NHS FPX 6008 Assessment 4 Lobbying for Change
Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Professor Name Date Lobbying for Change September 2023 Kenneth A. Scheppke Deputy Secretary for Health, Florida Department of Health 4052 Bald Cypress Way Tallahassee, FL 32399 Dear Kenneth, With due respect, I am writing this letter to highlight a significant healthcare economic issue of limited healthcare access impacting Tampa General Hospital and public individuals in Florida. Limited access to healthcare is a global issue, as per the World Health Organization, where half of the world suffers from inadequate healthcare and medical access (World Health Organization, n.d.). This issue leads to deteriorating health outcomes and burdens the state’s economy through increased healthcare costs and potential loss of workforce productivity. The ramifications of this problem are multifaceted, notably affecting the underserved, rural, low-socioeconomic, and disabled population (Blumenthal et al., 2020). The low-income community, in particular, has been primarily deprived of essential medical and health services due to prohibitive costs and their inability to afford them—such deprivation results in poor management of chronic diseases. Additionally, disabled populations face physical barriers that hinder their access to timely and appropriate care. The challenge amplifies for the geographically dispersed communities in Florida due to location constraints, which lead to delayed treatments, further aggravated by associated travelling expenses. I am bringing this healthcare economic issue to your concern as it extends its impact to the broader population of Florida, and your vital role is required to address the concern. Addressing this healthcare economic issue through strategic planning and resource allocation can significantly improve health outcomes for the broader Florida population. NHS FPX 6008 Assessment 4 Lobbying for Change These outcomes include better management of chronic diseases and timely prevention and treatment of contagious diseases (Oleribe et al., 2019). Furthermore, reduced health disparities among low-socioeconomic and demographic groups will promote health equity. The resulting inequitable distribution of resources minimized health disparities among the marginalized, underserved, and diverse socio-economic communities. Consequently, healthcare costs are reduced due to the prevention of misdiagnoses and immediate interventions (McMaughan et al., 2020). Contrary to this, not addressing the concern may further aggravate the healthcare costs for communities related to exacerbated health conditions and for healthcare organizations because of overburdened healthcare departments. Subsequently, the quality of care is impacted, declining quality of life and may lead to increased mortality (Kaye, 2020). The research underscores that socioeconomically disadvantaged individuals and those with disabilities experience compromised health outcomes due to limited healthcare access (McMaughan et al., 2020). Specifically, these individuals tend to suffer from preventable illnesses, and their aging process is detrimentally affected (Doherty et al., 2020). At the institutional level, healthcare providers often grapple with overburdened systems due to late-stage presentations of illnesses resulting from an initial lack of access. The local community witnesses this as delayed treatment for acute conditions and inconsistent management of chronic diseases, exacerbating health problems further. On a state and national scale, limited healthcare access affects public health and results in economic downturns due to diminished workforce productivity. NHS FPX 6008 Assessment 4 Lobbying for Change It is crucial to recognize the ethical aspect of promoting health equity. This involves ensuring that vulnerable populations like the homeless, migrants, and the disabled receive timely and appropriate healthcare. Doing so can diminish health disparities and move toward social justice (Núñez et al., 2021). Geographical barriers further intensify this issue. Many, especially in remote areas, cannot access healthcare facilities promptly due to vast distances. Innovative solutions, like optimizing transport or mobile health clinics, can alleviate these challenges (Weiss et al., 2020). A beacon of hope in addressing this is telehealth. Leveraging this technology does not only provide care remotely but also champions cultural sensitivity. Through platforms that respect and understand patient diversity, healthcare providers can deliver tailored care that adheres to the highest ethical standards, especially in rural communities (Struminger & Arora, 2019). From personal experiences witnessing the effects of limited healthcare access, I have prioritized resources for community outreach and mobile clinics. During my professional tenure at the hospital, I noticed a trend in late-stage illnesses due to delayed care, prompting me to focus on understanding the entry barriers patients encounter. As a mitigation strategy, I have proposed resource shifts to improve early diagnosis and preventive care as a mitigation strategy. On an organizational level, our hospital’s annual patient feedback survey highlighted transportation as a significant barrier. In our resource planning, we have begun collaborating with local transportation services and considering telehealth integrations to counter this challenge. These profoundly ingrained experiences have become a cornerstone of my resource planning and risk analysis approach. By witnessing the adverse outcomes of delayed healthcare access, I have been propelled to advocate for resource reallocation, risk management, and community