system is shifting towards patient-centered care. Prakash (2010) notes that patient satisfaction levels significantly impact on medical malpractice claims, patient retention, and clinical outcomes. That is, it affects quality healthcare’s timely, efficient, and patient-centered delivery, making it both a proxy but a very effective key indicator for measuring the hospitals and doctors’ success. Consequently, supporting the improvements of patient satisfaction levels can positively affect several healthcare organizations’ components, such as preventive possible malpractice lawsuits, securing a positive local reputation, and enhancing patient retention rates. Thus, there is an increased need to develop strategies to improve ED patient’s satisfaction with the provided care services. Increasingly, the use of real-time location systems (RTLS) by hospitals to track patients, instead of relying on the traditional, manually-entered status updates, is increasingly being viewed as a better strategy to decrease the number or rate of Left Without Being Treated (LWBT) patients, and thus, improve ED patient’s satisfaction levels and hospital’s revenue collection (Boulos & Berry, 2012). Thus, the paper will explore whether the utilization of RTLS in the hospital’s ED, compared to manually-entered status updates to tract patients, help decrease the rate of LWBT and to raise revenue collection within 6 months, for ED patients with decreasing satisfaction levels with the provided healthcare services.
A wide array of factors is responsible for the decreased rate of satisfaction levels amongst ED patients. The current delays, long waits, leaving without being treated, decreased revenue collection from the ED unit, and reduced patient satisfaction scores have negatively portrayed the hospital's reputation to the public. As a result, the daily patient visits have continued to decrease as people attribute the facility to poor emergency care services delivery. All these complications result from the use of combined data resources and manual entry status updates when tracking patient records. This manual tracking cannot meet the demand for many patients and leads to overcrowding due to and reduced patient flow in the ED. Therefore, there is a need to install an automatic patient tracking system to increase the flow.
Patient satisfaction level, especially for hospital’s emergency department (ED) is increasingly becoming a key health quality indicator. Patient satisfaction regards the degree to which patients are happy with their healthcare (Heath, 2016). Patient satisfaction levels is a care quality measure and gives healthcare providers infor ...
15 April 2013Page of 1 ProQuest___________________________.docxhyacinthshackley2629
15 April 2013
Page of 1
ProQuest
_______________________________________________________________
_______________________________________________________________
Report Information from ProQuest
April 15 2013 10:30
_______________________________________________________________
Table of contents
PLEASE RIGHT CLICK HERE AND SELECT "Update Field" TO UPDATE TABLE OF CONTENTS.
1. Thirty-Day Readmission Rates as a Measure of Quality: Causes of Readmission After Orthopedic Surgeries and Accuracy of Administrative Data/PRACTITIONER APPLICATIONDocument 1 of 1
Thirty-Day Readmission Rates as a Measure of Quality: Causes of Readmission After Orthopedic Surgeries and Accuracy of Administrative Data/PRACTITIONER APPLICATION
Author: McCormack, Richard; Michels, Ryan; Ramos, Nicholas; Hutzler, Lorraine; Slover, James D, MD; Bosco, Joseph A, MD; Khan, Arby
Publication info: Journal of Healthcare Management 58. 1 (Jan/Feb 2013): 64-76; discussion 76-7.
ProQuest document link
Abstract: The rate of unplanned 30-day readmissions to the hospital after discharge is being used as a marker to compare the quality of care across hospitals and to set reimbursement levels for care. While the readmission rate can be reported using administrative data, the accuracy of these data is variable, and defining which readmissions are unplanned and preventable is often difficult. The purpose of this study was to review readmissions to a single orthopedic hospital to identify the causes for readmission and, in particular, which readmissions are planned versus unplanned. Using that hospital's administrative database of patient records from 2007 to 2009, we identified all patients who were readmitted to the hospital within 30 days of a previous hospitalization for a procedure. Readmissions were broadly categorized as planned (a staged or rescheduled procedure or a direct transfer) or unplanned. Unplanned readmissions were defined as either surgical or nonsurgical complications (medical conditions not directly related to the procedure). Almost 30 percent of readmissions were planned. Of the unplanned readmissions, close to 60 percent were triggered by an infection or a concern for an infection. Nonsurgical complications accounted for 18.2 percent of unplanned readmissions. This study highlights the importance of careful data collection and abstraction when calculating early readmission rates. Preventing surgical site infection and better coordinating care between orthopedic surgeons and primary care and medical subspecialty physicians may significantly reduce readmission rates. [PUBLICATION ABSTRACT]
Links: Linking Service
Full text: Richard McCormack, MD, chief resident, New York (N.Y.) University Hospital for Joint Diseases; Ryan Michels, medical student, New York University School of Medicine; Nicholas Ramos, medical student, New York University School of Medicine; Lorraine Hutzler, quality project manager, New York University Hospital for Joint Diseases; James D. Slover.
Unit 1Emergency Department Overcrowding Due to L.docxwillcoxjanay
Unit 1
Emergency Department Overcrowding Due to Lack of Access to Primary Care
Teresa Cochran
November 12, 2015
Emergency Department Overcrowding Due to Lack of Access to Primary Care
Emergency Department overcrowding related to patients seeking care for non-emergent conditions is an increasing concern for hospitals across the country. In rural areas, this issue is of concern not only for patient care but also has an impact economically on hospital financial viability.
Current Situation
Emergency Departments are designed to provide expedient care for individuals with emergent, life-threatening situations. However, in the current state, emergency departments are increasingly serving as a source of providing primary care. The resulting inappropriate use of the emergency department for non-emergent visits has been shown to increases cost, impact patient safety and quality.
Healthcare organizations must find and development innovative methods to provide quality patient care while maintaining low cost and maximum efficiencies. While demand for Emergency Services grows in part due to an aging population, the volume also has grown due to lack of primary care physicians and patient preference. The financial pressures faced by hospitals due to reductions in reimbursement necessitate a restructuring of the standard model of healthcare care delivery.
Problem Statement
As the population continues to grow emergency departments will continue to see not only acute illness but more chronic illness. It is essential for health care systems to continue in developing new and innovative means related to optimization of care delivery. Specifically this will identify factors that affect overutilization of the emergency department by individuals that are more appropriately treated in the primary care setting. Therefore, the increasing use of emergency departments will impact overall patient care due to lack of continuity that is provided in the primary care setting for chronic illness.
Research Objective
This research proposal will evaluate the feasibility of incorporating a medical home into the emergency department setting, therefore, reducing overcrowding in the Emergency Department. This increased access to primary care will ultimately increase access to quality care in the most appropriate cost-effective setting
Research Question
The intended purpose of this research proposal will examine the concept volume and acuity of patients seen in the Emergency Department. The following questions will be addressed. What measures can be implemented to reduce the overutilization of the ED yet offer the appropriate level of care for the patient? What barriers are associated with accessing sustained primary care?
Hypothesis
In order to improve outcomes, healthcare organizations must evaluate the feasibility of healthcare redesign related to the delivery of care. By restructuring how and where care is delivered will reduce the number of non-eme ...
The impact of nurse practitioner regulations onpopulation acdaniatrappit
The impact of nurse practitioner regulations on
population access to care
Donna Felber Neff, PhD, RN, FNAPa,*, Sul Hee Yoon, PhDb, Ruth L. Steiner, PhDc,
Ilir Bejleri, PhDb, Michael D. Bumbach, PhD, FNP-BCd, Damian Everhart, PhD, RNe,
Jeffrey S. Harman, PhDf
a College of Nursing, University of Central Florida, Orlando, FL
b Department of Urban and Regional Planning, University of Florida, Gainesville, FL
c Center for Health and the Built Environment, Department of Urban and Regional Planning, University Of Florida, Gainesville, FL
d College of Nursing, Department of Family, Community, and Health System Science, University of Florida, Gainesville, FL
e Centers for Medicare and Medicaid Services, University of Central Florida, Palm City, FL
f Department of Behavioral Sciences & Social Medicine, College of Medicine, Florida State University, Tallahassee, FL
A R T I C L E I N F O
Article history:
Received 15 November 2017
Accepted 5 March 2018
Available online 8 March 2018.
Keywords:
Nurse practitioner scope of
practice
Population access to care
Drive time
State NP practice regulations
A B S T R A C T
Background: By 2025, experts estimate a significant shortage of primary care pro-
viders in the United States, and expansion of the nurse practitioner (NP) workforce
may reduce this burden. However, barriers imposed by state NP regulations could
reduce access to primary care.
Purpose: The objectives of this study were to examine the association between three
levels of NP state practice regulation (independent, minimum restrictive, and most
restrictive) and the proportion of the population with a greater than 30-min travel
time to a primary care provider using geocoding.
Methods: Logistic regression models were conducted to calculate the adjusted odds
of having a greater than 30-min drive time.
Findings: Compared with the most restrictive NP states, states with independent
practice had 19.2% lower odds (p = .001) of a greater than 30-min drive to the closest
primary care provider.
Discussion: Allowing NPs full autonomy to practice may be a relatively simple policy
mechanism for states to improve access to primary care.
