From a healthcare perspective, there are a few ethical and moral issues presented in this article. One issue with the Patient Protection and Affordable Care Act (also known as Obamacare) is cost control. By failing to maintain cost control, Obamacare may not be able to ensure widespread access to healthcare (ACEP, n.d.). The main issue with cost control is distributive justice (ACEP, n.d.). Patient responsibility is another issue found within Obamacare. There are fewer taxes on harmful behaviors and more positive incentives (ACEP, n.d.). The issue with this is they are silent on harmful behaviors that cause the highest amount for the healthcare system. The last issue found in this article is about crowded emergency departments. One study found that people were visiting the emergency department even though they had a primary care physician (ACEP, n.d.). I agree with all of the issues presented. I know personally how hard it is to try to get in to see my primary care physician on short notice. It is frustrating when a sudden illness happens, and I can’t get in to see my doctor for three weeks. This makes me have to choose to either go to the ER or wait it out and be miserable and possibly get worse.

A major issue that came up was the growing population. I think that while attempting healthcare reforms in the future, this should be taken into account. Not only should they study the population growth, but attempt to estimate whether it will continue to increase or if it will decrease, and include that information in the planning of any reforms.

The article described first what the morals or fundamental goals of every American want and expect from our health care system. There are four fundamental goals and desires that have shaped the US health care system.  First, there’s quality care.  Second, there’s freedom of choice in health care.  Third, health care must be affordable. Fourth, we want our fellow citizens to share in the considerable benefits of health care (ACEP, n. d.).  Some of the ethical issues the article referred to were for instance a serious constitutional challenge to the PPACA is grounded on claims for individual liberty: it asserts that requiring Americans to purchase health insurance exceeds the authority placed in the hands of Congress by the US Constitution. Other countries, however, accept significant responsibility for the material welfare of their fellow citizens. These nations clearly place a high priority on the egalitarian goal of universal access to health care (ACEP, n. d.). I grew up in Germany where the employer and employee both pay 50% of the healthcare insurance and everyone has to have insurance. Another ethical issue the article was dealing with was tort reform of cost containment. I can see where defensive medicine results in costly diagnostic testing, hospitalizations, and therapeutic interventions. There needs to be some legal intervention to prevent frivolous lawsuits (ACEP, n. d.).  Access of care and emergency room crowding was another ethical and moral issue discussed. Many Americans who have been hard to insure because of pre-existing conditions had no choice but to go to the emergency room. I know I have a hard time to get in with my primary care physician and I have been told that I can always be seen at the ER if it gets too bad. I don’t agree with this because it’s passing the bug mentality. The last ethical issue the article talked about was end-of-life issues. I agree that communication, education, and joint decision-making plays a vital role in this situation.

I think for future healthcare reform we really need to look at how insurance companies can turn away customers with pre-existing health conditions. 

From a healthcare administrator’s perspective, the ethical issues in regards to the Affordable Care Act, present unique issues that still need to be addressed. The main issues presented in the article by the ACEP (n.d.) are, ”cost containment, public health, access to care, ED crowding, and end-of-life issues.” I would definitely have to agree that these issues are the leading cause of the fiscal fiasco that is the American healthcare system. According to the OECD (2018), on average, the US spends twice ($10,348) what other comparable western countries ($5,169) spend on health care. This ties into the ethical ramification of distributive justice in a fiscal perspective as we as a nation are spending so much money for a product that is not comparable any better than other western countries. The cost of access is so high that it discourages those who can’t afford it from receiving proper medical care. Cost transparency for multiple payers and standard rules for submission was suggested by Blanchfield (2010) that would, hypothetically, save $7 billion in billable time. Saving both time and money in this instance would effectively increase access to care as well as ED overcrowding. Utilizing savings from wasted man-hours increases funds available for ED renovations.

synthesis the 3 paragraphs above, at least 250 words.

 

What are social determinants of health? How do social determinants of health contribute to the development of illness? What is a communicable disease chain? Are there steps that a nurse can take to break a link within the communicable disease chain? Give a specific example. 