engagement. Therefore, I request that you take immediate action on this significant healthcare economic issue. Addressing this issue will not only make healthcare accessible to all but will also uphold the principles of social justice in healthcare. This effort promises a healthier, more inclusive community. Yours sincerely, References Blumenthal, D., Fowler, E. J., Abrams, M., & Collins, S. R. (2020). Covid-19 — implications for the health care system. New England Journal of Medicine, 383(15). https://doi.org/10.1056/nejmsb2021088 Doherty, A. J., Atherton, H., Boland, P., Hastings, R. P., Hives, L., Hood, K., James-Jenkinson, L., Leavey, R., Randell, L., Reed, J., Taggart, L., Wilson, N., & Chauhan, U. (2020). Barriers and facilitators to primary health care for people with intellectual disabilities and/or Autism: An integrative review. BJGP Open, 4(3). https://doi.org/10.3399/bjgpopen20X101030 Kaye, A. (2020). Economic impact of covid-19 pandemic on health care facilities and systems: International perspectives. Best Practice & Research Clinical Anaesthesiology, 35(3). https://doi.org/10.1016/j.bpa.2020.11.009 McMaughan, D. J., Oloruntoba, O., & Smith, M. L. (2020). Socioeconomic status and access to healthcare: Interrelated drivers for healthy aging. Frontiers in Public Health, 8(231). https://doi.org/10.3389/fpubh.2020.00231 NHS FPX 6008 Assessment 4 Lobbying for Change Núñez, A., Sreeganga, S. D., & Ramaprasad, A. (2021). Access to healthcare during COVID-19. International Journal of Environmental Research and Public Health, 18(6), 2980. https://doi.org/10.3390/ijerph18062980 Oleribe, O. E., Momoh,
NHS FPX 6008 Assessment 3 Business Case for Change
Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Professor Name Date Business Case for Change Welcome all, my name is ——. Today, in this presentation, we will dive into the business case for change in healthcare economic issues, highlighting limited access to care. We will further overview how this issue impacted my organization and community. Next, we will examine the feasibility and cost-benefit considerations of implementing a proposed solution for the healthcare economic issue of limited access to care. Moreover, we will analyze various ways to mitigate the risks. Next, we will discuss proposed changes that can improve community care access. Lastly, we will explain how the proposed solution is culturally sensitive, ethical and equitable for community and healthcare organizations. So, let us delve into this vast but significant topic! Healthcare Economic Issue and Its Impact The healthcare economic issue I will highlight in this presentation is the lack of access to care. Limited or inadequate access to care is a global issue, as WHO states that half of the world has limited access to primary healthcare services (World Health Organization, n.d.). Limited access to care impacts particular groups such as low-income people, remote area natives, people with disabilities, and others. This issue impacts the community as their poor health outcomes cause them to suffer in various ways, including loss in productivity, reduced life span, increased healthcare costs, and enhanced mortality rates. Limited access to care must be adequately addressed to improve community health and economic stability. Impact on Stakeholders The most affected populations are impoverished people with low socioeconomic status, people with disabilities, and geographically distant or rural dwellers. I witnessed this issue in my healthcare organization, Tampa General Hospital, where limited access to care resulted in people dying from chronic diseases and delayed delivery of care treatments. These situations profoundly impacted my work as watching people die lingered on my nerves and intervened in my work, leading to near-miss events. Furthermore, my colleagues had similar feelings that interrupted their keen attention to the nursing tasks. The organization suffered various consequences of this healthcare economic issue, including higher costs due to increased hospital readmission rates and a negative impact on hospital reputations. Now, I will explain the significant impact this issue had on the community, as they were the primary victims of limited access to healthcare. Due to severe financial constraints, populations with poor socioeconomic backgrounds could not bear medical expenditures, and hospitals did not provide them with essential health and medical services (McMaughan et al., 2020). As a result, they suffered from their ailment, and many patients died. Moreover, disabled people, due to physical barriers, encountered limited access to medical facilities and experienced adverse health outcomes. Lastly, the people from remote areas had geographical barriers in accessing healthcare services and required strategic planning that could help them acquire healthcare services at home or near home. Considering the negative impact on all stakeholders, there is a pressing need to delve further into this matter and foster a change in systems that promise enhanced access to care for all vulnerable groups. Feasibility and Cost-Benefit Considerations The limited access to care poses health implications and badly impacts financial security. Therefore, healthcare organizations must explore this economic issue’s feasibility and cost-benefit considerations. These considerations will facilitate healthcare organizations in assessing the viability and practicality of initiatives for improving access to care. Some feasibility considerations explored for limited access to care are as follows: Enhanced Costs Due to Preventable Complications The preventable diseases and manageable health conditions may worsen due to limited access to