Cite this article: Neff, D. F., Yoon, S. H., Steiner, R. L., Bejleri, I., Bumbach, M. D., Everhart, D., & Harman,
J. S. (2018, JULY/AUGUST). The impact of nurse practitioner regulations on population access to care. Nursing
Outlook, 66(4), 379–385. https://doi.org/10.1016/j.outlook.2018.03.001.
Background
The benefits of an adequate supply of primary care pro-
viders on patient health have been well documented in
the scientific literature, including improved care coor-
dination and better overall patient outcomes (Macinko,
Starfield, & Shi, 2007; Starfield, Shi, & Macinko, 2005).
However, a shortage of primary care physicians (MDs)
in the United States is estimated to exceed 52,000 by
2025 (Petterson et al., 2012), most notably in key geo-
graphic locations, including medically underserved and
health professional shortage ...
A few months ago I wrote an article entitled Unplanned Readmissions: Are They Quality Measures or Utilization Measures? It explained the Hospital Readmissions Reduction Program (HRRP) that began in October 2012 as part of the Affordable Care Act (ACA). That article explained the program and its results over the past 5 years. However, more and more healthcare leaders and organizations are beginning to question whether HRRP is a valuable program or whether it is time to move on to something that focuses on quality of care and clinical outcomes, rather than cost savings. This article will address those issues. (In this article “readmissions” mean unplanned or preventable readmissions).
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996). For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000). Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013). The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019). The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996).
For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000).
Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013).
The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019).
The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
Work Breakdown Structure (WBS)Project Name Massive Solutions .docxlefrancoishazlett
Work Breakdown Structure (WBS)
Project Name: Massive
Solution
s International Data Center ExpansionDate: 1/19/19
Prepared by:
1.0 Current state analysis 1
1.1 Complete an inventory of all physical and virtual servers.
1.2 Complete an inventory of all software applications currently being provided, and critical index factor (CIF) for each.
1.2.1 Identify what an acceptable downtown would be for each application.
1.3 Determine the interdependencies between applications, servers, storage, and telecommunications.
1.4 Conduct a benchmarking of existing performance metrics of data center operations.
1.5 Determine viability of moving existing equipment or cost-benefit of procuring new equipment.
2.0 Planning and management 2
2.1 Identify potential costs.
2.2 Develop a budget.
2.3 Develop a process list of all anticipated move-related tasks.
2.4 Determine lessons learned from past moves.
2.5 Test move processes to identify problems or issues.
2.6 Obtain stakeholder approval to continue project.
3.0 Data center move strategy 3
3.1 Identify key personnel who will be involved with executing the move.
3.1.1 Determine if outsourcing of tasks is required.
3.2 Identify potential risks.
3.2.1 Develop risk mitigation processes.
3.3 Assign servers and applications to move bundles.
3.4 Prioritize the order in which bundles will be moved to the new data center.
4.0 Data center migration 4
4.1 Shift data center operations to a back-up site.
4.2 Verify operations are working properly.
4.3 Shut down current operations.
4.4 Procure/order new equipment required.
4.5 Uninstall existing equipment.
4.6 Prepare for shipment.
4.7 Track shipment.
4.8 Receive shipments at new data center.
4.8.1 New procurements
4.8.2 Existing equipment
4.9 Install equipment.
4.9.1 Test and verify.
4.10 Install software/applications.
4.10.1 Test and verify.
4.11 Migrate live data from backup site.
4.11.1 Test and verify.
5.0 Post-move verification
5.1 Ensure all installations are complete.
5.2 Conduct post-move benchmarks of performance, and compare with pre-
move benchmarks to determine delta (difference), if any.
5.3 Obtain stakeholder approval and accepatance.
.
work breakdown structureAssignment ContentCreate a Wor.docxlefrancoishazlett
work breakdown structure
Assignment Content
Create
a Work Breakdown Structure (WBS) and project schedule for the Learning Software Project.
Use
Microsoft® Project to list the components and breakdown of the project's WBS (i.e., project phases, grouping of tasks, resource assignments, etc.).
Develop
a Gantt chart with the following:
Project phase
Tasks
Resource names/titles
Duration
Start and finish dates
Predecessors
Milestones highlighted
Submit
your assignment.
.
Work as a team to complete a Lean Six Sigma implementation case. EV.docxlefrancoishazlett
Work as a team to complete a Lean Six Sigma implementation case. EVERYONE will interview two different person(s) who have experienced or associated with the Lean, Six Sigma, or Lean Six Sigma implementation project. The interviews can be via phone, f2f meeting, or video conference and focus on the following topics:
- The project’s objectives and outcomes (successful/failure), brief explaining methodology
- The roles of this person in the project
- Any forces and factors enabling the implementation process
- Any barriers or obstacles that limited or constrained the process
- Any techniques/tools and relevant metrics used by the organization
Section 1 – brief description of all interviews following the above topics
- Section 2 – drawing tables/figures finding similarities and differences of these interviews focusing on forces and factors enabling the implementation, as well as the barriers or obstacles that limited or constrained the process. Any other useful information on Lean Six Sigma implementation process should be presented.
A list of reference noting the interviews conducted (names of individuals and organizations can be masked), data utilized, and additional source materials cited or consulted.
QUESTIONS WHICH HAVE TO BE ASKED ARE LISTED IN BELOW ATTACHED PHOTO
.
Work Area Recovery Plan is a vital plan that establishes an adequate.docxlefrancoishazlett
Work Area Recovery Plan is a vital plan that establishes an adequate environment for people to work in the event of a disruptive incident. Discuss the challenges that organizations without proper Work Area Recovery Plan may face when disruptive events arise.
What are the benefits of performing Pandemic risk assessment in an organization?
.
WORK 1Mental Health DisorderNeurological developmental dis.docxlefrancoishazlett
WORK 1
Mental Health Disorder
Neurological developmental disorder
Introduction
1. Make a detailed summary where you define the disorders within the assigned category, their diagnostic criteria, specifiers and differential diagnoses.
2. What are neurodevelopmental disorders
3. Some causes of neurodevelopmental disorders
4. Classification of neurodevelopmental disorders
5. Intellectual disability
6. Communication disorders
7. Autism Spectrum Disorder (ASD)
8. Attention deficit hyperactivity disorder (ADHD)
9. Latest advances
10. Describe the prevalence, development and course
11. Risk factors
12. Cultural considerations
13. Present examples of situations / cases in relation to the assigned disorder
14. Present physical conditions associated with the disorder
15. Medications and clinical intervention models that have shown effectiveness
16. Look for articles or professional mental health journals (minimum 2 articles) that talk about these disorders and report relevant information for Clinical Social Work.
Important:
1. They must use the DSM V, textbooks, Virtual Library
2. The professional articles must be in this time frame 2015 to 2021.
3. They can use additional resources to support their presentation (videos, role play, cases to discuss)
4. APA format
WORK 2
Mental Health Disorders
Neurocognitive Disorder
Oral presentation content by topic:
Presentation 2
Introduction
1. MAJOR NEUROCOGNITIVE DISORDERS (DEMENTIA)
2. EPIDEMIOLOGY
3. ETHIOPATHOGENESIS
4. EVALUATION, DIAGNOSTIC CRITERIA AND CLASSIFICATION
5. COGNITIVE TESTS
6. TREATMENT
7. AFFECTIVE DISORDERS IN THE ELDERLY ADULT
-GENERAL PERSPECTIVES
-SPECIFIC ENTITIES
8. TREATMENT AND PROGNOSIS
9. SLEEP DISORDERS IN THE ELDERLY ADULT
10. THE FUNCTIONS OF SLEEP AND SPECIFIC ENTITIES
17. Latest advances
18. Describe the prevalence, development and course
19. Risk factors
20. Cultural considerations
21. Present examples of situations / cases in relation to the assigned disorder
22. Present physical conditions associated with the disorder
23. Medications and clinical intervention models that have shown effectiveness
24. Look for articles or professional mental health journals (minimum 2 articles) that talk about these disorders and report relevant information for Clinical Social Work.
Important:
1. They must use the DSM V, textbooks, Virtual Library
2. The professional articles must be in this time frame 2015 to 2021.
3. They can use additional resources to support their presentation (videos, role play, cases to discuss)
4. APA format
.
Wordsworths Tintern Abbey is reflection on nature. Pick one of .docxlefrancoishazlett
Wordsworth's
Tintern Abbey is
reflection on nature. Pick one of these poems, and discuss the role nature plays in human life according to its author. (Be sure to refer to specific evidence in the text.) Do you agree or disagree with their view? Why? write about 300 words.
.
Words400 Topic When it comes to politics, the role of a wome.docxlefrancoishazlett
Words:40
0
Topic:
When it comes to politics, the role of a women in a less developed country will change significantly as women are now allowed to vote and become members of the parliament.
Description:
Literature review:
This section
reviews
the literature on key topics and makes links to the chosen theme. Include definitions of key concepts, and analyse and compare the effects and importance of the various trends based upon the readings. The literature review requires the group to address key areas in relation to the topic and theme
(
Concentrate here
in the lit review
on the ideas authors discuss about the role of
political
representation
in overcoming inequality
. Maybe use a historical perspective. A lit review should focus on ideas/arguments of authors, not statistics
. What are Mitter & Rowbotham / Burchielli / Mehdizadeh / Braverman / Williams
’
ideas
about power & equality, roles & economic freedom? Even
the international labour rights movement
)
Attached are 5 journal articles that need to be used. And you need to get 5 other journal articles.
