Review of Current Healthcare Issues

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

  • Review the Resources and select one current national healthcare issue/stressor to focus on.
  • Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

By Day 3 of Week 1

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

By Day 6 of Week 1

Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

Will be adding two discussions that will need at least three references all in APA 7 format each. will be included in this payment.

The mail discussion will need at least 3 references and also in APA 7 format

Adams Discussion

Current Healthcare Issue

National Healthcare Stressor

The last decade in healthcare has been volatile at best with the adoption of the Affordable Care Act (ACA) and performance-based payment systems, the ever-increasing polar divide between our political party’s healthcare theories and the never ending back and forth political discord that threatens to blow it all up and start over with something better, but never explained in detail. One of the constants that I continue to see is the increase in psychiatric patients coming into the hospital that I work. A number of these patients are undiagnosed with a psychiatric diagnosis or cannot find a provider that is seeing new patients. Many providers that are seeing new patients currently have wait times four weeks out. Someone that is experiencing psychiatric symptoms this wait could have a derailing effect on the efficacy of the treatment.  

The number of patients needing psychiatric treatment in the United States is increasing and roughly one-third of the 10 million Americans are diagnosed with a psychiatric disorder but not getting treatment. (Olfson, 2016) One of the reasons for this is the lack of providers in the psychiatric specialty. With reimbursement rates falling lower than many other specialty services many institutions are struggling to cover salaries. With more than 60% of current providers aged 55 years or greater, this is also adding to the decreasing numbers. Another factor, is the increase in acceptability in discussing mental health issues and seeking out treatment. According to Weiner, (2018), with more patients seeking treatment, current providers are unable to increase their treatment numbers. 

Impact on work setting

The institution that I work at is a safety net hospital that provides medical and social care to a population where 70% live at or below the poverty line. Many of these patients have undiagnosed or unmanaged psychiatric disorders that provide harm and are a detriment to their medical issues such as diabetes, cardiac issues and COPD. Working nights, I am accustomed to doing more with less. One of the challenges that I face constantly is the lack of psychiatric evaluations once a patient leaves the emergency department. Medical teams are forced to make psychiatric pharmaceutical decisions off the cuff until 7 AM when the psychiatric team rounds on a particular patient. This is particularly difficult on patients and staff alike.

Respondence to the issue

To create a discussion on this our staff used our unit council to speak to the Director of Critical Care, Nursing and Medicine, inviting the Psychiatric department to our monthly unit council meeting in hopes to better understand why this was not a priority as well as speaking to the Vice President of Nursing and the Medical Director about the importance of psychiatric services outside the emergency room on a 24 hour basis. After years of voicing concerns to upper Medicine and Nursing Management our institution increased inpatient psychiatric coverage to 24 hours per day.  Patients in need of psychiatric evaluations who have made in past the emergency room have an opportunity to be treated when they arrive on our unit. Our ICU team now has a partner when questioning what type of medication to give an irate patient who is a danger to himself or others. This intervention exemplifies the use of the quadruple aim approach with its increase in global health, improving patient experience, lowering costs and improving work-life for our staff. (Jacobs et al., 2018)

References:

Jacobs, B., Heinmiller, J., McGovern, J., & Drenkard, K. (2018). Engaging Employees in Well-Being: Moving From the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3). https://doi.org/10.1097/NAQ.0000000000000303

Olfson, M. (2016). Building The Mental Health Workforce Capacity Needed To Treat Adults With Serious Mental Illnesses. Health Affairs, 35(6), 983–990. https://doi.org/10.1377/hlthaff.2015.1619

Weiner, S. (2018, February 12). Addressing the escalating psychiatrist shortage. AAMC. https://www.aamc.org/news-insights/addressing-escalating-psychiatrist-shortage.

