[Author Name(s), First M. Last, Omit Titles and Degrees]
[Institutional Affiliation(s)]
Author Note
Applying Regulations in Varying Care Settings
Common Standards of Healthcare
There are a number of common standards observed in the health care regulation, regardless of the practice setting. According to the handbook released by the World Health Organization ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"4CgvvFf9","properties":{"formattedCitation":"(Clarke, 2016)","plainCitation":"(Clarke, 2016)","noteIndex":0},"citationItems":[{"id":8,"uris":["http://zotero.org/users/local/0omESN17/items/SDMXJ7RH"],"uri":["http://zotero.org/users/local/0omESN17/items/SDMXJ7RH"],"itemData":{"id":8,"type":"article-journal","title":"Law, regulation and strategizing for health","container-title":"Strategizing national health in the 21st century: a handbook. Geneva: World Health Organization","author":[{"family":"Clarke","given":"David"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Clarke, 2016), a brief summary of these general standards is as follows;
Extend access to the sort of services necessary for the well-being of an individual.
Minimizing any and all inefficiency in the system, along with the development of mechanisms for pooling on funds and development of sustainable mechanisms.
Ensuring access to all essential medicines, along with the provision of effective and quality services based on the needs of the population.
Solo Medical Practices and Employed Physician Practices
A practice without any employment affiliations or partners associated with it is termed as a solo practice. On the other hand, health care corporations that own a number of clinics or a hospital with employed physicians are usually called employed physician practices. Following is a detail of various aspects of these services;
Staffing Requirements
Since the setup in a solo practice is rather small in scale as compared to the needs of employed physicians practices, the requirements of staff members on-board at all times is also small. Within a Solo practice, a patient-centered medical home model (PCMH) is used ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"9s73rFw8","properties":{"formattedCitation":"(Markovitz, Alexander, Lantz, & Paustian, 2015)","plainCitation":"(Markovitz, Alexander, Lantz, & Paustian, 2015)","noteIndex":0},"citationItems":[{"id":10,"uris":["http://zotero.org/users/local/0omESN17/items/CJVMKDJC"],"uri":["http://zotero.org/users/local/0omESN17/items/CJVMKDJC"],"itemData":{"id":10,"type":"article-journal","title":"Patient-centered medical home implementation and use of preventive services: the role of practice socioeconomic context","container-title":"JAMA internal medicine","page":"598-606","volume":"175","issue":"4","author":[{"family":"Markovitz","given":"Amanda R."},{"family":"Alexander","given":"Jeffrey A."},{"family":"Lantz","given":"Paula M."},{"family":"Paustian","given":"Michael L."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Markovitz, Alexander, Lantz, & Paustian, 2015), where the staff, along with caregivers, works with the patients in a collaborative manner, to provide them with well-coordinated and high-quality care ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"6jZcf0G4","properties":{"formattedCitation":"(Peikes et al., 2014; Shojania et al., 2006)","plainCitation":"(Peikes et al., 2014; Shojania et al., 2006)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":9,"uris":["http://zotero.org/users/local/0omESN17/items/W73T8RLR"],"uri":["http://zotero.org/users/local/0omESN17/items/W73T8RLR"],"itemData":{"id":9,"type":"article-journal","title":"Staffing patterns of primary care practices in the comprehensive primary care initiative","container-title":"The Annals of Family Medicine","page":"142-149","volume":"12","issue":"2","author":[{"family":"Peikes","given":"Deborah N."},{"family":"Reid","given":"Robert J."},{"family":"Day","given":"Timothy J."},{"family":"Cornwell","given":"Derekh DF"},{"family":"Dale","given":"Stacy B."},{"family":"Baron","given":"Richard J."},{"family":"Brown","given":"Randall S."},{"family":"Shapiro","given":"Rachel J."}],"issued":{"date-parts":[["2014"]]}}},{"id":11,"uris":["http://zotero.org/users/local/0omESN17/items/YDYYMY48"],"uri":["http://zotero.org/users/local/0omESN17/items/YDYYMY48"],"itemData":{"id":11,"type":"article-journal","title":"Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis","container-title":"Jama","page":"427-440","volume":"296","issue":"4","author":[{"family":"Shojania","given":"Kaveh G."},{"family":"Ranji","given":"Sumant R."},{"family":"McDonald","given":"Kathryn M."},{"family":"Grimshaw","given":"Jeremy M."},{"family":"Sundaram","given":"Vandana"},{"family":"Rushakoff","given":"Robert J."},{"family":"Owens","given":"Douglas K."}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Peikes et al., 2014).