References: 10
.
Words 500 Review the distinction between leadership and managem.docxlefrancoishazlett
Words: 500
Review the distinction between leadership and management. Then think about this in regard to how senior leaders versus senior managers lead change in an organization (especially when it comes to technical change in an organization).
When implementing change in an organization, there are always cultural issues that are faced, such as not accepting change, determine how differently this would be handled thinking about the management versus leadership constructs?
When dealing with performing work, how is this implemented differently within the management versus leadership constructs?
At least one scholarly (peer-reviewed) resource should be used in the initial discussion thread. Use APA references and in-text citations.
.
Wordcount 3.000 words (+-10).Cover, Table of Contents, Refe.docxlefrancoishazlett
Wordcount: 3.000 words (+/-10%).
Cover, Table of Contents, References and Appendix are excluded of the total slide count.
Font: Arial, size 12.5.
Text alignment: Justified.
The in-text References and the Bibliography have to be in Harvard’s citation style.
.
Words can be intelligible, cultural and storied. It may mean differ.docxlefrancoishazlett
“Words can be intelligible, cultural and storied. It may mean different things to you and to others. It may have one, several to many meanings, depending on where and who you are."
Pick one word or one phrase you feel you can write about to show you understand this. (Around Communications)
According to Communications and Culture:
1. Define it.
2. Explain its significance and meaning to you and us in our society
3. connect/refer to the topics /concepts taught in the course textbook only.
No references needed. References ONLY textbook and real-world examples.
Textbook: Strom, Bill and Agodzo, Divine (2018). More Than Talk: A Covenantal Approach to Everyday
Communication
, 5th edition. Dubuque, IA: Kendall/Hunt Publishing Company.
.
Word Test Out Materialw00_cumexam_council.xlsxCity of Floma C.docxlefrancoishazlett
Word Test Out Material/w00_cumexam_council.xlsx
City of Floma Council MembersSalutationFirst NameLast NameMrs.JenniferDoyleMr.DavidDawsonMr.RobertMosleyDr.JeremyRoy
Word Test Out Material/w00_cumexam_data.docx
City of Floma
Fiscal Year 2018 Audit ReportExecutive Summary
Introduction
This audit report was prepared to satisfy the City of Floma Charter’s requirement to have an external, independent, and qualified auditor annually examine its operations. The stated goal of the audit is to provide the citizens of the city with assurance that the city’s resources are being managed in accordance with local, state, and federal regulations.
The information presented in this audit report was compiled from data found in public records, transaction and management databases used by municipal software applications, and personal interviews of city employees. The data was reviewed for consistency and compliance with Generally Accepted Accounting Principles for state and local governments. Analysis of the data was then conducted to determine where opportunities for improved efficiencies exist.
The result of the audit can be found below. It includes specific findings by city department, supporting tables, and general recommendations.City Departments
Public Safety (Police and Fire)
The analysis of the personnel expenditures of both public safety agencies found that overall costs can be reduced by hiring additional police officers and firefighters. Calculations to support this conclusion can be found in Table 1 below. The current spending on overtime warrants the net addition of two police officers and one firefighter in fiscal year 2019.
The population growth of the city is noted, and as such, additional hires should be anticipated in each of the following two years. The hires required to maintain proper personnel levels in the police force and fire department will be financially covered by the expected increase in city tax revenue commensurate with the population growth.
Utilities
The acquisition of smart electricity meters has continued at a steady pace throughout 2018. We observed delays in the installation and proper configuration of the smart meters, which causes unnecessary inconvenience for citizens. The city personnel tasked with the implementation of the smart meters has not received sufficient training to complete the project within the allotted time frame.
The utility department should organize additional training sessions for the two supervisors so that they may in turn train their employees. This training is to focus on efficient installation of the meters and connection of the meters to the central utility computer system. Until such training is completed, it is not advisable to continue installation of the new meters to avoid disruptions and costly rework.
Waste Management
The Waste Management Department has not made any plans to address the city’s landfill capacity. The landfill is expected to reach its designed capacity in Q2, 2020. Several.
Words 1500 - 1700You have recently hired a new assistant, Susan .docxlefrancoishazlett
Words 1500 - 1700
You have recently hired a new assistant, Susan Thompson, who previously worked in a financial accounting office preparing journal entries, which provide you with a recording of the day-to-day activities of the company and financial statements (income statement, statement of owners' equity balance sheet, and cash flow statement). Although your new assistant has experience with and fully understands financial accounting, she has no experience with managerial accounting.
Assignment
In a memo to your new assistant, Susan Thompson, explain to her the similarities and differences between financial and managerial accounting. Provide examples of managerial accounting reports that she could expect to see within EEC, and explain how management might use the information to make decisions. Keep in mind that the income statement, statement of owners’ equity balance sheet, and cash flow statement, although generated in financial accounting, are used to develop all of your managerial accounting reports. Examples of a few of those reports are the horizontal analyzes, vertical analyzes, and ratios.
.
Woodside and McClam (2013) describe the three components of case.docxlefrancoishazlett
Woodside and McClam (2013) describe the three components of case management as case review, report writing and documentation, and client participation.
In your own words, describe each of these components. Why is each component important for case managers?
Which component do you think is most important? Justify your answer.
Woodside, M., & McClam, T. (2013).
Generalist case management: A method of human service delivery
(4th ed.). Belmont, CA: Cengage.
.
Word limit is 650, must be in APA format, citations and references.docxlefrancoishazlett
Word limit is 650, must be in APA format, citations and references
Consider this hypothetical situation:
David Doe is a network administrator for the ABC Company. David is passed over for promotion three times. He is quite vocal in his dissatisfaction with this situation. In fact, he begins to express negative opinions about the organization in general. Eventually, David quits and begins his own consulting business. Six months after David’s departure, it is discovered that a good deal of the ABC Company’s research has suddenly been duplicated by a competitor. Executives at ABC suspect that David Doe has done some consulting work for this competitor and may have passed on sensitive data. However, in the interim since David left, his computer has been formatted and reassigned to another person. ABC has no evidence that David Doe did anything wrong.
What steps might have been taken to detect David’s alleged industrial espionage?
What steps might have been taken to prevent his perpetrating such an offense?
.
Word limit is 200 word . High quality is most important. Needs to be.docxlefrancoishazlett
Word limit is 200 word . High quality is most important. Needs to be in APA format and you need to use and cite 2 sources in APA format.
Select a technology that is of interest to you (for example, sewing machines, tanks, computers, TV, etc.); write a paper about its historic and current impact on the economy, the environment, relationships, education, and morals.
Need it in an hour...
.
Woodrow Wilson, from The New Freedom (1913)Eugene V. Debs, The O.docxlefrancoishazlett
Woodrow Wilson, from The New Freedom (1913)
Eugene V. Debs, "The Outlook for Socialism in the United States" (1900)
Herbert Croly, Progressive Democracy (1914)
Theodore Roosevelt, from The New Nationalism (1910)
Compare these views on America and its desired future. Rate these authors by the radicalism expressed in these documents. What common themes do they share? Where are they significantly different? Which vision is the closest to the way America developed over the next several decades?
.
Word count; 150 wordsCompare and discuss the two basic categor.docxlefrancoishazlett
Word count; 150 words
Compare and discuss the two basic categories of health policies. Give an example of federal or state legislation that reflect each category
Discuss the impact of federal and state legislation on health related issues.
Word count; 150 words
Discuss the impact of health policies on health services in terms of the money, human resources, and technology used to produce these services. Your answer should include a discussion on each of the three areas?Word count; 150
Who are the demanders and suppliers in health policies? Describe what motivates each in a political marketplace.Word count; 150 words
Your Opinion and Observations
When you are ready, respond to the prompts below.
Is influence in Public Policy environments a matter of power and focus? Why or why not
Word count; 150 words
Discuss the necessity of rulemaking and the role that interest groups play in it. Discuss the necessity of analysis in the rulemaking process in healthcare Assess general tools and frameworks used in policy analysis within healthcare. Word count; 150 words
Discuss the role of policy analysis in policy modification. Include a description of a federal agency that supports policymaking through policy analysis. Word count; 150 words
Research a current health policy of your choice and discuss why you find it relevant to you personally and the population. You may also discuss any changes you would make to the policy. Please provide justification for the change. Word count; 150 words
Case Study Religious Prayer
You have recently hired a new employee who is skilled and experienced and has a Muslim background. He has requested he be granted time to conduct his prayer duty which is 5 times a day and a place to do it.
Current policy allows employees 2 fifteen minute breaks (one in the morning and one in the afternoon) and a 30 minute lunch period. Your company also recognizes Easter, Hanukkah, and Christmas as holidays.
What should you do, given current practices and policy that will not precipitate problems with the remaining staff? Word count; 150 words
What have you learned that clarifies the positions and tools used by the various stakeholder groups to impact health care reform legislation? Word count; 150 words
What have you learned that clarifies the process of policymaking on health related topics? Is there anything that you would change? Word count; 150 words
Write a 7-9 page paper with bibliography. Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources as appropriate. Refer to the Pocket Guide to APA Style to ensure in-text citations and reference list are correct.
