Perceived Issues in the Health Care - Essay Example

Assessment II ASSESSMENT II Introduction The prevalence of the global economic crisis is one phenomenon that elicited insights on the realities about the economic and social environment within various communities. This scenario enable people to visualize the complexity and continuous change that take place around them (ESRC Strategic Plan, 2009; p1). The same factors may have been interconnected with problems on human behaviors to certain extent. Several literatures have reported that as environments and interaction of people becomes more complicated; the more it is confronted with issues and controversies. Perceived Issues in the Health Care In the health care setting for example, there are numerous forms of predicaments and this includes health care fraud. The sapping of financial resources in the health care system, along with several other consequences, problems associated with personnel development plans and shortage of competent staff are just few of the magnified issues. The concerns on fraud and abuse greatly affected the everyday life of health care personnel particularly the nurse practitioners; since these professionals are the “front liners” in terms of delivery of care. Nurse practitioners (NPs) can hardly go away from working in clinical environments; and this expose them further to fiscal issues of billing, reimbursement and revenue production issues. In other words, the described situation is somewhat stressful for them. Fraud is actually described as “any act, omission, expression, or concealment calculated to delude another individual,” Merriam-Webster Dictionary of Law stated. Certain forms of abuse and health care fraud exist in variety of schemes. Medicaid, Assessment II 2 Medicare and other government funded health benefit programs are usually the targets of these schemes. Billing for needless or the double billing schemes, unperformed tests, and kickbacks are few of the most common fraudulent activity that burden most patients;this is reported by the Social Security Act, Section 1128C reiterates that (a) of the designed the Health Care Fraud as well as Program for Abuse Control Program (Department of Justice, 2000). Decision Making and Strategic Management of Key Areas There are several approaches to address concerns in an organization. One very important is the evaluation of the organization’s strengths, weaknesses, as well as opportunities. If limitations in the human and/or financial resources are identified, it may be a necessity to provide attention to the organizations opportunities through the use of phased approach. On the other hand, based on the Economic and Social Research Council Strategic Plan, (2009; p 5-7). Extensive consultations are very necessary to identify areas of strategic challenge, particularly if the problem of an organization is highly associated to the economic and social dimensions. The organization may build on the existing investments in order of them to help consolidate the body of knowledge about the issue, with considerations to the: Global Economic Performance; Health and Wellbeing; Policy and Management; New Technology, Innovation and Skills; Understanding Individual Behaviour; Environment; Energy and Resilience; Population Dynamics; Social Diversity; Conflict, Security, and Justice. Ideally, strategic action plans need to stimulate and maneuver the creation of new information useful and will become basis Assessment II 3 for a more effective, tangible economic and also social benefits. The organization must see to it that success indicators will be successfully measured; and must be aligned with the objectives in each area. The said objectives shall extend the reach of our the people, their jobs, methodologies used, the tools and the manner of collaboration with important stakeholders in government, scientific institutions, business and the community. Administrators should be able to find out if their strategic plans can create an impact through skilled people: Impact through social and scientific research; Impact through international leadership; Impact through world class infrastructure and Impact through partnerships. On the matter of health care fraud, the administration can intensify the assistance to their health care team, conduct of in-service trainings and support their continuing education specially in the clinical setting. Funding according to the Joint Commission on Accreditation of Health care Organizations (2008) is very important to facilitate the development of simulation based clinical skills among the health care team. Strategic management or interventions provides an effective approach to address problems. It is a process towards developing and enacting plans in order to reach a long-term goal which takes into account some internal variables as well as external factors. Strategic management includes a future-oriented, integrated, and a managerial perspective which is externally focused forward-thinking based on the employees performance (Kiggundu; 1996). Another pressing issue is the increasing concern of the aging health care practitioners. In an article in Boston Herald that tackles about seasoned nurses and their administrators. A writer Assessment II 4 named Restuccia (2007) highlighted that there are somewhat 17 out of 100 seasoned educators nursing along and are expressing serious muscular-skeletal structure pain. This is the primary factor which can be considered as a barrier to a good performance at work. Various workforce analyses, research published in the peer-reviewed journals, and other publications have confirmed that wages have crucial role played in the labor supply of qualified health care providers like nurses. In fact, the supply of the labor force is expanded because of the wage incentives by attracting students to proceed into training programs (Chiha and Link 2003) and by keeping them on the job (Brewer 1996; Parker and Rickman 1995), as well as by encouraging more hours of work (Brewer 1996). On this note, the Economic and Social Research Council further emphasizes the social and economic aspects of preventing, predicting, and responding to existing threats from health challenges; some long run socio-economic outcomes of ill health and poor wellbeing; develop some effective policies, evidence, and interventions which will lead to improvement of health of stakeholders and wellbeing, at the same time, reduce health inequalities. All these (ESRC Strategic Plan, 2009; p 7) can be achieved when national and international data resources, longitudinal and administrative data the growing wealth of cohort, and development of new and innovative means of combining diverse datasets are utilized to understand the state of health and wellbeing. It is necessary