Readings within your text covering international/global health and the following websites will assist you in answering these questions:

1. U.S. Centers for Disease Control and Prevention (CDC) Global Health website: http://www.cdc.gov/cogh/index.htm
2. U.S. Department of Health & Human Services (HHS) Global Health website: http://www.globalhealth.gov/index.html
3. Families USA – Why Global Health Matters—Here and Abroad website: http://www.familiesusa.org/
4. World Health Organization (WHO) website: http://www.who.int

Approved Topics:

1. Examine how participative leadership functions in today’s modern health care organization and compare it to other types of leadership styles. Evaluate how each type of leadership style may impact organizational culture, employee performance, and how it may help or hinder the legitimacy of authority.

After identifying your topic, choose a health care organization in your area. This organization may be small or large and may provide single inpatient health service or multiple outpatient services; it is your choice. Consider your topic in light of the leadership of this organization and research the challenges and successes it has faced in managing operational effectiveness.  You are welcome to use as many research methods as possible to obtain information for your organization and its managers (e.g., web-based resources, electronic articles, or personal interviews). The more informed you are, the better prepared you will be to complete your project.  

Finally, develop a management training program that includes relevant guidelines and information to combat the issues identified in the selected topic, as well as recommendations for managers to more effectively lead health care organizations. Your training program should be in the form of a 20 to 25 slide PowerPoint presentation (excluding title and reference slides) that includes comprehensive speaker’s notes (i.e., at least 150 words) for each slide. Utilize at least three to five scholarly sources from the Ashford University Library and two to three current, scholarly web sources (total of five to eight references required). All sources must be cited according to APA style.Your presentation must be engaging and relevant to your audience. Lines of text on a slide will not be sufficient for this project. It should contain at least five images, graphics, and/or multimedia that communicate your training clearly to your audience. For tips on creating an excellent presentation, read this overview

The Senior Project:

1. Must be 20 to 25 PowerPoint slides (excluding title and reference slides) in length. There are 20 content criteria worth a total of 10 points.  
2. Must include a title slide that contains the following: 
   1. Title of project
   2. Your name
   3. Course name and number
   4. Instructor’s name
   5. Date submitted
3. Must include an introduction with a succinct thesis statement.
4. Must address the topic of the project with critical thought in the areas of: 
   1. Organization details
   2. Challenges and opportunities
   3. Training program outcomes
   4. Impact on at least three stakeholder groups involved delineated by cost, quality, and access to service
   5. Suggested actions
5. Must include a conclusion that reaffirms your thesis.
6. Must use at least five supporting graphics (images, graphics, and/ or multimedia) are included and relevant communicating the training content (two points).
7. Must include speaker’s notes that have evidence of critical thinking and application (content analysis, synthesis, evaluation) related to the research methodology used to develop (six points): 
   1. Project content
   2. Practical and relevant solutions to the organizational challenges/opportunities
   3. Appropriate evaluation of individual stakeholder groups involved
8. Must use at least three to five scholarly sources from the Ashford University Library and two to three current, scholarly web sources.
9. Must document all sources in APA style, as outlined in the Ashford Writing Center.
10. Must include a separate reference slide, formatted according to APA style as outlined in the Ashford Writing Center.

 
1- excellent post. I can imagine it is a great challenge to be without a manager, and I am glad to hear you may have a new manager soon. I agree that stress, job dissatisfaction, and a negative work environment can lead to conflicts. Our text book states that conflict is a natural and inevitable outcome in any group or organization. Conflict has the potential to be a positive force in determining group performance. Since conflict is natural and Huber (2014) states it should be accepted, one important part is how we deal with a negative conflict, and how we work as a team work to solve it. I also agree that not everyone can be a manager. It is indeed a challenging job, and it takes a very special person to handle being a manager while being successful and appreciated by his/her employees.

Thank you.

Reference: 

Huber, D. (2014). Leadership and Nursing Management, 5th Ed. [Pageburstls]. 

