Plainsview Hospital: Measuring The Quality Of Health Care Writing Sample

Introduction

Quality issues in healthcare are not only focused on improving the health of individuals, families, communities as well as general populations, but also on increasing the value of healthcare, and working round-the-clock to enhance the core concerns involved in defining healthcare quality (Wubker, 2007). The current paper attempts to explicate some core issues relating to viewing, defining and measuring quality in health care at the Heart Department of Plainsview Hospital, based in Massachusetts.

Analysis: The Heart Department

Most heart-related diseases are difficult to treat and costly to manage (Wubker, 2007), hence the need for quality initiatives in the provision of care. The Heart Department of Plainsview Hospital is aware of that fact, and has started programs and initiatives aimed at maximizing the quality of healthcare for patients visiting the facility.

In this department, quality of care is viewed as a shift from the traditional healthcare services that were largely provider-centric, to a more customer-centric paradigm that takes into consideration the needs and expectations of the patients (Manjunath, 2008). The head of the department is leading the shift away from the former scenario, where healthcare professionals made major decisions about what was good for the patients even without consulting them and analyzing their views as well as fears.

Consequently, quality in healthcare can be defined as “…the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Manjunath, 2008, p. 73). It is imperative to note that the definition underlines the significance of health outcomes as well as professional requirements. These are the two core principals that continue to guide the Heart Department as it navigates its way towards the provision of quality healthcare.

Leaders and health professionals in the Heart Department have developed valid and reliable measures for a broad allay of diagnostic and therapeutic service encircling a comprehensive range of healthcare challenges that compromise cardiac events. The capacity to cure the patients of their inflictions is one important measure for judging the quality of healthcare services offered. A marked reduction of medical errors and an overemphasis on patient safety is yet another measure that has been used to demonstrate that quality of care has indeed improved (Stange et al., 2010). Third, the department has used patient satisfaction scores to evaluate its position in the care continuum (Barelds et al., 2010), with the positive results received so far demonstrating positive care outcomes.

Benchmarking healthcare services with the industry’s best practices through the internalization of process quality and outcome quality has also been used as a measure (Barelds et al., 2010). In process quality, it is evident that not only are the doctors at the department friendly, responsive and professional, but the facility itself is well equipped with patient-centered services as well as technical equipment. In outcome quality, the department is on record for speedy patient’s recovery time-frames, elimination of all preventable complications, as well as minimal after-effects (Manjunath, 2008).

Conclusion

The discussion demonstrates that the quality of care in healthcare institutions can be modeled around three critical components – the quality of treatment outcome, hospital care, and professional physician care (Barelds et al., 2010). The onus for the Heart Department, it seems, is to continue in its quest to deliver quality care from a user-oriented perspective and in an environment where both collaboration and coordination are central pillars of the quality movement.

References

Barelds, A., Van De Goor, I., Van Heck, G., & Schols, J. (2010). Quality of care and service trajectories for people with intellectual disabilities defining the aspects of quality from the client’s perspective. Scandinavian Journal of Caring Sciences, 24(1), 164-174.

Manjunath, U. (2008). Care issues in defining health quality. ICFAI Journal of Services Marketing, 6(4), 72-78.

Stange, K.C., Nutting, P.A., Miller, W.L., Jaen, C.R., Crabtree, B.F., Flocke, S.A., & Gill, J.M. (2010). Defining and measuring the patient-centered medical home. JGIM: Journal of General Internal Medicine, 25(6), 601-612.

Wubker, A. (2007). Measuring the quality of healthcare. Disease Management & Health Outcomes, 15(4), 225-238.

World Public Health Status

Why the United States Is Concerned About Improving the Health Status of the World

The world health status is a modern concept of human development in science today, although it has roots in antiquity. From the beginnings of human civilization, it was recognized that polluted water and lack of proper waste disposal spread communicable diseases. The early religious convictions attempted to control behavior that specifically associated to health with some types of food eaten which included regulating certain indulgent behaviors, such as drinking alcohol or sexual relations (Grodin, 2005). The establishment of governments such as the United States placed responsibility on leaders to develop public health policies and programs in order to gain some understanding of the causes of disease and thus ensure social stability prosperity, and maintain order.

The United States is concerned about improving the health status of the world to provide leadership on matters critical to health and engaging in partnerships where joint action is needed to control diseases.