You will synthesize your understanding of why Medicare Part D passed, as well as the influence of the various interest groups and governmental entities during this process. Make sure to discuss both the policy process and the policy environment—that is.
Word count The report should be between 600 to 800 words (excludi.docxlefrancoishazlett
Word count:
The report should be between 600 to 800 words (excluding the bibliography) with the following title:
Title: The Carrying Capacity of the Planet
Explain and evaluate, using referenced evidence and data, what the concept of “the planet’s carrying capacity” means and how it is measured. You should explain how humanity might find ways to deal with this problem.
Ensure that you provide clear titles for separate sections within the report.
.
Word count needs to be 150 words each bulleted itemHow does sensit.docxlefrancoishazlett
Word count needs to be 150 words each bulleted item
How does sensitivity analysis relate to contingency planning? What are several risk mitigation strategies that you could implement to desensitize these variables?
Is it realistic that a commitment to continuous improvement could actually replace operational controls? Strategic controls?
.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...
WORK BREAKDOWN STRUCTUREProject TitleDate Prepared 1.Proje.docx
1. WORK BREAKDOWN STRUCTURE
Project Title: Date Prepared:
1. Project
1.1. Major Deliverable
1.1.1. Control Account
1.1.1.1. Work package
1.1.1.2. Work package
1.1.1.3. Work package
1.1.2. Work package
1.2. Control Account
1.2.1. Work package
1.2.2. Work package
1.3. Major Deliverable
1.3.1. Control account
1.3.2. Control account
1.3.2.1. Work package
1.3.2.2. Work package
Page 1 of 1
Running Head: EVALUATING PHYSICIANS AND NURSES
PERSPECTIVE ON FACTORS CONTRIBUTING TO
READMISSION OF OPHTHALMIC DISCHARGED PATIENTS
AND POTENTIAL ONLINE FOLLOW-UP STRATEGIES TO
REDUCE THEIR READMISSION IN A GOVERNMENT
HOSPITAL OF RIYADH
[Type text] [Type text] [Type text]
EVALUATING PHYSICIANS AND NURSES PERSPECTIVE
ON FACTORS CONTRIBUTING TO READMISSION OF
OPHTHALMIC DISCHARGED PATIENTS AND POTENTIAL
ONLINE FOLLOW-UP STRATEGIES TO REDUCE THEIR
2. READMISSION IN A GOVERNMENT HOSPITAL OF
RIYADH
Evaluating Physicians and Nurses Perspective on Factors
Contributing to Readmission of Ophthalmic Discharged Patients
and Potential Online Follow-Up Strategies to Reduce Their
Readmission in a Government Hospital of Riyadh
CHAPTER I
Introduction
Annually, unplanned readmissions cost 15-20 billion dollars,
and preventing such readmission will potentially improve the
quality of life for patients and decrease the financial pain of
health care systems, (Alper,2017). The existing precedence of
many healthcare facilities is to reduce readmissions using post-
discharge follow-up practices. The definitive objective of health
care providers is to deliver high-quality health care services to
patients using transitional care models. The methodologies
encourage the use of appropriate outpatient follow-up
appointments implemented through Medicare incentives to
promote the reduction in hospital readmissions (Adib-
Hajbaghery, Maghaminejad & Abbasi, 2013). Comment by
Editor: Setting of margins required
Many of the researchers analyzing the outcome of follow-up on
outpatients in reducing hospital readmissions majors on
particular illnesses in a state; hence it is shallow. The review
indicates that outpatient follow-ups decrease sickle cell anemia,
pediatric asthma, and heart failure patient readmission (Hasan et
al., 2010; Alper, 2017). However, there is an indication of
mixed results obtained from examinations on hospitalized
individuals. One study carried out by the Medicare Payment
Advisory Commission demonstrated that there is no relationship
between the timing of outpatient follow-up, and 30-day
readmission rate in discharged patients from medical facilities
(Ferrandino et al., 2017).
Statement of the Problem
According to Ferrandino et al. (2017), the readmission of
3. roughly a half of the Medicaid receivers countrywide is within
30 days of discharge, and they fail to get a follow-up on
outpatient before readmission. Equally, patients readmitted for
chronic illnesses recorded a decrease in outpatient follow-up. It
implies that the use of timely follow-ups to decrease the rates of
readmissions is extensive. According to Jencks et al. (2009),
13,065,937 patients from the Medicare program “fee-for-
service” are enrolled in total and from October 1st, 2003 to
September 30th, 2004; 4926 were discharged. Within 30 days
19.6% of the patients were readmitted, 34.0% within 90 days,
and 56.1% within 365 days.The analysis of information aims to
draw the relationship between immediate outpatient follow-up
through possibly an online-based system and probability of
readmission. As discussed by Adib-Hajbaghery et al. (2013),
only one study used an online-based post-discharge follow-up
method. This web-based system enabled patients to
communicate with nurses and record parameters related to their
conditions. Using such a system appeared to be more effective
in reducing the readmission rate; in the stated intervention
group, only 8.3% were readmitted whereas 41.6% were admitted
in other groups using the conventional follow-up method.
This present work aims to establish the true benefit of using an
online-based follow-up method to be able to develop the online
system in the future to reduce readmission rates. For the
purpose of this research, hospital readmission is defined as the
total number of patients who were discharged from the hospital
and readmitted within 365 days from the initial discharge.
An Internet-based follow-up approach provides an innovative
revenue to provide patients' direct contact to their healthcare
providers. Such systems can offer a framework for chronic
medical management that simplifies patient-physician
communication, personalization, and education. A software-
based system can be easily developed and adapted along with
the appropriate workflow guideline, and it only requires access
to the Internet, (Kashem et al., 2008)
4. CHAPTER II
Review of Literature
Definition
Hospital readmission is defined as the return of the same patient
to the same hospital for the same condition within a 30-day
period. Unplanned readmissions are indicative of inadequate
health care outcomes; factors that precipitate high readmission
rates emanate partly from offhand practices that exist within
healthcare facilities (Gruneir et al., 2017). Hospital
readmissions after 30 days have proven to be costly not only to
patients but also to the state, and as such, it has attracted public
policy attention. In concurrence with Alper, O'Malley, and
Greenwald (2017) on the cost of readmission, Zuckerman et al.,
(2016) assert that hospital readmissions that occur within 30
days after discharge consume about 17 billion of the entire
affordable care act expenditure.
History
Alper, O'Malley, and Greenwald (2017) also observed that
among Medicare beneficiaries, about 20% of those discharged
from hospitals were readmitted within thirty days. The level of
readmissions as observed thereof impact significantly on the
cost of health-care (Medicare Payment Advisory Commission,
2007). Alper, O'Malley, and Greenwald (2017) also indicate that
the cost of unplanned readmission alone ranges between 15-20
million US dollars annually. To demonstrate how costly the rate
of readmission can get, Adib-Hajbaghery, Maghaminejad,
Abbasi (2013) indicate that in the year 2003, the cost of
readmission for patients who presented with heart failure in Iraq
alone was about 400 billion Rials. Readmissions, therefore,
weigh significantly on health financial allocation in various
countries and constitute a considerable amount of the entire
Medicare budget in the US, (Alper, O'Malley & Greenwald,
5. 2017).
Alper, O’Malley & Greenwald (2017) also observe that
readmissions sometimes arise when patients are discharged
excessively early in cases where continued hospitalization are
necessary. In such instances, healthcare professionals have
often demonstrated a failure by putting little considerations on
the severity of the patients’ conditions and ailments (Ferrandino
et al., 2017). Discharging patients without proper considerations
to the seriousness of their conditions as well as discharging
patients into environments that hardly support their recovery
process invariably set the ground for readmission.
In concurrence with Alper, O'Malley & Greenwald (2017) on
the factors that precipitate the rate of hospital readmissions,
Adib-Hajbaghery, Ahmadinejad and Abbasi (2013) opine that
when the input of caregivers, pharmacists, and insurers are not
sought at the time of discharge, the success of continual care
outside the precincts of healthcare facilities may be impeded.
According to Alper, O'Malley, and Greenwald (2017), some of
the individuals whose input are critical when preparing a
discharge plan for a patient include the insurer, social worker,
physician, occupational therapists among others.
Since the formulation of the hospital readmission reduction
program, the rate of readmission has reduced remarkably.
Zuckerman et al., (2016) indicate that readmission rates for
targeted and no targeted conditions have decreased significantly
from 2012 to 2016. According to Alper, O'Malley, and
Greenwald (2017), hospital readmission risk factors
encapsulates clinical, logistical and demographic factors such as
low health literacy, race, and discharge against medical advice.
Besides, lack of adequate training tools, a factor that can be
classified as a logistical hitch, makes it impossible for
healthcare professionals to isolate patients who would likely be
readmitted in the future so that they could be subjected to
rigorous treatment that could reduce readmission. Lack of
practical training tools, therefore exemplifies a failure, from the
hospital end, that potentially precipitates readmission rate,
6. (Alper, O'Malley & Greenwald,2017).
