This week’s topic  is :  The Case of the Man with the Weak Arm

Albert, a seventy-two year old African-American man, is brought into the emergency room by his daughter. Approximately 45 minutes before arriving, Albert dropped his book when his right arm and hand “fell asleep”. When he tried to rise, he noticed his right leg was weak and he needed to hold onto the couch to stand up. He had a difficult time talking because the right side of his face and mouth were “numb” and his tongue felt “thick”.

In obtaining a medical and family history it was noted that Albert has smoked at least 1 pack of cigarettes per day for the last 40 years and both of his parents died of strokes when they were in their mid sixties. He has previously been diagnosed with both essential hypertension and hypercholesterolemia. He admits to “skipping” his anti-hypertensive medication because of the unpleasant side effects it causes. Albert notes that he has been experiencing short (5 – 10 minutes) incidences of weakness on his right side, but he attributed this to the position he was in, causing his arm or leg to “fall asleep”. He has also noticed that he is having mild headaches, but recently, these have been less frequent.

Physical examination indicated that Albert was alert and anxious, but his speech was slurred. He was afebrile, had a respiratory rate of 16 breaths per minute, a regular heart rate of 86 beats per minute and a blood pressure of 190/120 mm Hg. Albert had no irregular heart sounds and presented with slight bilateral edema of the ankles. Examination of the nervous system indicated intact tactile sensory function, decreased strength of the right extremities, a diminished gag reflex, diminished right deep tendon reflexes, and right facial droop. Based on these symptoms the emergency room physician suspected a thrombolytic stroke and immediately ordered a head CT scan and various blood tests. The physician also discussed the relative benefits and risks of various treatments and courses of action with Albert and his daughter. Albert was given aspirin for possible thrombosis and a b-blocking anti-hypertensive and his condition was monitored closely while awaiting the test results.

Results of the laboratory tests indicated hyperglycemia, hypercholesterolemia, normal blood clotting times and platelet numbers. In addition, the head CT was normal. Despite the treatments initiated, Albert’s condition continued to deteriorate. While his blood pressure decreased to 170/84 mm Hg, his heart rate was elevated to 100 beats per minute and became irregular. He continued to demonstrate decreased sensation on his right side, slight dysarthria, and further decreases in strength in both right extremities. Based on these results, treatment with plasminogen activator was initiated and an electrocardiogram (ECG) was conducted. The results of the ECG indicated atrial flutter.

After 5 hours, Albert’s condition improved to the point that the hemiparesis and dysarthria were at baseline levels and his blood pressure was stabilized at 156/70 mm Hg. Further treatments were then initiated to stabilize Albert’s atrial flutter and hypertension. He was given digoxin, which stabilized the atrial flutter and heart rate at 80 beats per minute and an angiotensin converting enzyme (ACE) inhibitor was prescribed for the hypertension. An echo-cardiogram indicated bilateral stenosis of the carotid arteries. Anti-thrombolytic therapy (325 mg aspirin/day) was also prescribed. Albert was encouraged to stop smoking and to modify his diet and was discharged.

What symptoms suggested that Albert was having a stroke? What risk factors did Albert present which would support the symptoms observed? Why does Albert’s treatment include aspirin?

Performance management is, ideally, an ongoing quality-assurance-based process to provide an organization, its employees, regulatory agencies, accreditors, and other stakeholders with a structured means to support and accomplish mutually identified strategic goals and objectives.

Assume the role of a newly-hired risk management officer for a hypothetical new allied health organization in your chosen career field. You and your team will need to develop the organization’s policies.

The first item you will create will be a performance management plan. Using the Health Resources and Services Administration (HRSA) 

(https://hrsa.gov/quality/toolbox/methodology/performancemanagement/index.html)or other qualified framework, craft a proposal (1,250-1,500 words) for a performance management plan for your new organization that includes the following:

1. Organizational Goals. Provide a statement of your organization’s goals in terms of workplace safety, risk management, or quality improvement. Pick one area, and develop five goals for that one area.
2. Outline of Organizational Objectives. Outline and provide a brief evaluation of specific objectives that support the organizational goals you previously identified.
3. Summary of Relevant Performance Measures. Summarize the steps and measures your new organization will adopt to measure performance. Consider: (a) How well measures will align with your stated goals? (b) How do these measures demonstrate a relationship to positive health outcomes? (c) Are the measures you select able to be controlled by your organization (i.e., can your organization effect change in this area?)? (d) Which measures meet criteria related to reliability and validity, and which are standardized?
4. Performance Baseline. Determine a performance baseline for the measures you have selected. This will enable your organization to conduct comparisons of desired goals versus actual results as time moves on.
5. Performance Evaluation. Select one of three commonly accepted methods to measure provider quality and summarize the features and why it applies best to your organization. Refer to the assigned reading, “The Measurement of Health Care Performance: A Primer From the Council of Medical Specialty Societies,” by the Council of Medical Specialty Societies (CPSS) (http://www.cmss.org/uploadedFiles/CMSS_Quality_Primer.pdf).
6. Definition of Success. Define what success means to the organization. Now that you have chosen measures to assess organizational performance, you need to identify what success means to your organization; otherwise, you are chasing a moving target. Be explicit in the level of performance you see as acceptable. This will change as an organization grows, but you need to start somewhere in order to get anywhere.

You are required to use and cite a minimum of three qualified resources from the readings, qualified website

Competency

Analyze  leadership and management roles in change management.

Instructions

An effective leader must possess the  skills, emotional intelligence, and knowledge base to influence and convince the members of the organization to not only adopt, but to become advocates for the change that the leader seeks to implement.

In order for one to develop the leadership skills that are required to affect change within the organization, one must become familiar with a variety of approaches previously utilized by successful leaders and managers in organizational transformation.

For this assignment, utilize the Rasmussen Business Library resource to research a business case study of an organization going through strategic change. Then research two leadership strategies that have been used to successfully drive organizational change during the past 10 years. Once you have located these strategies, write a paper analyzing the effectiveness of each strategy, and relate how effective management strategy alone may well be challenged to achieve desired change without effective leadership. In your analysis, address the following:

• Identify and research two leadership strategies.
• Develop a description of the leadership strategies.
• Formulate an overview of how the strategy is used and rate its effectiveness.
• Argue whether the strategy is still relevant and effective in present day organizations. Why or Why not?
• Describe how management alone will fall short of achieving desired organizational change without all levels of leadership effectively operating in their rolls.

Please identify these strategies  from references found in the Rasmussen College Library.

Assignment Requirements are as follows:

1. The body of the paper should be 2-3 pages.
2. The paper should include an APA formatted cover page and reference page.
3. The paper should include at least two peer-reviewed sources, such as journal articles from the Rasmussen Library.
4. The paper should be proofread for correct spelling, grammar, and punctuation.

You should be using complete sentences to answer the questions. Ensure that you are using correct grammar. In addition, support your answers using your textbook, course materials, credible internet resources, and scholarly journals. SkyScape is a great suggestion for assistance in completion of this assignment. All citations must be in APA format.1 Point

1. Identify and Describe communication techniques that can be used to promote safety within the healthcare facility?2 Points

2. Describe how communication can assist in providing optimal patient care?2 Points