that strategic managers be able to identify long-range targets, scan their operating environments, evaluate their organization’s structures and resources, match these to the challenges they face, identify stakeholders and build alliances, prioritize and plan actions, and make adjustments to fulfill performance objectives over time. Assessment II 5 One concrete example in magnifying organization’s strengths, weaknesses and opportunities could be the implementation of programs which provide nurses control of their practice as well as enforcement of expectation that will push every member of the health care team to demonstrate true collaboration, if meantime, funds are not available to increase wages up to a more competitive level. Administration must see to it that the nurses are in a healthy work environment which are indicated by the following; Existence of organizational leaders who acknowledge the value and necessity of sustaining a healthy work environment and collaborative functions. Collaboration improves collegial relationship that can break burn out, isolation, and job dissatisfaction. Instead, worker may attain high level of enthusiasm, professional fulfillment, at their work and job satisfaction. Clinicians will become more effective and equipped in the clinical areas, able to reconcile differences among clients and shortcomings within the organization and able to settle conflicts effectively. If one practice collaboration, difficult tasks become manageable, new ideas emerge, and later improve schools’ curriculum and instruction. Indeed, collaboration is essential in identifying and resolving complex challenges. It should possibly take the form of interdisciplinary research, research collaboration, international projects as well as agreements with government, business, or third sector organizations. The global, national, local; social, economic as well as environmental causes of a better physical and mental health as well as well-being throughout the life course. In the light of an aging population, resilience in the event of well-being and ill health should be served (ESRC, 2009; p 7). Assessment II 6 Brinkerhoff (1991 and 1994) characterizes strategic management as looking out, looking in, and looking ahead. “Looking out” means exploring beyond the boundaries of your organization to set feasible objectives, identify key stakeholders, and build constituencies for change. “Looking in” implies critically assessing and strengthening your systems and structures for managing personnel, finances, and other essential resources. Finally, “looking ahead” entails melding your strategy with structures and resources to reach your policy goals, while monitoring your progress and adjusting your approach as needed. Lovell (2006) cited that in making a sound decision, goal setting must include appropriate approaches in order to attain a healthy work environment which is basically dependent on the work setting, availability of resources, size, and workers commitment of administration. Administration must think that “overworking” their employees might push them out of their workplace to other health care settings that has more positive working conditions; and though hiring bonuses may attract other health care professionals, this do not address the continuing concerns on wages and also of the working conditions of among them. Honest evaluation or assessment needs to be practiced in an existing workplace or environment. Other than that, development of a programs for the employees which could address their opportunities and weaknesses in their workplace; implementation of change; and appropriate evaluation of results or outcomes must be well implemented (Florida Center of Nursing, 2004). Assessment II 7 The Department of Human Service of Victoria or DHSV (2003) added that in order to achieve high level of competency among nurses, specially those expose in the clinical setting, the allied health trainees must be able to access to communication skills training that is simulation based; for physiotherapy, speech pathology, and prosthetics trainees must also have access to some important simulation skills facilities. For professionals returning to the practice and other who are enrolled in specialist training such as coronary care, intensive care, renal dialysis, theater and emergency; Clinical skills - simulation based training has to be provided. It is evident that the recent extreme dynamic job market, academic requirements and health care industries need to review for policy amendments, to ensure competitiveness in the system and also the equity of resources. There may be varied issues and concerns with their respective stakeholders will express, but administrators should always consider the significance of reliable data bases for hiring and retention. In addressing health care issues, strategic management process may be acted upon on the bases of applications of agreement as well as initiation of the set strategic management process; Articulation with clarity of the organization’s mission, objectives, as well as their current strategies; Analysis of the organizations internal strengths and weaknesses; Measuring threats and opportunities identified from the external environment; Meeting the key stakeholders with their respective expectations; Identification of strategic issues that the organization is confronting; Strategic alternative design; Implementation of strategy; and Monitoring and review of the strategy’s performance. Assessment II 8 REFERENCES Joint Commission on Accreditation of Healthcare Organizations, (2008) Health Care at the crossroads: Strategies for addressing the evolving nursing crisis. Publication Manual of the Commission. The Department of Health and Human Services and The Department of Justice (2000) Health care fraud and abuse control program. Annual Report For FY 2000. The Economic and Social Research Council. (2009) ESRC strategic plan 2009-2014. Royal Charter Government. Economic and Social Research Council. Polaris House, North Star Avenue, Swindon SN2 1U. Starnes-Ott, K, & Kremer, M. J., Recruitment and retention of nurse anesthesia faculty: Issues and strategies. American Association of Nurse Anesthetists Journal.75:1, p 4. The Department of Health and Human Services and The Department of Justice (2000) Health care fraud and abuse control program. Annual Report For FY2000. US Department of Justice (2000) Reimbursement for the costs of conducting investigations, audits and for monitoring compliance plans. Section 1128C(b) of the Social Security Act, 42 U.S.C. 1320a-7c(b). US Department of Justice (2000) Reimbursement for the costs of conducting investigations, audits and for monitoring compliance plans. Section 1128C(b) of the Social Security Act, 42 U.S.C. 1320a-7c(b). Read More