Benefits of Public Health System in the United States

The United States recognizes the importance of public health programs in reducing the incidence disease, disability, and the effects of aging and other physical and mental health conditions. In recent years the United States has provided vaccinations and made incredible strides in promoting public health funding of health programs such as USAID. The government has also helped in the eradication of smallpox and controlled diseases that have plagued people for thousands of years.

The other benefits of public health system in the United States include providing leadership on matters critical to health and engaging in partnerships where joint action is needed, shaping a research agenda and stimulating the young generation, translation and dissemination of valuable knowledge regarding health, setting norms and standards that promote and monitor the implementation of public health programs, it has also helped the government of the United States to articulate ethical and evidence-based policy options that monitor the health situation of the people.

The United States also has a public health surveillance program that serve as an early warning system for impending public health emergencies (Grodin, 2005). It also monitors and clarifies the epidemiology of health problems in the United States and allows priorities to be set in regard to the government’s public health policies and strategies. To some extent the surveillance program in the United State can be used to diagnose, investigate, and monitor health problems and health hazards of the people.

Importance of Good Health Status of the World

The central ethical dilemma in public health is not for humanitarian reasons but to balance respect for individual freedom and liberty with the responsibility of governments to provide their citizens with some degree of protection in relation to health. With the present economic crisis within many governments, it has become hard for them to fulfill their role of ensuring certain basic services, such as clean air and water, are provided to the people (Gruskin, 1999). Measures that were previously hotly contested and seen as “nanny state interference”, such as pasteurization of milk and fortification of white bread, are no longer contentious.

With the increased number of diseases and advancement of microbes into drug resistant stages, the traditional bioethics that was applied in the old days can not work today and hence modern techniques of disease control need to be applied. This can only be achieved by Educating and training public health professionals throughout the world in Medical Schools, Veterinary Schools, Schools of Nursing, Schools of Public Health, and Schools of Public Affairs (Gruskin, 1999). The training typically requires a university degree with a focus on core disciplines of biostatistics, epidemiology, health services administration, health policy, health education, behavioral science and environmental health.

The Return on Investment (ROI)

Return on Investment (ROI) is a performance measure that is used to evaluate the efficiency of an investment or to compare the efficiency of a number of different investments. In order to calculate Return on Investment (ROI) the benefit (return) of an investment is divided by the cost of the investment and the result is expressed as a percentage or a ratio.

In the above formula “gains from investment”, refers to the profits obtained from selling the investment of interest. Return on investment is a very popular metric because of its versatility and simplicity. That is, if an investment does not have a positive ROI, or if there are other opportunities with a higher Return on Investment (ROI), then the investment should not be undertaken.

References

Grodin, M. A. (2005) “Perspectives on health and human rights.” USA: Routledge.

Gruskin, S. (1999). “Health and human rights.” USA: Routledge.

Childhood Obesity And Healthy Lifestyles

Promoting Healthy Eating and an Active Lifestyle in Schoolchildren

Summary

O’Connor, a nutrition scientist, researched the various ways of fostering good eating habits and healthy lifestyles among schoolchildren (O’Connor, 2011). Her study aimed at describing the key elements of a balanced diet. She also highlighted the importance of physical activity in promoting health. O’Connor argued that growth and development were dependent on good nutrition. For this reason, the growth rate of an individual would indicate the sufficiency of the diet one is taking. The dietary habits of a child usually influence future eating habits even through to adulthood. Therefore, poor eating habits and lack of physical activity in childhood may lead to health problems in later stages of life. Some of the common problems that manifest themselves later in life include obesity, heart disease, diabetes, and osteoporosis. Some cancers such as bowel cancer are also associated with such lifestyles. The best way to prevent such issues later in life is to identify such habits early in life and work towards staying healthy.

Children who are just starting school are at a stage in life when they are growing fast. At this stage, children also become more active and require relatively higher levels of energy than those required by adults. Therefore, their food should contain good quantities of proteins, vitamin A, vitamin D, and other micronutrients. Since children at that age have started making their own decisions concerning what to eat, it is important for them to be encouraged to have a balanced diet. Such foods should contain fruits, vegetables, proteins, and starch. Intake of alternatives with low fat should be encouraged. Food containing fiber is also important for children because it would help prevent constipation and future complications such as gastrointestinal diseases. As children reach adolescents, they require high levels of calcium. This mineral is important for bone formation. During this stage, girls require a diet rich in iron due to the loss of blood during menstruation.

