Reply To Intilligent Failure Discussion Board

Reply To Intelligent Failure Discussion Board

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Reply to Elvite:

Dear Elvite, I agree with the definition of failure which says that failure is the omission of required and expected action ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"2ZNIgofT","properties":{"formattedCitation":"(\\uc0\\u8220{}Towards Understanding The Action-Omission Distinction,\\uc0\\u8221{} n.d.)","plainCitation":"(“Towards Understanding The Action-Omission Distinction,” n.d.)","noteIndex":0},"citationItems":[{"id":261,"uris":["http://zotero.org/users/local/5OlhLovK/items/E3K4I5LP"],"uri":["http://zotero.org/users/local/5OlhLovK/items/E3K4I5LP"],"itemData":{"id":261,"type":"webpage","title":"Towards Understanding The Action-Omission Distinction","container-title":"Psychology Today","abstract":"When negligence begins to resembles active causation","URL":"http://www.psychologytoday.com/blog/pop-psych/201312/towards-understanding-the-action-omission-distinction","language":"en-US","accessed":{"date-parts":[["2019",11,22]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Marczyk,2013). This urges a person to learn from the mistakes and to take the required actions which he missed in the first attempt. It is relatively easy to consider failure as just the absence of success and get away with it but it requires strong courage to learn from the mistakes and come back stronger. I agree with the idea that Hooli, a fixture company is just trying to imitate tech giants like Apple and Google and upper management is making a decision without analyzing critically where they actually stand. The efforts to take the Nucleus app into the market successfully by exerting extra pressure on the team and not catering to the holdbacks suggests a foggy environment of the company. This is the representation of a lack of communication between the team and the management which is a recipe for failure.

Reply to Charles

I agree that failure is a blessing in disguise because it can be considered as a learning opportunity both for organizations and for individuals. In the field of business and technology, the term ‘intelligent failure’ is often used and it is seen as a positive failure. These failures occur because the solutions to those problems do not exist already in the environment and these failures open the doors for the possible solutions (Stengel, 1991). I agree with your opinion that in the case of Hooli, the failure cannot be termed as an intelligence failure because it could easily be avoided. Apparently, the failure is due to upper management and business leaders due to a lack of communication with developers or unrealistic expected results. The failure could be minimized or avoided by effective communication and by addressing the problems during the project management stage so that developers, managers and external stakeholders could perform their tasks according to the requirement and well on time.

References

Stengel, R. F. (1991). Intelligent failure-tolerant control. IEEE Control Systems Magazine, 11(4), 14-23. ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Towards Understanding The Action-Omission Distinction. (n.d.). Retrieved November 22, 2019, from Psychology Today website: http://www.psychologytoday.com/blog/pop-psych/201312/towards-understanding-the-action-omission-distinction

Reply To Jacob

Reply to Jacob

Felisha Jones

Reply to Jacob

I just went through your post, and I believe you highlighted the right things as to how one can focus on the quality while profiting from the business aspect of the healthcare industry. Fisher, however, thinks that in the business of healthcare, quality is what one needs to focus on. The business owners who work in this industry can make profits through various means, but they should not compromise over the quality and patient-centric approach ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"MrZTtFdJ","properties":{"formattedCitation":"(Vance and Larson 2002)","plainCitation":"(Vance and Larson 2002)","noteIndex":0},"citationItems":[{"id":509,"uris":["http://zotero.org/users/local/8reWiRZH/items/NJ2L3PFT"],"uri":["http://zotero.org/users/local/8reWiRZH/items/NJ2L3PFT"],"itemData":{"id":509,"type":"article-journal","container-title":"Journal of nursing Scholarship","issue":"2","page":"165–171","source":"Google Scholar","title":"Leadership research in business and health care","volume":"34","author":[{"family":"Vance","given":"Connie"},{"family":"Larson","given":"Elaine"}],"issued":{"date-parts":[["2002"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Vance and Larson 2002). Solomon broadens the concept of business in health care by paying attention to the concerns of patients ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"tYZzdnSJ","properties":{"formattedCitation":"(Hub 2017)","plainCitation":"(Hub 2017)","noteIndex":0},"citationItems":[{"id":503,"uris":["http://zotero.org/users/local/8reWiRZH/items/KJBHN2FU"],"uri":["http://zotero.org/users/local/8reWiRZH/items/KJBHN2FU"],"itemData":{"id":503,"type":"webpage","abstract":"Health care is changing rapidly due to several factors, including legislative reform, technological innovation, and changes in the practice of medicine. One…","container-title":"Brigham Health Hub","genre":"text/html","language":"en","title":"Patient-Centered Care: What Does It Mean for You?","title-short":"Patient-Centered Care","URL":"https://brighamhealthhub.org/treatment/what-patient-centered-care-means-for-you","author":[{"family":"Hub","given":"Brigham Health"}],"accessed":{"date-parts":[["2020",1,24]]},"issued":{"date-parts":[["2017",1,26]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hub 2017). He argues that patient-centric approach is not just related to catering to the concerns at the right time, but rather, it is about looking towards the best alternative, the business owners can provide to patients. He is actually a critic of the concessions, the health-related business owners extend toward doctors and paramedics ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ktlPFScf","properties":{"formattedCitation":"(Hub 2017)","plainCitation":"(Hub 2017)","noteIndex":0},"citationItems":[{"id":503,"uris":["http://zotero.org/users/local/8reWiRZH/items/KJBHN2FU"],"uri":["http://zotero.org/users/local/8reWiRZH/items/KJBHN2FU"],"itemData":{"id":503,"type":"webpage","abstract":"Health care is changing rapidly due to several factors, including legislative reform, technological innovation, and changes in the practice of medicine. One…","container-title":"Brigham Health Hub","genre":"text/html","language":"en","title":"Patient-Centered Care: What Does It Mean for You?","title-short":"Patient-Centered Care","URL":"https://brighamhealthhub.org/treatment/what-patient-centered-care-means-for-you","author":[{"family":"Hub","given":"Brigham Health"}],"accessed":{"date-parts":[["2020",1,24]]},"issued":{"date-parts":[["2017",1,26]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hub 2017).

The cash-flow, or the cost related aspect you highlighted is critical, but one needs to broaden the understanding of health-related finance before opening. The cash-flow and business techniques being used in the health care industry are mostly the same, as they are in different other businesses. The only difference that Fisher highlights is related to the stakeholders’ involvement ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"UJGjHOns","properties":{"formattedCitation":"(Top10 Basic Business Principles n.d.)","plainCitation":"(Top10 Basic Business Principles n.d.)","noteIndex":0},"citationItems":[{"id":505,"uris":["http://zotero.org/users/local/8reWiRZH/items/NZMRGKBW"],"uri":["http://zotero.org/users/local/8reWiRZH/items/NZMRGKBW"],"itemData":{"id":505,"type":"webpage","title":"Top10 Basic Business Principles","URL":"https://www.slideshare.net/GregFish/top10-basic-business-principles","accessed":{"date-parts":[["2020",1,24]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Top10 Basic Business Principles n.d.). Girmay and Marye’s costing approach is limited to identify the ratio of profit and loss in health care ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"MTi65bnI","properties":{"unsorted":true,"formattedCitation":"(Girmay et al. 2018)","plainCitation":"(Girmay et al. 2018)","noteIndex":0},"citationItems":[{"id":507,"uris":["http://zotero.org/users/local/8reWiRZH/items/WJC5VWJT"],"uri":["http://zotero.org/users/local/8reWiRZH/items/WJC5VWJT"],"itemData":{"id":507,"type":"article-journal","container-title":"BMC research notes","issue":"1","page":"310","source":"Google Scholar","title":"Patients expectation strongly associated with patients perception to nursing care: hospital based cross sectional study","title-short":"Patients expectation strongly associated with patients perception to nursing care","volume":"11","author":[{"family":"Girmay","given":"Alem"},{"family":"Marye","given":"Tekleweyni"},{"family":"Haftu","given":"Mebrahtu"},{"family":"Brhanu","given":"Tsion"},{"family":"Gerensea","given":"Hadgu"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Girmay et al. 2018). There are market-competitive methods, which aim at providing enormous benefits to the business holders. In health care, they are not that much profitable. One reason being, the large input of money and huge risks attached to the health care equipment. It is the reason why people avoid investing in heavy sums in this industry. My point to your argument is that the healthcare business has different aspects, along with maintaining safety and assuring cleanliness.

References:

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Girmay, Alem et al. 2018. “Patients Expectation Strongly Associated with Patients Perception to Nursing Care: Hospital Based Cross Sectional Study.” BMC research notes 11(1): 310.

Hub, Brigham Health. 2017. “Patient-Centered Care: What Does It Mean for You?” Brigham Health Hub. https://brighamhealthhub.org/treatment/what-patient-centered-care-means-for-you (January 24, 2020).

“Top10 Basic Business Principles.” https://www.slideshare.net/GregFish/top10-basic-business-principles (January 24, 2020).

Vance, Connie, and Elaine Larson. 2002. “Leadership Research in Business and Health Care.” Journal of nursing Scholarship 34(2): 165–171.

Reply To Luis Blackman Case

Lewis Blackman Case:

Student’s Name:

University Affiliations:

Professor’s Name:

Course Title:

Lewis Blackman Case

Sugiti Response

The learner begins by offering a perfect introduction to the Lewis Blackman’s case. The introduction makes the reader learn the unfortunate death that occurred to the subject of the case study. The student goes ahead to describe the main cause of death, which was the medicine related. A systematic guide is illustrated on how the patient was taken in by the surgeons and later handed over to the nurses. Despite the incidence occurring, the hospital’s leadership, which is responsible for any activities in the facility, declines to own up the mistake. It was important for the student to outline the latter since it helps understand the case better. The apology from the hospital could have aided in making the parents feel better for the error done (Allhoff & Borden, 2019). It is eminent that there was no crisis management team in the stated facility and this contributed to the death of the patient. The conclusion provided by the student is informative and provides a solution to what could be done about the Lewis case.

Etleva’s Response

The student begins by comparing the current case with another case that had occurred similarly. Sympathetic sentiments are provided which one can relate to considering that this case was an accident. The student highlights that the patient should not have succumbed considering that this was a routine surgery for the patient. A more detailed description of Lewis's condition is written which makes the reader learn why the surgery was taking place. Several tests were done but the nurses and residents decided to be ignorant as demonstrated by the student in a larger part of Etleva’s writing. The errors that led to Lewis Blackman's death are mentioned which included; failure to communicate, the failure to intervene and lack of knowledge on how to handle the whole situation. Each hospital system ought to have a resolution program (Schweitzer et al, 2015). The student concludes the paper by offering suggestions on how the organization should have handled the Lewis case.

Sources

Allhoff, F., & Borden, S. L. (Eds.). (2019). Ethics and Error in Medicine. Routledge.

Schweitzer, M. E., Brooks, A. W., & Galinsky, A. D. (2015). The organizational apology. Harvard Business Review, 93(9), 44-52.

Reply To Luis Blackman Discussion Board

Emily  

Lewis Blackman

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This week’s case was another difficult story to watch and read about. I felt a great deal of anger and frustrating learning about the events that led up to Lewis Blackman’s tragic death. Listening to Lewis’ mother recount her experiences watching her son suffer and the handling of his care by the nurses was gut wrenching. I was appalled when I heard that one of the weekend residents was offended that Lewis’ mother asked for the attending doctor to be notified. I can imagine that the patient’s family members felt powerless over the situation. Ultimately, not doctor was ever called, and the patient went two days without seeing an attending physician. Because of the assumptions made by the care team, the nurses and residents failed to act upon Lewis’ increasing signs of instability. No one seemed concerned that this might be an emergency requiring immediate action. Lewis’ mother notes in one of the videos that one of the main problems with what happened to Lewis was that people were following protocols and guidelines and not looking at the patient. She made another comment about how in her son’s post-surgery care, nothing was coordinated, and no one seemed to be in charge of care. This reminded me of last week’s case on Elaine Bromiley, where confusion and lack of direction led to a disastrous medical error. Specifically, in Lewis Blackman’s case, the underlying issues behind the error were a lack of situational awareness, communication failure, failure to escalate, and failure to rescue.

