HLT 540  Week 8 Proposal Development Paper

HLT 540  Week 8 Proposal Development Paper

HLT 540 Grand Canyon Week 8 Discussion 1

Re-visit the roadmap that you began at the start of your program of study. Complete information regarding this course. In the discussion, reflect on how this course meets your career goals. What have you gleaned from the course that will help you in your career path? Respond to at least two other classmates.

HLT 540 Grand Canyon Week 8 Discussion 2

Discuss your thoughts about the ethics of using informed consent vs. blinding the subjects to the expected outcomes of the intervention. Should they be told? How much should they be told? How would the placebo effect be impacted if subjects are told which intervention is being applied to them?

 

HLT 540 Grand Canyon Week 8 Assignment 1

Proposal Development Paper

Details:

Write a proposal paper (1,250-1,500 words) for a major change project that you would like to lead.

Identify a health care issue that interests you and explain why.

Develop a rationale using evidence-based research, including:

1) The background.

2) Statistical findings.

3) Probable stakeholders.

4) Logical conclusions.

Design an implementation plan for the project, including:

1) A communications plan.

2) Creation of a design and implementation team by roles.

List the strategies you would use to lead the team to success and identify potential obstacles that may be faced, along with plans to deal with them.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 

Stakeholder Scenario

Details:

1) Read and complete “Stakeholder Scenario.”

2) Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Stakeholder Scenario

Goal: To convince a group of people to use a specific, new type of antibiotic for patients pre-operatively in order to decrease surgical wound infections.

Scenario: You are a healthcare administrator that is trying to introduce a change in practice to a group of stakeholders. Your goal is to help them understand the rationale and need for the change, and to get a sense of the areas of resistance to the change. The change under discussion is to implement a new antibiotic to be given one hour before surgery starts as a way of reducing post-op wound infections. The Centers for Medicare and Medicaid Studies (CMS) have indicated that timely pre-op application of specific antibiotics is becoming a requirement and will be a publicly reported indicator on the CMS Web site for your hospital. Thus, institution of this new procedure is something you really need to pull off.

As the administrator in this scenario, you will hear the initial responses of each of the stakeholders. You will then be presented with several options for your response. Select the option you think is most effective.

Review the stakeholders’ responses to the option you selected. According to their own perspectives and prerogatives, the stakeholders will respond in different ways to each choice. Your goal is to achieve some level of buy-in to the change.

Issues:

• The antibiotic is new and people aren’t familiar with it.
• Requires administration within one hour of the actual surgery start time.
• Requires administration by IV.
• Adds a step to the busy pre-op nurse’s work load.
• Saves the hospital $28,000 per year.
• Research shows wound infections down 47% with this new antibiotic if it is administered in a timely fashion.

Players:

• Pharmacist: He’s learned about the new antibiotic through his research studies, and is excited about using it.
• Pre-op Nurse: She is worried about having one more thing added to the pre-op activities list she must complete before the patient goes to surgery, but she’s very interested in doing the right thing for her patients.
• Surgeon: He hates government mandates, doesn’t like to be told what to do, generally has a pretty good track record for his patients’ outcomes after surgery, but has no idea what his actual rates of wound infection are.
• Finance Analyst: It’s all about the money. Don’t make it harder by concentrating on anything other than the dollars.

Stakeholders’ Background Thinking

Pharmacist: I really like this idea, because this antibiotic is better and cheaper too. If we can standardize to this antibiotic, I can save money by stocking only one antibiotic for surgery. It will save my staff time in preparation also. This is a great idea for me and my department.

Pre-op Nurse: I am just worn out trying to keep up with all the changes they keep hitting us with. It’s hard enough to do my job and remember to do things differently and use different items. Why can’t they give me a break? Now I’ll have to start an IV as well as give a drug, and they are already pressuring me to get the patient ready for the OR faster. Sometimes I just want to go home!! But I got into nursing to help people, and if this really makes a difference, I guess I can suck it up.

Physician: The government makes me crazy! Those bureaucrats think they know how to practice medicine better than I do. The last thing I need is some ivory tower academic telling me what antibiotics to give! I’ve been doing this for 30 years, and I know what works and what doesn’t. The stupid hospital better shut up and let me do what I know is right and stop telling me how to be a doctor. My patients like me and that is what counts. I’m sure voting Libertarian in the next election!

Financial Analyst: I have been tasked to save this hospital hundreds of thousands of dollars this year, and this one change will save us a bundle. Why are they all arguing? This change could save their jobs! Don’t they get that it’s all about the money? I wish they’d just shut up and approve the change so we could go get lunch.