Other key contributors to readmissions include complications
from the initial hospital's stay such as infections from initial
surgical procedures, chronic conditions that create frequent
acute events, poorly managed post-acute care one of which is
medication non-compliance, taking the wrong dosage, not
taking the prescribed regimen (Auerbach et al., 2016). Poor
communication between hospital clinicians and primary care
providers often result in poor care coordination and of course,
increases the chances of patients' care readmission. It explains
why the key goal of chronic care management is managing
communication between provider to provider to patients to
improve compliance and reduce the rate of readmission.
The rates of readmissions have, in part, been exacerbated by the
way patient discharge into homes has been handled. For
instance, research has shown that, in some cases, relatively
stable patients have been discharged with little considerations
to the patients’ ability to perform self-care activities, (Alper,
O’Malley & Greenwald, 2017). Failure to explore questions as
to whether patients can or cannot maintain proper diet after
discharge and whether they can maintain follow up calls with
designated providers have heightened the likelihood of
readmissions, (Alper, O’Malley & Greenwald,2017). Similarly,
discharge from one facility to another has, in some cases, been a
recipe for readmission. Often times, a mismatch arises between
a patient’s needs and the services offered in facilities where
they are enrolled subsequent to their discharge from previous
facilities. Failure to reconcile such mismatch invariably leads to
hospital readmissions.
Further, lack of clear discharge summaries that are meant to
provide roadmaps for aftercare providers on ways of continuing
care after a patient is discharged. Failure to review discharge
information by family/ patient caregivers leads to the challenge
of readmission (Alper, O'Malley & Greenwald, 2017). Others
include therapeutic errors, i.e., patients sent home without the
requisite regimen for their complications or ailments.
7. Significance of the Problem Worldwide
Van Walraven, Bennett, Jennings, Austin, & Forster (2011)
explain that hospital readmission has, for a while, been used as
a measure of the quality of care. Much as this measure is
accurate, it has, nonetheless, been used on a limited scale
because it is only applicable in cases where the proportions of
readmissions that are avoidable are known (Alper, O'Malley &
Greenwald, 2017). Of note, even if readmission can be used as a
metric for gauging the quality of care offered by health
facilities, studies indicate that the process of establishing
avoidable readmissions reliably is yet to be achieved.
Clinician resources investigate and facilitate interventions that
improving healthcare discharge; some of such interventions take
the form of project boost and the care transition programs. The
interventions mentioned thereof provide roadmaps for continued
care even after discharge. The lack of such programs
contributes towards soaring hospital readmission rates
especially if other interventions explored in place of project
boost and the care transition programs prove to be ineffective.
According to Adib-Hajbaghery, Maghaminejad, Abbasi (2013),
the efficiency of nursing care after discharge contributes
significantly in controlling and reducing the rate of readmission
for patients who have suffered from heart failure at a point in
their lives.
Since reimbursement has transitioned from pay per service to
value-based care, chronic care professionals have reworked
their priorities. The Center for Medicare and Medicaid Services
announced that almost all Medicare payment would be value-
based. The announcement presented an enormous challenge for
readmissions (Alper, O'Malley & Greenwald, 2017). The
hospital readmission reduction program anchored in the
affordable care act seeks to control the pronounced readmission
rates for specified conditions some of which include total knee
or hip replacement, heart failure, myocardial infarction among
others.
Interventions explored by the state has presented healthcare
8. facilities with a different reality; in some cases, patients who
would ordinarily be readmitted have, in some cases, been kept
in observation units and denied readmission, (Zuckerman et
al.,2016). Readmission trends post the ACA have, therefore,
been somewhat consistent with incentives that have been
created to reduce readmissions.
Until recent years, the quality of care derived from health
facilities was pegged on evidence-based clinical care. Boulding
et al. (2011) indicate that patients' perceptions and overall
satisfaction scores of the overall discharge process have been
found to correlate negatively with the hospitals 30-day
readmission rates. Much as the drivers of hospital readmission
are complex, the findings of Boulding et al., 2011 reveal that
patients' perspective on inpatient care and discharge are shaped
significantly by hospital performances, (Boulding et al., 2011).
Patients overall satisfaction was also found to be dependent on
factors such as interactions between hospitals’ staff and the
patients. Some of the answers to the quality of care received by
a patient has been determined by answering questions such as;
how often nurses communicated well with patients? The issues
could also seek to unearth whether patients receive help quickly
from hospital staff when they ask for assistance.
Administrators at the hospitals have learned that higher
readmission rates are consistent with low patient satisfaction.
To curb the challenge of patient satisfaction; hospitals have
instituted a raft of, measures to reduce patient readmission.
Bradley et. al. (2012) report on efforts adopted by healthcare
facilities. Among the techniques that have particularly made a
list regarding reducing patient readmission rates are patient
education, follow-up telephone calls, proper coordination with
outpatient providers and home visits, (Bradley et al., 2012).
Some hospitals also employ medication management practices
that are geared towards achieving medication reconciliation and
reducing the chance of wrong prescriptions. Some of the areas
that health care providers have slacked in include; failure to
provide patients with home health services the contacts for
9. specific inpatient physicians in case they had inquiries, and lack
of means to alert outpatient physicians to the discharge within
48 hours, (Bradley et al., 2012). Some hospitals also failed to
make discharge summaries. In cases where patients were
transferred from one hospital to another nurse-nurse report were
not always conducted.
According to Jack et al., (2009), reengineered hospital
discharge (RED) decreased readmissions and department visits
within 30 days of discharge Jack et al., (2009) observe that the
RED intervention explored comprehensive discharge planning,
post-discharge reinforcement and patient center education. The
intervention thereof translated into a reduction in instances of
adverse drug events and by extension the rate of readmissions.
Patient education was also found to be integral because other
than equipping patients with knowledge on the prescribed
regimen, they also generally helped patients to hone
comprehension skills needed for patients self-care.
While healthcare facilities might have benefited from patients’
readmissions in the past, the affordable care act (ACA) sought
to discourage readmissions rates for target conditions by
imposing penalties on health care facilities whose readmission
rates surpassed allowable readmission rates. In compliance with
the Affordable care act’s readmission rates, healthcare facilities
have explored a host of pre and post-discharge interventions
(Hasan et al., 2010). Some of the interventions include patient
education, pre-discharge planning, home visits and follow-up
calls (Alper, O’Malley & Greenwald, 2017). Some health
facilities have even coopted telemedicine in their day-to-day
practice to help bridge the distance between patients,
pharmacists, doctors, and nurses.
In healthcare facilities where telemedicine has been explored,
the interactions between caregivers and the patients improved.
Kashem et. al. (2008) explain that interactions in an isolated
case involving patients with heart failure (HF) and providers
stood at 3774 while the messages that emanated from the
telemedicine patients were 1887. According to a study
10. conducted by Kashem, Droogan, Santamore, Wald, Bove (2008),
the application of telemedicine for patients who had a history of
heart failure diminished hospitalization and readmission rates.
Telemedicine eased communication between providers and
providers over secure internet system.
Significance of the Problem in Saudi Arabia
Literature outlines that a 30-Day Readmission Rate is
considered as an indicator of the quality of inpatient care.
However, some early readmissions are thought to be avoidable.
A randomized trial done prospectively showed that from all
readmission that 12% to 75% could be prevented through
patient education, pre-discharge assessment, and timely
aftercare. Patient’s demographics, co-morbidities, preoperative
care, length of stay, and post-discharge care are variable
contributing to the readmission after discharge within 30 days.
In addition, shorter length of stay and early discharge are linked
with higher risk of readmission after discharge immediately
afterward, (Azza et al., 2012).
CHAPTER III
Objectives
Purpose of the Study
The purpose and the primary objective of this study is to assess
the opinions of professional health care providers (physicians &
nurses) and to understand the reasons leading to unplanned
hospital readmission after discharge.
The secondary objective focused on the interventions that might
be helpful in developing an online tool as a follow-up
mechanism after discharge for patients to communicate with
their healthcare providers in King Khaled Eye Specialist
Hospital to decrease unplanned hospital readmissions rates and
facilitates coordination of transition and continuum of care.
The approach aims at improving attempts that assist patients in
acquiring and adhering to the treatment regimen and outpatient
appointments.
CHAPTER IV
11. Methodology
Setting, Participants, and Sample size & Selection
The setting took place at King Khaled Eye Specialist Hospital
in Riyadh, Kingdom of Saudi Arabia, focusing on the transition
and continuum of care. This also cares for high-risk patients by
improving the quality of care and offering support. The
participants involved were physicians and nurses working at
King Khaled Eye Specialist Hospital to assess their feedback on
strategies to prevent readmission, & possible online follow-ups
after discharge interventions to reduce readmission.
The targeted population was physicians and nurses working at
King Khaled Eye Specialist Hospital will be included in the
research for purposes of the study analysis.
The physicians and nurses participated in responding and filling
the questionnaire survey during the study. The questionnaire is
a paper-based survey, and questions consist of a mixture of both
open and closed-ended questions. A convenience sampling
selection technique was the method of choice for the research
purpose.
The sample size is 180 subjects drawn out of a total population
of 300, with a confidence level of 95%, the margin error being
about 5.0 %
Eligibility Criteria
The Purpose of Eligibility Criteria is to define the sample
characteristics required for meeting the study objectives.
Inclusion Criteria
Type of studies:
· Studies from any geographical location.
