Complete this week’s assigned readings, chapters 39-43. After completing the readings, post a short reflection, approximately 1 paragraph in length, discussing your thoughts, opinions, questions or concerns about one or several of the specific topics covered in the textbook readings. Identify which one MSN Essential most relates to your selected topic in your discussion.

As a reminder, no scholarly sources are required and students do not have to reply to a classmate’s original post.  I’M a Family Nurse Practitioner student.

Integration of Health Systems

Note: Before completing this Assignment, please familiarize yourself with the Week 4 Assignment Rubric, located in the Course Information area of the course navigation menu.

Intermountain Healthcare is a high-performing integrated health system with facilities in Utah and Idaho. The health system has a long-standing clinical integration structure that encourages professional collaboration. Despite this, in 1999, many physicians at Intermountain Healthcare found it difficult to fulfill the needs of patients with co-occurring physical and mental health conditions. To efficiently and effectively address this issue, Intermountain Healthcare adopted a mental health integration model in many of its primary care facilities, as well as some of its specialty clinics and partner clinics. The team-based approach has improved the coordination of services, resulting in higher quality care at a savings of cost.

Consider the example above. What advantages does integration afford Intermountain Healthcare? Do other integrated health systems experience similar benefits? Are there disadvantages to integration? If so, what are they?

To prepare for this Assignment, review the information related to vertical and horizontal integration presented in the Learning Resources.

Select one of the following horizontally integrated health systems:

• National Surgical Hospitals
• Select Medical Healthcare
• Sunrise Senior Living
• Labcorp
• Quest Diagnostics
• Pfizer Pharmaceuticals

Also select one of the following vertically integrated health systems:

• Kaiser Permanente
• Mayo Clinic
• Cleveland Clinic
• MedStar Health
• Memorial Hermann Healthcare System Houston

As an alternative, you may use Becker’s Hospital Review resource to identify a vertically integrated health system.

Using the Walden Library and credible sources on the Internet, research your selected health systems. Investigate the rationale for pursuing integration and the strategies each health system has used to achieve integration. Note information related to the size of each health system, settings/locations, and types of services it provides.

Based on your research, consider the ways in which the two health systems are similar to and/or different from one another.

Assess the business and health care-related implications of horizontal and vertical integration of your selected health systems. How does integration impact the management of your selected organizations and the patients/consumers they serve, especially in terms of cost, quality, and access?

Consider any applicable insights you have gained through the Discussion for this week.

The Assignment

Write a paper in which you:

• Compare the horizontally integrated health system and the vertically integrated health system you have selected (e.g., size, settings/locations, and types of services).
• Explain each health system’s rationale for pursuing integration and the strategies it has used to achieve integration.
• Assess the business and health care-related implications of integration for your selected health systems, including how integration impacts the patients/consumers the organization serves.

General Guidance on Assignment Length: Your Assignment should be 3–4 pages, excluding a title page and references. Refer to the Week 4 Assignment Rubric for grading elements and criteria. Your Instructor will use the rubric to assess your work.

Required Resources

Readings

• Shi, L., & Singh, D. (2015). Delivering health care in America: A systems approach (6th ed.). Burlington, MA: Jones & Bartlett.
  • Chapter 9, “Managed Care and Integrated Organizations” (pp. 361–368)
• Cohen, A., Klein, S., & McCarthy, D. (2014). Hill Physicians Medical Group: A market-driven approach to accountable care for commercially insured patients. Retrieved from http://www.commonwealthfund.org/~/media/files/publications/case-study/2014/oct/1770_cohen_hill_physicians_aco_case_study.pdf
• Cutler, D. M., & Morton, F. S. (2013). Special communication: Hospitals, market share, and consolidation. JAMA, 310(18), 1964–1970.
  Retrieved from the Walden Library databases.
• Sanford, K. D. (2013). Integration requires new roles and responsibilities. Healthcare Financial Management, 67(3), 56–60.
  Retrieved from the Walden Library databases.
• Summer, L. (2014). Research insights: Integration, concentration, and competition in the provider marketplace. Retrieved from http://www.academyhealth.org/files/publications/AH_R_Integration%20FINAL2.pdf

Use the following resources to select integrated health systems on which to focus for your Assignment. You may also use this list to develop background information as you research health systems in your area for the Discussion.