In their recommendations for organizations, using the power of transparency, Sadler & Stewart (2015) urge organizations to commit to learning from serious clinical crises. The authors suggest that organizations conduct a thorough assessment of all clinical crises to understand and learn from failings, which will help reduce risk of future events. Outside advisers are welcomed and provide their perspective to aid in the organization’s continual learning, improving and sharing of lessons learned. Sadler & Stewart (2015) also recommend that organizations actively support compassionate patient, family and employee communication. It is important that this type of policy is made known to the entire organizations and it includes appropriate apology, rapid disclosure when harm occurs, and support. Lazare (2006) notes that the patient’s family wants to know through the apology that the physician cares about the well-being of the patient. “This is communicated through the quality of the apology, special attending afforded the patient, follow-up telephone calls, and even attending the patient’s funeral” (Lazare, 2006). Because the outcome of the medical error did result in a death, there should be the maximum amount of effort, sincerity, and attention given to the Blackman family in the aftermath of this unnecessary crisis. Lazare also suggests that the family needs the opportunity to ask questions and express feelings to the physicians, who needs to listen to such feelings and concerns and respond appropriately and empathetically. I believe that Lewis’s attending physician, along with the hospital’s senior leadership should take an active role in the apology.

Some of the specific suggestions for leadership given by Sadler & Stewart (2015) that could have been used by the hospital leadership in Lewis’s case are to “act with intense urgency, own the problem and form a crisis management team.” This feeds into another recommendation, which is to design, disseminate and regularly test a crisis management plan. Sadler & Stewart (2015) mention that this must be a written plan that is regularly tested, modified and reviewed by executive leadership, clinicians and, and the board, and is inclusive of the core principles of internal and external transparency and support for second victims. It is clear that this type of plan was neither in place nor utilized by the care team in Lewis’s case. The attending clinicians should have acted with a greater sense of urgency when Lewis and his mother were raising concerns. They did not recognize or appropriately response to these concerns and no one took ownership of the crisis. The staff and hospital leadership should use this egregious error as fuel to quickly establish an effective crisis management team to prevent instances like this again.

Lewis’s attending physician was a key stakeholder in his case, and he was not notified of Lewis’s symptoms and declining condition during the hours following his surgery. All stakeholders ought to be notified of emergency situations immediately. Another leadership tactic – “lead with your genuine feelings – empathy, outrage, sadness, and disappointment” (Sadler & Stewart, 2015) – should have been used by the nurses and Lewis’s care management team during the weekend. Instead, the clinicians disregarded the patient’s strong concerns and expressions of pain. All of these examples of failures of listening led to the tragic and unnecessary crisis of Lewis Blackman's death. 

References:

Lazare, A. (2006). Apology in Medical Practice: An Emerging Clinical Skill. JAMA, 296(11).

Sadler, B. L., & Stewart, K. (2015). Leading in a Crisis: The Power of Transparency. The Health Foundation.

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Response:

The tragic demise of Lewis Blackman is the most disastrous, heart-breaking, and excruciating case of medical malpractices. The death of Lewis elucidates the connotation of all the managerial implications; generally, people think that communicational efficacy and other intertwined practices are based only on theories and therefore do not have any significance in real-life. But unfortunate cases such as Lewis remind professionals regarding the utter imperativeness of pursuing the strategically devised guidelines in a rather harsh manner. Healthcare is a somber profession because it involves the notion of life and death, and even a little slipshod can take the patients to the murky abyss of mortality. Medical malpractices are severe negligence that occurs when healthcare personnel fail to proffer adequate treatment. In the wake of their heedlessness, they provide patients with substandard treatment that can have detrimental and morbid consequences. Such malpractices are unforgivable and require legal proceedings along with concrete corrective and preventive measures.

Reference:

Pandit, M., & Pandit, S. (2009). Medical negligence: Coverage of the profession, duties, ethics, case law, and enlightened defense - A legal perspective. Indian Journal Of Urology, 25(3), 372. doi: 10.4103/0970-1591.56206

Sarah

Top of Form

In this case study, Lewis Blackman and his parents were simply ignored which ultimately caused his death. Lewis Blackman went into the hospital for an elective surgery. His condition was called pectus excavatum. His breast plate was malformed and which causes his lungs to inadequately grow. His parents were told its almost like getting a tooth pulled out that it would be quick and simple. He went to the Medical University of South Carolina Children's Hospital in Charleston to get this surgery. There had been reports of successful similar surgeries. This surgery would have been placing a metal bar through small incisions and propping the breast bone up. A couple days after the surgery, Lewis was injected with Toradol for pain medication. Immediately, he experienced immense pain in his stomach. The nurses kept pushing it off saying it was consitpation due to the medication. The side effects of the pain medication was stomach ulcers. No one listened to Lewis complain, they just kept saying he had to go for a walk and to walk it off. 

Ultimately, if one nurse decided to actually listen to Lewis he could have been alive today. He ended up having internal bleeding from the ulcers and lost 3 liters internally. Lewis Blackman's mom wanted to know what happened but all they did was apologize. An apology is not sufficient in this case. Not saying money is everything, but they should get something for the mental restitution for the parents. Hospital leadership should effectively manage situations like these to eliminate more medical errors. If someone actually listened to Lewis and did a simple blood test he would probably be alive today. The crisis management team would have to work with a very agitated family due to the loss of their eleven year old son. Overall, this whole situation could have been simply avoided. 

Response:

“If nurse decided to listen,” “if this, and if that,” this “IF” is a substantial dilemma that should not be a part of the healthcare profession. Legendary nurses such as Edith Cavell and Florence Nightingale practically demonstrated that how a nurse should be; emphatic, compassionate, and selfless. The underlying objectives of all healthcare professionals should pivot the idea of saving lives, and for that, they need to devise and follow sustaining practices. Any rules and regulations that impede the flow or appropriateness of patients’ treatment should be strictly discouraged and dejected for the well being of humanity. Doctors are there to make things better for the sufferers; they are not supposed to add insult to the injury. Moreover, the nursing staffs mandatorily comprehend the adversaries of every drug or medicine they are permeating into patients. Age and dosage and particular circumstances of the patient are inevitable to be analyzed and justified before prescribing or giving any medications. “If” only, nursing staff would have evaluated the effects of Toradol, Lewis would have escaped from a miserable end; healthcare métier should eliminate this "if" altogether.

References:

Croke, E. (2003). Nurses, Negligence, and Malpractice. AJN, American Journal Of Nursing, 103(9), 54-63. doi: 10.1097/00000446-200309000-00017

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Reply To Real World Negotiation (discussion Board)

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Response 1

Dear Kelly, after reading your post I must say that you possess amazing negotiation skills. Negotiations are generally the discussions that are intended to reach an agreement (Cao & Clark, 2018). Most of the people avoid doing negotiations as they lack confidence. However, in life there are several moments where negotiations are important. I really liked your third negotiation where you requested your boyfriend to get you a kitten. Negotiation is not a way of obtaining a position yet is a way of successfully turn the agreement in one’s favor. In the scenario you mentioned that you agreed upon cleaning the litter box helped me a lot in understanding that negotiation is a give and take process. Although you were in doubt yet still you managed to make your boyfriend accept your request is commendable. To be a successful negotiator we should not only make people understand our perspective yet we should also understand another person’s needs (Thompson & Gunia, 2010).

Response 2

Dear Sugiti, after reading your discussion post I must say that you do possess the ability to negotiate. I think that negotiations are agreements which is a binding arrangement between two parties on a specific issue (Pinkley & Bennett, 1994). In real life, we all have experienced several difficult situations where we had to negotiate. After reading your post I appreciate that unlike many people you tried your best to negotiate rather than avoiding the situation. Although your third negotiation was unsuccessful and you already knew that you will not be able to succeed yet still you tried which is highly admirable. I like the idea that before negotiating you had a backup plan (Brett & Thompson, 2016). This helped me in understanding that we should always have an alternative plan before we start negotiating. This is because if our negotiations fail so that we can handle the situation appropriately.

References

Brett, J., & Thompson, L. (2016). Negotiation. Organizational Behavior and Human Decision Processes, 136, 68-79.

Cao, K., Lazaridou, A., Lanctot, M., Leibo, J. Z., Tuyls, K., & Clark, S. (2018). Emergent communication through negotiation. arXiv preprint arXiv:1804.03980.

Pinkley, R. L., Neale, M. A., & Bennett, R. J. (1994). The impact of alternatives to settlement in dyadic negotiation. Organizational Behavior and Human Decision Processes, 57(1), 97-116

Thompson, L. L., Wang, J., & Gunia, B. C. (2010). Negotiation. Annual review of psychology, 61, 491-515.

Reply To The Red Bead Game Discussion

Reply to the Red Bead Game Discussion

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Reply to the Red Bead Game Discussion

Response 1

Dear Bonnie, after reading your discussion post, must I must say that you did an amazing job in explaining the issue. Specifically, I like how you provided a brief background of the issue being discussed and then commented on the issue. White Bead Production Corporation is a company that aims to produce only white beads without any red beads mixed in. As you discussed some flaws in the hiring system of the company, I also agree with you that both Bart and Carla were extremely rude. The statement they made that anyone can be replaced was not appropriate as this hinders a person's working ability. I also think that no one wants to work in a place where they do not have job security. Despite implementing several techniques to achieve performance efficiency, the employees still failed to perform as expected. I think that this is because working in a high-pressure environment is extremely difficult, and especially without clear instructions employees can complete the task efficiently (Blaug & Lekhi, 2007).

Response 2

Dear Colleen, after reading your discussion post, I think that you did an incredible job in not only explaining the scenario but highlighting the issues that employees were facing as well. I also agree with you that the White Bead Production Corporation was in denial as they believe that their workflow is perfect. Due to this false belief, the Corporation was not ready to take any suggestions to improve the workflow. Although the fault was in a machine yet, the company blamed employees and fired them. I also agree with you that the company must have listened to the workers' side of the story and should incorporate their suggestions while implementing a plan to achieve desired results. After your discussion post, I think that it is necessary to create a collaborative environment in a company so that all the employees can share their concerns with the higher authorities. Also, a company must provide job security to the workers so that they can work without the pressure of losing a job (Semmer, 2003).

References

Blaug, R., Kenyon, A., & Lekhi, R. (2007). Stress at work. The work foundation, London.

Semmer, N. K. (2003). Job stress interventions and organization of work.

Reply To Your Classmates: Carla's Story

Discussion Reply

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Discussion Reply

Response 1

Dear Isabella after reading your post I must say that you did a commendable job in explaining Carla’s story. The increased hospital visits and timeliness are indeed one of the biggest problems that our current healthcare system is facing. I also agree with you that when poor blood flow in Carla’s catheter was discovered she should have been sent to the emergency department for an ultrasound. However, with time, her condition got worse. This shows a lack of assessments from both the nurse and physician side (Kurth & Palincsar, 2002). As Carla was working women she missed several appointments, in this case, her caseworkers should have been proactive yet they failed to do so. I agree with your suggestions and I would also like to add that most of the hospitals do not use a patient-centered approach that can accommodate their needs as well. It is, therefore, necessary to ensure patient safety and comfort first (Epstein & Street, 2011).

Response 2

Dear Jacob after reading your take on Carla’s story I must say that you did an incredible job in highlighting the main points of the story that facilitate the reader a lot. I agree with you that when Carla had obstructed flow she should have been treated earlier. Due to the negligence of both physicians and nurse she had to stay in the hospital for over a week. Also, in our healthcare systems clerks are responsible for scheduling an appointment who has no idea how one missed appointment can lead to severe consequences (Gupta & Denton, 2008). This highlighted one major issue in the healthcare system that needs to be addressed. In your post you mentioned about discharge instruction, I would like to add that most of the patients do not have a medical background so they do not understand what precautions they should take. So hospital staff must instruct patients with simple language rather than using medical jargon to avoid any further issues (Zavala & Shaffer, 2011).