Rationale: This assessment study did not have the resources
necessary to evaluate and accommodate non-English writing
publications.
Location:
· Riyadh, Kingdom of Saudi Arabia.
Rationale: This study did not have the resources necessary to
evaluate data from outside of Riyadh.
Setting:
12. · King Khaled Eye Specialist Hospital.
Rationale: Resources necessary to evaluate from outside from
this particular setting are not available.
Participants:
· Physicians and nurses dealing directly with patients working
in outpatient and inpatient departments at King Khaled Eye
Specialist Hospital.
Rationale: The professional feedback of those selected
individuals is the key focus of this study because they are in
direct contact with their patients and are responsible for the
smooth discharge transition.
Exclusion Criteria
Participants:
· Other HCP working at King Khaled Eye Specialist Hospital.
Rationale: Not all health care providers are involved with the
discharge process, and they do not work closely and directly
with patients at the time of discharge and post-discharge.
Information Sources
The information gathered from physicians and nurses in the
inpatient and outpatient units at King Khaled Eye Specialist
Hospital to provide their perspective regarding reasons for
readmission and interventions that might be helpful in
developing an online tool for healthcare staff that might reduce
hospital readmission.
Study Design
A cross-section descriptive study design was used. The
investigation will focus on the professional point of view of
physicians and nurses working at KKESH on the strategies to
prevent readmission and practicability of online follow-up
interventions post-discharge to reduce their hospital
readmission. Readmission is the return to the hospital to seek
medical attention after getting permission from the physician to
go home. There is no difference between deliberate and
unintended readmission. Also, the clinical relationship between
the first admissions and the readmission is indistinguishable.
13. Pilot Study
A published questionnaire has been adapted and used in the
research for which the validity and liability have already been
checked (Herzig et al., 2016).
Methods of data collection
Gathering of information was through the primary methods of
data collection. Physicians and nurses participated in
responding to the questionnaires. In addition, reports from the
journal and different books and articles provided the basis for
comparing the primary and secondary data.
Ethical Considerations
It is essential to safeguard the personal details of patients to
protect their identity and privacy. The research was conducted
with a high standard of quality and integrity; all participants
contributed voluntarily, and informed consent were obtained; all
data collected were treated with the utmost autonomy and
confidentiality, and a non-maleficence approach was followed
throughout the entire research process. Additionally, there was
no forcing of respondents to provide information in subjects
they felt uncomfortable to share.
Statistical Data Analysis
The frequency with which physicians and nurses selected each
of the pre-specified factors that in their opinion contributed to
re-admission ranked from low to high. The frequency of each
category subject presented. For the strategies to prevent
readmission, we report the frequency with which the doctors
and nurses reported anything other than “no probability” for
each of the potential preventive strategies (slightly probable,
slightly less than 50/50 and slightly probable). We choose this
because we are interested in any degree of preventability. The
percentage of slightly more than 50/50 and strongly probable
indicate a possible way to prevent readmission.
CHAPTER V
Results & Discussion
Presentation and Discussion of the Results of the Field Study:
This section deals with the analysis of the results of the field
14. study by presenting and analyzing the demographic data of the
study sample, as well as presenting the responses of the sample
members to the questions of the study (paragraphs), and
processing it statistically by using descriptive statistics
concepts and statistical methods to reach the results. To address
the study data, frequencies and percentages were used to
identify the demographic data of the study sample and to
determine their responses to the terms of the study instrument
used. The results of the field study are presented below:
First: Demographic Data Results:
1- Profession Variable for the Study Sample:
To identify the Demographic Information, the frequencies and
percentage of the profession were calculated, and the results
were as follows:
Table (1):
The Distribution of the Sample of the Study According to the
(Profession) Variable
profession
Frequency
Percent
Doctor
30
16.9
Nurse
148
83.1
Total
178
100.0
The previous table, on the distribution of the study sample
according to the variable (profession), shows that (148) of the
study sample work in the profession of (Nurse) and their
percentage was (83.1%), while (30) of the study sample work as
(Doctor) and their percentage was (16.9%). The following
figure illustrates this:
15. Figure (1):
Explains Profession Variable
2-The Sub-Specialty Variable of Doctors:
To specify the doctors' sub-specialty, the frequencies and the
percentage of the sub-specialty variable were calculated, and
the results were as follows:
Table (2):
The Distribution of the Sample of the Study According to the
Variable of (The Doctors' Sub-Specialty)
the Doctors' Sub-Specialty
Frequency
Percent
Cornea
1
3.3
Glaucoma
6
20.0
Anterior segment
6
20.0
Oculoplastic
3
10.0
Pediatric
1
3.3
Resident
5
16.6
Retina
8
26.6
16. Total
30
100.0
The previous table shows the distribution of the study sample
according to (the doctors' sub-specialty) that (8) of the study
sample (Retina) with their percentage (26.6%), then (6) of the
study sample (Glaucoma) and their percentage (20.0%), and (6)
of the study sample (Anterior Segment) with their percentage
(20.0%), and then (5) of the study sample (Resident) with their
percentage (16.6%), and (3) out of the study sample
(Oculoplastic) with their percentage (10.0%), then (1) out of the
study sample (Cornea) with their percentage (3.3%), and (1) out
of the study sample (Pediatric) with their percentage (3.3%).
The figure mentioned below shows that:
Figure (2):
Shows Doctors' Sub-Specialty
Second: Results for Answering the Questionnaire:
To achieve the objectives of the study and the analysis of the
collected data, many appropriate statistical methods were used
using (Statistical Package for Social Sciences) which is
abbreviated as SPSS, after coding and inputting data to the
computer.
The Following Statistical Measures Were Then Calculated:
· Frequencies and percentages to identify the responses of the
sample of the study towards the terms of the main axes
contained in the study instrument.
· The arithmetic "Mean" to find out how high or low responses
of the study sample on the main axes (Mean phrases), knowing
that it is useful in the order of axes by the highest arithmetic
mean.
· The standard deviation to identify the extent of deviation of
the study sample responses for each of the terms of the study
variables, and each axis of the main axes of the mean
arithmetic. It is noted that the standard deviation shows the
17. dispersion in the responses of the members of the study sample
for each of the terms of the study variables. The more the value
of the standard deviation is close to zero, the responses become
more focused, and fragmentation decreased between the scales.
1 - Factors Contributing to the Return of Discharged Patients:
In order to identify the factors contributing to the return of
discharged patients, this part of the scale was given grades of
(1, 2, 3, 4, 5). These figures correspond to the following:
- Number (1) contribution to the degree (none).
- Number (2) contribution to the degree (low).
- Number (3) contribution to the degree (medium).
- Number (4) contribution to the degree (high).
- Number (5) contribution to the degree (very high).
To determine the length of the five-meter cells (minimum and
upper limits) used to identify (factors contributing to the return
of discharged patients), the range (5-1 = 4) was calculated then
divided by the number of cells of the scale to obtain the correct
cell length, i.e. (4/5 = 0.80). This value was then added to the
lowest value in the scale to determine the upper limit of this
cell; thus the cell length became as follows:
· From 1.00 to 1.79 represents (non-existent) towards each
statement according to the axis to be measured.
· From 1.80 to 2.59 (low) towards each statement according to
the axis to be measured.
· From 2.60 to 3.39 (medium) towards each statement according
to the axis to be measured.
· From 3.40 to 4.19 (high) towards each statement according to
the axis to be measured.
· From 4.20 to 5 represents (very high) towards each statement
according to the axis to be measured.
Table (3):
The Views of the Study Sample on the Statements of the Axis
(Factors Contributing to the Return of Discharged Patients)
No
Statement
Acceptance degree
20. 31.5
3.93
1.01
4
4
Patient inability to otherwise care for him/herself or caregiver's
inability to otherwise provide care Insufficient or ineffective
patient or caregiver education
5
2.8
7
3.9
33
18.5
65
36.5
68
38.2
4.03
0.99
2
General arithmetic mean
4.04
CONTINUITY OF CARE AND PROVIDER
COMMUNICATION
1
Failure to involve you sufficiently in the development of the
post-discharge plan
10
5.6
10
5.6
28
15.7
52
29.2
21. 78
43.8
4.00
1.15
3
2
Discharge summary unavailable in a timely manner
11
6.2
7
3.9
24
13.5
74
41.6
62
34.8
3.95
1.10
5
3
Discharge summary is poorly written or with missing or
erroneous information
9
5.1
8
4.5
30
16.9
66
37.1
65
36.5
3.96
1.08
4
22. 4
Lack of verbal communication with you re follow-up plans
6
3.4
6
3.4
33
18.5
60
33.7
73
42.0
4.06
1.02
2
5
Failure to obtain an appropriately timed follow-up appointment
or follow-up studies
2
1.1
11
6.2
29
16.3
69
38.8
67
37.6
4.06
0.94
1
6
The inability of the patient to keep the follow-up appointment
or follow-up studies
1
6
23. 8
4.5
35
19.7
90
50.6
44
24.7
3.94
0.82
6
7
Insufficient monitoring of the patient's condition(s) after
discharge
5
2.8
6
3.4
42
23.6
69
38.8
56
31.5
3.93
0.97
7
General arithmetic mean
3.98
SOCIAL SUPPORTS
1
Inadequate support for non-clinical issues (such as food, heat,
transportation, or ability to afford medications)
50
28.1
19
24. 10.7
70
39.3
17
9.6
22
12.4
2.67
1.31
2
2
Inadequate home services or equipment after discharge
16
9.0
21
11.8
70
39.3
39
21.9
32
18.0
3.28
1.16
1
General arithmetic mean
2.98
PROBLEMS WITH INITIAL ADMISSION
1
Misdiagnosis made during the initial admission
12
6.7
10
5.6
33
18.5
26. 1.00
3
4
Absent, erroneous, or incomplete medication reconciliation
11
6.2
25
14.0
44
24.7
49
27.5
49
27.5
3.56
1.21
4
General arithmetic mean
3.66
The total arithmetic mean of the axis
3.66
The table above shows the views of the study sample on the
terms of the axis (factors contributing to the return of
discharged patients), the general arithmetic mean for this aspect
(3.66) which means that the sample of the study agrees on the
axis degree (high) in general. Given the arithmetical averages of
the dimensions discussed in this aspect, we find out that
dimension (PATIENT UNDERSTANDING AND ABILITY TO
SELF-MANAGE) obtained an average of 4.04, which means that
the sample of the study agree with the degree (high), according
to the gradual five-dimensional scale, the highest dimensions of
the contribution to the return of discharged patients of other
dimensions. While the lowest after a contribution to the return
of discharged patients from the point of view of the sample of
the study is (SOCIAL SUPPORTS), which obtain an average of
27. (2.98), which corresponds to the degree (medium) according to
the gradual five-dimensional scale.