• Rodak, S. (2013). 100 integrated health systems to know. Retrieved from http://www.beckershospitalreview.com/lists/100-integrated-health-systems-to-know.html

Vertically Integrated Health Systems

• Cleveland Clinic. (n.d.). Retrieved March 27, 2015, from http://my.clevelandclinic.org
• Kaiser Permanente. (n.d.). Retrieved March 27, 2015, from http://kp.kaiserpermanente.org/
• Mayo Clinic. (n.d.). Retrieved March 27, 2015, from http://www.mayoclinic.org
• MedStar Health. (n.d.). Retrieved March 27, 2015, from https://www.medstarhealth.org/
• Memorial Hermann Healthcare System Houston. (n.d.). Retrieved March 27, 2015, from http://www.memorialhermann.org

Horizontally Integrated Health Systems

• Labcorp. (2014). Retrieved March 27, 2015, from https://www.labcorp.com/
• National Surgical Healthcare. (n.d.). Retrieved March 27, 2015, from http://www.nshinc.com
• Pfizer Pharmaceuticals. (n.d.). Retrieved March 27, 2015, from http://www.pfizerrxpathways.com/
• Select Medical. (n.d.). Retrieved March 27, 2015, from http://www.selectmedical.com
• Sunrise Senior Living. (n.d.). Retrieved March 27, 2015, from http://www.sunriseseniorliving.com/
• Quest Diagnostics. (n.d.). Retrieved March 27, 2015, from http://www.questdiagnostics.com/

In Week 1, you developed your practicum professional development objectives. How have your experiences thus far in the practicum contributed to your growth as nurse leader-manager or nurse informaticist? What difficulties, if any, have you experienced, and how might this affect the achievement of your objectives?

In this Discussion, you assess your progress toward fulfilling your practicum professional development objectives and consider how you could enhance or alter your activities to achieve your aims.

To prepare:

• Reflect on the practicum professional development objectives you developed and outlined in your Practicum Professional Experience Plan in Week 1.
• Keeping in mind the practicum activities you have engaged in thus far, consider the following questions:
  • How have these activities helped to promote your professional development?
  • Are you satisfied with your progress toward meeting your objectives? If not, what will you do to ensure you achieve them before the end of your Practicum Experience? As a reminder, you must complete all of your practicum hours on or before Day 5 of Week 11.
  • What challenges or unexpected opportunities have arisen at your practicum site? How has this affected your professional development?
• Think about the experiences you may have in the forthcoming weeks. Do you foresee any particular challenges on the horizon? If so, what is your plan for addressing those challenges?
• Think about the time you have spent with your Preceptor. How has this time enhanced or changed your understanding of the role and functions of the nurse leader-manager or nurse informaticist?

Post on or before Day 3 an assessment of your progress toward achieving your practicum professional development objectives, including how your involvement in specific practicum activities has contributed to your development. Explain what you will do to ensure you achieve your objectives by the end of your practicum. Summarize challenges or unexpected opportunities that have arisen, as well as any challenges that you anticipate may arise. Explain how you will address those challenges. Finally, summarize what you have learned about the role and functions related to your specialization through time spent with your Preceptor.

MUST HAVE CIATATIONS, FOLLOW RUBRIC, BE IN FORMAT, BE ONTIME, BE VALID

Read/review the following resources for this activity:

• Textbook: Chapters 7, 8
• Lesson
• Minimum of 2 scholarly source (in addition to the textbook)
• Narrated PowerPoint Tutorial (Make sure to review this tutorial before you begin recording.)

