As a medical billing/coding how will you write the termination letter to your patient? This is an example of the patient that you will write the letter to:

Mabel Whitaker lives at 4200 Taos Drive, Parkview MA 12345. She owes Dr. Sally Hart $564 for professional services rendered. Mrs. Whitaker has not made any payments since September 2016. All attempts to reach Mrs. Whitaker have gone unanswered. Dr. Hart has asked you to send a termination letter to Mrs. Whitaker informing her that she can no longer treat her for her Hypertension and Gout.

In a Word document, compose the letter, name the file “TerminationLetter”

From Chapter 2 and Figure 4 (Schema for solving ethical problems), describe some of the administrative/organizational challenges as it relates to ethics that managers must consider when looking to solve ethical problems.

Must be at least 250 words

Supported by at least two references

Darr, K. (2011). Ethics in health services management, fifth edition. Retrieved from https://ebookcentral.proquest.com

Increasingly patients are creating and maintaining personal health records (PHRs) with data from a variety of healthcare providers as well as data they have generated about their health. What provisions should be included in a model privacy and security policy that patients might use in making decisions related to their privacy and the security of their PHRs?

Respond

 

EXPERIENCE

I had been a bedside nurse for 24 years before I transitioned into my current position as an Accreditation Specialist. I have been in my position a little over two years and due to being a bedside nurse I never had to deal with any budgeting issues. My husband tends to all our personally finances. I honestly have to admit, I am not good with money. My husband is so much better in planning and saving for the future, I have more of a spontaneous personality. I paying more attention and asking more questions to my department manager and director in regards to our budget. They have quarterly leadership meeting where our organizations financial information is discussed. After these meetings, my leaders share the information and are willing to answer any of our questions. They want to be transparent to allow us to be educated and knowledgeable in regards to our organization.

REFLECTION

The pre-conceived notion I had of healthcare financial and budgeting principle is of staffing. I did not realize developing a staffing budget consisted of a certain formula. I was unaware of the number of factors related to identifying the full-time equivalents (FTEs) needed to staff a hospital floor. I now understand that an FTE consisted of 2,080 hours/year for a full-time employee. And patient hours are a major factor, the percentage of direct admits from the emergency room (ER). The budget also has to take into consideration the skill mix needed for your organization.

Two concepts that were very interesting to me were the nonprofit and for-profit concepts. They only difference is that non-profit organizations do not pay taxes. For profit hospitals are owned and operated by financial cooperation’s and have access to larger sums of money when needed. Nonprofit organizations are more community oriented and focuses on what the community needs. They are typically in area that are financially well off but that is not the case for the organization I am affiliated with. My community is poor and Medicaid and Medicare are a high percentage of our reimbursement. Quality verses quantity is always a main focus for us. We do not provide a lot of specialty services but what we offer is quality care with the capability to stabilize and transfer to affiliated hospitals. We like to ensure our patients are receiving quality care not matter where they are sent.

IMPLICATIONS FOR THE FUTURE

My proposed project is implementing a sepsis bundle checklist to improve sepsis bundle compliance in the Emergency Department (ED) to improve patient outcomes. This project is not a high cost to the organization. The sepsis bundle checklist can be created by our quality department and once passed through the form committee for approval it can be rolled out for use. The education department will be involved to develop the education for the staff and providers to ensure the checklist is getting implemented correctly. The checklist will be printed in our print shop so each department, mainly ED, will order and charged to their cost center. There are no areas of additional financial or budgeting data that I feel will be affected by this proposal. 

References:

Fouka, G. & Mantzorou, M. (2011). What are the Major Ethical Issues in Conducting Research? 

Is there a Conflict between the Research Ethics and the Nature of Nursing? Health Science Journal, 5(1), 3-14. 

Furuya, Y., Dick, A., Perencevich, E., Pogorzelska, M., Goldman, D., & Stone, P. (2011). Central line bundle implementation in US intensive care units and impact on bloodstream infections. PLoS ONE, 6(1), 1-6. 

 Graling, P., & Vasaly, F. (2013). The effectiveness of 2% CHG Cloth Bathing for Reducing Surgical Site Infections. AORN Journal, 97(5): 547-551.

Jeanes, A., & Bitmead, J. (2015) Reducing bloodstream infection with a chlorhexidine gel IV dressing. British Journal of Nursing, 24, S14-S19.

Kim, J., Holtom, P., & Vigen, C. (2011). Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: Epidemiologic and economic consequences. American Journal of Infection Control, 39(8), 640-646.

Klinworth, G., Stafford, J., O’Connor, M., Leong, T., Hamley, L., Watson, K., Kennon, J., Bass, P., Cheng, A. C., & Worth, L. (2014). Implementation of a successful hospital-wide initiative to reduce central line–associated bloodstream infections. American Journal of Infection Control, 42(6), 685-687.

Kramer, N. (2016). Monitoring Central Line-Associated Bloodstream Infections [CLABSI] in Home Infusion. Infusion, 22(4), 35-44.

McAlearney, A., Hefner, J., Robbins, J., Harrison, M., & Garman, A. (2013). Preventing central line-associated bloodstream infections: A Qualitative Study of Management Practices. Infection Control & Hospital Epidemiology, 36(5), 557-563. 

Mermel, L. (2014). MRSA and CLABSI Compendium updates offer additional focus on implementation. Patient Safety Monitor Journal, 15(9), 1-4. 