However, team-based care is more prevalent in employed physician practices. Here, staffing practices are based on the needs of the patient population as well as the needs of the institute, a large workforce is usually staffed with individuals that work together with high levels of efficiency and communication ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"FPe6UAhj","properties":{"formattedCitation":"(Milani & Lavie, 2015)","plainCitation":"(Milani & Lavie, 2015)","noteIndex":0},"citationItems":[{"id":14,"uris":["http://zotero.org/users/local/0omESN17/items/YZPIDYQZ"],"uri":["http://zotero.org/users/local/0omESN17/items/YZPIDYQZ"],"itemData":{"id":14,"type":"article-journal","title":"Health care 2020: reengineering health care delivery to combat chronic disease","container-title":"The American journal of medicine","page":"337–343","volume":"128","issue":"4","source":"Google Scholar","title-short":"Health care 2020","author":[{"family":"Milani","given":"Richard V."},{"family":"Lavie","given":"Carl J."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Milani & Lavie, 2015).
Release of Patient Records
Release of medical information, both in solo and employed physician practices, are to comply with the state as well as federal guidelines. This process generally remains the same through different stats and health practices. The one requesting the records must submit written consent with information like;
Patient information
Last four digits of SSN
Name and address of one asking for the records.
Signature of patient
Patient Rights
The notion of rights for a patient was developed under the 1948 Universal Declaration of Human Rights, which gives every human being equal and undeniable rights. It allows them dignity, privacy (regarding medical records), review of the billing statement, express concern as well as have a right to knowledge about clinical trials which may improve their ailing health, among various others. These rights remain constant throughout all medical practices, solo or otherwise, with the state.
Administrative Structure
At present, most healthcare practices adhere to the “Patients before Paperwork” initiative that was first taken in 2015. It redirects the efforts of physicians and other members of the staff to care for their patients and attend to their needs and deliver appropriate treatments as opposed to keeping up with the administrative tasks ADDIN EN.CITE <EndNote><Cite><Author>Erickson</Author><Year>2017</Year><RecNum>444</RecNum><DisplayText>(Erickson, Rockwern, Koltov, & McLean, 2017)</DisplayText><record><rec-number>444</rec-number><foreign-keys><key app="EN" db-id="0xspd9026f2x5oeadwwv29f0apvsspafr2zr" timestamp="1557537603">444</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Erickson, Shari M</author><author>Rockwern, Brooke</author><author>Koltov, Michelle</author><author>McLean, Robert M</author></authors></contributors><titles><title>Putting patients first by reducing administrative tasks in health care: a position paper of the American College of Physicians</title><secondary-title>Annals of internal medicine</secondary-title></titles><periodical><full-title>Annals of internal medicine</full-title></periodical><pages>659-661</pages><volume>166</volume><number>9</number><dates><year>2017</year></dates><isbn>0003-4819</isbn><urls></urls></record></Cite></EndNote>(Erickson, Rockwern, Koltov, & McLean, 2017). According to ADDIN EN.CITE <EndNote><Cite AuthorYear="1"><Author>Knox</Author><Year>2015</Year><RecNum>445</RecNum><DisplayText>Knox, Brach, and Schaefer (2015)</DisplayText><record><rec-number>445</rec-number><foreign-keys><key app="EN" db-id="0xspd9026f2x5oeadwwv29f0apvsspafr2zr" timestamp="1557538559">445</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Knox, L</author><author>Brach, C</author><author>Schaefer, J</author></authors></contributors><titles><title>Primary care practice facilitation curriculum (Module 32)</title><secondary-title>Rockville, MD: Agency for Healthcare Research and Quality [Internet]</secondary-title></titles><periodical><full-title>Rockville, MD: Agency for Healthcare Research and Quality [Internet]</full-title></periodical><dates><year>2015</year></dates><urls></urls></record></Cite></EndNote>Knox, Brach, and Schaefer (2015), the administrative structure in a health care practice comprises of;
Human resources
Information technology management
Financial management and billing
Quality improvement
Reporting and regulatory marketing
Business development and marketing
Risk management
Designing and managing workflow
Maintaining medical records
Security
Medical care staff – such as doctors and nursing staff
Clinic work
Most solo practices have diverse administrative teams, with an individual playing more than one role in the system to deal with all the above-mentioned administrative tasks. On the other hand, employed physicians’ practices usually have a department dedicated to a certain task.