First Responses of Stakeholders

• Pharmacist: “This is really important. All the research on this new antibiotic shows that it makes a big difference in reducing wound infections. We could get our rate from 13% presently down to 2%. We need to do this.”
• Pre-op Nurse: “This is going to take much more time. We’ve always been able to give our patients pill antibiotics, and now you want me to have to start an IV and administer the drug that way? What happens if I give it and the surgery is delayed? There is already so much I have to do to get the patient to the OR.”
• Surgeon: “What a bunch of horse hockey! I’ve been using the same antibiotic for 25 years and its fine. No need to make silly changes just to keep the government happy. What do they know about medicine anyway? All they want to do is make us follow some stupid ‘cookbook’ and it’s ridiculous. They should just leave all that up to the doctor.”
• Finance Analyst: “It saves money. Just do it.”

Administrator’s Response Options

Select one:

1) “Well, we have to do this because it’s a government requirement.”

2) “You all raise valid points of concern. The evidence shows a significant benefit to our patient care.”

3) “What could be done in the implementation that would relieve some of your worries?”

Responses to Option 1

Pharmacist: “We can make this switch as soon as you are ready.”

Pre-Op Nurse: “We’ll have to tell the patient to come in four hours before the surgery to do this. What a pain.”

Surgeon: “The heck with this. You can’t make me do it.”

Finance Analyst: “It saves money. Just do it.”

Responses to Option 2

Pharmacist: “There is a real benefit. Surgical site infections drop like crazy. It’s the right thing to do.”

Pre-op Nurse: “I want to do the right thing. If Pharmacy can get the drugs up to the unit in the morning, maybe I can start the IVs faster.”

Surgeon: “I’m all about patient care, but why can’t I use what I’ve always used?”

Financial Analyst: “It saves money. Just do it.”

Responses to Option 3

Pharmacist: “It would help me to know how many drug doses to stock in the OR each morning so I can make sure they have what they need on hand.”

Pre-op Nurse: “That would sure help me. We can begin by having the IVs pre-prepared so we just have to put the needle in the patient.”

Surgeon: “Can I see the data about wound infections? How do I stack up against other surgeons?”

Financial Analyst: “Great, you all see it. It saves money. Let’s do it.”

Assignment

As is usually the case, it is possible to achieve some measures of acceptance of changes. The way you respond will affect your ability to do this. However, in real life, it rarely happens this quickly.

When involved in negotiations, key elements to remember include:

• Pay close attention to the reasons people give for their resistance. You will gain a better insight into their thought processes and can tailor your responses to their perspectives.
• You may have to ask questions several times to dig into the real reasons why people may oppose something. The opposition sometimes can be driven by fears and anxieties, but those are not usually expressed initially. However, if you keep asking questions and listening carefully, they will begin to emerge.
• Once you have a sense of the perspectives of the various stakeholders about the change, you can begin to address them and use them to overcome any objections to the change.
• Sometimes the best you can get in the initial conversations is a willingness to move away from “I’m not gonna.” to “Let me see the data.” That’s a big step toward willingness.

Based on this initial scenario, develop an implementation plan. It should include:

• The administrator’s initial statement of what is being implemented and why.
• (Review the stakeholder’s background thinking and first responses.) The administrator’s (your) response option choice.
• How to communicate with the stakeholders (especially if they need further convincing).
• What evaluation criteria are needed?
• Time frames.
• Other items you think would be valuable to include.

 

 

MORE INFO 

Healthcare issues today

Introduction

The Affordable Care Act (ACA) has made it possible for millions of Americans to gain access to affordable health care. But the law isn’t perfect, and there are still many complex issues that may affect your coverage. In this article, we’ll discuss some of the major problems with health insurance today and what options might be available for you if you need care or want more information about what options are available in your area.

Healthcare costs are skyrocketing.

Healthcare costs are skyrocketing.

Healthcare costs are increasing faster than inflation, wages and income.

If you have health insurance, you may get a tax credit to help pay your premiums.

Tax credits are available to help pay for your monthly premiums. If you don’t have health insurance, but make too much money to qualify for Medicaid or Medicare, you may still be eligible for tax credits.

Tax credits are based on your income and the cost of health insurance in your area. For example, if you live in a low-cost area with high-premium plans that cost $1,000 per month (or more), but earn $50 per week ($6 per hour), then there’s probably no way that even with tax credits would make up the entire difference needed between what it costs to get covered and what it costs not to get covered at all—that’s why they’re called “subsidies” instead of “taxes.”