References

Epstein, R. M., & Street, R. L. (2011). The values and value of patient-centered care

Gupta, D., & Denton, B. (2008). Appointment scheduling in health care: Challenges and opportunities. IIE transactions, 40(9), 800-819.

Kurth, L. A., Anderson, C. W., & Palincsar, A. S. (2002). The case of Carla: Dilemmas of helping all students to understand science. Science Education, 86(3), 287-313.

Zavala, S., & Shaffer, C. (2011). Do patients understand discharge instructions?. Journal of Emergency Nursing, 37(2), 138-140.

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The process of fertilization can be described as the fusion of gametes that is eggs and sperms form a zygote. Both egg and sperm contain one set of chromosomes and upon fertilization, the genetic material will be combined to form a zygote that is diploid. Generally, in mammals, the egg is protected by a layer that consists of glycoproteins also known as zona pellucida. A series of biochemical events occur when sperms bind to zona pellucida. These series of events are known as an acrosomal reaction. In placental mammals the acrosome degenerate glycoprotein that protects egg, and allows sperm plasma membrane to fuse with the egg. During a fusion, the sperm plasma and egg plasma membrane are responsible for creating an opening that allows the sperm nucleus to enter the ovum. Then the nucleus membrane of the cell breaks down and two haploid genomes combine to form one dipole genome that leads to the formation of a zygote which will further be divided to form a blastocyst. When blastocysts enter the uterus it implants in the endometrium thus beginning pregnancy (Florman & Ducibella, 2006).    

Spermatogenesis is a process during which the male gamete that is sperm is formed in testis while oogenesis is the process during which a female gamete that is ovum is formed in ovaries. This process occurs in ovaries. Sperm have less food reserve while ovum has more. The sterol cells are present in the sperms, and are absent in the oogenesis process.While talking about similarities between the two processes both the process takes place inside gonads and are completed in three-phase that are multiplicative, growth and maturation phase. Also both the process forms haploid gametes (Short & Balaban, 1994).

Testosterones are the hormones that belong to the class of male hormones however females also have this hormone as well as estrogen. Testerones are the sex hormones responsible to regulate sex drive, muscle mass, bone mass as well as the production of sperms and red blood cells. With the increasing age the level of testosterone drops. The low level of testosterone causes loss of body hair and muscle bulk, reduction in sex drive as well as increased body fat and increased vulnerability to chronic diseases whereas an increase in testosterones leads to early puberty. On the other hand, estrogen is female sex hormones that are responsible for accelerating metabolism, thickening of vaginal walls while increasing the growth of the uterus. It also helps in reducing the bone structure such as it helps in narrowing the shoulder. It helps to increase fat storage around thighs and hips also making voice box smaller. The reduction in the level of estrogen results in mood swings, breast tenderness, and depression ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"kAizNPjt","properties":{"formattedCitation":"(\\uc0\\u8220{}OnlineMedEd,\\uc0\\u8221{} n.d.)","plainCitation":"(“OnlineMedEd,” n.d.)","noteIndex":0},"citationItems":[{"id":41,"uris":["http://zotero.org/users/local/sbFMNDWM/items/8IYKLYT7"],"uri":["http://zotero.org/users/local/sbFMNDWM/items/8IYKLYT7"],"itemData":{"id":41,"type":"webpage","title":"OnlineMedEd","URL":"https://onlinemeded.org/","accessed":{"date-parts":[["2019",8,20]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“OnlineMedEd,” n.d.).

References

Florman, H. M., & Ducibella, T. (2006). Fertilization in mammals. Knobil and Neill’s physiology of reproduction, 3, 55-112.

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY OnlineMedEd. (n.d.). Retrieved August 20, 2019, from https://onlinemeded.org/

Short, R. V., & Balaban, E. (Eds.). (1994). The differences between the sexes. Cambridge University Press.

References

Report Applying System Thinking In Public Health

Applying Systems Thinking in Public health

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Author Note

Applying Systems Thinking in Public health

Executive Summary

The document aims to look into the increased rates of obesity all over the world and in the US and present the correlation of these increased rates to health and socioeconomic differences. It also presents the various other causes behind these increased rates. Additionally, the differences in the prevalence of obesity among different genders, age groups and communities have been discussed. The role of stakeholders and associated challenges have been debated towards the end. It is recommended to make efforts to reduce health and related inequalities, increase stakeholder's involvement, employ systems thinking strategies and model building plans to address the increased rates of obesity in the US.

Introduction

Obesity is a worldwide public health issue with all the countries facing the problem. According to recent figures, the number of obese people has increased from 857 million in 1980 to more than 2.1 billion in 2013 ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"PK6PHPcp","properties":{"formattedCitation":"(Wise, 2014)","plainCitation":"(Wise, 2014)","noteIndex":0},"citationItems":[{"id":117,"uris":["http://zotero.org/users/local/YjWHJPzk/items/IR98V48B"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/IR98V48B"],"itemData":{"id":117,"type":"article-journal","title":"Obesity rates rise substantially worldwide","container-title":"Bmj","page":"g3582","volume":"348","author":[{"family":"Wise","given":"Jacqui"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Wise, 2014). The increase observed in children was around 1.5% higher compared to the rise witnessed among adults ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"e0n3lcCU","properties":{"formattedCitation":"(Wise, 2014)","plainCitation":"(Wise, 2014)","noteIndex":0},"citationItems":[{"id":117,"uris":["http://zotero.org/users/local/YjWHJPzk/items/IR98V48B"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/IR98V48B"],"itemData":{"id":117,"type":"article-journal","title":"Obesity rates rise substantially worldwide","container-title":"Bmj","page":"g3582","volume":"348","author":[{"family":"Wise","given":"Jacqui"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Wise, 2014). According to the Center for Disease Control and Prevention (CDC), from 2015 to 2016, about 39% of the adult population in the US suffered from obesity. It is interesting to note that the distribution patterns are different in different ethnic groups. Non-Hispanic black populations and Hispanics are most affected with a cumulative percentage of 97.8 whereas least affected are non-Hispanic Asians (CDC, 2018). Many different biological and socioeconomic causes of obesity have been suggested by researchers ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"DlqKYOEJ","properties":{"formattedCitation":"(Haidar & Cosman, 2011)","plainCitation":"(Haidar & Cosman, 2011)","noteIndex":0},"citationItems":[{"id":118,"uris":["http://zotero.org/users/local/YjWHJPzk/items/D5G4CKEP"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/D5G4CKEP"],"itemData":{"id":118,"type":"article-journal","title":"Obesity epidemiology","container-title":"Clinics in colon and rectal surgery","page":"205–210","volume":"24","issue":"04","source":"Google Scholar","author":[{"family":"Haidar","given":"Yarah M."},{"family":"Cosman","given":"Bard C."}],"issued":{"date-parts":[["2011"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Haidar & Cosman, 2011). Biological causes include genetic abnormalities, metabolic disorders and digestive diseases. Socioeconomic factors include availability to healthy foods, lifestyle choices, income status, job type and exercise patterns ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"pAZXxboN","properties":{"formattedCitation":"(Haidar & Cosman, 2011)","plainCitation":"(Haidar & Cosman, 2011)","noteIndex":0},"citationItems":[{"id":118,"uris":["http://zotero.org/users/local/YjWHJPzk/items/D5G4CKEP"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/D5G4CKEP"],"itemData":{"id":118,"type":"article-journal","title":"Obesity epidemiology","container-title":"Clinics in colon and rectal surgery","page":"205–210","volume":"24","issue":"04","source":"Google Scholar","author":[{"family":"Haidar","given":"Yarah M."},{"family":"Cosman","given":"Bard C."}],"issued":{"date-parts":[["2011"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Haidar & Cosman, 2011).

The treatment of the disease lies almost entirely on prevention strategies. Prevention is surely better than the treatment especially to prevent childhood obesity ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"PSGmj12S","properties":{"formattedCitation":"(Pandita et al., 2016)","plainCitation":"(Pandita et al., 2016)","noteIndex":0},"citationItems":[{"id":121,"uris":["http://zotero.org/users/local/YjWHJPzk/items/2I85YG83"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/2I85YG83"],"itemData":{"id":121,"type":"article-journal","title":"Childhood obesity: prevention is better than cure","container-title":"Diabetes, metabolic syndrome and obesity: targets and therapy","page":"83","volume":"9","author":[{"family":"Pandita","given":"Aakash"},{"family":"Sharma","given":"Deepak"},{"family":"Pandita","given":"Dharti"},{"family":"Pawar","given":"Smita"},{"family":"Tariq","given":"Mir"},{"family":"Kaul","given":"Avinash"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Pandita et al., 2016). Awareness programs on the need and benefits of adopting healthy life choices and exercise are significantly helpful to reduce these ever-growing obesity rates ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fL3S6dxs","properties":{"formattedCitation":"(Pandita et al., 2016)","plainCitation":"(Pandita et al., 2016)","noteIndex":0},"citationItems":[{"id":121,"uris":["http://zotero.org/users/local/YjWHJPzk/items/2I85YG83"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/2I85YG83"],"itemData":{"id":121,"type":"article-journal","title":"Childhood obesity: prevention is better than cure","container-title":"Diabetes, metabolic syndrome and obesity: targets and therapy","page":"83","volume":"9","author":[{"family":"Pandita","given":"Aakash"},{"family":"Sharma","given":"Deepak"},{"family":"Pandita","given":"Dharti"},{"family":"Pawar","given":"Smita"},{"family":"Tariq","given":"Mir"},{"family":"Kaul","given":"Avinash"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Pandita et al., 2016). To implement childhood obesity prevention strategies, it is important to keep the researchers and stakeholders engaged ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ek6keE3y","properties":{"formattedCitation":"(Williams & Fruhbeck, 2009)","plainCitation":"(Williams & Fruhbeck, 2009)","noteIndex":0},"citationItems":[{"id":122,"uris":["http://zotero.org/users/local/YjWHJPzk/items/HQFGZAX7"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/HQFGZAX7"],"itemData":{"id":122,"type":"book","title":"Obesity: Science to practice","publisher":"John Wiley & Sons","source":"Google Scholar","title-short":"Obesity","author":[{"family":"Williams","given":"Gareth"},{"family":"Fruhbeck","given":"Gema"}],"issued":{"date-parts":[["2009"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Williams & Fruhbeck, 2009).

Body

Obesity is a public health issue of concern in the US as it affects thousands of people on daily basis leading to several other including cardiovascular diseases, blood pressure, heart failure, anxiety and depression ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"PMCjh4s0","properties":{"formattedCitation":"(Hurt, Kulisek, Buchanan, & McClave, 2010)","plainCitation":"(Hurt, Kulisek, Buchanan, & McClave, 2010)","noteIndex":0},"citationItems":[{"id":125,"uris":["http://zotero.org/users/local/YjWHJPzk/items/T2QC5VQF"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/T2QC5VQF"],"itemData":{"id":125,"type":"article-journal","title":"The obesity epidemic: challenges, health initiatives, and implications for gastroenterologists","container-title":"Gastroenterology & hepatology","page":"780","volume":"6","issue":"12","author":[{"family":"Hurt","given":"Ryan T."},{"family":"Kulisek","given":"Christopher"},{"family":"Buchanan","given":"Laura A."},{"family":"McClave","given":"Stephen A."}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hurt, Kulisek, Buchanan, & McClave, 2010). The amount of money spent on obesity and associated mortalities in the US crosses $150 billion. The number of obese including adults and children have been increasing and have reached to a total number of affected adults to 60 percent making it the biggest challenge in healthcare systems ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"r3enUg8W","properties":{"formattedCitation":"(Hurt et al., 2010)","plainCitation":"(Hurt et al., 2010)","noteIndex":0},"citationItems":[{"id":125,"uris":["http://zotero.org/users/local/YjWHJPzk/items/T2QC5VQF"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/T2QC5VQF"],"itemData":{"id":125,"type":"article-journal","title":"The obesity epidemic: challenges, health initiatives, and implications for gastroenterologists","container-title":"Gastroenterology & hepatology","page":"780","volume":"6","issue":"12","author":[{"family":"Hurt","given":"Ryan T."},{"family":"Kulisek","given":"Christopher"},{"family":"Buchanan","given":"Laura A."},{"family":"McClave","given":"Stephen A."}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hurt et al., 2010).