Specific care environment
Health outcomes of a patient are greatly affected by the healthcare provider, as well the environment the patient receives this care in, regardless of their background ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"PgHPPab2","properties":{"formattedCitation":"(McClain, Hawkins, & Yehia, 2016)","plainCitation":"(McClain, Hawkins, & Yehia, 2016)","noteIndex":0},"citationItems":[{"id":19,"uris":["http://zotero.org/users/local/0omESN17/items/PDW8UPVQ"],"uri":["http://zotero.org/users/local/0omESN17/items/PDW8UPVQ"],"itemData":{"id":19,"type":"article-journal","title":"Creating welcoming spaces for lesbian, gay, bisexual, and transgender (LGBT) patients: An evaluation of the health care environment","container-title":"Journal of homosexuality","page":"387-393","volume":"63","issue":"3","author":[{"family":"McClain","given":"Zachary"},{"family":"Hawkins","given":"Linda A."},{"family":"Yehia","given":"Baligh R."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (McClain, Hawkins, & Yehia, 2016). Thus, hospitals need to be spaces that are responsive to patient’s needs, which directly influences their ability to get better. Thus, while solo practices are a better situation to provide with short-term care, employed physician practices are better suited to looking after the needs of a patient, especially one in critical condition. They host intensive care units (ICU), burn units and other specialized care units situated specifically for cases that need individual attention ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"kmG170ep","properties":{"formattedCitation":"(Fradgley, Paul, Bryant, Zucca, & Oldmeadow, 2018)","plainCitation":"(Fradgley, Paul, Bryant, Zucca, & Oldmeadow, 2018)","noteIndex":0},"citationItems":[{"id":20,"uris":["http://zotero.org/users/local/0omESN17/items/ZD9YBYTS"],"uri":["http://zotero.org/users/local/0omESN17/items/ZD9YBYTS"],"itemData":{"id":20,"type":"article-journal","title":"System-Wide and Group-Specific Health Service Improvements: Cross-Sectional Survey of Outpatient Improvement Preferences and Associations with Demographic Characteristics","container-title":"International journal of environmental research and public health","page":"179","volume":"15","issue":"2","author":[{"family":"Fradgley","given":"Elizabeth"},{"family":"Paul","given":"Christine"},{"family":"Bryant","given":"Jamie"},{"family":"Zucca","given":"Alison"},{"family":"Oldmeadow","given":"Christopher"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Fradgley, Paul, Bryant, Zucca, & Oldmeadow, 2018).
References
ADDIN ZOTERO_BIBL {"uncited":[["http://zotero.org/users/local/0omESN17/items/FCGCCCXX"],["http://zotero.org/users/local/0omESN17/items/ARY8NGN8"]],"omitted":[["http://zotero.org/users/local/0omESN17/items/YDYYMY48"]],"custom":[]} CSL_BIBLIOGRAPHY Clarke, D. (2016). Law, regulation and strategizing for health. Strategizing National Health in the 21st Century: A Handbook. Geneva: World Health Organization.
Erickson, S. M., Rockwern, B., Koltov, M., & McLean, R. M. (2017). Putting patients first by reducing administrative tasks in health care: a position paper of the American College of Physicians. Annals of Internal Medicine, 166(9), 659–661.
Fradgley, E., Paul, C., Bryant, J., Zucca, A., & Oldmeadow, C. (2018). System-Wide and Group-Specific Health Service Improvements: Cross-Sectional Survey of Outpatient Improvement Preferences and Associations with Demographic Characteristics. International Journal of Environmental Research and Public Health, 15(2), 179.
Knox, L., Brach, C., & Schaefer, J. (2015). Primary care practice facilitation curriculum (Module 32). Rockville, MD: Agency for Healthcare Research and Quality [Internet].
Markovitz, A. R., Alexander, J. A., Lantz, P. M., & Paustian, M. L. (2015). Patient-centered medical home implementation and use of preventive services: the role of practice socioeconomic context. JAMA Internal Medicine, 175(4), 598–606.
McClain, Z., Hawkins, L. A., & Yehia, B. R. (2016). Creating welcoming spaces for lesbian, gay, bisexual, and transgender (LGBT) patients: An evaluation of the health care environment. Journal of Homosexuality, 63(3), 387–393.
Milani, R. V., & Lavie, C. J. (2015). Health care 2020: reengineering health care delivery to combat chronic disease. The American Journal of Medicine, 128(4), 337–343.
Peikes, D. N., Reid, R. J., Day, T. J., Cornwell, D. D., Dale, S. B., Baron, R. J., … Shapiro, R. J. (2014). Staffing patterns of primary care practices in the comprehensive primary care initiative. The Annals of Family Medicine, 12(2), 142–149.
