Critical Thinking: Case Study – Cost Containment 

Choose a current event pertaining to an effort to contain costs or review this case study: 

Manzoli, L., Di Candia, V., Flacco, M. E., Panella, M., Capasso, L., Sargiacomo, M., & … Muraglia, A. (2012). The impact of health policy: the extreme case of Abruzzo, Italy. International Journal of Care Pathways, 16(4), 115-121. doi:10.1177/2040402613479343

Write a four- to six-page report evaluating the case and providing your recommendations for this case. Your report should address the following substantive requirements:

• Description      of what occurred, who was affected, and rationale
• Assessment      of the case from the following perspectives:
  • Health reform – illustrate how this case and your role       as administrator are different now due to changes in health law and       expectations from health reform.
  • How cost containment plays a factor in your decision.
• Recommendations      for implementation of procedures or partnerships to continue containing      costs and increasing efficiency.

Your well-written report should meet the following structural requirements:

• Be      four to six pages in length, not including the cover or reference pages.
• Formatted      according to Saudi Electronic University and APA writing guidelines.
• Provide      support for your statements with in-text citations from a minimum of four      scholarly articles. Two of these sources may be from the class readings,      textbook, or lectures, but two must be external.
• Use      correct terminology pertaining to the law and ethics
• Utilize      the following headings to organize the content in your work.
  • Introduction and Description
  • Assessment
  • Recommendations
  • Conclusion

Assignment Overview

This assignment is intended to demonstrate your comprehension of the main principles of health informatics, as well as the primary applications of health informatics in healthcare organizations.

For this assignment, you will read a case study that presents difficulties associated with implementing a new computer system in a professional setting. Based on the scenario described in the case study and assignment details, you will create a short PowerPoint presentation.

Assignment Details:

Perform the following tasks:

· Complete the reading assignment and the interactive lesson before attempting this assignment.

· To complete this assignment:

o Review the case study and select one of the committee roles.

o Download the provided PowerPoint template to create a presentation that includes:

§ Your selection as a member on the committee 

§ Identification one or more issues, related to your role on the committee

§ Identification of probable cause(s) of identified issue(s)

§ Proposed recommendations to resolve the identified issues 

§ Reference slide – list of academic references, using APA style 

o Ensure to support the content of your slides with research from your text or the LRC.

·

Ø Case Study

Read the following case study

A good friend of yours is director of nursing at a 220-bed community hospital. Last year the hospital merged with a much larger medical center. One of the upsides, as well as one of the challenges, resulting from this change has been the rapid introduction of new computer systems. The goal is to bring the hospital “up to speed” within 3 years. At present, the Computerized Physician Order Entry (CPOE) is being implemented. The general medical and surgical units went live last month. The ICU, pediatrics, and obstetrics units are scheduled to go live next month. The plan is to work out any kinks or problems on the general units and then go live in the specialty units. Most of the physicians, nurse practitioners, and physician assistants initially complained but are now becoming more comfortable with the computers and are beginning to integrate the CPOE process into their daily routines. Several physicians are now requesting the ability to enter orders from their offices and others are looking into this option. However, three physicians have not commented during this process but are clearly resisting. For example, after performing rounds and returning to their offices they called the unit with verbal orders. After being counseled on this behavior, they began to write the orders on scraps of paper and put these in the patient’s charts or leave them at the nurses’ station. When they were informed that these were not “legal orders,” they began smuggling in order sheets from the non-activated units. In addition, they have been coercing the staff nurses on the units to enter the orders for them. This has taken two forms. Sometimes they sign in and then ask the nurses to enter the orders. Other times they ask the nurses to put the orders in verbally and then they confirm the orders. The nurses feel caught between the hospital’s goals and the need to maintain a good working relationship with these physicians. 

You suggest to your friend (director of nursing) to create an informal committee to review the issues surrounding the CPOE implementation. The committee would determine methods to address these issues, prior to implementing CPOE within the ICU, pediatrics, and obstetrics units. Your friend appreciates the suggestion and forms a small committee with the following members:

· Taylor Terrific, RN – a nurse practitioner

· Dr. Dudley Do-Right – a physician who uses the CPOE system routinely and correctly

· Dr. Frank Burns – a physician who rarely, if ever, uses the CPOE system

The director of nursing asks each committee member to create a short PowerPoint presentation for the committee. The presentation would identify issues that occurred during CPOE implementation, identify potential causes of such issues, and list specific recommendations, based on strong rationale and research, to resolve the identified issues prior to the next CPOE implementation. Each committee member will have a unique perspective, based on their position (i.e., nurse, physician).

