You have been hired as the manager of a community health center. This health center provides medical care to children.  One of your first tasks is to develop a static annual budget for the health center.  In fact, the Board of Directors wants to see your budget by Saturday at midnight. 

In order to develop an accurate static budget you know you need to get some facts.  You ask around to see what kind of information you can gather. This is what you find out:

• The center pays rent of $12,000 per month.
• The center has a number of full-time staff members:  4 physicians, 6 clinical staff members and 8 administrative staff members.
• The center has to occasionally use part-time workers or pay overtime when patient volume is high.
• The center sees about 3,000 patients per month.
• Medical supply costs seem to run about $2 per patient.

Unfortunately, that’s all that you can find out on such short notice.  Nobody seems to have any more information.  You know that this is not enough information to build a proper static budget, so you will need to make some assumptions to get the job done.  You are comfortable with making assumptions because you know that it is OK to incorporate assumptions into a budget as long as you clearly identify the assumptions when you present the budget.  You also know that it is important to make assumptions that are based on reliable information.  Luckily, you recall that you have an HFMA membership and access to a variety of online databases with credible information!

You go home to review your old Health Services Finance text to see if there is anything there that can help you.  You find Chapter 16 and begin to read.  Luckily, you come across Table 16-4 (page 185) which shows you what a typical static budget looks like. It’s all coming back to you now!….You need to show your Revenue, your Expenses, and your Net Income.  You open a new Excel file and begin.

Requirement:  Create an annual static budget for the health center described above using Excel.  Submit the budget using the link provided below.

 

A 23-year-old male patient is admitted with a fracture of C6 and C7 that has resulted in quadriplegia. He was injured during a football game at the university where he is currently a senior. His career as a quarterback had been very promising. At the time of the injury, contract negotiations were in progress with a leading professional football team.

1. Use Roy’s criteria to identify focal and contextual stimuli for each of the four adaptive modes.

2. Consider what adaptations would be necessary in each of the following four adaptive modes: (1) physiological, (2) self-concept, (3) interdependence, and (4) role function.

3. Create a nursing intervention for each of the adaptive modes to promote adaptation.

 Parse’s Human Becoming Theory

Write a 1250-1500 word APA paper addressing each of the following points. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least two (2) sources and your textbook using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Case Study

The hospice nurse sat with Ann’s husband, Ben. Ann was resting quietly as the increased dosage of IV pain medication gradually reached its therapeutic level. Ben turned his head and slowly turned, looking out the room’s only window. As he glanced up, a small flicker of light caught his breath. It was a shooting star. A tear fell from the corner of his eye and he turned to Ann. The nurse sensed that something significant to Ann and Ben was unfolding. Shuffling to Ann’s bedside, he took her small fragile hand in his. These hands had rocked cradles, burped babies, and groomed the horses she loved to ride. Gently holding her hand, he turned to the nurse. “She would ride like the wind was chasing her.” Looking back to Ann his voice broke; choking back tears “Ann, Ann I saw Jessie…Jessie is calling.” Ben turned “Jessie was our daughter. She died having a baby that was too big. When she died it was a pitch-black night. Cold, so cold, the baby died too, a little boy, named him Abe, Jr. after Jessie’s husband. I took Ann outside so she could cry to God above and there in this dark sky we saw two falling stars…together…just falling. We knew it had to be Jessie and Abe…two angels to light up the night.” Ben turned back as a deep sigh escaped from Ann’s lips. A soft smile remained as she joined Jessie and Abe.

• Based on this case study how would the nurse actualize Parse’s theory of Human Becoming?
• What are characteristics of a human becoming nurse?  What are strengths and weaknesses to this theory of nursing?
• What challenges exist for healthcare institutions to switch to this nursing approach?
• How might Parse’s understanding of transcendence guide the nurse, as Ann’s death became a reality to Ben?
• From the nursing theories we have discussed, what additional theory would you apply to this case study? Develop a plan of care to include both nursing theories (be specific and provide reasons)

Assignment Expectations:

Length: 1250 – 1500 words

Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.

References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) outside scholarly sources and the textbook are required for this assignment.

Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.

Format: Save your assignment as a Microsoft Word document (.doc or .docx) or PDF document (.pdf)

Reply 1

 

In healthcare we are constantly searching for ways to find innovative ways with better quality of care for patients for improved outcomes. Research is gathering the evidence-based findings and formulating a plan of action based on fact. Research is developing a hypothesis and collection of data to support a study and able to be applied to general population. The research can be qualitative or quantitative. Qualitative and quantitative research is both ways research can be performed, but it is just two different types of information that is collected. Quantitative used with numbers and numeric variables while quantitative is used with non-numeric variables observation or open-ended questions.