Role of stakeholders

The role of stakeholders is critical in obesity control programs. Many stakeholders have an interest in diet-related interventions in the workplace ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"qdGV0fMG","properties":{"formattedCitation":"(Griffiths, Maggs, & George, 2008)","plainCitation":"(Griffiths, Maggs, & George, 2008)","noteIndex":0},"citationItems":[{"id":126,"uris":["http://zotero.org/users/local/YjWHJPzk/items/GH4UNK5E"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/GH4UNK5E"],"itemData":{"id":126,"type":"article-journal","title":"Stakeholder Involvement’: Background paper prepared for the WHO/WEF joint event on Preventing Noncommunicable Diseases in the Workplace (Dalian/China, September 2007)","container-title":"World Health Organization","author":[{"family":"Griffiths","given":"John"},{"family":"Maggs","given":"Hayley"},{"family":"George","given":"Emma"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Griffiths, Maggs, & George, 2008). Some people and organizations like owners, workers, trades unions and ministries of health and labour are naturally taken as a stakeholder. Other than these, some other stakeholder groups should also be involved. These groups include private sector food producers, organisations in the agricultural industry, and food retailers ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"xPvsKSeD","properties":{"formattedCitation":"(Griffiths et al., 2008)","plainCitation":"(Griffiths et al., 2008)","noteIndex":0},"citationItems":[{"id":126,"uris":["http://zotero.org/users/local/YjWHJPzk/items/GH4UNK5E"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/GH4UNK5E"],"itemData":{"id":126,"type":"article-journal","title":"Stakeholder Involvement’: Background paper prepared for the WHO/WEF joint event on Preventing Noncommunicable Diseases in the Workplace (Dalian/China, September 2007)","container-title":"World Health Organization","author":[{"family":"Griffiths","given":"John"},{"family":"Maggs","given":"Hayley"},{"family":"George","given":"Emma"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Griffiths et al., 2008). The rationale provided for the involvement of stakeholders include personal choice; they do it because they think it is the right thing to do, investment; it a source of valuable interest. Additionally, the other two factors are compulsion and lost the opportunity. Compulsion means they are expected to do it with no choice and lost opportunity refers to getting involved because of competitors. Compulsion generates the lowest quality or minimal output as the organisation or the person is doing it forcefully without personal interest ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"mYXVNkhy","properties":{"formattedCitation":"(Griffiths et al., 2008)","plainCitation":"(Griffiths et al., 2008)","noteIndex":0},"citationItems":[{"id":126,"uris":["http://zotero.org/users/local/YjWHJPzk/items/GH4UNK5E"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/GH4UNK5E"],"itemData":{"id":126,"type":"article-journal","title":"Stakeholder Involvement’: Background paper prepared for the WHO/WEF joint event on Preventing Noncommunicable Diseases in the Workplace (Dalian/China, September 2007)","container-title":"World Health Organization","author":[{"family":"Griffiths","given":"John"},{"family":"Maggs","given":"Hayley"},{"family":"George","given":"Emma"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Griffiths et al., 2008).

Systems thinking approach and challenges

Systems thinking approach is a philosophy and can differ in meaning in different perspectives. It is opposite to traditional analysis approaches which analyse the systems by dividing into separate components ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"JFDyTYst","properties":{"formattedCitation":"(De Savigny & Adam, 2009)","plainCitation":"(De Savigny & Adam, 2009)","noteIndex":0},"citationItems":[{"id":127,"uris":["http://zotero.org/users/local/YjWHJPzk/items/DFJC878E"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/DFJC878E"],"itemData":{"id":127,"type":"book","title":"Systems thinking for health systems strengthening","publisher":"World Health Organization","ISBN":"92-4-156389-3","author":[{"family":"De Savigny","given":"Don"},{"family":"Adam","given":"Taghreed"}],"issued":{"date-parts":[["2009"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (De Savigny & Adam, 2009). The systems thinking approach, in contrast, suggests analysing the connections between different systems and how they interrelate to each other ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"QesoXiV6","properties":{"formattedCitation":"(De Savigny & Adam, 2009)","plainCitation":"(De Savigny & Adam, 2009)","noteIndex":0},"citationItems":[{"id":127,"uris":["http://zotero.org/users/local/YjWHJPzk/items/DFJC878E"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/DFJC878E"],"itemData":{"id":127,"type":"book","title":"Systems thinking for health systems strengthening","publisher":"World Health Organization","ISBN":"92-4-156389-3","author":[{"family":"De Savigny","given":"Don"},{"family":"Adam","given":"Taghreed"}],"issued":{"date-parts":[["2009"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (De Savigny & Adam, 2009). To address the issue of obesity, the systems-thinking approach provides new ways to mutually address this complicated societal issue ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"XOnsligY","properties":{"formattedCitation":"(Finegood, 2012)","plainCitation":"(Finegood, 2012)","noteIndex":0},"citationItems":[{"id":128,"uris":["http://zotero.org/users/local/YjWHJPzk/items/3LPVXWRQ"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/3LPVXWRQ"],"itemData":{"id":128,"type":"chapter","title":"The importance of systems thinking to address obesity","container-title":"Obesity Treatment and Prevention: New Directions","publisher":"Karger Publishers","page":"123-137","volume":"73","author":[{"family":"Finegood","given":"Diane T."}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Finegood, 2012).

The systems thinking approach at multiple levels is helpful to analyse and control obesity. Studying the correlations between different systems working on obesity control brings out several challenges and obstacles. For example, smaller obesity control programs working at a school or organisation level are not connected to national programs working for the same cause. Combining this approach with group model-building strategies will aid the characterization of complex systems ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"nNM9qfiq","properties":{"formattedCitation":"(Brennan, Sabounchi, Kemner, & Hovmand, 2015)","plainCitation":"(Brennan, Sabounchi, Kemner, & Hovmand, 2015)","noteIndex":0},"citationItems":[{"id":129,"uris":["http://zotero.org/users/local/YjWHJPzk/items/ZU3PN6TA"],"uri":["http://zotero.org/users/local/YjWHJPzk/items/ZU3PN6TA"],"itemData":{"id":129,"type":"article-journal","title":"Systems thinking in 49 communities related to healthy eating, active living, and childhood obesity","container-title":"Journal of Public Health Management and Practice","page":"S55-S69","volume":"21","author":[{"family":"Brennan","given":"Laura K."},{"family":"Sabounchi","given":"Nasim S."},{"family":"Kemner","given":"Allison L."},{"family":"Hovmand","given":"Peter"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Brennan, Sabounchi, Kemner, & Hovmand, 2015).

Conclusion

To conclude, it can be said that obesity is one of the biggest challenges in America and other nations. Several factors increase its number and prevalence in different age and ethnic groups. Voluntary and non-voluntary stakeholders play a crucial role in prevention programs. It is the responsibility of policymakers and government organisations working in healthcare to ensure unbiased health facilities to all groups and in all areas. This will help to reduce these higher rates and related mortalities. Additionally, incorporating systems thinking approach with the model-building models will surely accelerate the process of obesity control.

Recommendation

To increase the efforts to minimise health-related and socioeconomic disparities.

To increase the number of stakeholders for obesity control programs.

To increase the engagement among stakeholders incorporating systems thinking approaches.

To employ model building plans with the systems thinking strategies.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Brennan, L. K., Sabounchi, N. S., Kemner, A. L., & Hovmand, P. (2015). Systems thinking in 49 communities related to healthy eating, active living, and childhood obesity. Journal of Public Health Management and Practice, 21, S55–S69.

De Savigny, D., & Adam, T. (2009). Systems thinking for health systems strengthening. World Health Organization.

Finegood, D. T. (2012). The importance of systems thinking to address obesity. In Obesity Treatment and Prevention: New Directions (Vol. 73, pp. 123–137). Karger Publishers.

Griffiths, J., Maggs, H., & George, E. (2008). Stakeholder Involvement’: Background paper prepared for the WHO/WEF joint event on Preventing Noncommunicable Diseases in the Workplace (Dalian/China, September 2007). World Health Organization.

Haidar, Y. M., & Cosman, B. C. (2011). Obesity epidemiology. Clinics in Colon and Rectal Surgery, 24(04), 205–210.

Hurt, R. T., Kulisek, C., Buchanan, L. A., & McClave, S. A. (2010). The obesity epidemic: Challenges, health initiatives, and implications for gastroenterologists. Gastroenterology & Hepatology, 6(12), 780.

Pandita, A., Sharma, D., Pandita, D., Pawar, S., Tariq, M., & Kaul, A. (2016). Childhood obesity: Prevention is better than cure. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 9, 83.

Williams, G., & Fruhbeck, G. (2009). Obesity: Science to practice. John Wiley & Sons.

Wise, J. (2014). Obesity rates rise substantially worldwide. BMJ, 348, g3582.

Researcg Problems

Institutional Affiliation

Student’s name

Course

Date

Research Problem: Causes and Effects of Heart Attack

The research problems in this context are the cause and effects of the heart attack. This is one of the health issues affecting most people, yet its main cause is undefined (Gupta et al, 2018). There are various theories that are used in explaining the cause of heart attack but still, they don’t provide adequate information on this particular health issue. This research is important to health workers since they need to understand the actual cause of heart attack so that they can well educate society on things to avoid so that they may not fall victims. The major question of the research is whether the heart attack affects people due to age factors or merely through the kind of lifestyles people lead.

In searching for the articles appropriate for this health problem, some of the keywords used include coronary diseases, stroke and high blood pressure (Stewart et al, 2016). All these are some of the issues that are closely related to heart attack, and their present have high chances of triggering a heart attack. The type of article found is a secondary source, which highlights various issues related to heart attack. This includes causes, diagnosis, and prevention among other things.

The article basically reviews some of the information that is important in having much understanding of the issue of the heart attack. Various prevention measures are also well highlighted, one of the information that is very helpful to the reader (Yousufuddin et al, 2018). I feel the article is good since it has all aspects related to heart attack. When it comes to the study of causes of heart attack and its effects, there are various things which need to be looked at in order to have a better insight of the same. The article is a secondary source. This is because is found under the medical news, meaning that the information was extracted from another source before being shared.

Article: https://www.medicalnewstoday.com/articles/151444.php

References

Gupta, K., Kaul, P., & Kaur, A. (2018, February). An Efficient Algorithm for Heart Attack Detection using Fuzzy C-means and Alert using IoT. In 2018 4th International Conference on Computational Intelligence & Communication Technology (CICT) (pp. 1-6). IEEE.

Stewart, T. L., Chipperfield, J. G., Perry, R. P., & Hamm, J. M. (2016). Attributing heart attack and stroke to “old age”: Implications for subsequent health outcomes among older adults. Journal of Health Psychology, 21(1), 40-49.

Yousufuddin, M., Young, N., Keenan, L., Olson, T., Jessica Shultz, B. S. N., Taylor Doyle, B. S. N., ... & Murad, M. H. (2018). Five-Year Mortality After Transient Ischemic Attack. Stroke.

Research

Title page

The frequency of hand washing

Social and clinical value

No direct benefits from participants are expected. Risk value assessment is discussed by providing information to the patients. The frequency of hand washing by nurses is linked to the quality of hygiene and minimizing possibilities of microbial infections. Hygiene is a critical element for infection control activities. The social and clinical value will explain the possibilities of developing risks during the process of research CITATION Pur11 \l 1033 (Mathur, 2011). This depicts that the topics have significant value for society because it is linked to the increased quality of hygiene and care.

Scientific validity

Scientific validity is proved by include empirical research and supporting scholarly database. The study assumes that the adoption of adequate hygiene standards such as hand washing before addressing the patient will minimize risks of such infections. Adequate handwashing among nurses can be used as a precautionary measure for reducing the threats of cross-transmission infections CITATION Pur11 \l 1033 (Mathur, 2011). The findings of scholarly articles suggest that in critical care settings the chances for infusion transmission are high.