Rebeccas Discussion

Review of Current Healthcare Issues
 

National Healthcare Issue/Stressor 

        Healthy People is a set of strategic goals released by the U. S. Department of Health and Human Services designed to measure progress toward

specific health objectives aimed at enabling people to live long and healthy lives. Healthy People 2020 is the fourth Healthy People initiative released.

 It includes the goal of improving mental health through prevention and by ensuring access to appropriate, quality mental health services (Healthy

People, 2020).  Mental health disorders such as anxiety, depression, and substance abuse are increasing in prevalence and most cases of mental

illness occur earlier in life. The disease burden and costs associated with untreated or under-treated mental health disorders are rapidly increasing.

Mental health disorders are a common cause of disability and suicide is the 10th leading cause of death in the U.S. In addition, our country will see a

heavier mental health burden due to the COVID-19 pandemic (Stephenson, 2020). Therefore, it is crucial to include mental health objectives in the

Healthy People goals, to measure our progress, and to recognize the importance of meeting these goals.    

Impact on Work Setting  

        Currently, I work for a large health insurance company where I conduct medical necessity reviews of behavioral health treatment modalities to

include both inpatient and outpatient care.  Our company has seen sharp increases in the need for behavioral health treatment to include inpatient

mental health stays, inpatient detox stays, partial hospital stays, and intensive outpatient therapy.  More behavioral health clinicians had to be

brought on and trained to meet this current demand. Another impact to my work setting involves the fact that poor mental health has negative

impacts on physical health. Untreated mental illness can lead to chronic diseases which drive up the cost of health care.  Active treatment of mental

health issues, as opposed to prevention and early intervention, is more costly.  

Responding to the issue 

        Our company firmly believes in quality, cost-effective care and awards facilities that meet these milestones.  We continuously assess and update

our guidelines and coverage policies to reflect this. The company recognizes that mental health treatment is not a one-size-fits-all approach.  Recently

we changed guidelines for reviewing substance abuse treatment to the American Society of Addiction Medicine (ASAM) guidelines.  This approach

looks at the whole patient by assessing 6 dimensions that consider a person’s needs and severity of illness to help develop a treatment plan. The

premise is that patients can be assigned to treatments that “yield the best outcomes in the least restrictive and costly settings” (Stallvik et al., para 8).

By reviewing against these guidelines, we are ensuring that patients get the appropriate treatment at the appropriate time.   

        The company has been educating staff on current behavioral health trends, new treatments, and the impact of the COVID pandemic. We have an

active behavioral health case management team that reaches out to patients before, during, and after treatment to ensure they are set up with the

necessary follow up. We encourage and assist patients with finding primary care providers.  Park et al. (2018) state that primary care produces a

higher quality of care, improves access and outcomes, and lowers cost.  Additionally, one of our nurse leaders recently posted an informative series

about the social determinants of health and the importance of helping our patients overcome barriers so they can achieve their best physical and

mental health.  An organization needs effective leaders like this who can bring these issues to the forefront and encourage others to become active

participants in the change process (Broome & Marshall, 2021). The company’s website includes links to many resources such as food pantries, ride-

sharing, and mental health services.  By making this information readily available, we are making efforts to increase prevention and early

intervention. As a whole, I believe the company has responded well to the national healthcare issue of mental illness and I feel confident that we will

continue to look for ways to improve patient access and patient outcomes.  
 

References 

Broome, M., & Marshall, E.S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY:

        Springer.  

Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2020: Mental health and mental disorders. Retrieved November 28, 2020

        from  https://www.healthypeople.gov/2020/topics-objectives/topic/mental-health-and-mental-disorders 

Park, B., Gold, S.B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the

       Quadruple Aim. Journal of the American Board of Family Medicine, 31(4), 588-604.  