care. The unmet needs of these health problems due to delayed or inadequate treatments escalate to more severe stages requiring costly interventions. The expensive treatment and interventions exceed early diagnosis and preventive care costs. For instance, diabetes management is less costly if timely diagnosed and treated than delayed treatment or lack of adherence to therapeutic care due to limited care (Singer et al., 2022). By granting adequate patient access, one can prevent the economic burden that incurs on patients and healthcare organizations. Public Health Impact The limited access to care for the vulnerable population with contagious diseases may lead to disease outbreaks. This will further create massive chaos as it creates broader public health implications. The ultimate consequences will be unmanaged diseases, costly treatments, and higher prevalence rates. Therefore, this provides a nuanced feasibility consideration to change healthcare organizations to improve public health by providing timely access to healthcare services. Cost-Benefit Considerations By improving access to care for vulnerable populations, cost-effectiveness can be procured. As the populations receive adequate access to care, their health outcomes will be improved, leading to a productive life. This will enhance the economy of the community and the overall country. To substantiate the cost-benefit considerations, one study supports expanding access to care for all people through telehealth facilities. The study’s results showed that for a 300-patient load per year, the annual cost savings amounted to €19,500 by expanding telehealth services. Moreover, Skype, as a less costly alternative, further decreased the telemedicine costs to €3149 (Buvik et al., 2019). Considering such strategies to enhance access to care, healthcare organizations can improve cost-effectiveness, benefiting them in the long run. Evidence-Based Ways to Mitigate Risks to Financial Security Changes or Solutions to Address Limited Care to Access Benefits of Implementing Proposed Plans These changes will benefit the community and assist the organization and colleagues. The organization can provide consultations to a broader range of people with limited access to care. This will be done by optimizing resource allocation and planning, which will lead to cost-effectiveness. Moreover, the organizations will acquire an increased return on investment leading to cost-benefit (Moroz et al., 2020). The organization’s reputation will be enhanced through expanded patient care access. Furthermore, effective implementation of proposed plans will promote the long-term stability of organizations as it positively contributes towards community well-being. By providing adequate access to care, healthcare professionals will be motivated to serve the community and enhance their productivity.
NHS FPX 6008 Assessment 2 Needs Analysis for Change
Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Professor Name Date Need Analysis for Change In this assessment, the need analysis for change will highlight the vast and emerging healthcare economic issue of limited access to care for Tampa General Hospital, Florida. With adequate access to care, community health and the economy will be improved. Moreover, vulnerable populations of low socioeconomic backgrounds or people encountering geographical barriers often face health disparities and diminished access to healthcare services and treatment. Therefore, addressing this primary healthcare concern and analyzing how to improve access to care for the general population and particularly vulnerable groups is paramount. This will predict outcomes and opportunities for growth once the proposed changes are analyzed and implemented. Summary of Healthcare Economic Issue The chosen healthcare economic issue is limited access to healthcare. The availability of healthcare services and adequate access to them can potentially treat diseases timely and prevent their long-term impacts on patients. However, in Tampa General Hospital, the access to care is a tremendous issue. Many nations face this healthcare issue globally, where hundreds of millions lack access to care due to poverty and inability to bear healthcare expenses (World Health Organization, n.d.). This issue profoundly impacted my work, organizational functionality, colleagues, and community. Having witnessed this issue in my healthcare organization, I was deeply impacted by this heinous healthcare economic issue. I could not function properly watching impoverished people lack basic healthcare necessities due to costly treatments and medical bills. Moreover, the diverse group populations facing limited access to healthcare due to geographical barriers were dying due to ill management of chronic disease. The existence of health disparities and geographical barriers in accessing care made me sad and confused, which impacted my nursing practice. I made a few errors that were fortunately recovered promptly. My colleagues had similar feelings, and their minds were boggling due to limited access to healthcare services. NHS FPX 6008 Assessment 2 Needs Analysis for Change Moreover, my organization encountered the aftermaths of this healthcare economic issue, including higher costs due to enhanced hospital readmission rates and declining reputation. The community was the most affected body, particularly those with low socioeconomic status and living in remote areas. This issue caused them various health problems, including poor management of chronic conditions, delayed diagnoses, further increasing costs to their treatments, and increased length of hospital stay. The rationale for pursuing this issue is my inspiration from my