Fair subject selection

Some patients face high risks of developing infections that indicate the need for providing special attention. Touching the patient’s skins or intimate object in ICU or patient’s room increases risks of infection transmission CITATION Pur11 \l 1033 (Mathur, 2011). The study will use the literary database for examining the relationship between hand washing frequency and disease transmission. Participants' undergoing chronic medical issues will be not be considered.

Risk-benefit ratio

The research ensures adequate risk-benefit ratio and that participant will be withdrawn in case of high-risk circumstances. The serious and adverse events will be identified such as that nurse who don’t wash their hands before or after patient checkup are less likely to transmit microbial or pathogenic infections. Hand washing decontaminates hands before nurse interaction with the patients. This includes hand washing after using the restroom, before direct contact patients, before and after eating food, after direct contact with patients, before donning gloves when a nurse needs to insert an intravascular catheter and after having direct contact with body fluids. These are adequate measures that will eliminate the risks of disease or infection transmission CITATION Pur11 \l 1033 (Mathur, 2011). High pathogen count is associated with patients contact with contaminated hands.

Institutional review

The procedures will be explained to the Institutional Review Boards (IRB). It will ensure the well-being of the participants. It will also safeguard the rights and safety of the participants in research settings. Qualifications of the researcher will be considered. The agents used in research will be explained such as alcohols, non-medicates or antiseptics soaps, sanitizers and Chlorhexidine are effective agents for removing contamination.

Informed consent

The participants will be informed about the purpose of the research. They will be explained the hygiene conditions such as alcohol-based hand rub are effective for removing contamination or germs. The participants will be allowed to choose from free will. They will not be influenced to become part of the research CITATION Eze00 \l 1033 (Emanuel, Wendler, & Grady, 2000). The participants must agree that they weren't to be part of the research.

Respect for potential and enrolled subjects

The research will ensure that the participants will be treated with respect. Their privacy will be respected and no personal information will be leaked. They will also be allowed to change their decision until the research begins CITATION Eze00 \l 1033 (Emanuel, Wendler, & Grady, 2000). This principle also suggests monitoring the welfare of the participants involved in research. It also requires that the researcher must ensure that the participants will be provided with adequate treatments if they develop infections. They will also be informed about the knowledge on the subject.

References

BIBLIOGRAPHY Emanuel, E. J., Wendler, D., & Grady, C. (2000). What Makes Clinical Research Ethical? (link is external. Journal of the American Medical Association, 283 (24), 2701-27.

Mathur, P. (2011). Hand hygiene: Back to the basics of infection control. Indian J Med Res, 13 (5), 611–620.

RESEARCH

Analyze the frequency of Handwashing by Nurses in a Hospital.

Name

Affiliation

Date

Research Topic

The research topic is to analyze the frequency of Handwashing by Nurses in a Hospital.

Background

Hospital infection remains a serious public health problem throughout the world. Among its main measures of prevention and control is hand washing, which is an important instrument for reducing its rates. A study showed that the transfer of gram-negative bacilli to the patient through the hands of nurses was 17% with an alcohol-based manual rinse versus 92% when hand hygiene was performed with soap and water. This indicates that when the hands of sanitary personnel are heavily contaminated.

Problem Statement

Each patient in Hospital is open to some microbial agents throughout their hospitalization. The interaction amongst the nurses and patient, in itself, doesn’t essentially produce clinical illness, since there are other issues that affect the frequency and nature of nosocomial infections, but can lead to various diseases and allow the dissemination of these pathogens with epidemiological relevance in health centers. Infection by any of these microorganisms can be transmitted by an inert object or by dirty substances from another human. The use of a maximum level of hygiene in all care work is essential to reduce both the cross-transmission of any infectious agent. Therefore, this descriptive study of a quantitative nature has an approach aimed at analyzing the frequency of hand washing by nurses in 'The Mount Sinai Hospital', located in the city of New York, USA. After approval from the Hospital, the study will be started using a questionnaire as a tool for data collection with open and closed questions about the practice of washing hands.

Research Question

To measure the frequency of hand washing by nurses in 'The Mount Sinai Hospital' of New York.

References

Mathur, P. (2011). Hand hygiene: Back to the basics of infection control. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249958/

Randle, J., & Vaughan, N. (2010). P09.06 A longitudinal study of hospital hand hygiene adherence. Journal Of Hospital Infection, 76, S29. doi: 10.1016/s0195-6701(10)60096-5

Research

Paper Title

Name

Institution

Research

Abstract:

Obesity is one of the serious problems that is faced by almost everyone nowadays due to unhealthy eating habits and less physical activities, but there are also some genetic reasons that accompany this disease. Previously doctors and nurses used to rely on exercise and monitoring of sugar intake to control the problem, but it was seen that the problem was not solved and also it affects other body systems therefore now surgeries are being used to control this. So in this study, the types of surgeries and the effect of obesity on body systems are examined.

Introduction:

Gastric sleeve, gastric band, and gastrointestinal bypass are the commonly used procedures to reduce body weight. Gastric sleeve is also called vertical sleeve gastrectomy which is a good option for all those patients who are too sick to undergo treatments like bariatric procedures. In case of the gastric sleeve, the side part of the stomach is removed while a smaller tub is left for food storage. In this, the hormone-like gherlin is also removed which is responsible for hunger stimulation. Once the surgery is done the patients feel full after eating one or three ounces of food and in this way their body weight is controlled. While in case of the gastric band a silicone band is placed around the upper part of the stomach to decrease stomach size thus reducing the food intake. Gastrointestinal surgery is another procedure for weight loss where the size of the stomach is shrunk so that the patient cannot eat as much as he used to before. Part of the digestive system is also re-routed so that food is not absorbed in enough amounts (Mosinski & Kirwan, 2016). Although all these methods are in practice due to the prevailing obesity and the risk factors that are there with the disease. Exercises and other physical activity along with food intake monitoring are some of the common practices that are used by the healthcare providers but they are not enough to cure the disease therefore doctors are now suggesting to their patients to undergo these surgeries because not only they are the fastest methods to reduce weight but also limited health risks are involved in all these surgeries, therefore, doctors across the US are now using these methods to cure obesity so I will also help my patients to get rid of the extra weight with the help of these surgeries (Park & Torquati, 2011).

Digestion is a process where the food is broken down by chewing and churning and also by some of the chemical processes like the digestive system of the stomach and intestine. When the food is digested, then the body feels hungry and wants to get more food. Once the food particles are converted into smaller particles, then they are absorbed by the epithelial cells of the intestinal villi. Among all the food groups carbohydrates are the most commonly consumed ones they are consumed in the form of polysaccharides and disaccharides; therefore, they are required to broken down in monosaccharide for their utilization by the body. The digestion process starts from the mouth where with the help of saliva they are hydrolyzed. As the food does not stay long in the mouth; therefore, most of the starch is not hydrolyzed here. The salivary starches are denatured once the bolus reaches the stomach which results in the digestion of the food in the small intestine when the pancreatic amylase hydrolyzes the starch into maltose and dextrin. After the digestion, the monosaccharide are transported via the small intestine into the liver. In the liver, the monosaccharide is converted to various metabolites. Some of the glucose is transported to the blood where it is absorbed and then reaches to the entire body. Once the person has surgery then the digestion rate is slower so that the person feels full all the time because of the food that is still present in the stomach and also the absorption process is slower so that fewer carbohydrates are supplied to the body and the individual do not get the right amount, and the weight is controlled in this way (Cdn.ymaws.com, 2019).

The respiratory system is one of the most important systems in homeostasis and the reason is due to the gas exchange of gases. The gas exchange occurs in the alveoli of the lungs. When the blood passes through the capillaries in the alveolar sacs, change the pressure gradient which ultimately allows carbon dioxide and oxygen to diffuse in and out of the blood. When the body gains weight, then the individual suffers from multiple issues including respiratory issues. Obesity causes the diaghphrm, lungs and chest cavity to compress mechanically which further leads to damage of pulmonary ventilation. The pulmonary ventilation is also responsible for the breathing process or the exchange of gases between outside gases and the alveoli of lungs. Ventilation is a mechanical process that depends on the differences between the pressure in the alveoli and the atmospheric air. It is important to have proper lungs expansion and have full capacity because only then the homeostasis will be maintained due to obesity this particular function is disturbed because of the fat accumulation in the veins due to which the lungs are not able to expand properly, and certain problems occur (Mayaan et al., 1992).

Conclusion:

Weight gain and obesity are one of the rising concerns in healthcare due to the issues that are followed by the problem. Although the healthcare providers are using multiple strategies like food intake monitoring and physical activities to control body weight even then, this is not controlled. Sue to these reasons some of the doctors prefer to do surgeries on the patients who are obese and are in severe problems. Although there are serious concerns related to these surgeries, these are the only effective and easy way to reduce body weight.

References

Cdn.ymaws.com. (2019). [online] Available at: https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/Competencies/CompilationPopFocusComps2013.pdf

Maayan, C. H. A. N. N. A., Carley, D. W., Axelrod, F. B., Grimes, J. A. N. E. T., & Shannon, D. C. (1992). Respiratory system stability and abnormal carbon dioxide homeostasis. Journal of Applied Physiology, 72(3), 1186-1193.

Mosinski, J. D., & Kirwan, J. P. (2016). Longer-term physiological and metabolic effects of gastric bypass surgery. Current diabetes reports, 16(6), 50.

Park, C. W., & Torquati, A. (2011). Physiology of weight loss surgery. The Surgical Clinics of North America, 91(6), 1149.

Research

Modifying the Billing System and Implementing new ICD

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Modifying the Billing System and implementing New ICD Codes

Project management is the driving force behind any venture, though, it is often unheeded in the creative processes. Effective project management is the key to complete a project with high efficiency and delivering the results that can surpass the expectations. Contrary wise, poor implementation of project management techniques can kill a project to its entirety. Every organization want to excel in their niche and want to obtain benefit from the tools and techniques in best practices. In the same way, organizations also use the tools of project management to accomplish their projects with full potential ad take benefit from improved outcomes and lower costs. Due to the consideration of patient’s well-being in every project, project management in this industry more complex, however, it is worth the effort if done right ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"O8at5nQv","properties":{"formattedCitation":"(Guptill, 2005)","plainCitation":"(Guptill, 2005)","noteIndex":0},"citationItems":[{"id":1046,"uris":["http://zotero.org/users/local/orkqtrjP/items/PF7FQKPM"],"uri":["http://zotero.org/users/local/orkqtrjP/items/PF7FQKPM"],"itemData":{"id":1046,"type":"article-journal","title":"Knowledge management in health care","container-title":"Journal of health care finance","page":"10-14","volume":"31","issue":"3","author":[{"family":"Guptill","given":"Janet"}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Guptill, 2005). This report is based on the project of modifying the billing system of a healthcare facility to encounter updated International Classification of Diseases (ICD) code sets.

Project Introduction

The term ICD is a medical classification list managed by the World Health Organization (WHO). For the US, it is managed by the Center of Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS). ICD 10 codes are basically codes for identification of diseases, signs and symptoms and other health conditions ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"GKYVQRlC","properties":{"formattedCitation":"(\\uc0\\u8220{}ICD - ICD-10-CM - International Classification of Diseases, Tenth Revision, Clinical Modification,\\uc0\\u8221{} 2019)","plainCitation":"(“ICD - ICD-10-CM - International Classification of Diseases, Tenth Revision, Clinical Modification,” 2019)","noteIndex":0},"citationItems":[{"id":1049,"uris":["http://zotero.org/users/local/orkqtrjP/items/DNNACI23"],"uri":["http://zotero.org/users/local/orkqtrjP/items/DNNACI23"],"itemData":{"id":1049,"type":"webpage","title":"ICD - ICD-10-CM - International Classification of Diseases, Tenth Revision, Clinical Modification","URL":"https://www.cdc.gov/nchs/icd/icd10cm.htm","language":"en-us","issued":{"date-parts":[["2019",8,5]]},"accessed":{"date-parts":[["2019",9,17]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“ICD - ICD-10-CM - International Classification of Diseases, Tenth Revision, Clinical Modification,” 2019). ICD-10 is the tenth revision to such code list. The work on the tenth version started in 1983 and was first used by the member states of the US in the year 1994. ICD-10 code set comprises of over 70,000 procedural coding system (PCS) codes and 69000 clinical modification (CM) codes used for tracking of many new diagnoses compared to its older ICD-9 version which contained roughly 14000 diagnosis codes. ICD-10-CM was developed by the NCHS after an extensive discussion with the key players such as physician groups, clinical coders, etc. ICD-9 had several limitations that prevented precise coding and billing of many treatments and health conditions.

