Final Exam

_ bbjbj .0bbbnnnnn4GIIIIIItBmnmnnnnGG,GR 30 hhnhnmmh 4 Communication and Leadership Final Examination

April 29th, 2019

Name Raquel Shuff

1.1 Dr Raper noted that he and his 1917 Clinic and St Georges colleagues did not want this vulnerable patient population to feel that yet another thing was being done to them. Rather, he wanted individuals to see what was being done for them therefore, Dr Raper and the 1917 Clinic staff viewed patient involvement as a top priority. Please distinguish between doing to them versus doing for them Comment on patient involvement as a top priority.

The term doing to them implies that the health care providers treat the patient as an obligation. It involves helping a patient get better and cope with their status. The health care provider does what they think the patient requires. The patient has no input in the kind of treatment he/she gets. On the other hand, doing for them means providing care from the patients point of view. Actions of healthcare providers are informed by patients input.

Patient involvement entails treating the patient as a person, involving them in decision making, and establishing their views on treatment. Involvement is essential for positive patient experience. Involved patients heal fast and are able to effectively manage chronic illnesses. Seeking patients opinions and preferences result to highly satisfied patients. Patient involvement results to better health outcomes and reduced healthcare costs.

1.2. Some patients were also reluctant to transfer their care to the 1917 Clinic due to its affiliation with an academic institution and medical research enterprise. Is this a common problem What are the roots of this type of problem What actions do you recommend to counter this problem

Patients shy away from accessing health care in clinics with links to academic and medical research enterprise. Patients are not assured of confidentiality and privacy. Most of these institutions give medical researchers access to patients records. These institutions do not fund such kind of research. This means that quality of findings is not guaranteed. Patients are treated as subjects by medical researchers. Research is meant for commercial purposes. Patients concern and opinions are not taken into consideration.

The most effective way to counter this problem is to ensure that the mandate to review these medical researchers is not entirely left in the hands of internal review boards. An external regulatory agency should be enforced to interrogate the quality of drugs, devices or procedures used in these hospitals.

1.3. Describe the administrative challenges in the transition that included but were not limited to patient confidentiality, medical records and patient data, parking, pharmacy, delays in access to care, and patient communication. Describe the actions taken to resolve these problems and comment on their success.

Funding was a major hurdle encountered during the transfer of patients. St. Georges population was characterized by vulnerable patients who needed retention in 1917 clinic. Among the patients were victims of drug abuse and mental illness. This group needed medicine and access to psychiatric treatment. The clinic did not have the capacity to provide continued healthcare. The clinics parking lot, pharmacy and general infrastructure were inadequate. There was minimal communication between the healthcare providers and patients. Health care providers focused on treating the patients. The views and opinions of patients were ignored.

The first step was to enlist the help of social workers to enhance transition. Patients attended transitional visits conducted by these social workers. This helped ease the fear and anxiety associated with moving to a new environment. The clinic countered the challenge of large number of patients by scheduling weekend clinics to accommodate more people. Clinic 1917 engaged many of the staff from St. Georges University hospital. This alleviated the problem of inadequate health personnel. The administration commenced construction of more exam rooms. With time, the institution developed an electronic medical record system which helped solve the problem of mishandling of patients medical records.

The clinic invested in intensive research on HIV/AIDS. Research touches on effective methods of primary HIV care and treatment. Research also focuses on improved communication between health workers and patients. Research is done using advanced equipment and qualified personnel.

1.4 What were the financial factors that were important to this case Explain the role of Ryan White funding and health insurance.

Patients received from the hospital came from poor backgrounds. Majority of them were HIV patients who were obese, victims of substance abuse, depressed and mentally disturbed. Besides fighting HIV/AID as a disease and stigma, they lacked resources to access quality health care. These patients were either not insured or under-insured.

Ryan White aimed towards provision of affordable healthcare to HIV/AIDs patients. The purpose was to avail funds to care for this population. Funding is directed towards acquisition of affordable antiretroviral drugs. The medicine is then given to the patients at no cost. Patients without insurance cover and those that are under-insured are provided outpatient HIV/AIDs treatment and care.

1.5. Comment on the success or lack of success of the transition of this vulnerable patient transition.

The transfer of patients was successful. This was necessitated by the well-structured transition. Despite the transition challenges, the clinic progressively built capacity to cater for HIV/AIDS patients.

Reference

Fifolt, N., Batey, D.S., Raper, J.L, Mobley, J.E. McCormick, L.C. (2017). The fragile balance

of community-based health care One communitys united response when the HIV/AIDS

primary care safety net failed. J Public Health Manag Pract. 23(5)507-514. doi 10.1097/PHH.0000000000000566.

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