“Quality improvement is a systematic and formal approach to collecting, analyzing, and disseminating data in order to improve services or products that a business renders.” (Helbig, 2018) With quality improvement the Plan-Do-Study-Act is a powerful tool used for quality improvement. QI benefits mainly the process. QI does not implement something new, but improves something already in place.

Difference- we can research ways to improve quality improvement but can not use quality improvement data for research. Another difference is with the quality improvement data is formulated and reported to improve care to patients based on current events while research is based on evidence of past events for new procedures. Another difference is while research requires consent Quality Improvement does not. QI usually occurs in the facility where the problem was found where the research is dependent on what your trying to find. So overall the main difference is based on intent.

In the unit I work there are quantitative data on if a HCG bath was done or soap and water. Which we then monthly gather the qualitative percent of HCG bath vrs soap and water and compare to the infection rate. From this evidence we have mandated that all baths be HCG unless contraindicated and if it is contraindicated the open ended why documented required.

Resources

Agency for Healthcare Research and Quality. (2013). Plan-do-study-act-(PDSA) cycle. Retrieved from https://innovations.ahrq.gov/qualitytools/plan-do-study-act-pdsa-cycle

Helbig, June. (2018) Statistical Analysis. https://lc.gcumedia.com/hlt362v/applied-statistics-for-health-care/v1.1/#/home

Reply 2

 

According to the National Institutes of Health, research is defined as A systematic, intensive study intended to increase knowledge or understanding of the subject studied, a systematic study specifically directed toward applying new knowledge to meet a recognized need, or a systematic application of knowledge to the production of useful materials, devices, and systems or methods, including design, development, and improvement of prototypes and new processes to meet specific requirements. A research study must be approved by an Institutional Review Board before starting to work on it. An IRB is a committee that applies research ethics to all studies to assure no harm is done to participants (Helbig,2018).

 According to Department of Health and Human services (2011) quality improvement is defined as “systematic and continuous actions that lead to measurable Improvement in health services and the health status of targeted patient groups”. QI project may not be the implementation of something new, but an improvement upon something already in place. Teamwork is essential to produce result of QI project. There is no risk or minimal risk in QI project and even sometimes the participants are unaware that they are being a part of QI project.

 At my workplace, we do quarterly meeting where we do discuss about the number of falls, skin tear, bruises, any kind of incident happened. We track how many incidents happen, time of day, date, age of patient involved, staff present, and other circumstances, which could help to prevent the incident in future. In quantitative research we track number of incidents happens. Qualitative research we track the circumstances related to incident. We take all possible measures like staff and resident teaching, keep call light within reach all the time, proper lighting. We ensure all necessary step are taken to prevent any incidents.

References:

Helbig, J. (2018). Statistical analysis: Applied statistics for health care. Retrieved from https://lc.gcumedia.com/hlt362v/applied-statistics-for-health-care/v1.1/#/chapter/4

 Gregory, K. (2015). Differentiating Between Research and Quality Improvement. Journal of Perinatal and Neonatal Nursing.Retrieved from https://www.nursingcenter.com/pdfjournal?AID=3099809&an=00005237-201504000-00005&Journal_ID=54008&Issue_ID=3099787

1. What competitor information categories are useful in competitor analysis? Are these categories appropriate for health care organizations? How can these information categories provide focus for information gathering and strategic decision making?
2. Why is it important to clearly define the service area? How does managed care penetration affect service area definition?

Professional Development: 

Conduct a service area competitor analysis within your community. Keep it fairly small in scope (i.e. laser hair removal business, extended care facility for ventilator-dependant patients, etc.) so that it is manageable. Begin by introducing the macro issues (general and health care) and then use this outline as an initial guide:

1. Specify the Service Category
2. Delineate the Service Area.
   1. General
   2. Economic
   3. Demographic
   4. Psychographic
   5. Health Status
3. Perform a Service Area Structure Analysis
   1. Threat of New Entrants
   2. Intensity of Rivalry
   3. Threat of Substitutes
   4. Power of Customers
   5. Power of Suppliers
4. Do a Competitor Analysis/Identify Service Category Critical Success Factors
   
   1. Competitor Strengths and Weaknesses
   2. Critical Success Factors
   3. Strategic Groups
   4. Map Competitors
   5. Likely Responses of Competitors
5. Identify and Map Strategic Groups
6. Provide a Synthesis.