Apart from solid food, fluids are also a major requirement. This mainly helps to prevent dehydration, which causes headaches, constipation and may affect mental health. Dietary habits should also be observed in order to ensure healthy teeth. Eating foods with large quantities of sugar and other fermentable carbohydrates may lead to dental problems. One of the major dental issues includes dental caries.

Food habits may also affect health in that they may lead to obesity in children. This occurs when a child’s weight has increased a lot faster than the individual’s height. Such individuals may experience several health issues and these may include high blood pressure, diabetes, heart disease, and issues with the musculoskeletal system. O’Conner recommended that such children should perform a physical exercises such as running, skipping, climbing in order to burn calories while developing muscle strength and improving bone health.

Urinary Polycyclic Aromatic Hydrocarbons and Childhood Obesity

Summary

Scinicariello and Buser (2014) investigated the role of some environmental toxicants in childhood obesity. This issue became of concern because of the increasing prevalence of childhood obesity in the U.S. Some environmental toxins that were identified as health hazards were the polycyclic aromatic hydrocarbons (PAHs). These elements are derived from the incomplete combustion of organic matter. The sources of these hydrocarbons include exhaust fumes, processed fossil fuel, and cigarette smoke. Alternatively, they could be derived from eating charred meat. Contaminated flour, water, or milk may also contain the chemical. Other sources include contaminated air and soil. PAHs are known to cause cancer and are suspected to also interfere with the endocrine system.

It has been established that these substances are transported and stored in all tissues containing fats. They can also be stored in the liver and kidneys. Experiments have been done in mice and results indicate that these substances may lead to increased fat mass. They may cause changes in food intake and result in general weight gain. The study by Scinicariello and Buser aimed at investigating whether these substances were associated with an increase in body mass index (BMI) and obesity.

The results indicated that the PAHs were associated with an increase in BMI scores, weight circumference, and obesity cases. These observations were made particularly among individuals aged between 6 and 11. However, this was not the case for individuals aged between 12 and 19. Urinary naphthalene, on the other hand, was identified to cause obesity among adolescents and younger children. The PAHs identified included fluorine, phenanthrene, naphthalene, and pyrene. Naphthalene was exposed to the individuals through inhalation while the rest were through ingestion. These elements disrupted the normal functioning of the adipose tissue and increased weight and fat.

Expanding the Role of Primary Care in the Prevention and Treatment of Childhood Obesity

Summary

Vine, Hargreaves, Brieffel, and Orfield (2013) noted that pediatric providers were traditionally believed to only assess and treat childhood obesity and other childhood health problems. In their view, they believed that there was a need to expand the provider role to help prevent and treat childhood obesity. They reviewed the various roles played by primary care providers in the treatment and prevention of such conditions. The authors aligned some of the interventions with several documented recommendations and came up with nine aspects that health providers could adopt.

One of the areas highlighted was weight status assessment and monitoring. Unlike the usual intervention that includes the assessment of body weight status using BMI, this intervention would ensure the complete assessment of all the aspects. This may include assessment of diet, child and family health history, and the child’s lifestyle. Another area identified is healthy lifestyle promotion. This intervention calls for adherence to proper diet while at the same time engaging in physical activity and reducing screen time, among other activities. Patient treatment is another area identified. This intervention recommends individual case management when administering treatment. This could be done using patient-centered counseling and age-appropriate conversations. Clinician skill management was also identified as an intervention. This would ensure that the health givers would be adequately trained in the various ways of administering treatment to children with obesity. Another area that was identified was clinical infrastructure development. Several changes should be made in the clinical setting in order to facilitate the screening process, diagnosis, and treatment of the condition. In addition to this, capacity building should be enhanced and improved healthcare systems and models should be used by healthcare providers. Other interventions that were identified included community program referrals, community health education, multi-sector community initiatives, and policy advocacy. These were identified as the strategies for primary care and community settings.

