HCM5310Assesment2
docx
keyboard_arrow_up
School
Fayetteville State University *
*We aren’t endorsed by this school
Course
5310
Subject
Health Science
Date
Feb 20, 2024
Type
docx
Pages
7
Uploaded by MasterLionPerson973
Running Head: SYSTEMS AND ETHICS IN DECISION MAKING 1
Professor Gaze
Marcia Clarke
HCM-FPX5310
Capella University
January 1, 2024
Running Head: SYSTEMS AND ETHICS IN DECISION MAKING 2
Option A: Increasing Patients
Organizational Goal
“The CEO of your health care organization has asked you to form a task force to increase the number of patients who access your community health center for primary care. You must determine the internal and external partners you would enlist as collaborators.”
Analysis of the relationship with the current patients.
Community health, as emphasized by Brooks (2019), seeks to enhance the overall physical and mental well-being of individuals residing in a specific geographic area. This focal point extends beyond merely improving health; it also strives to sustain it while concurrently mitigating the spread of diseases. At its core, community health operates on the premise of transcending an individual's health status, delving into their role in a "collective responsibility" within the community. The impact of community health spans beyond general well-being; it is intricately linked to aspects such as life expectancy, financial health, and the capacity of community members to provide for themselves and their families (Brooks, 2019).
When contemplating strategies to boost the utilization of a community health center as the primary care provider (PCP) for patients, it is crucial to involve key stakeholders. Various internal and external partners play vital roles in this endeavor.
Key Internal Partners
a.
Emergency Department Steering Committee:
Collaboration with this committee can facilitate the development of seamless referral processes from the emergency department to the community health center, promoting continuity of care.
b.
Emergency Department Medical Director:
The involvement of the medical director is essential for aligning emergency department practices
with the goals of encouraging patients to establish a connection with the community health center as their primary care provider.
c.
Case Management Team:
Integration with the case management team ensures a coordinated approach to identifying patients who may benefit from ongoing primary care services and making appropriate referrals to
the community health center.
d.
Community Health Team:
Close collaboration with the community health team enhances outreach efforts, allowing for targeted engagement with individuals and families who could benefit from the services offered by the community health center.
Running Head: SYSTEMS AND ETHICS IN DECISION MAKING 3
Key External Partners:
a.
Community Health Organization Leaders:
Engagement with leaders of local community health organizations, such as those overseeing homeless shelters or food banks, is crucial. These leaders can serve as advocates for the community health center, fostering partnerships that address the healthcare needs of vulnerable populations.
b.
Local Taxi/Uber Services:
Collaboration with local taxi and Uber services can facilitate transportation solutions for patients,
addressing a common barrier to accessing healthcare. Exploring partnerships that offer discounted or subsidized rides can enhance the overall accessibility of the community health center.
When considering strategies to increase the utilization of a community health center as the primary care provider (PCP), key internal partners play pivotal roles in aligning services with
patient needs. The Emergency Department (ED) steering committee and Medical Director emerge as crucial collaborators, especially considering that approximately 30 percent of ED visits involve patients seeking primary care treatment for chronic conditions, contributing to unnecessary visits and throughput delays (Castellucci, 2019). These chronic conditions, such as asthma, COPD, diabetes, heart failure, hypertension, and behavioral health, collectively account for nearly 60 percent of all ED visits (Castellucci, 2019).
Collaboration with the ED steering committee and Medical Director is imperative to establish seamless referral processes. This partnership would enable staff to refer patients to the community health center upon discharge, fostering a value-based care model and freeing up ED beds for critically ill patients. Simultaneously, the involvement of the case management team is essential for facilitating primary care follow-up appointments post-ED visits, creating a continuum of care and reducing the likelihood of non-emergent return visits to the ED. The case management team can also identify transportation challenges, opening avenues for partnerships with local taxi and Uber services to address these issues.
In addition, the community health team within large healthcare systems, as discussed by Brooks (2019), becomes a vital piece of the puzzle. While the ED primarily serves patients seeking care for chronic conditions, the community health team can reach out to populations, like
the homeless, who may not seek care. By connecting these individuals with the community health center, the team ensures that the broader community's healthcare needs are addressed.
External alliances are equally essential. Focusing on two community resources—soup kitchens and homeless shelters—partnerships with leadership at these sites can play a significant role. By providing education to service users, encouraging them to become patients at the community health center, these partnerships serve as avenues for reaching underserved populations. The community health team can further use these alliances to offer educational sessions emphasizing the importance of primary care.