Implementation of new ICD-10-CM involves the modification of the billing system of a practice that has about 25 doctors and an independent system to verify the patients and support billing system. The project involves the comprehension of physicians of the impacts of ICD-10 on almost all the clinical and management systems. The implementation of the new system needs the employment of project management tools and techniques. In order to attain a smooth application of new ICD codes, a variety of plans in accordance with the needs of an organization are required. The project can be divided into different phases such as planning, communicating the need, assessment, need of operational implementation and transition to the new system of codes.

Phases of the project

The first phase of this project would be panning the transition. In this primary phase, project management structure would be developed. All the plans including the plan to communicate with the key stakeholders, risk management plan will be established. The second phase will be related to the communication and awareness of the transition to the new coding system. For this purpose, a communication plan will be created, and the training needs of employees will be assessed. A training plan will be devised based on the needs assessment. A meeting will be conducted with the staff members with regard to the impacts of ICD-10 and roles and responsibilities will be identified. At the next stage, business and policy impacts will be assessed alongside technological impacts. Vendors’ capabilities are also evaluated with regard to the transition to the new coding system.

After the completion of the assessment phase, the next step is the actual operational implementation. For this purpose, the first step would be to recognize system migration strategies. After that, the technical modifications needed would be implemented and training will be arranged and provided accordingly. The next step after this would be to test the system implemented, testing could be at the two levels, level 1 and level 2 training. The first level testing indicates internal compliance testing while level 2 testing indicates external testing. The final transition step will involve evaluating the impact of the new coding system on revenue and business operations. Any corrective action is taken if required.

Key participants

The key participants of a project are all those entities that have a direct or indirect impact on the success and failure of a project ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"EwMhnQpR","properties":{"formattedCitation":"(Smith, 2000)","plainCitation":"(Smith, 2000)","noteIndex":0},"citationItems":[{"id":1051,"uris":["http://zotero.org/users/local/orkqtrjP/items/YEF8C9DM"],"uri":["http://zotero.org/users/local/orkqtrjP/items/YEF8C9DM"],"itemData":{"id":1051,"type":"paper-conference","title":"Stakeholder analysis: a pivotal practice of successful projects","container-title":"Proceedings of the Project Management Institute Annual Seminars & Symposium, Houston, Texas, USA","author":[{"family":"Smith","given":"L. M."}],"issued":{"date-parts":[["2000"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Smith, 2000). This project of billing system modification or implementation of new ICD-10-CM is also dependent on many players and partners. The internal and external stakeholders, in this case, would be the contact vendors, linked medical facilities, physicians and other claims and electronic billing services. Other stakeholders include senior management, clinical department managers, medical staff, and IT personnel. The involvement and commitment of all these stakeholders are pivotal for the successful transition from ICD-9 to ICD-10. The planning phase of the project must ensure that the involvement of the key participants of the project. Organization-wide awareness related to ICD-10 is necessary for all stakeholders to enhance the effectiveness of the project.

Key Outcomes and Benefits of the Project

There are numerous advantages of implementation of ICD-10 to the healthcare fraternity, like – improving clinical, improving financial aspects, and improving administrative performance and much more ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"kGhZNC9s","properties":{"formattedCitation":"(Libicki & Brahmakulam, 2004)","plainCitation":"(Libicki & Brahmakulam, 2004)","noteIndex":0},"citationItems":[{"id":1044,"uris":["http://zotero.org/users/local/orkqtrjP/items/R8DFNKI3"],"uri":["http://zotero.org/users/local/orkqtrjP/items/R8DFNKI3"],"itemData":{"id":1044,"type":"book","title":"The costs and benefits of moving to the ICD-10 code sets","publisher":"RAND Corporation","ISBN":"0-8330-3585-1","author":[{"family":"Libicki","given":"Martin C."},{"family":"Brahmakulam","given":"Irene T."}],"issued":{"date-parts":[["2004"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Libicki & Brahmakulam, 2004). The implementation of ICD-10 is associated with a large number of benefits and it aims to eliminate the limitations. The ICD-9-CM is said to put a restriction the reporting, operations, and analytics procedures and it also used an outdated coding system. The codes also lack the specificity to support claim reimbursement, accurate anatomical descriptions, risk and severity differentiation, and value-based purchasing methodologies. In addition, the codes also fail to provide important details to streamline the automated claim processing that results in the delays in claim-payments. The key benefit of this project will be the elimination of all these limitations of the previous coding system ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VfxJ6KAL","properties":{"formattedCitation":"(Bowman, 2008)","plainCitation":"(Bowman, 2008)","noteIndex":0},"citationItems":[{"id":1045,"uris":["http://zotero.org/users/local/orkqtrjP/items/ZMLQFHVD"],"uri":["http://zotero.org/users/local/orkqtrjP/items/ZMLQFHVD"],"itemData":{"id":1045,"type":"article-journal","title":"Why ICD-10 is worth the trouble","container-title":"Journal of AHIMA","page":"24-29","volume":"79","issue":"3","author":[{"family":"Bowman","given":"Sue E."}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Bowman, 2008).

Furthermore, the new system is more detailed and it enhances the current medical practice. The new details in the plan inform the physicians about the patient history and health plan, which eventually improves the case management functions. Accurate coding, linked with the new system decreases the volume and number of claims that get rejected owing to the confusions ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"OCBWqU3M","properties":{"formattedCitation":"(Topaz, Shafran-Topaz, & Bowles, 2013)","plainCitation":"(Topaz, Shafran-Topaz, & Bowles, 2013)","noteIndex":0},"citationItems":[{"id":1047,"uris":["http://zotero.org/users/local/orkqtrjP/items/NGGQL66Z"],"uri":["http://zotero.org/users/local/orkqtrjP/items/NGGQL66Z"],"itemData":{"id":1047,"type":"article-journal","title":"ICD-9 to ICD-10: evolution, revolution, and current debates in the United States","container-title":"Perspectives in Health Information Management/AHIMA, American Health Information Management Association","volume":"10","issue":"Spring","author":[{"family":"Topaz","given":"Maxim"},{"family":"Shafran-Topaz","given":"Leah"},{"family":"Bowles","given":"Kathryn H."}],"issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Topaz, Shafran-Topaz, & Bowles, 2013). The implementation of updated codes with enhance the operational procedures for the reason that it will classify the details within codes to process compensation and payments precisely. It also keeps up with the medical and technological advances by updating disease classifications and terminology. The flexibility for future updates is also increased. Coding precision and specificity are improved to categorize severity, anatomic site, and etiology. In addition to this, it also supports the advanced reimbursement models that result in the delivery of justifiable payments for critical conditions.

Besides, the new coding system also streamline payment operations resulting in automation aims at reducing payment delays and denials and payer-physician queries. The detailed data from these codes help in better understanding of disease patterns that is imperative in order to react to public health outbreaks ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"RGvyYQok","properties":{"formattedCitation":"(Libicki & Brahmakulam, 2004)","plainCitation":"(Libicki & Brahmakulam, 2004)","noteIndex":0},"citationItems":[{"id":1044,"uris":["http://zotero.org/users/local/orkqtrjP/items/R8DFNKI3"],"uri":["http://zotero.org/users/local/orkqtrjP/items/R8DFNKI3"],"itemData":{"id":1044,"type":"book","title":"The costs and benefits of moving to the ICD-10 code sets","publisher":"RAND Corporation","ISBN":"0-8330-3585-1","author":[{"family":"Libicki","given":"Martin C."},{"family":"Brahmakulam","given":"Irene T."}],"issued":{"date-parts":[["2004"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Libicki & Brahmakulam, 2004). Implementing and developing fresh pricing and reimbursement structures is made easy with the new coding system owing to the higher specificity. Not only this, but the benefit of integration to this new system will also help the oversight agencies, program integrity contractors and payers to detect any fraud or abuse.

Resources Required

The resources needed for the project will comprise of financial resources, technical resources and vendors’ resources ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VwVmzDCP","properties":{"formattedCitation":"(Bowman & Zeisset, 2012)","plainCitation":"(Bowman & Zeisset, 2012)","noteIndex":0},"citationItems":[{"id":1053,"uris":["http://zotero.org/users/local/orkqtrjP/items/ZPRTEYYL"],"uri":["http://zotero.org/users/local/orkqtrjP/items/ZPRTEYYL"],"itemData":{"id":1053,"type":"article-journal","title":"ICD-10-CM/PCS transition: Planning and preparation checklist","container-title":"ICD-10-CM/PCS Transition: Planning and Preparation Checklist/AHIMA, American Health Information Management Association","author":[{"family":"Bowman","given":"Sue E."},{"family":"Zeisset","given":"Ann M."}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Bowman & Zeisset, 2012). The technical resources required consists of Billing Software and Back-Up Server. Billing software is the simplest way to send and track invoices that help businesses easily manage their sales and purchasing records. The software can track the hours worked by employees, as well as the expenses associated with projects or clients. An invoice is a list of items and services that contain the costs you owe to your business. Basically, an invoice is a bill that can have all shapes and sizes, can be written by hand on a piece of paper, put together in a word processor or created with specialized software.

In today's time, all organizations want to automate their systems and processes, which helps them to reduce errors, same goes with a healthcare organization ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ibb1XEwh","properties":{"formattedCitation":"(Poulymenopoulou, Malamateniou, & Vassilacopoulos, 2012)","plainCitation":"(Poulymenopoulou, Malamateniou, & Vassilacopoulos, 2012)","noteIndex":0},"citationItems":[{"id":1054,"uris":["http://zotero.org/users/local/orkqtrjP/items/XEL6U6NM"],"uri":["http://zotero.org/users/local/orkqtrjP/items/XEL6U6NM"],"itemData":{"id":1054,"type":"article-journal","title":"Emergency healthcare process automation using mobile computing and cloud services","container-title":"Journal of medical systems","page":"3233-3241","volume":"36","issue":"5","author":[{"family":"Poulymenopoulou","given":"M."},{"family":"Malamateniou","given":"Flora"},{"family":"Vassilacopoulos","given":"George"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Poulymenopoulou, Malamateniou, & Vassilacopoulos, 2012). Online billing software can automate various processes for companies because it has the ability to synchronize and import/export data from other software and applications, you will no longer have to worry about manually entering information related to invoices. All the data is stored on the server close to the network. Then this data gets stored to the nearest server in the datacenters. The data is stored in one server, but the backup of that server is made to another server. It is made so that if the main stored server goes down then there must be another server that can provide the reply to the requests provided by the users. In this scenario, we cannot make out the number of backup servers provided in one data center or any other data centers.

Backups are essential to take one to the point where data was originally created. These are helpful if something wrong happens with the system and data is vulnerable. Backup helps to restore that data in such cases. They not only save time but also monetary resources and plays an imperative role when transition is made from one system to other. Off-site backups are made in some location other than that of original location of data. These are very helpful in case of any disaster and mishap.

Timeline for implementation

The project phases are the steps needed to complete the project. Timeline indicates time needed to complete each task or phase.