Intervention Plan

Several health issues were identified in O’Conner’s paper. However, childhood obesity is one of the major issues associated with poor eating habits. Therefore, an intervention plan that would help reduce childhood obesity in the community would be appropriate. One of the ways of reducing the incidence of obesity in children is by encouraging them to eat a balanced diet. This should include foods with sufficient quantities of proteins, carbohydrates, and vitamins. Children should also be trained to avoid taking drinks with sugar-sweeteners and carbonated drinks because they may contribute to obesity. To foster a good eating habit among the children, it is also important to educate them on the importance of adopting a good eating habit. Therefore, such lessons should be incorporated into the school’s curriculum.

Consistent physical activity may also help in maintaining normal body weight and increasing health. In this case, schools should ensure that physical exercise is included as a daily activity. The playground should be fitted with the appropriate and safe equipment to ensure safety and efficiency. The games should include those that require running, jumping, and climbing. These activities would help obese children to burn the extra fats. They also ensure the good bone formation and muscle strength.

PAHs have been identified as the toxins that may contaminate the air, food, and water and end up in the human body either through inhalation or through ingestion. One of the sources of these toxins is cigarette smoke. Therefore, one of the ways of reducing exposure to toxins in children is through managing smoking habits. Parents should first be educated on the health implications of the PAHs on their children. The first step in the intervention plan would be the raising of awareness among the parents. Parents who smoke will be encouraged to smoke away from their homes so that their children would not be exposed to secondary smoke. The fireplace is also a source of smoke that may contain PAHs. Since research has indicated that children between ages 6 and 11 are mostly affected by the PAHs, it would be advisable that the parents avoid exposing such children to smoke from open fireplaces. Barbecuing food over charcoal and wood also causes the emission of such chemicals. Therefore, children should stay away from when such activities are underway.

Parents should also ensure that their children are not constantly and directly exposed to fumes from vehicles or other machinery. While using pesticides, people should be careful to remove food, dishes, or toys around that area. This would help reduce the chances of exposure to children. Fruits and vegetables should also be washed thoroughly to remove any contaminants. Parents should also discourage their children from playing around dumpsites. Such sites may contain substances with the PAHs and they could be inhaled.

In order to properly manage obesity, it is necessary for healthcare providers to provide holistic service. Individuals who are overweight and obese should be monitored closely so as to be able to provide proper intervention. Apart from frequent assessment of weight status, they should also follow up with the family to understand the child’s lifestyle and risk factors. This way, they would be able to recommend various ways of managing the health condition. Awareness of the importance of adopting a healthy lifestyle should be raised. Recommendations should be made on the proper diet to take and the physical activities to engage in.

Individual case management is appropriate for the management and treatment of obesity. Healthcare practitioners should provide care at an individual level. This implies that the clinician should understand the needs of the particular individual and provide interventions that are appropriate to the particular individual rather than generalizing. The clinicians should receive the appropriate training in the standardized techniques of assessment, management, and treatment. With this knowledge, they would be able to diagnose an individual as obese or overweight. They would also be able to know the proper strategy to employ in order to manage and treat the condition.

The clinics should have the proper equipment for screening, diagnosing, and treating health conditions. This would involve infrastructural development and integration. In the event that the clinicians do not have time to offer services to children who are overweight or obese, they should provide referrals to community-based programs. This way, the children would be able to receive the needed care and assistance. Health practitioners should also be instrumental in the provision of health education to the community as a whole. They can provide valuable information about the various lifestyle practices that can be adopted in order to manage health and avoid obesity. The development of a multi-sector community initiative may go a long way in reducing the incidence of obesity. This could be done through the training of personnel and deploying them to the community to provide the required services. Such initiatives could be introduced in schools. The media may also be used as a marketing tool to provide appropriate advertisements. Finally, policy changes could be made in order to ensure that initiatives are supported. For example, more funds could be channeled towards research and the various initiatives that work towards preventing and treating obesity.

References

O’Connor, A. (2011). Promoting healthy eating and an active lifestyle in schoolchildren. Nursing Standards, 25(48), 48-56.

Scinicariello, F., & Buser, M. (2014). Urinary polycyclic aromatic hydrocarbons and childhood obesity: NHANES (2001-2006). Environmental Health Perspectives, 122(3), 1-7.

Vine, M., Hargreaves, M., Briefel, R., & Orfield, C. (2013). Expanding the role of primary care in the prevention and treatment of childhood obesity: A review of clinic-and community-based recommendations and interventions. Journal of Obesity, 2013(172035), 1-17.

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