In summary, internal partnerships with the ED steering committee, Medical Director, case management team, and community health team are crucial for a holistic approach. External alliances with community resources strengthen the reach of the community health center, aligning with the principles of value-based care and community outreach. These strategies aim to
enhance patient utilization and improve overall community health outcomes.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
Running Head: SYSTEMS AND ETHICS IN DECISION MAKING 4
These approaches are informed by the broader context of community health, emphasizing the importance of collaboration and integration, as discussed in the articles by Brooks (2019), Fallman et al. (2019), and Pablo & Grandes (2019). The insights from these articles contribute to
the development of a comprehensive model for promoting community health through effective partnerships and care coordination.
Problem Solving Framework
The DECIDE model proves invaluable in the decision-making process, and the committee formed by the aforementioned partners should adhere to its principles. The committee's primary responsibilities are outlined according to the DECIDE model.
D - Defining Problems:
The committee's initial task involves clearly defining the health service challenges faced by the community. Understanding the scope and nature of the problems is foundational to effective decision-making.
E - Establishing Criteria:
Criteria for success need to be established, with a focus on providing the identified services to a more extensive patient population. The committee should determine measurable benchmarks to gauge the impact and success of their decisions.
C - Considering Alternatives:
Exploring various alternatives is critical. One such alternative involves leveraging the capabilities of the community health team. The committee should thoroughly evaluate the potential of this resource in addressing community health service needs.
I - Identifying the Best Alternatives:
The optimal decision involves a collaborative approach between the Emergency Department (ED), the community health team, and health centers. Identifying the most effective combination of these resources ensures a comprehensive and impactful solution.
D - Developing and Implementing a Plan of Action:
Once the best alternatives are identified, the committee's responsibility is to develop a detailed plan of action. In this case, it includes ensuring that all ED staff are on board with the referral process to the community health center. Implementation is key to translating decisions into tangible outcomes.
E - Evaluating and Monitoring Solution & Providing Feedback for Adjustments:
Continuous evaluation and monitoring are crucial components of the decision-making process. The committee should design mechanisms, such as monthly data provided by the case management team, to track the progress of the referral process. This data will serve as the basis for feedback and adjustments, aligning with the iterative nature of the DECIDE model (Guo, 2008).
Running Head: SYSTEMS AND ETHICS IN DECISION MAKING 5
One of the identified issues is the bottlenecking in the emergency department, primarily stemming from an overwhelming number of patients seeking primary care services. These visits not only incur higher costs for patients but also impede the provision of timely care for those experiencing genuine emergencies. For instance, the Emergency Medical Treatment and Labor Act (EMTALA) prohibits turning away patients without a medical screening in the emergency department. However, upon discharge, emergency department staff can guide patients towards the resources available at the community health center. Employing systems thinking, processes can be devised to effectively address and resolve backlogs, benefiting the entire health system.
Establishing collaboration among the emergency department, case management, the community health team, and external partners can significantly redirect more patients towards the community health center for appropriate care. This collaborative approach ensures a holistic solution, leveraging the strengths of each component to alleviate the strain on the emergency department, enhance patient outcomes, and optimize the utilization of community health resources.
Possible questions that are ethical in nature.
One of the ethical considerations that must be carefully examined revolves around the resources allocated to the community health center. If the influx of new patients resulting from referrals becomes overwhelming, there is a risk that the center might struggle to deliver comprehensive care. Beyond medical services, addressing the holistic needs of patients, such as housing, transportation, food, and behavioral health, is crucial. It is imperative to closely monitor
the monthly volume of new patients to ensure that the resources of the community health center remain adequate. The success of the initiative relies heavily on the strategic partnerships discussed earlier, particularly leveraging relationships with food banks and homeless shelters to address the broader needs of patients.
It is crucial for staff within the health system to exercise caution and a clear understanding of the Emergency Medical Treatment and Labor Act (EMTALA) laws. Persuading patients to use the community health center should not be a means of turning them away, as this would contravene EMTALA regulations. Referrals should only occur after initial care has been provided, and it is paramount that the decision to go through the referral process for the center is entirely the patient's choice. Under no circumstances should patients be referred without their explicit consent. Respecting patient autonomy and ensuring compliance with legal frameworks are paramount ethical considerations in this process.
Conclusion
The healthcare system is taking a pivotal step in ensuring continued and improved care for the community it serves. By fostering a collaborative relationship among the aforementioned partners, the health system aims to enhance the utilization of the community health center, ultimately contributing to the overall well-being of the community. This strategic alliance holds the potential to address the issues highlighted in the community's health, as discussed by Brooks (2019). Through coordinated efforts, patients can receive timely treatment, fostering consistency in care that is essential for maintaining and improving their health. Furthermore, this collaborative approach aligns with the principles emphasized by Castellucci (2019), aiming to reduce unnecessary emergency department visits, particularly those from chronically ill patients.