Stallvik, M., Gastfriend, D.R., & Nordahl, H. M. (2015). Matching patients with substance use disorder to optimal level of care with the ASAM Criteria

       software. Journal of Substance Use, 20(6), 389-398.  https://doi.org.ezp.waldenulibrary.org/10.3109/14659891.2014.934305 

Stephenson, J. (2020). CDC report reveals “considerably elevated” mental health toll from COVID-19 stresses. Retrieved November 29, 2020 from

        https://jamanetwork.com/channels/health-forum/fullarticle/2770050 

paper

 

Search the GCU Library and find two new health care articles that use quantitative research. Do not use articles from a previous assignment, or articles that appear in the Topic Materials or textbook.

Complete an article analysis for each using the “Article Analysis: Part 2” template.

Refer to the “Patient Preference and Satisfaction in Hospital-at-Home and Usual Hospital Care for COPD Exacerbations: Results of a Randomised Controlled Trial,” in conjunction with the “Article Analysis Example 2,” for an example of an article analysis.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Attachments 

Structural Versus Strategic Family Therapies

2 pages

  • Summarize the key points of both structural family therapy and strategic family therapy.
  • Compare structural family therapy to strategic family therapy, noting the strengths and weaknesses of each.
  • Provide an example of a family in your practicum using a structural family map. Note: Be sure to maintain HIPAA regulations.
  • Recommend a specific therapy for the family, and justify your choice using the Learning Resources.Required Readings

helpfull links

McNeil, S. N., Herschberger, J. K., & Nedela, M. N. (2013). Low-income families with potential adolescent gang involvement: A structural community family therapy integration model. American Journal of Family Therapy, 41(2), 110-120. doi:10.1080/01926187.2011.649110

Méndez, N. A., Qureshi, M. E., Carnerio, R., & Hort, F. (2014). The intersection of Facebook and structural family therapy volume 1. American Journal of Family Therapy, 42(2), 167-174.  doi:10.1080/01926187.2013.794046 

Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Boston, MA: Pearson.
Chapter 4, “Bowen Family Systems Therapy” (pp. 56-71)
Chapter 5, “Strategic Family Therapy” (pp. 72-88)
Chapter 6, “Structural Family Therapy” (pp. 89-104

Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207-215. doi:10.1111/famp.12025

Ryan, W. J., Conti, R. P., & Simon, G. M. (2013). Presupposition compatibility facilitates treatment fidelity in therapists learning structural family therapy. American Journal of Family Therapy, 41(5), 403-414. doi:10.1080/01926187.2012.727673 

Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy, 41(4), 415-427. doi:10.1111/jmft.12113

​Szapocznik, J., Muir, J. A., Duff, J. H., Schwartz, S. J., & Brown, C. H. (2015). Brief strategic family therapy: Implementing evidence-based models in community settings. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 25(1), 121-133. doi:10.1080/10503307.2013.856044

TherapistAid. (2020). Genograms for psychotherapy. Retrieved from https://www.therapistaid.com/therapy-guide/genograms

Your Leadership Profile

 

Your Leadership Profile

Do you believe you have the traits to be an effective leader? Perhaps you are already in a supervisory role, but as has been discussed previously, appointment does not guarantee leadership skills.

How can you evaluate your own leadership skills and behaviors? You can start by analyzing your performance in specific areas of leadership. In this Discussion, you will complete Gallup’s StrengthsFinder assessment. This assessment will identify your personal strengths, which have been shown to improve motivation, engagement, and academic self-conference. Through this assessment, you will discover your top five themes—which you can reflect upon and use to leverage your talents for optimal success and examine how the results relate to your leadership traits.

To Prepare:

Complete the StrengthsFinder assessment instrument, per the instructions found in this Module’s Learning Resources.

Please Note: This Assessment will take roughly 30 minutes to complete.

NOTE: Please keep your report. You will need your results for future courses. Technical Issues with Gallup:
If you have technical issues after registering, please contact the Gallup Education Support group by phone at +1.866-346-4408. Support is available 24 hours/day from 6:00 p.m. Sunday U.S. Central Time through 5:00 p.m. Friday U.S. Central Time.