experience of witnessing people suffer due to limited access to care. Furthermore, adequate access to care is the right of every citizen regardless of their location and socioeconomic status. Therefore, I strongly advocate the need for analysis for change on this peculiar topic impacting millions of lives and their health. The gaps contributing to the need for addressing this healthcare economic issue are geographic disparities and socioeconomic barriers. These gaps must be adequately addressed to change the system to improve access to care for all citizens. Socioeconomic or Diversity Disparities The healthcare economic issue of lack of adequate access to care particularly impacts low-income populations, where people suffer from financial constraints and cannot bear basic health necessities. The lower-income populations tend to suffer various health inequalities as they cannot manage the healthcare costs and remain unserved. This leads to limited access to basic healthcare services and worsening health outcomes due to unmanaged health conditions (Mishra et al., 2021). Moreover, people from remote areas and underserved communities are vulnerable groups who encounter diversity disparities. Due to geographical barriers, people often neglect seeking medical care, and delay required health checkups. The limited access to care for people living in remote areas significantly hinders regular health checkups (Nguyen et al., 2020). Moreover, health disparities persist for people with disabilities due to a lack of accommodations and specialized services, causing physical barriers to accessing care (Doherty et al., 2020). The health disparities, particularly for these groups, necessitate changes in healthcare systems to enhance access to these groups so their health outcomes can be improved. Evidence-Based Sources for the Need to Address Issue and Implementation Plans Limited access to healthcare services has been a global issue, as WHO states that half of the global population lacks access to primary care services (World Health Organization, n.d.). Consequently, several evidence-based research studies address this primary health concern, aiming to provide adequate healthcare services to all populations, including vulnerable groups. According to McMaughan et al. (2020), limited access to care in lower-income people can increase morbidity rates, resulting in further poverty and reduced access to care. In addition, another study emphasized the need for improved healthcare access for rural populations as they face significant challenges in obtaining essential healthcare services. Specifically, rural populations are less affluent, sick, and older, with poorer health outcomes (Wilson et al., 2020). Similarly, a study highlights the pressing need for health equity and enhanced access to care for socially and culturally marginalized young people. The presence of multiple discriminations and access barriers such as cost, service locations, gender and racial differences, and confidentiality concerns have severely impacted low-income and homeless young people living in rural areas (Robards et al., 2019). This has resulted in poor health outcomes affecting their life at a young age. The potential changes and implementation plans based on research are highlighted in one of the studies by Jeste et al. (2020), where it is advocated to increase access to healthcare and educational services for disabled individuals through videoconference sessions and telehealth services to meet their medical, educational, and health needs adequately (Jeste et al., 2020). NHS FPX 6008 Assessment 2 Needs Analysis for Change Literature also supports procuring rural-based solutions to provide care to rural populations closer to home and narrow health disparities (Wilson et al., 2020). This can be achieved by integrating telehealth services and social media to improve health literacy and involve professionals. Through telehealth, vulnerable population groups will acquire healthcare consultations, care treatments, and education with better access overcoming geographical and financial barriers to travelling to
NHS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue
Student Name Capella University NHS-FPX 6008 Economics and Decision Making in Health Care Professor Name Date Identifying a Local Health Care Economic Issue Hospital readmission rates are a perilous healthcare economic issue that has a considerable impact on the elderly population in Texas, United States. This concern is centered around the fact that a higher number of older adults are readmitted to healthcare facilities after their discharge, impacting patients’ health as well as incurring financial implications. Therefore, this assessment explores more about the particular economic concern, its impact on the population and the working groups, and identifies the gap contributing to rising readmission rates. Issue Description and its Impact on Elderly Population Hospital readmission is described as the number of patients returning to the hospital within a specific interval from discharge, usually 30 days, for further treatment. It is an important measure that indicates adverse outcomes which are preventable by improving the quality of care. According to the Centers for Medicare & Medicaid Services (CMS), hospital readmissions are frequent, where 20 percent of Medicare receivers are readmitted within 30 days of discharge (Gupta et al., 2019). Our observations reveal that repeated readmissions can result in poor health outcomes for older adults. Each hospital stay transmits the risk of acquiring hospital-related infections, medical errors, and adverse events, which can further complicate their existing health