Possible risks associated with the project

Implementation of new and updated ICD-10 is linked with many risks. One of these risks is the failure of internal and external parties to remain on the schedule. The implementation of this new coding system requires coordination with the partners, vendors and other stakeholders. Failure to coordinate effectively result in the delay of project completion. Some other risks that can lengthen the process include lack of payer readiness, inadequate or untimely staff training, loss of key staff, and loss of key vendors and limitations of the budget. In addition, the transition from the previous system to the new system can also affect the revenue stream of the practice system ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"IJkvfcDL","properties":{"formattedCitation":"(Sanders et al., 2012)","plainCitation":"(Sanders et al., 2012)","noteIndex":0},"citationItems":[{"id":1048,"uris":["http://zotero.org/users/local/orkqtrjP/items/IRVAEHGZ"],"uri":["http://zotero.org/users/local/orkqtrjP/items/IRVAEHGZ"],"itemData":{"id":1048,"type":"article-journal","title":"The road to ICD-10-CM/PCS implementation: forecasting the transition for providers, payers, and other healthcare organizations","container-title":"Perspectives in health information management/AHIMA, American Health Information Management Association","volume":"9","issue":"Winter","author":[{"family":"Sanders","given":"Tekla B."},{"family":"Bowens","given":"Felicia M."},{"family":"Pierce","given":"William"},{"family":"Stasher-Booker","given":"Bridgette"},{"family":"Thompson","given":"Erica Q."},{"family":"Jones","given":"Warren A."}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Sanders et al., 2012). The revenue stream is impacted by the following risks, such as lack of payer's readiness, increased payer's analysis, and increased payer's request for medical records.

Another major risk is vulnerability to allegations of fraud and abuse. Government contractors and private payers also seek opportunities for fraud and abuse. Audit scrutiny will also increase with regard to the coding practices and recovery actions will be increased ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"YM4gz70u","properties":{"formattedCitation":"(Jackson & Muckerman, 2012)","plainCitation":"(Jackson & Muckerman, 2012)","noteIndex":0},"citationItems":[{"id":1052,"uris":["http://zotero.org/users/local/orkqtrjP/items/HBV47FP5"],"uri":["http://zotero.org/users/local/orkqtrjP/items/HBV47FP5"],"itemData":{"id":1052,"type":"article-journal","title":"Navigating regulatory change: preliminary lessons learned during the healthcare provider transition to ICD-10-CM/PCS","container-title":"Perspectives in Health Information Management/AHIMA, American Health Information Management Association","volume":"9","issue":"Winter","author":[{"family":"Jackson","given":"Veronica E."},{"family":"Muckerman","given":"Alexander"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Jackson & Muckerman, 2012). Coding discrepancies may result in the formal investigations, administrative sanctions, and other punishments. There is also a probability of disruptions in relationships with patients and payers. During and right after the transition to the new systems, employees have to respond back to the payers concerned about payment delays and denials. A high burden of work is expected and in case of poor response to them, the relationships get disrupted. The implementation of the new coding system will have a direct impact on care, case and disease management. Employees will have to familiarize themselves with the ICD-10-related payer needs. Another risk that associated with the implementation of the new coding system is that these more detailed codes offer payers an opportunity to apply novel pricing and reimbursement frameworks.

Project Completion

Considering the benefits and necessity of implementation of ICD-10, every healthcare organization is required to update their billing systems. From sensing healthcare fraud and abuse to processing claims for reimbursement ICD-10 offers countless benefits. After the completion of the project, leadership involved in the implementation must be made aware of its impacts across the industry. Continuous improvement and training efforts must be continued. Daily activities must be monitored after the implementation of the new coding system and vendor support must be obtained to maintain the effectiveness of billing operations.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Bowman, S. E. (2008). Why ICD-10 is worth the trouble. Journal of AHIMA, 79(3), 24–29.

Bowman, S. E., & Zeisset, A. M. (2012). ICD-10-CM/PCS transition: Planning and preparation checklist. ICD-10-CM/PCS Transition: Planning and Preparation Checklist/AHIMA, American Health Information Management Association.

Guptill, J. (2005). Knowledge management in health care. Journal of Health Care Finance, 31(3), 10–14.

ICD - ICD-10-CM - International Classification of Diseases, Tenth Revision, Clinical Modification. (2019, August 5). Retrieved September 17, 2019, from https://www.cdc.gov/nchs/icd/icd10cm.htm

Jackson, V. E., & Muckerman, A. (2012). Navigating regulatory change: Preliminary lessons learned during the healthcare provider transition to ICD-10-CM/PCS. Perspectives in Health Information Management/AHIMA, American Health Information Management Association, 9(Winter).

Libicki, M. C., & Brahmakulam, I. T. (2004). The costs and benefits of moving to the ICD-10 code sets. RAND Corporation.

Poulymenopoulou, M., Malamateniou, F., & Vassilacopoulos, G. (2012). Emergency healthcare process automation using mobile computing and cloud services. Journal of Medical Systems, 36(5), 3233–3241.

Sanders, T. B., Bowens, F. M., Pierce, W., Stasher-Booker, B., Thompson, E. Q., & Jones, W. A. (2012). The road to ICD-10-CM/PCS implementation: Forecasting the transition for providers, payers, and other healthcare organizations. Perspectives in Health Information Management/AHIMA, American Health Information Management Association, 9(Winter).

Smith, L. M. (2000). Stakeholder analysis: A pivotal practice of successful projects. Proceedings of the Project Management Institute Annual Seminars & Symposium, Houston, Texas, USA.

Topaz, M., Shafran-Topaz, L., & Bowles, K. H. (2013). ICD-9 to ICD-10: Evolution, revolution, and current debates in the United States. Perspectives in Health Information Management/AHIMA, American Health Information Management Association, 10(Spring).

Research And Apply Evidence To Practice

Evidence-based practice of Medicine Safety Administration

[Authors Name]

Evidence-based practice of Medicine Safety Administration

Research Topic: Evidence-based practice of Medicine Safety Administration

Reason for choosing this topic

Administration of medicine to patients is a major responsibility of nurses therefore, nurses should possess required skills, knowledge and competency to administer medicines to patients. I choose this topic because nurses are usually involved in dispensing, preparation and administration of medicine. By implementing evidence-based practice in the administration of medicine death associated with medicine error, medicine related complications and health cost can be reduced. This, in turn, will lead to improving patient outcome. Wrong administration of medicine can lead to serious consequences, such as serious harm, lengthy stay at a hospital, or even death. Medicine error usually occurs due to the wrong administration of medicines (wrong dose, wrong time and wrong administration).

How it will support my practice

The method I have chosen to collect information regarding safe medication administration by nurses is by conducting a literature review to gather relevant information on my topic. This topic will help me to learn and implement effective strategies on the safe administration of medicine in my practice. Secondly, knowledge about barriers in the safe administration of medicine will help me to overcome them in my practice. Thirdly this topic will help me to know about the reason for not reporting errors that are associated with the administration of medicine and will also help me to report error during my practice. This in turn lead to the identification of recurring problems associated with medicines.

Objectives

To identify the effective strategies that can be used to prevent error associated with the administration of medicines

To determine the different infection control practices in medicine administration

To determine the factors associated with the errors in medicine administration.

To identify the reason for poor reporting of medicine administration error by nurses

Article 1:

Source

ADDIN EN.CITE <EndNote><Cite><Author>ABA</Author><Year>2007</Year><RecNum>66</RecNum><DisplayText>(ABA, 2007)</DisplayText><record><rec-number>66</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1567664691">66</key></foreign-keys><ref-type name="Generic">13</ref-type><contributors><authors><author>ABA, An Bord Altranais</author></authors></contributors><titles><title>Guidance to nurses and midwives on medication management</title></titles><dates><year>2007</year></dates><publisher>An Bord Altranais (ABA)</publisher><urls></urls></record></Cite></EndNote>(ABA, 2007)

Relevance to objective 1 and 2

Nurses play an important role in preparing, administration monitoring and evaluating the response to medicines. They also have a responsibility to educate patients about medicines. This article is relevant to my topic as it provided a proper guideline which is necessary for safe medication administration. This article clearly defined the nurse's role in the administration of medicine that is needed to obtain safe patient outcomes. This article also recognizes the value of the competencies of nurses in avoiding medicine error and in safe medication administration.

The strategies which are given in this article include the practice of safe administration of medicines. For the safe medication administration, nurses should possess appropriate knowledge on medication safety as well the appropriate practices to avoid medication errors. Nurses should assess suitability of medicine based on the health status of the patient. They should have information about the medicine dose, side effect, route and adverse effect. They should know how to do accurate dose calculation and prepare medicine correctly. In this article double-checking is evidenced as a method to recognize actual errors and to prevent serious error in the administration of medicines such as route medication error and intravenous preparation instead of oral. This strategy will help the nurses to identify any error on time before administering to the patients. Before administering medicine to patient nurses should consult physicians about any kind of patients’ allergies and should also check the prescription details (timing, dose, frequency, strength and route). Nurses should also check the prescription for its clarity, patient identity and authorized signatures. If possible, medication chart can be used to avoid any kind of error in the administration of medicine.

Control and prevention of infection transmission are very important in the administration of medicines. To ensure the safety of the patient infection control practices should be implemented such as hand hygiene which can be maintained by washing hand before and after patient contact, proper handling of sharps and waste, use of aseptic methods during the formulation and administration of IV medication, safe injection practice like e single-use syringes, infusion supplies and needles.

How this information is useful

This information is useful in many ways such as by knowing different strategies in the safe administration of medicines health care cost associated with the error in medicine administration will reduce. Implementation of different strategies will help in the prevention of serious errors in medicine which in turn will improve the safety of patients. By implementing these strategies infection transmission will be prevented.

Implementation safe medicine administration strategies in my practice

As humans we all make errors. There are many types of medication administration errors and different strategies to avoid them. However, I believe that it is possible to prevent their occurrence by proper monitoring, identification and reporting. By keeping in my mind that I have a great responsibility to dispense and administer medicines. I will follow each guideline regarding the safe administration of medications. First, I will adhere to all the right of medicine (right dose, right time, right route, right patient, and right documentation) to avoid any type of error in administering of medicines. I will always update my knowledge regarding medicine side effects, dose and interaction. I will check all prescription orders for their clarity and appropriateness before administering to the patient. Before prescribing medicines to patients, I will review prescription and confirm the patient name, time of the dose and route of administration. I will always ask my patients regarding any allergies they have. I will respond to telephone and verbal prescription order only if circumstances allow me. I will always educate my patients about taking medicines. Before administering medicines to patients, I will verify the medicine order, name of the patient, name of medicine, pharmacy labels, medicine dosage and strength and route of administration. While preparing medicine I will always try to be vigilant by avoiding distractions. I will collaborate with pharmacists to ensure that all medicines are stored at their place.

Article #2

Source

ADDIN EN.CITE <EndNote><Cite><Author>Hammoudi</Author><Year>2018</Year><RecNum>67</RecNum><DisplayText>(Hammoudi, Ismaile, &amp; Abu Yahya, 2018)</DisplayText><record><rec-number>67</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1567665789">67</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hammoudi, Baraa M</author><author>Ismaile, Samantha</author><author>Abu Yahya, Omar</author></authors></contributors><titles><title>Factors associated with medication administration errors and why nurses fail to report them</title><secondary-title>Scandinavian journal of caring sciences</secondary-title></titles><periodical><full-title>Scandinavian journal of caring sciences</full-title></periodical><pages>1038-1046</pages><volume>32</volume><number>3</number><dates><year>2018</year></dates><isbn>0283-9318</isbn><urls></urls></record></Cite></EndNote>(Hammoudi, Ismaile, & Abu Yahya, 2018)

Relevance to objective 3

The most common threat to a patient's safety is poor medication administration errors. It is a responsibility of the nurses to provide the best quality care and patient safety. There are different barriers which prevent the nurses to adhere to the guidelines of drug administration such as failure to implement evidence-based practice, poor support, lack of communication among different team members and a working environment that is not supportive. Other than this poor knowledge about the patient allergies, difficulty in reading prescription order, confusion in medicines which have similar names.

How this information is useful

This information is useful in several ways by knowing the different factors that are associated with errors in the administration of medicines, strategies can be formulated which will remove all these barriers.

How I will overcome these barriers in my practice

Evidence has confirmed that most of the error in the administration of medicines is due to their packages. As when medicines are removed from their package it can be confused easily with other medicines. Therefore, in my practice, I will try my best to label all the medicines properly to increase safe medication administration. I will try to establish effective communication with physicians and pharmacists because evidence has shown that most of the errors in the administration of medicine occur due to poor communication. I will try to maintain proper information on all medicines and will adhere to the guidelines of medicine administration. I will report all errors which I will found during my practice and this will further help in the identification of recurring problems associated with the administration of medicines.