The most important factors contributing to the return of
discharged patients can be summarized from the point of view
of the study sample in all dimensions in the following:
· Patient or caregiver lack of understanding of the post-
discharge plan.
· Failure to obtain an appropriately timed follow-up
appointment or follow-up studies.
· Inadequate home services or equipment after discharge.
· Inappropriate/inadequate treatment of the patient during the
initial admission.
2- The Sample of The Study Investigate That the Other Reason
That Might Contribute to Unplanned Readmission:
· No clear communication.
· Early discharge.
· No outpatient follow-ups.
· Discharge against medical advice.
· Unplanned discharge.
· Patients do not report adverse events.
· No instruction post-discharge.
· Doctors do not communicate properly with patients.
· Unclear medication education.
· Patient does not understand instructions.
· Family discharge patient against medical advice.
· The patient is unaware of their serious conditions.
· Poor patient-doctor communication.
· Doctors discharge patient too early.
· Patients are not taking care of themselves.
· The patient does not want to get treatment.
· Doctors do not listen to patient concerns.
3-Factors Contributing to Reducing the Return of Discharged
Patients (How Probable Do You Think Each of These Potential
Types of Interventions Might Have Been Contributing in
Preventing Readmission):
In order to identify factors contributing to the reduction of
28. discharged patients' return, this part of the scale was given a
number of responses:
· No probability.
· Slightly probable.
· Slightly less than 50-50.
· Slightly more than 50-50.
· Strongly probable.
· Nearly certain.
To determine the length of the hexagrams (minimum and upper
limits) used to identify the factors contributing to the reduction
of discharged patients' return, the range (6-1 = 5) was
calculated and then divided by the number of cells of the scale
to obtain the correct cell length (5/6 = 0.83) Then this value
was added to the lowest value in the scale to determine the
upper limit of this cell, thus the cell length became as follows:
• From 1.00 to 1.83 represents (No probability) towards each
statement according to the axis to be measured.
• From 1.83 to 2.66 (Slightly probable) towards each statement
according to the axis to be measured.
• From 2.66 to 3.49 (Slightly less than 50) towards each
statement according to the axis to be measured.
• From 3.49 to 4.32 (Slightly more than 50) towards each
statement according to the axis to be measured.
• From 4.32 to 5.15 (Strongly probable) towards each statement
according to the axis to be measured.
• From 5.15 to 6.00 represents (Almost certain) towards each
statement according to the axis to be measured.
Table (4):
The Views of the Study Sample on the Statements of the Axis
(Factors Contributing to Reducing the Return of Discharged
Patients)
No
Statement
Acceptance degree
Mean
29. standard deviation
Order
No probability
Slightly probable
Slightly less than 50-50
Slightly more than 50-50
Strongly probable
Nearly certain
F
P
F
P
F
P
F
P
F
P
F
P
How probable do you think each of these potential types of
interventions might have been contributing to preventing
readmission?
1
Complete communication of information (e.g., tests or
appointments to be completed after discharge)
33. How probable do you think each of these potential types of
interventions after discharge might have been contributing to
preventing readmission?
1
Improved communication of care between the patient &
healthcare provider
1
.6
2
1.1
7
3.9
2
1.1
60
33.7
106
59.6
5.45
0.87
1
2
Improved attention to medication safety (e.g., medication
reconciliation)
-
-
4
2.2
2
1.1
10
5.6
66
37.1
96
53.9
34. 5.39
0.83
3
3
Increased awareness of personal hygiene and sanitation in
reducing the probability of acquiring infections through detailed
education from healthcare providers
1
.6
7
3.9
1
.6
9
5.1
56
31.5
104
58.4
5.38
0.98
4
4
Lifestyle adjustment to increase the chance of remission
through detailed education from healthcare providers
1
.6
5
2.8
7
3.9
8
4.5
67
37.6
90
35. 50.6
5.28
0.99
6
5
Improved patient transition to the outpatient follow-up process
1
.6
8
4.5
4
2.2
9
5.1
52
29.2
104
58.4
5.33
1.06
5
6
Increasing awareness to declaring adverse events by patients
after discharge
-
-
4
2.2
8
4.5
7
3.9
49
27.5
110
61.8
36. 5.42
0.93
2
General arithmetic mean
5.37
The total arithmetic mean of the axis
5.31
The above table shows the views of the study sample on the
statements of the axis (factors contributing to reducing the
return of discharged patients), the overall arithmetic mean for
this aspect (5.31), which means that the sample of the study
believe that the factors mentioned in this axis can contribute to
reducing the return of discharged patients degree (nearly
certain) in general, this average is in the sixth category of the
scale ranging from 5.15 to 6.00.
Given the arithmetical averages of the dimensions discussed in
this aspect, we find that dimension (How probable do you think
each of these potential types of interventions might have been
contributing in preventing readmission?), obtained an average
of (5.25), which means that the sample of the study sees this
contribution as (nearly certain).
Also, the dimension (How probable do you think each of these
potential types of interventions after discharge might have been
contributing in preventing readmission?), obtained an average
of (5.37), which means that the sample of the study sees its
contribution to the degree (almost certain).
The most important factors contributing to reducing the return
of discharged patients can be summarized as follows:
· Improved discharge planning (e.g., appointments scheduled in
advance).
· Improved self-management plan at discharge (e.g., patient-
centered discharge instructions, transition coaches).
· Improved communication of care between patient & healthcare
provider.
· Increasing awareness of declaring adverse events by patients
37. after discharge.
4- The Sample of the Study Tries to Illustrate Other Things
Related to the Contributions to Unplanned Readmissions:
· Unplanned discharge.
· No outpatient follow-up.
· No Clear communication.
· Poor communication.
· Unplanned discharge.
· Discharge against medical advice.
· Cultural and personal barriers.
· The patient will not listen to doctors.
· The patient does not understand how to takes their medication.
· Patient refuse treatment.
· Doctors are not engaged with their patient after discharge.
The most important findings of the previous chapter (results &
discussion), with a review of some of the views in previous
studies related to these results. The most important results
reached are as follows:
1- The results showed that most of the study sample which is
(148) study samples are working as "Nurse" (83.1%). The
researcher believes that this ratio gives the study greater
credibility, as Nurses are the most categories of contact with
patients, who are primarily responsible for providing health care
and follow-up and supervise patients.
2 - The results of the study showed that the most important
factors contributing to the return of discharged patients (In your
opinion, rank according to seriousness which of the following
factors may have contributed to the readmission?), are as
follows:
-Patient or caregiver lack of understanding of the post-discharge
plan. This result indicates the importance of ensuring that the
patient reaches an appropriate degree of recovery, allowing
him/her to leave the hospital and continue his/his life, this
requires a review of the patient's health status and specific
guidance for continued recovery.
38. -Failure to obtain an appropriately timed follow-up appointment
or follow-up studies. This result indicates the importance of
timely access to patients for review, follow-up of their
condition and health developments. Because of this procedure
reduces their re-hospitalization.
3- The results of the study showed that the most important
factors contributing to reducing the return of discharged
patients (How probable do you think each of these potential
types of interventions might have been contributing in
preventing readmission) are as follows:
- Improved discharge planning (e.g., appointments scheduled in
advance). This result indicates the importance of planning and
organizing the times of patient review of the hospital, timing,
and interviews of the patient's condition and the amount of
medication given to him.
CHAPTER VI
Conclusion (including limitation) Comment by Nada A.
Alabdan: In conclusion do not give others references
they can be given in discussion to make it more strong and in
depth, this will also increase the paras of discussion.