conditions. Furthermore, hospital readmissions can impose a substantial monetary burden on the patients and their families, especially for those without insurance coverage (Lau et al., 2021). Other potential impacts include reduced quality of life and experiences of anxiety, stress, and vulnerability due to recurring health problems and the need for hospitalizations. The Rationale for Choosing Particular Healthcare Economic Issue The reasons for choosing the particular healthcare economic issue are my personal and professional experiences related to this matter. One of the reasons is that recurrent admissions within my workplace have led to several monetary penalties under the act of the Hospital Readmissions Reduction Program (HRRP). The focus of the program is to improve healthcare services, enhance communication, and optimize care coordination to prevent avoidable readmissions, eventually improving patient outcomes and quality of care (Centers for Medicare & Medicaid Services, 2023). Hospitals showing contrary observations may receive minimal reimbursements and pay additional penalties in this regard, consequently imposing a financial burden on the organizations. Another reason for choosing this problem is a personal connection where I witnessed the struggles and difficulties that my parents and grandparents have encountered due to repeated hospitalizations. The values that I hold as a registered nurse to provide empathetic and compassionate care for the well-being of patients have led me to choose this critical healthcare economic issue, requiring immediate interventions by the stakeholders. Impact of Increasing Hospital Readmission Rates As healthcare workers, the mounting concern of hospital readmission rates has had an overwhelming impact on our work and our organization. As we strive to provide adequate care to returning patients to improve their health and well-being, aggregated workload and resource scarcity are two major challenges that my colleagues and I have confronted. My colleagues and I have had to adapt to more complex patient needs, improve our care coordination process, augment discharge planning, and expand follow-up protocols, all of which demand for additional work and resources. While the organization had to pay penalties for the recurrent admissions, it also handled the detrimental challenge of additional expenses used on the surplus resources. A study presents that these additional costs may lead to decreased profitability for the organization, eventually impacting financial viability (Upadhyay et al., 2019). Simultaneously, the increasing hospital readmission rates are particularly challenging for the low socio-economic population within the community. Since the population has limited access to preventive care services and post-discharge support, they are at high risk for acute health issues, increasing the probability of hospitalization and readmission. NHS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue Moreover, social factors like insecure housing, lack of proper food, and insignificant income impact their overall well-being, contributing to higher hospitalization rates (Murray et al., 2021). Lastly, frequent readmissions can lead to extensive out-of-pocket costs for medications and other healthcare expenses, which may aggravate the existing financial burden for these diverse and low socioeconomic groups. Therefore, it is crucial to focus on healthcare equity and accessibility while devising interventions to address readmission rates within the community. The Contributing Gap and its Evidence The gap significantly increasing the readmission rates exists in the quality of healthcare due to inadequate post-discharge care planning and ineffective care coordination. A systematic review by Hunt‐O’Connor et al. (2021) corroborated a reduced risk of readmission rates for those patients who had received comprehensive post-discharge care. Discharge planning is essential to prevent post-hospital complications and reduce errors, ultimately minimizing the readmission rates. Another important factor is fragmented healthcare. Ineffective care coordination and disintegrated care are associated with higher risks of readmissions in chronically ill patients (Joo, 2023). Elderly patients often experience fragmented care due to the complex nature of their diseases; thus, healthcare professionals must ensure care coordination while dealing with chronic illnesses and older adults. Addressing these gaps is fundamental to improving the transition from hospital to patients’ residences and reducing hospital readmission rates. References Centers for Medicare & Medicaid Services. (2023, June). Hospital readmissions reduction program (HRRP). CMS.gov. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/hospital-readmissions-reduction-program-hrrp Gupta, S., Zengul, F. D., Davlyatov, G. K., & Weech-Maldonado, R. (2019). Reduction in hospitals’ readmission rates: Role of hospital-based skilled nursing facilities. Inquiry: A Journal of Medical Care Organization, Provision and Financing, 56, 0046958018817994. https://doi.org/10.1177/0046958018817994 Hunt‐O’Connor, C., Moore, Z., Patton, D., Nugent, L., Avsar, P., & O’Connor, T. (2021). The effect of discharge planning on length of stay and readmission rates of older adults in acute hospitals: A systematic review and meta‐analysis of systematic reviews. Journal of Nursing Management, 29(8), 2697–2706. https://doi.org/10.1111/jonm.13409 NHS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue Joo, J. Y. (2023). Fragmented care and chronic illness patient outcomes: A systematic review. Nursing Open, 10(6), 3460–3473. https://doi.org/10.1002/nop2.1607 Lau, H. L., Patel, S. D., & Garg, N.