  • Reflect on the results of your Assessment, and consider how the results relate to your leadership traits.

By Day 3 of Week 5

Post a brief description of your results from the StrengthsFinder assessment. Then, briefly describe two core values, two strengths, and two characteristics that you would like to strengthen based on the results of your StrengthsFinder assessment. Be specific.

Discussion: Examining Nursing Specialties

 

  • Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization.

 Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member. 

My specialty is pschiatry- PMHNP

Atomic Habits Image.jpg

Book Review – 3 pages

  

You have selected one of the designated books to read. You will now write a book review that expresses your motivation for selecting the particular book, the impression the book made on you, information from another external, reliable source that either corroborates or contradicts the book, and how or why this book will or will not impact you. See Content Criteria on page 4 for more details. Note that your additional source should be from a recent (within last 5 years), professional journal or website (NIH, CDC, etc.). Blogs, magazines, and newspapers are not considered professional resources. An external source is one that is not included within the course readings.

Book Review Option #1

Clear, J. (2018). Atomic habits. Avery. ISBN: 9780735211292

Atomic Habits Image.jpg

Book Review Option #2

Dow, M. (2015). The brain fog fix. Hay House, Inc. ISBN: 9781401946487

The Brain Fog Fix.jpg

public health laws

 

Public health laws and regulations are often passed in response to human-caused or natural disasters or the spread of an infectious disease or other health epidemic. Select a law or regulation that was passed after a significant public health event or in response to an epidemic. In a 1,250-1,500 word paper, discuss the public health law or regulation and describe its impact on a community, including its ethical implications. Examples could include laws/regulations targeting smoking, obesity, healthy mothers and babies, vaccinations, etc. Include the following:

Introduction with an overview of the law/regulation, why it was passed, and how it was or is being implemented on the local, state, and/or federal level.

  1. A discussion of who the law/regulation targets and how they are being impacted.
  2. An evaluation of the efficacy of the law/regulation. Include evidence demonstrating whether it is or is not working.
  3. A discussion of the law/regulation’s ethical implications-Do you think this law is fair and ethical in natural? It is being applied ethically/fairly? Were/are there any unforeseen/unintended consequences to be considered?

Essay

  

The client is a 68-year-old female who presents herself at the clinic. Her major symptoms include; disturbed sleep pattern, difficulty concentration, anhedonia, low self-esteem, guilty, decreased appetite, and disordered thought process. After careful assessment of the symptoms, the client is diagnosed with a major depressive disorder. The likely appropriate medication for the client is fluoxetine (Prozac) because research indicates that it is one of the most effective antidepressants for patients aged 65 and above (Kashani et al., 2017). Fluoxetine is a selective serotonin reuptake inhibitor (SSRIs) and doctors prefer to prescribe them to patients with major depressive disorder since it is safe and has fewer side effects compared to other antidepressants.

          When administering fluoxetine to a client, the nurse should inform her about the expected side effects from the use of the medication such as headaches, dizziness, upset stomach, and vomiting. The patient should report back to the clinic if there worsening or new symptoms. Also, the patient needs to comply with the medication directions including dosage and taking the medication at the right time. After using fluoxetine for 2 months, it is expected that the symptoms will improve both in frequency and severity. As the body gets used to fluoxetine, some of the side effects will improve gradually. If the client does not respond to the medication prescribed, a combination of medication and psychotherapy such as cognitive-behavioral therapy (CBT). If the condition persists, brain stimulation therapies such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) can be suggested. ECT and TMS are used if a patient is not responding to medication (Livingston et al., 2016). In ECT, an electrical current is used to impact the functioning of the brain and relieve depression while for TMS treatment coil is placed on the scalp to send magnetic pulses and stimulate nerves in the brain that controls mood and depression.

English composition Q3

 1.  Define the following words: 

a.tone 

b.irony 

c.simile 

d. metaphor 

e. personification  

2. How can you use these terms to analyze poetry?