Current and Future Considerations for Healthcare Delivery Note: Before completing this Assignment, please familiarize yourself with the Week 8 Assignment Rubric, located in the Course Information area of the course navigation menu. Imagine that you are an administrator in a health services organization, and the CEO of your organization asks you to assess and report on developments that are likely to affect the organization's success. What will you discover as you investigate changes in your community and the broader health care landscape? In preparation for this Assignment, review your completed Week 3 Assignment, including any feedback you received from your Instructor. Select one organization from that Assignment on which to focus for this Assignment (i.e., imagine that this organization is the one in which you work). Use the Learning Resources provided in this week, as well as previous weeks, and locate additional sources through the Walden Library and credible websites to conduct your research. Use the following questions to guide your investigation: What are the prevalent health concerns in this community? What are the key issues related to cost, quality, and access that affect the organization and the people this organization serves? Which organizations in this area are business competitors and/or which organizations use highly effective practices or strategies that this organization may learn from or adopt? How will demographics and health reform likely impact the organization, as well as the broader community, in the next 5 years? Next, review the information on business writing included in the Learning Resources. Consider what the central point of your memo should be. For instance, is there a critical challenge the organization is likely to encounter? Does the information you have gathered suggest the need for a particular course of action or a new business direction? If so, use this memo to inform and influence the CEO. If not, share the findings of your research with the assumption that the CEO will use this information as a launching point for future discussions. The Assignment Write a business memo in which you address: Prevalent health concerns in the community Issues related to cost, quality, and access that affect the organization and the people it serves Organizations in the community that are business competitors and/or from which you can learn highly effective practices or strategies Ways in which changing demographics and health reform will likely affect your organization and the broader community in the next 5 years General Guidance on Assignment Length: Your Assignment should be 3-4 pages, double-spaced (or 1-2 pages single-spaced), excluding a title page and references. Be sure to follow the . Refer to the Week 6 Assignment Rubric for grading elements and criteria. Your Instructor will use the rubric to assess your work. Submit your Assignment by Day 7. Continuum & Coordination of Care Tara Hunter Walden University March 17, 2016 Importance of Transitions of Care According to Joint Commission, \"organizations need the following to provide safe, quality transitions of care for their patients: Leadership support, multidisciplinary collaboration, early identification of patients/clients at risk, transitional planning, medication management, patient/family action/ engagement and transfer of information.\" (www.jointcommission.org) Patient 75 year old male living in a rural with his wife of which he provides primary care for since her stroke 3 years ago. The wife needs some assistance with mobility and basic living assistance. The patient has significant chest pain or discomfort late one evening and he has to call 911 due to his significant family history of heart disease. He is rushed to the emergency room and diagnosed with Coronary Heart Disease (CHD) The patient has a Coronary artery bypass grafting (CABG) surgery. Care Setting #1 - Emergency Medical Service (EMS) Rural, Non-profit EMS that covers multiple counties Partial pay personnel, no monetary support from county Transportation of patient from home to local aka rural hospital emergency room Rural hospital emergency team diagnosis patient with CHD transport to appropriate level of care Medicare covers ambulance services to or from a hospital only when other transportation could endanger your health Communication to next level of care providers is a huge whole this team plays for continue of care Care Setting #2 - Rural Emergency Department 5 ER Beds - 2 dedicated to trauma Critical Access Hospital Important for the transition of care - the sharing of information to the surgeon to preform the surgery or possibility the physician accepting the patient for admission According to Shi & Singh, \"the ED has been a vital outpatient component of many community hospitals.\" (Shi & Singh, 2015) Care Setting #3 - Urban Acute Care Hospital Patient transferred for surgical procedure (CABG) Anesthesia, Ventilator, heart-lung bypass machine, incision in chest and leg Intensive Care Unit - Post Procedure Stay (1-2 days) Pace maker, compression stockings, IV medications for blood circulation, oxygen therapy, care for incision to prevent infections Medical/Surgical Unit - (3-5 days) Discharged Home (Full Recovery 6-12 weeks) Follow Cardiac Rehab Follow Cardiologist (different than who preformed surgery or physicians seen within hospital) Appropriate Medications Wound Care instructions Care Setting #4 - Follow up Care (Cardiologist & Cardiac Rehab & Health Wellness) Local/Rural Cardiologist Available (4 options by appointment) Local/Rural Cardiology Outpatient Clinic Available Local/Rural Pharmacy Health & Wellness Center local within hospital Assistance with wife's care (at least for 12 week recovery) Payment Concerns Will Medicare pay for the 2nd transport from rural emergency room to urban facility if recommendation to transport by air? Will Home Health or Personal Assistance Care be covered for wife during husband's admission? Will all needed cardiac medication be covered? What will the out of pocket expenses be? Will all the outpatient and follow up visits be covered? Will Medicare pay for all physician expenses? IOM #1 - Patient-Centered The example of the patient being able to get post surgical and acute care follow up locally is very patient-centered. Many rural areas do not have these options available and often patients do not get quality post-acute care treatment \"The individual patient's culture, social context, and specific needs deserve respect, and the patient should play an active role in making decisions about own care.\" (IOM) IOM #2 - Efficient \"Health care system should be efficient, constantly seeking to reduce the waste - and hence the cost - of supplies, equipment, space, capital, ideas, time, and opportunities.\" (IOM) Positive Attribute: Standardization for a CABG procedure is very efficient because it allows for all involved to be prepared for unexpected outcomes Negative Attribute: National Average for procedure is $21,000. What about if there are complications or abnormal expenses? Since we are standardize and eliminating waste shouldn't this procedure be cheaper? Resources The Joint Commission. (2013). Transitions of care (ToC) portal. Retrieved fromhttp://www.jointcommission.org/toc.aspx National Heart, Lung, and Blood Institute. (2012) What is Coronary Artery Bypass Grafting? Retrieved from: http:// www.nhlbi.nih.gov/health/health-topics/topics/cabg Lavaca County Texas. Lavaca County Emergency Medical Services Retrieved from: http:// www.co.lavaca.tx.us/default.aspx?Lavaca_County/EMS Centers for Medicare and Medicaid. (2015) Medicare Coverage of Ambulance Services Retrieved from: https:// www.medicare.gov/Pubs/pdf/11021.pdf Resources Centers for Medicare and Medicaid. Retrieved from https ://www.medicare.gov/hospitalcompare/details.html?msrCd=prnt5grp2su b1&ID=451376,451346&stsltd = Retrieved from: http://www.lavacamedcen.com/ Dunn, L. (2013). The acute-care continuum: The future of hospital-based care. Retrieved fromhttp://www.beckershospitalreview.com/whitepapers/the-acute-care-continuum-the-future-of-hospital-based-care.html Institute for Healthcare Improvement. (2014). Across the chasm: Six aims for changing the health care system. Retrieved from http://www.ihi.org/resources/Pages/ImprovementStories/AcrosstheChasm SixAimsforChangingtheHealthCareSystem.aspx Across the chasm: Six aims for changing the health care system. Cambridge Massachusetts: Institute for Healthcare Improvement; 2012. Available on www.IHI.org