If you’re uninsured, check out your state’s health insurance exchange.

If you don’t have insurance, check out your state’s health insurance exchange. The exchanges are run by the states and provide a place for people to compare plans and buy them. You can access the exchanges by:

• Googling “[state name] Health Insurance Exchange”

• Calling 1-800-318-2596 from within the U.S., or +1 (202) 522-4111 from outside the U.S., or visiting healthcare.gov directly (this is only available if you’re physically located in one of these states). If you’re eligible for Medicaid, but live in a state where Medicaid isn’t offered through their exchange program (called “invisible high risk”), then it may be worth applying through your local county office instead of going through health insurance exchanges—you’ll get free medical care while waiting on approval!

The Affordable Care Act (ACA) provides many new options

The ACA provides many new options for people who are uninsured. If you have a preexisting condition, or if your insurance plan has changed in the last year, it’s important to check your policy to make sure that you aren’t getting charged more than usual. You should also review what kind of coverage is required under the law—and if you’re unsure whether this applies to your situation, talk with guidance counselors at community health centers and other organizations that can help answer questions about how the law affects individuals’ lives.

The ACA provides many new options for people who have insurance but want to minimize their out-of-pocket costs while still receiving quality medical care from doctors and hospitals. Some plans may offer lower premiums than typical employer-sponsored plans; others might allow patients access their networks without having any copays or deductibles (only paying for services as they occur); still others may limit how much time patients spend waiting on hold before being connected with a provider (or even provide online checklists). If possible choose these types of policies instead because these tend only apply when there’s an emergency situation where immediate attention needs provided immediately – otherwise regular visits would be much cheaper!

The PTC is available to people with incomes between 100% and 400% of the federal poverty level.

The PTC is available to people with incomes between 100% and 400% of the federal poverty level. People with incomes below 100% of the federal poverty level may be eligible for Medicaid, while those with higher incomes may be eligible for premium tax credits.

People who are eligible for Medicaid may have state-funded coverage that provides comprehensive care for a set amount per month.

If you’re eligible for Medicaid, you can get comprehensive health care coverage. Medicaid pays for most of the costs of your health care and helps pay for long-term services and supports like nursing homes and home health care.

Medicaid eligibility is based on income level, but people who make too much money to qualify aren’t automatically turned down—they may still be able to get help from their state’s program if they meet certain requirements. People with disabilities often qualify as well because they have special needs that require extra attention from doctors or other professionals in the healthcare system.

People who are uninsured may be able to buy affordable coverage through the exchanges, or they can qualify for Medicaid or apply for other federal subsidies.

If you don’t have health insurance, there are a few options to think about. In most states, people who are uninsured may be able to buy affordable coverage through the exchanges (also known as marketplaces). Or they can qualify for Medicaid or apply for other federal subsidies that can help them afford coverage.

If your state does not run an exchange and you don’t qualify for Medicaid or another program that helps pay your medical bills, there are still things you can do:

• Ask your employer if they provide insurance coverage through work; this could include some small businesses with fewer than 50 employees who offer health care benefits through their payroll tax contributions. It also applies to larger companies with more than 50 employees where full-time workers can enroll in existing group plans.* Most large employers provide these benefits voluntarily—and many smaller ones do too! As long as the employee meets certain criteria laid out by law (such as being employed full time), then he/she qualifies.* Check out your state’s health insurance exchange website [state name]. This site provides information about how much each person will pay monthly based on age and income level.* If eligible based on income level but not age rating (#1) requirements (#2), then check out our article called State Health Insurance Exchanges 101: How Do They Work?

You can access affordable health care.

You can get a tax credit to help pay your premiums.

If you’re uninsured, this is a good option for you. You can use the health insurance marketplace and compare options that fit your needs and budget. If one plan doesn’t work out, there are others on the exchange that may be better suited for what you need or want.

You can buy affordable health insurance through the exchanges (or “marketplaces”).

You will have access to coverage that meets all of your needs—including prescription drugs and mental health care—and all at an affordable price! And even if it’s not right now, it will be soon enough (it took me several months after being uninsured until I found a plan I liked).

You qualify for Medicaid or apply for other federal subsidies

Conclusion

We hope this article has served as a reminder that there are many options available to you. If you’re uninsured, it’s important to understand your eligibility and financial circumstances so that you can make informed decisions about what is best for you. If you have health insurance through an employer or another source, be sure to check whether there are any changes going on with your current plan before March 31st!