Retrieved from https://pageburstls.elsevier.com/#/books/9781455740710/

2-The readings this week discuss power and conflict extensively. Our textbook states that common sources of conflicts within organizations include communication, power, personalities, values, roles, and resources. Furthermore, change increases the risk for conflict within a group or an organization. Changes can be both positive and negative; they may lead to either stress and conflict, or something positive that results in an improvement within the workplace (Huber, 2014).

Conflict is a natural and inevitable outcome in any group or organization and should be accepted; the crucial part is how employees deal with conflict and how they try to solve it. Also, according to Huber (2014), there are different types of conflicts. In this particular example, the situation appears to be related to relationship conflict; awareness of interpersonal incompatibilities, which includes feelings of frustration and tension among the nurses and the new director. Also, this director appears to have an autocratic leadership style; she makes all the decisions without inviting feedback from other employees (Sfantou et al., 2017).

As mentioned above, power can be a source of conflict in a group setting. When used incorrectly, power may lead to conflict within a team of individuals. Consequently, this may lead to ineffective teamwork, and a negative work environment. As a nurse leader, it is important to address conflicts as soon as possible, as it may result in dysfunctional and destructive outcomes. In this scenario, I would suggest using the creative problem-solving mode. The goal is to come to a solution that leads to feelings of gain and no feelings of loss for all participants; a win-win solution. According to Huber (2014), creative problem solving is the most effective mode of conflict management. When using this approach, there are a few important steps to include. These steps are:

1)    Initiate discussion

2)    Respect individual differences

3)    Be empathic with everyone involved

4)    Have assertive dialogue; keep feelings and facts separate, clearly state the main issues, be an active listener

5)    Agree on a solution that balances the power and satisfies everyone involved

Though the word power relates to strength, it can also mean the ability to control and dominate. In addition, power can be viewed as something positive. Nurse leaders recognize that understanding and acknowledging power and learning to seek it appropriately, is imperative in nurses’ efforts to help shape their own practice and the broader health care environment. As the largest health care professional, nursing must use power and influence to facilitate change in health care organizations (Huber, 2014).

References:

Huber, D. (2014). Leadership and Nursing Care Management, 5th Edition. Retrieved from http://evolve.elsevier.com

Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review. Healthcare (Basel, Switzerland), 5(4), 73. doi:10.3390/healthcare5040073

3-I can see why there could be some resentment when input was not requested from the current employees. I am currently going through a reorganization with management at my place of employment. For months, we have been without a nurse manager, but we just received word of a newly hired manager. I feel that this new manager will be faced with conflict from current staff since we have gone without for so long.

There are three different types of conflict, these include intrapersonal, interpersonal, and intergroup (Huber, 2014). Intrapersonal conflict comes from within a person; this could be stress or internal conflict (Huber, 2014). Interpersonal conflict occurs when conflicting roles occur between different responsibilities (Huber, 2014). Leadership and Nursing Care Management gives the example of the working parent deciding if they should go to work or stay home to take care of their sick child (2014). Intergroup conflict when there is conflict between different groups (Huber, 2014).

There are different factors that could lead to conflict. A few examples include job dissatisfaction, stress, and negative work environment (Huber, 2014). In order to resolve conflict, one must first assess the situation; it is helpful to have an open mind to new ideas and be accepting to help that is offered (Huber, 2014). It is also best to address problems soon after they arise, scheduling a staff meeting is one way that the problems are able to be addressed promptly (Huber, 2014). I feel that having open communication with staff members is appreciated. If I was a Nurse Manager, I would be sure to listen to my staff member’s concerns, and address issues early on. I would also be sure to make the staff aware that they are appreciated. A staff member who feels appreciated will likely go the extra mile at work.

I feel that not everyone can be a manager. Managers can have difficult jobs when attempting to restructure or change an organization, and they will likely face pushback from some employees. It is helpful to understand that change is never easy, especially for employees who are used to doing things a certain way. Having an open mind and a little understanding from all involved will go a long way.

Huber, D. (2014). Leadership and Nursing Care Management, 5th Edition. [Pageburstls].

 Retrieved from https://pageburstls.elsevier.com/#/books/9781455740710/