Instructions

For this week’s assignment respond to one of the following options, and include Option 1, 2, or 3 as part of your heading.

Option 1: The first option is to name and describe in detail a key specific and recent healthcare technology. What are at least two key moral problems this technology creates? What are the proper moral guidelines for dealing with it in your view? Compare your approach to what a utilitarian and ethical egoist would say (each independently). Consider whether differing ethical beliefs globally might or not agree with what you say.

Option 2: In the second option, name and describe in detail a key specific and recent social technology. What are at least two key moral problems this technology creates? What are the proper moral guidelines for dealing with it in your view? Compare your moral approach to what a utilitarian and social contract ethicist would say (each independently). Consider whether differing ethical beliefs globally might or not agree with what you say.

Option 3: John Doe, Patient One, is in late stage of kidney disease. If he does not receive a new kidney, then he is predicted to die within a week. Doe is 45, single, and has no children. Doctors theorize that Doe damaged his kidney by not following a low-salt diet. Doe inherited one million dollars and is known for giving money to charity. Without a transplant, he will probably be forced to spend all his money searching for a kidney outside of the usual legal channels. Patient Two is Jane Doe (no relation to John). Patient Two is a mother of two children (ages 21 and 24). She is divorced and 55 years old. She developed kidney problems due to eating a high-fat and high-sugar diet. If she does not receive a kidney within one month, doctors believe she will die. Patient Three is an orphan. This orphan lives in a state facility. She was born with a genetic condition that constantly damages her kidney. The only known approach to her condition is to provide her with a kidney transplant every so often. She is 11 and has already undergone two kidney transplants. She will perish in two months if she does not receive another transplant.

All three patients are at the same hospital. The hospital only has one kidney to give out. The orphan’s birth parents were known to be of a religion that is opposed to organ donation. The other patients come from religions that do not oppose organ donation. Who should get the kidney? Why should that candidate receive it over the others? Devise a course of social action and a solution for this case by using the ethics of egoism and then utilitarianism to a key moral conflict involving health care in this case. Appraise the interests of diverse populations (in terms of ethnicity, race, religion, sexual orientation, etc.) and how they relate to the case. Consider whether differing ethical beliefs globally might or not agree with what you say.

For all the options:

Cite the textbook and incorporate outside sources, including citations.

You should not be using any text you used in a discussion board or assignment for this class or any previous class.

Consider whether differing ethical beliefs globally might or not agree with what you say.

You will submit the following:

• An audiovisual presentation that presents one of the options above. Be sure to give equal time to each element. Doing a PowerPoint presentation with audio recorded on the slides is preferred. Please refer to the Narrated PowerPoint Tutorial located in the Required Resources in this assignment.
• Please provide a transcript of anything said in the recording aloud that does not appear as text on a slide. This transcript can be provided as a Word document or placed in the Notes section on the PowerPoint slides.
• The link or a scan of the article mentioning any health technology, social technology, or case you are reporting on. If you made up the case, please indicate that in your report. If you choose to do option #3 (the case about a shortage of transplant kidneys), your article would likely be an article about the shortage of transplant organs, or a shortage of people signing up to be transplant donors, or the status of educating people about being donors, etc.

Presentation Requirements

• Length: 4-6 minutes narrated presentation 
• Slide length: 4-6 slides (not including title slide, conclusion slide, or references slide)
• Title slide
• Conclusion slide
• References slide (minimum of 2 scholarly sources cited in APA format; not narrated)

Using the text and the Internet, such as the PDR website, classify each of the following drugs and include a generic name, if possible. Also, list the clinical usage of each and the adverse effects that could arise.

Use the Classifying Drugs Template when completing this assignment.

1. Atropine
2. Dexamethasone
3. Adenosine
4. Neo-Synephrine
5. Epinephrine
6. Lanoxin
7. Benydryl
8. Glucagon
9. Vasopressin
10. Nitroglycerin
11. Dopamine

APA format is not required, but solid academic writing is expected.