Power, J., Peed, J., Burns, L., & Davis, M. (2012). Chlorhexidine bathing and microbial contamination in patients’ basin. American Journal of Critical Care, 21(5), 338-342.

Pyrek, K. (2015). Experts Address the Promise and Challenges of CHG Bathing Interventions. Infection Control Today, 19(1), 32-36.

Quach, C., Milstone, A, Perpe, C., Bonenfant, M., Moore, D., & Perreault, T. (2014). Chlorhexidine Bathing in a tertiary care neonatal intensive care unit: Impact on central line–associated bloodstream infections. Infection Control & Hospital Epidemiology, 35(2), 158-163.

Richardson, J., & Tjoelker, R. (2012). Beyond the central line-associated bloodstream infection bundle: the value of the clinical nurse specialist in continuing evidence-based practice changes. The Journal of Advanced Nursing Practice, 26(4), 205-211. 

Sandoval, C. (2015). Three practice bundles to reduce CLABSIs. American Nurse Today, 10(11), 37-38. 

Scheithauer, S., Lewalter, K., Schroder, J., Koch, A., Hafner, H., Krizanovic, V., Nowicki, K., Hilgers, R.-D., & Lemmen, S. (2014). Reduction of central venous line-associated bloodstream infection rates by using a chlorhexidine-containing dressing. Infection, 42(1), 155-159. 

Wilder, K. A., Wall, B. Haggard, D. & Epperson, T. (2016). CLABSI Reduction Strategy: A Systematic Central Line Quality Improvement Initiative Integrating Line-Rounding Principles and a Team Approach. Advances in Neonatal Care, 16(3), 170-177. 

U.S. Department of Health and Human Services. (2011). Health-care-associated infection (HAI). Retrieved 10/21/2016 from http://www.hhs.gov/ash/initiatives/hai/index.html

References:

Fouka, G. & Mantzorou, M. (2011). What are the Major Ethical Issues in Conducting Research? 

Is there a Conflict between the Research Ethics and the Nature of Nursing? Health Science Journal, 5(1), 3-14. 

Furuya, Y., Dick, A., Perencevich, E., Pogorzelska, M., Goldman, D., & Stone, P. (2011). Central line bundle implementation in US intensive care units and impact on bloodstream infections. PLoS ONE, 6(1), 1-6. 

 Graling, P., & Vasaly, F. (2013). The effectiveness of 2% CHG Cloth Bathing for Reducing Surgical Site Infections. AORN Journal, 97(5): 547-551.

Jeanes, A., & Bitmead, J. (2015) Reducing bloodstream infection with a chlorhexidine gel IV dressing. British Journal of Nursing, 24, S14-S19.

Kim, J., Holtom, P., & Vigen, C. (2011). Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: Epidemiologic and economic consequences. American Journal of Infection Control, 39(8), 640-646.

Klinworth, G., Stafford, J., O’Connor, M., Leong, T., Hamley, L., Watson, K., Kennon, J., Bass, P., Cheng, A. C., & Worth, L. (2014). Implementation of a successful hospital-wide initiative to reduce central line–associated bloodstream infections. American Journal of Infection Control, 42(6), 685-687.

Kramer, N. (2016). Monitoring Central Line-Associated Bloodstream Infections [CLABSI] in Home Infusion. Infusion, 22(4), 35-44.

McAlearney, A., Hefner, J., Robbins, J., Harrison, M., & Garman, A. (2013). Preventing central line-associated bloodstream infections: A Qualitative Study of Management Practices. Infection Control & Hospital Epidemiology, 36(5), 557-563.

Mermel, L. (2014). MRSA and CLABSI Compendium updates offer additional focus on implementation. Patient Safety Monitor Journal, 15(9), 1-4. 

Power, J., Peed, J., Burns, L., & Davis, M. (2012). Chlorhexidine bathing and microbial contamination in patients’ basin. American Journal of Critical Care, 21(5), 338-342.

Pyrek, K. (2015). Experts Address the Promise and Challenges of CHG Bathing Interventions. Infection Control Today, 19(1), 32-36.

Quach, C., Milstone, A, Perpe, C., Bonenfant, M., Moore, D., & Perreault, T. (2014). Chlorhexidine Bathing in a tertiary care neonatal intensive care unit: Impact on central line–associated bloodstream infections. Infection Control & Hospital Epidemiology, 35(2), 158-163.

Richardson, J., & Tjoelker, R. (2012). Beyond the central line-associated bloodstream infection bundle: the value of the clinical nurse specialist in continuing evidence-based practice changes. The Journal of Advanced Nursing Practice, 26(4), 205-211.

 

Sandoval, C. (2015). Three practice bundles to reduce CLABSIs. American Nurse Today, 10(11), 37-38. 

Scheithauer, S., Lewalter, K., Schroder, J., Koch, A., Hafner, H., Krizanovic, V., Nowicki, K., Hilgers, R.-D., & Lemmen, S. (2014). Reduction of central venous line-associated bloodstream infection rates by using a chlorhexidine-containing dressing. Infection, 42(1), 155-159. 

Wilder, K. A., Wall, B. Haggard, D. & Epperson, T. (2016). CLABSI Reduction Strategy: A Systematic Central Line Quality Improvement Initiative Integrating Line-Rounding Principles and a Team Approach. Advances in Neonatal Care, 16(3), 170-177. 

U.S. Department of Health and Human Services. (2011). Health-care-associated infection (HAI). Retrieved 10/21/2016 from http://www.hhs.gov/ash/initiatives/hai/index.html