PowerPoint Presentation

Directions:

1. Review the case study and select one of the committee roles.

2. Download the PowerPoint template (Week 2 Assignment Template). 

· The link to this template can be found in your Blackboard course in Week 2.

3. Select one of the following roles on the committee 

· Taylor Terrific, RN – a nurse practitioner

· Dr. Dudley Do-Right – a physician who uses the CPOE system routinely and correctly

· Dr. Frank Burns – a physician who rarely, if ever, uses the CPOE system

4. Use the PowerPoint template to create slides that:

· Identify one or more issues, related to your role on the committee

· Identifies probable cause(s) of identified issue(s)

· States proposed solutions or processes to address the identified issues

§ Solutions are supported by specific rational and research.

· Includes a reference slide – a list of academic references, using APA style 

5. Ensure to support the content of your slides by the case study, research from your text, or the LRC.

  Discuss the principles of data integrity, professional ethics, and legal requirements related to data security, regulatory requirements, confidentiality, and client’s right to privacy.  

• How can the use of the nurse’s personal communication device(s) impact patient care positively and/or negatively?
• What are the ethical and legal implications of the use of personal devices?
• What does the professional literature say about how communication devices can support safe nursing practice?

Comment 1

Random sampling, also known as probability sampling, requires that each member of the study population have an equal opportunity to be selected as a study subject. Selecting members of the population randomly enable members of the population to be selected equally. Random sampling enables each facet of the study population to be represented without bias (Little, 2016). For instance, a questionnaire is provided in an unsystematic way to a population so each individual in the population has a chance to submit information for that analysis. Again, many outcomes in statistics are derived from probability theory. Probability always assumes that random processes are functionally (Little, 2016). For any statistical outcomes to be valid, there is need to use samples which can be treated as random variables. Simple random samples make it easier to do that. There is less chance of results of analysis being skewed using random sampling.

However, there are limitations with random samples. It requires individuals within the population to volunteer and provides information. The people who usually participate may have the strongest opinion on the topic being analyzed. This brings the question of accuracy of the representation of such population (Little, 2016). There are two main limitations of random sampling. These are biased outcomes and laborious and time-consuming. Biased results are brought by the fact that the population of interest produces the people to be a sample. If the question is about things affecting them, they may be biased in providing information (Little, 2016). Random sampling is also time-consuming and involves a lot of things to be done hence laborious.

To have a truly random sample, one will need to have access to the target population and be able to assign each participant randomly to a condition. This is ideal since only random assignment to people by researchers before manipulation can provide causal interpretability of results (Little, 2016). To prevent problems and limitations with random sampling, there is need to ensure that you have a group which is bigger and each member has different views.

Comment 2 ( this is an answer for the teacher about my answer) concerning this  question. Explain each sampling technique discussed in the “Visual Learner: Statistics” in your own words, and give examples of when each technique would be appropriate.

Thanks you Rosy for your answer. When doing statistical interpretation of any data, we always hope to achieve a good understanding of the estimated population parameters. Naturally, we do this using observed data from various samples. 

But how do you realistically determine the sample size based on confidence level?

 No Plagiarism please, assignment will be checked with Turnitin. 

Will need 4 full pages,  double spaced all throughout the page for the case study, APA Style, Times New Roman, font 12, Title Page and a Reference page. 

 Make sure all of the topics in the case study have been answered 

Cite at least 3 References; journal articles, textbooks, or evidenced-based websites to support the content. 

All sources must be within five years (2012-2017).

Case Study 3:  Disorders of Fluid and Electrolyte Balance

Amanda is an 18-year-old with anorexia nervosa. She was recently admitted to an eating disorders clinic with a BMI of 13.9, and although she was a voluntary patient, she was reluctant about the treatment. She was convinced she was overweight because her clothes felt tight on her. She complained that even her hands and feet “were fat.” One of her nurses explained that a protein in her blood was low. The nurse further explained that, as difficult as it may be to believe, eating a normal healthy diet would make the “fat hands and feet” go away. 

What protein do you suspect the nurse was referring to? How would a deficiency in this protein contribute to edema?

What is the difference between the physiology of pitting and nonpitting edema? 

Because of her weakened condition, Amanda was moved around the ward in a wheelchair when she was not on bed rest. How does this affect her edematous tissues?