In conclusion give your own findings do not quote others even
if findings are similar,
You can change the language and give it as your findings
/study inferences
Use sentences like:
It has been found in the present study,
Observed in the present work, reported in the undertaken study,
and so on
Recommendations Comment by Editor: Use specific sentences
for every parameter or criterion or observation like :
It is recommended that , it is suggested that
Can be re drafted as per style indicated in comment
39. References Comment by Editor: Style of writing all
references must be same do not change the format keep them
constant
For Ex
Name of Journal
Adib-Hajbaghery, M., Maghaminejad, F., & Abbasi, A. (2013).
The Role of Continuous Care in Reducing Readmission for
Patients with Heart Failure. Journal of caring sciences, 2(4),
255.
Alper, E., O’Malley, T., & Greenwald, J. (2017). Hospital
Discharge and Readmission. UpToDate. Retrieved March 2018,
from https://www.uptodate.com/contents/hospital-discharge-
and-readmission
Auerbach, A. D., Kripalani, S., Vasilevskis, E. E., Sehgal, N.,
Lindenauer, P. K., Metlay, J. P., & Williams, M. V. (2016).
Preventability and Causes of Readmissions in a National Cohort
of General Medicine Patients. JAMA Internal Medicine, 176(4),
484-493.
Azza A. El. Mahalli; Al-Nujaidi, Heba Y.; Al-Turaiyef, Nourah
A.; Al-Rashed, Sara
S.; Al- Asiri, Salha F(2012). 30-Day Readmission Rate as an
40. Indicator of the Quality of Elective Surgical Inpatient Care at
one of the Eastern Province's Hospitals, Kingdom of Saudi
Arabia. Journal of King Abdulaziz University: Medical Sciences
. 2012, Vol. 19 Issue 2, p29-43. 15p. Comment by Editor:
Match this with
Boulding, W., Glickman, S. W., Manary, M. P., Schulman, K.
A., & Staelin, R. (2011). Relationship between patient
satisfaction with inpatient care and hospital readmission within
30 days. The American journal of managed care, 17(1), 41-48.
Comment by Editor: Match this with below
Bradley, E. H., Curry, L., Horwitz, L. I., Sipsma, H.,
Thompson, J. W., Elma, M. A., … Krumholz, H. M. (2012).
Contemporary Evidence about Hospital Strategies for Reducing
30-Day Readmissions: A National Study. Journal of the
American College of Cardiology, 60(7), 607–614. Comment by
Editor: Letters are capitalComment by Editor: No year
Comment by Editor: No p here
Epstein, A. (2009). Revisiting Readmissions — Changing the
Incentives for Shared Accountability. The New England Journal
of Medicine, N Engl J Med 2009; 360:1457-1459. Comment by
Editor: Year is here
Ferrandino, R., Roof, S., Ma, Y., Chan, L., Poojary, P., Saha,
A., Teng, M. S. (2017). Unplanned Thirty-day Readmissions
after Parathyroidectomy in Patients with Chronic Kidney
Disease: A Nationwide Analysis. Otolaryngology-Head and
Neck Surgery :Official Journal of American Academy of
Otolaryngology-Head and Neck Surgery, 157(6), 955–965.
Gruneir, A., Dhalla, I. A., van Walraven, C., Fischer, H. D.,
Camacho, X., Rochon, P. A., & Anderson, G. M. (2011).
Unplanned Readmissions after Hospital Discharge Among
Patients Identified as being at High Risk for Readmission Using
a Validated Predictive Algorithm. Open Medicine, 5(2), e104–
e111.
Hasan, O., Meltzer, D. O., Shaykevich, S. A., Bell, C. M.,
Kaboli, P. J., Auerbach, A. D., … Schnipper, J. L. (2010).
Hospital Readmission in General Medicine Patients: A
41. Prediction Model. Journal of General Internal Medicine, 25(3),
211–219.
Herzig, S. J., Schnipper, J. L., Doctoroff, L., Kim, C. S.,
Flanders, S. A., Robinson, E. J.,
Auerbach, A. D. (2016). Physician Perspectives on Factors
Contributing to Readmissions and Potential Prevention
Strategies: A Multicenter Survey. Journal of General Internal
Medicine, 31(11), 1287–1293. http://doi.org/10.1007/s11606-
016-3764-5
Hesselink, G., Zegers, M., Vernooij-Dassen, M., Barach, P.,
Kalkman, C., Flink, M., on behalf of the European HANDOVER
Research Collaborative. (2014). Improving patient discharge
and reducing hospital readmissions by using Intervention
Mapping. BMC Health Services Research, 14, 389.
Jack, B. W., Chetty, V. K., Anthony, D., Greenwald, J. L.,
Sanchez, G. M., Johnson, A. E., … Culpepper, L. (2009). A
Reengineered Hospital Discharge Program to Decrease
Rehospitalization: A Randomized Trial. Annals of Internal
Medicine, 150(3), 178–187.
Jencks SF, Williams MV, Coleman EA. Rehospitalizations
among patients in the Medicare fee-for-service program. N Engl
J Med 2009; 360:1418.
Kashem, A., Droogan, M. T., Santamore, W. P., Wald, J. W., &
Bove, A. A. (2008). Managing heart failure care using an
Internet-based telemedicine system. Journal of cardiac failure,
14(2), 121-126.
McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2015).
Hospital Readmissions Reduction Program. Circulation,
131(20), 1796–1803.
MedPAC (Medicare Payment Advisory Commission). (2007,
June). Report to the Congress: Promoting Greater Efficiency in
Medicare. Retrieved from: http://medpac.gov/docs/default-
source/reports/Jun07_EntireReport.pdf
Van Walraven, C., Bennett, C., Jennings, A., Austin, P. C., &
Forster, A. J. (2011). Proportion of Hospital Readmissions
Deemed Avoidable: A Systematic Review. CMAJ : Canadian
42. Medical Association Journal, 183(7), E391–E402.
Zuckerman, R. B., Sheingold, S. H., Orav, E. J., Ruhter, J., &
Epstein, A. M. (2016). Readmissions, observation, and the
hospital readmissions reduction program. New England Journal
of Medicine, 374(16), 1543-1551.
Profession
profession Doctor Nurse 16.899999999999999
83.1
Doctors' sub-specialty Cornea Glaucoma Interior
segment Oculophstic Pediatric Resident Retina 3.3 20
20 10 3.3 16.600000000000001 26.6
1
1
You are Alex, the director of external affairs for a national not-
for-profit medical research center that
does not research on diseases related to aging. The center's
work depends on funding from multiple
sources, including the general public, individual estates, and
grants from corporations, foundations,
and the federal government.
Your department prepares an annual report of the center's
accomplishments and financial status for
the board of directors. It is mostly text with a few charts and
tables, all black and white, with a simple
cover. It is voluminous and pretty dry reading. It is inexpensive
to produce other than the effort to pull
together the content, which requires time to request and
43. expedite information from the centers other
departments.
At the last board meeting, the board members suggested the
annual report be 'upscaled' into a
document that could be used for marketing and promotional
purposes. They want you to mail the
next annual report to the centers various stakeholders, past
donors, and targets high-potential future
donors. The board feels that such a document is needed to get
there center 'in the same league'
with other large not-for-profit organizations with which it feels
it competes for donations and funds.
The board feels that the annual report could be used to inform
these stakeholders about the
advances the center is making in it's research efforts and it's
strong fiscal management for effectively
using the funding and donations it receives.
You will need to produce a shorter, simpler, easy to read annual
report that shows the benefit of the
centers research and the impact on peoples lives. You will
include pictures from various hospitals,
clinical, and long-term care facilities that are sing the results of
the centers research. You also will
include testimonials from patients and families who have
benefited from the centers research. The
report must be eye catching. It needs to be multicolor, contain a
lot of pictures, and easy-to
understand graphics, and be written in a style that can be
understood by the average adult potential
donor. This is a significant undertaking for your department,
which include three other staff
members. You will have to contract out some of the activities
and may have to travel to several
medical facilities around the country to take photos and get
44. testimonials. You will also need to put
the design, printing, and distribution out to bid to various
contractors ti submit proposals and prices
to you. You estimate that approximately 5 million copies need
to be printed and mailed.
It is now April 1. the bard asks you to come to its next meeting
on May 15 to present a detailed plan,
schedule, and budget for how you will complete the project. The
board wants the annual report 'in
the mail' by November 15, so potential donors will receive it
around the holiday season when they
may be in a giving mood. The centers fiscal year ends
September 30, and its financial statements
should be available by October 15. However, the non financial
information for the report can start to
be pulled together right after May 15 board meeting.
Fortunately, you are taking a project management course in the
evening at a local university and see
this as an opportunity to apply what you have been learning.
You know that this is a big project and
that the board has high expectations. You want to be sure you
meet their expectations, and get them
to approve the budget that you will need for this project.
However, they will only do that if they are
confident that you have a detailed plan for how you will get it
all done. You and your staff have 6
weeks to prepare a plan to present to the board on May 15. If
approved, you will have 6 months from
May 15 to November 15, to implement the plan and complete
the project.
Your staff consists of Grace, a marketing specialist; Levi, a
writer/editor, and Lakysha, a staff
assistant whose hobby is photography (she is going to college
45. part-time in the evening to earn a
degree in photojournalism and has won several local
photography contests).