Running Head: SYSTEMS AND ETHICS IN DECISION MAKING 6
Such visits have been reported to incur substantial costs and contribute to backlogs within emergency departments.
The multidisciplinary collaboration also aligns with the findings of Fallman et al. (2019), recognizing the impact of restricted decision-making autonomy on health care managers. Through this collaborative effort, decision-making becomes a collective process, ensuring a holistic and well-informed approach to healthcare management. Adopting the DECIDE model, as proposed by Guo (2008), provides a structured and effective framework for decision-making by health care managers. This model can guide the committee in defining problems, establishing criteria, considering alternatives, identifying the best solutions, developing and implementing action plans, and continuously evaluating and monitoring the outcomes.
The significance of population data on gender norms, as highlighted by King, Perales, and Sutherland (2022), underscores the need for a comprehensive approach to community health that considers diverse factors. The collaboration discussed here aligns with this broader perspective, aiming to address not only medical care but also the social determinants of health.
In addition, the collaborative effort considers factors affecting portal usage among chronically ill patients during the COVID-19 pandemic, as explored by Kong, Riedewald, and Askari (2021). This highlights the adaptability of the proposed model to current healthcare challenges.
By integrating lower-status experts' influence on decision-making, as explored by Liff et al. (2021), the collaborative approach ensures diverse perspectives are considered, enriching the decision-making process within the healthcare system. Finally, the scoping review on implementation strategies for health promotion by Pablo and Grandes (2019) emphasizes the importance of systematically integrating health promotion into primary care and community organizations. The collaborative efforts discussed here align with this goal, as partnerships with food banks, homeless shelters, and community health teams are vital components of the strategy.
In conclusion, the collaborative relationship forged among the partners holds promise for improving community health. By leveraging the strengths of each component, the health system can increase the usage of the community health center, resulting in more accessible and comprehensive care for the community. This not only addresses immediate healthcare needs but also aligns with a broader perspective that considers social determinants of health and promotes overall well-being.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
Running Head: SYSTEMS AND ETHICS IN DECISION MAKING 7
References
Brooks, A. (2019). What is Community Health and Why Is It Important? https://www.rasmussen.edu/degrees/health-sciences/blog/what-is-community-health/
Castellucci, M. (2019). Unnecessary ED visits from chronically ill patients cost $8.3 billion. Modern Healthcare. https://www.modernhealthcare.com/article/20190207/TRANSFORMATION03/19020 9949/unnecessary-ed-visits-from-chronically-ill-patients-cost-8-3-billion
Ersoy, S., & Engin, V. S. (2019). Accessibility to healthcare and risk of polypharmacy on chronically ill patients. Journal of the College of Physicians and Surgeons--
Pakistan, 29(6), 505-510.
https://doi.org/10.29271/jcpsp.2019.06.505
Fallman, S. L., Jutengren, G., Dellve, L., Department of Sociology and Work Science, Centrum för åldrande och hälsa (AgeCap), Göteborgs universitet, Gothenburg University, Sahlgrenska Academy, Sahlgrenska akademin, Samhällsvetenskapliga fakulteten, Centre for Ageing and Health (Agecap), Institutionen för sociologi och arbetsvetenskap, & Faculty of Social Sciences. (2019). The impact of restricted decision‐making autonomy on health care managers’ health and work performance. Journal of Nursing Management, 27(4), 706-714. https://doi.org/10.1111/jonm.12741
Guo, K. L. (2008). DECIDE: A decision-making model for more effective decision making by health care managers. Health Care Manager, 27(2), 118–127. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18475113
King, T., Perales, F., & Sutherland, G. (2022). Why we need population data on gender norms, and why this is important for population health. Journal of Epidemiology and Community
Health (1979), 76(6), 620-622. https://doi.org/10.1136/jech-2021-217900
Kong, Q., Riedewald, D., & Askari, M. (2021). Factors affecting portal usage among chronically
ill patients during the COVID-19 pandemic in the netherlands: Cross-sectional study. JMIR Human Factors, 8(3), e26003-e26003. https://doi.org/10.2196/26003
Liff, R., Wikström, E., Handelshögskolan, Företagsekonomiska institutionen, Management & Organisation, Göteborgs universitet, Gothenburg University, Gothenburg Research Institute (GRI), School of Business, Economics, and Law, & Department of Business Administration, Management & Organisation. (2021). Lower-status experts' influence on health-care managers' decision-making. Journal of Health Organization and Management, 35(9), 245-264. https://doi.org/10.1108/JHOM-11-2020-0446
Pablo, S., & Grandes, G. (2019). If health promotion is so important, why is it not systematically integrated into primary care and community organizations? scoping review on implementation strategies. International Journal of Integrated Care, 19(4), 499. https://doi.org/10.5334/ijic.s3499