Article # 3

Source

ADDIN EN.CITE <EndNote><Cite><Author>Koohestani</Author><Year>2009</Year><RecNum>68</RecNum><DisplayText>(Koohestani &amp; Baghcheghi, 2009)</DisplayText><record><rec-number>68</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1567666304">68</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Koohestani, Hamid Reza</author><author>Baghcheghi, Nayereh</author></authors></contributors><titles><title>Barriers to the reporting of medication administration errors among nursing students</title><secondary-title>Australian Journal of Advanced Nursing, The</secondary-title></titles><periodical><full-title>Australian Journal of Advanced Nursing, The</full-title></periodical><pages>66</pages><volume>27</volume><number>1</number><dates><year>2009</year></dates><urls></urls></record></Cite></EndNote>(Koohestani & Baghcheghi, 2009)

Relevancy to objective 4

This article discusses the barriers for not reporting errors that are associated with the administration of medicines. Fear and administrative barrier were found to be the major reason for not reporting medication error. Other reasons for not reporting errors include being incompetent, negative attitude of patient, decrease knowledge, forensic problems, a threat to the job, criticism from other professionals, not serious to be reported and time-consuming.

How this information is useful

In light of the above findings’ steps can be taken to increase the reporting of errors by nurses in health care settings.

Reporting of errors in my practice

I will try to overcome all these barriers and will report all errors that I will discover during my practice. I will report even those error which are not serious as I believe that all errors should be reported to decrease mortality and morbidity associated with the wrong administration of medicines.

Discussion

Globally safety of the patient is a major concern in a healthcare setting. Errors in the administration of medicine are very common which result in negative consequences on the health of the patient and also increase the economic burden. The first article discusses the different strategies that can be used to prevent errors in the administration of medicines. Secondly, it also discusses the infection control practice that can be used by nurses in the administration of medicine. In contrast, the second article discusses the different barriers which prevent the nurses to adhere to the guidelines of drug administration. These barriers can be removed by implementing proper strategies and by adhering to the guidelines of safe administration of medicines as discussed under the first article. Although by implementing effective strategies most of the errors in medicine administration can be removed as nurses are also humans and mistakes can also occur from them. In that case, errors should be reported to the concerned authority. The third article discusses all the reason for underreporting of medicine administration related error.

Most rigorous and relevant resource

The most rigorous and relevant resource to me was the third article as it appropriately answers the questions regarding reasons of underreporting of errors that are associated with the administration of medicines.

Most reliable and current resource

The most reliable and current resource for me was article 1. It provides a thorough and strong discussion about the most effective strategies in detail that can be easily implemented in any health care setting and used to prevent errors in the administration of medicines.

Most useful resource

The most useful resource to me were all three articles as my objectives are covered in all three articles.

Areas which require further research

The first area which requires further research and evaluation are barriers associated with underreporting of errors in the administration of medicine. Qualitative studies should be conducted to know more in detail the reasons why nurses do not report errors associated with the administration of medicines. Secondly, further research is needed to identify factors which cause errors in medicines.

Conclusion

In this article evidence-based practice in the safe administration of medicines was seen. Three articles were chosen based on the relevance priority of objectives. The first article focusses on the main objective of effective strategies in the safe administration of medicine, the second article discusses the barriers in the safe administration of medicine and third article focus on the reason why errors in medicine are not reported by nurses. Further research is needed to identify the barriers in underreporting of errors in medication administration and factors associated with the medicine administration errors.

References

ADDIN EN.REFLIST ABA, A. B. A. (2007). Guidance to Nurses and midwives on medication management: An Bord Altranais (ABA).

Hammoudi, B. M., Ismaile, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian journal of caring sciences, 32(3), 1038-1046.

Koohestani, H. R., & Baghcheghi, N. (2009). Barriers to the reporting of medication administration errors among nursing students. Australian Journal of Advanced Nursing, The, 27(1), 66.

Research And Evidence - Support The Need For A Change

Support the Need for a Change

Fall Prevention

Article 1 Summary

Application of the qualitative approach to promote and support change, research was directed to understand the studies determining the efficiency of workout plans in anticipation of falls. It was a methodical evaluation, and statistics were collected from exploring already published research. This study was established by Shier and the colleagues in the year 2016 on prevailing accessible data to assess these evaluations (Shier et al., 2016). The review suggests that there is a noteworthy connection between physical therapy program interferences in decreasing the integer of falls in patients. With increasing deliberation to community-based health management in the United States, doctors, counselors and health association leaders need a profound knowledge to link older population in the adaptation of suitable exercise programs at public levels. Assembling robust evidence that fall prevention plans focused on exercise can promote and reduce falls (Shier et al., 2016). The research has provided additional comprehensive methods for the effective provisions in medical and health organizations. These programs and policies, however, need suitable organization, expert therapists, skilled nursing staff, committed efforts, and consistent follow-ups. These policies can bring a change in the improvement policies to reduce falls. The change would be adapted in the form of improved exercise therapies at healthcare facilities as well as at home.

Article 2 Summary

Fall-associated damages among older individuals resulting in around 750,000 admissions in healthcare facilities and 25,000 demises per year in the United States. There is a need for changes in the current healthcare systems and interventions to reduce the fall. However, interventional and interferential studies are lagging far behind which has tremendously increased the number of falls. To generate a change in the society an interferential study established on PICO examination was steered for this aim in 2016. This research has specifically compared the consequences and the effectiveness of prevention policies using PICO inquiries (Crandall et al., 2016). Chief question was to recognize the health of the bones and related improving elements in decreasing falls-linked damages; the second was to evaluate the effectiveness of hip protectors in anticipation and prevention of falls-linked injuries. The third inquiry was connected to the interference of exercise in plummeting fall-associated damages. Forth problem was to detect the ecological association and alteration in the reduction of fall-associated injuries. The fifth inquiry was to detect the risk component screening in anticipation of falls-associated damages. Lastly, to observe the multiple interferential policies in controlling fall-linked injuries and damages. The data was analyzed from 50 researches of related studies that have created changes in the interventions to reduce falls risk (Crandall et al., 2016). Consequences were of various range, consuming the nutrients, for example, vitamin D and calcium consumption can decrease falls-connected injuries, and suggested hip protectors to defend persons from falls (Crandall et al., 2016). The studies displayed evidence-based practices for the recommendations of exercises and therapies related to the movements to bring a change and to avoid falls. Ecological alterations and multiple anticipation policies and approaches significantly are adapted to reduce the number of falls.

Article 3 Summary

The falls-associated injuries can significantly reduce to adapt and change the current approaches and strategies to reduce the number of falls. Falls in the older population is a community and society based problem. It is preventable by introducing recent therapies and strategies to improve the health education of people. It is a significant issue to be deliberated because it can have devastating consequences in deaths and injuries in older people. Physiotherapists are experts that can play a significant and vigorous role in the prevention and anticipation of falls. The evidence-based physiotherapy as a novel approach to bringing a change in the recent methodologies was evaluated by Sherrington and Tiedemann in the year 2015. According to this research, physical exercises can improve the patient's gait, balance, equilibrium, and posture (Sherrington & Tiedemann, 2015). This would be ultimately outcome in better understanding for the older people to create balance during walk and movement. The research recommended that training, physical exercise, and community-based movements can considerably decrease the integer of falls in aged individuals. Consistent follow-ups besides routine physical therapy in hospitals and at homes can have a robust influence on the decrease of falls (Sherrington & Tiedemann, 2015). Though, physical exercises counting power and equilibrium movements in persons disposed to fall (Sherrington & Tiedemann, 2015). Interventional researches to decrease integer of falls, including improved understanding of patients regarding movements and equilibrium, should be executed at a public level to bring a change in the societies, particularly reducing the number of falls.

Conclusion

Fall-associated damages and injuries is a significant public health subject among older people. Studies have shown that 95% of falls are preventable and avoidable with improved interventions. Currently, older people are ignored in clinics and hospitals. The current policies and strategies at hospitals and clinical need novel approaches to reduce the number of falls. It required the establishment of new approaches such as the introduction of physical therapy, improved bone health, and health education for the older people. As evident from studies that 750 000 admissions in the hospitals are because of falls (Crandall et al., 2016). By introducing changes in the interventions and interferences, falls-associated injuries can be reduced to a significant level. However, widespread evidence on other operational treatment and anticipation approaches remains scarce. Founded on the results and consequences of these studies and additional evidence from other researches, a plausible change is required to be embraced to introduce changes in the current interventions and interventions to decline the risk of fall and threats in older persons.

References

Crandall, M., Duncan, T., Mallat, A., Greene, W., Violano, P., Christmas, A. B., & Barraco, R. (2016). Prevention of fall-related injuries in the elderly: An Eastern Association for the Surgery of Trauma practice management guideline. Journal of trauma and acute care surgery, 81(1), 196-206.

Shier, V., Trieu, E., & Ganz, D. A. (2016). Implementing exercise programs to prevent falls: a systematic descriptive review. Injury Epidemiology, 3(1), 16.

Sherrington, C., & Tiedemann, A. (2015). Physiotherapy in the prevention of falls in older people. Journal of physiotherapy, 61(2), 54-60.

Research Article Utilizing The Library Sources Provided By Aspen University

Report of a Research Article

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Report of a Research Article

Article: Process Mining in Healthcare by R.S. Mansa, W.M.P. van der Aalsta, and Rob J.B. Vanwerschb

Literature Review: Process mining in healthcare: A literature review by Eric Rojas, Jorge Munoz-Gama, Marcos Sepúlveda, and Daniel Capurro

Discussion Findings of the article one

In healthcare, people who work in this system need actionable information to treat the people coming to the hospitals. Employees working in the healthcare system including management, physicians and nurses may need the record, information regarding, costs, and services, medical files and steps to take care of patients. This information has to be provided to caregivers to serve people with efficient healthcare and high-quality services. These are services that can be named as the Hospitals Information System (HIS), and to improve operations and services, hospitals need to adopt this system ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"WjyKWv1i","properties":{"formattedCitation":"(Ismail, Abdullah, & Shamsuddin, 2015)","plainCitation":"(Ismail, Abdullah, & Shamsuddin, 2015)","noteIndex":0},"citationItems":[{"id":498,"uris":["http://zotero.org/users/local/F0XOCTdk/items/AQFSZ8ZX"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/AQFSZ8ZX"],"itemData":{"id":498,"type":"article-journal","title":"Adoption of Hospital Information System (HIS) in Malaysian Public Hospitals","container-title":"Procedia - Social and Behavioral Sciences","collection-title":"Contemporary Issues in Management and Social Science Research.","page":"336-343","volume":"172","source":"ScienceDirect","abstract":"Hospital Information System (HIS) is important to be adopted by the hospitals to improve their operations and services. Despite their importance, only 15.2% of Malaysian Public Hospitals implemented the system through THIS, IHIS and BHIS categories which shows low adoption level of HIS in Malaysia. This study aims to identify factors affecting the HIS adoption across different categories of HIS's hospitals. The finding showed that there are significant differences between factors affecting HIS adoption in the THIS compared to IHIS's hospitals, and THIS and BHIS's hospitals. However there is no significant difference among factors between IHIS with BHIS's hospitals.","DOI":"10.1016/j.sbspro.2015.01.373","ISSN":"1877-0428","journalAbbreviation":"Procedia - Social and Behavioral Sciences","language":"en","author":[{"family":"Ismail","given":"Nurul Izzatty"},{"family":"Abdullah","given":"Nor Hazana"},{"family":"Shamsuddin","given":"Alina"}],"issued":{"date-parts":[["2015",1,27]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ismail, Abdullah, & Shamsuddin, 2015).

The healthcare reference model was studied, which shows the data of the hospitals. This approach may help to extract the targeted data for the collection of the data required for the cases. During the process of mining, some questions are raised which can be answered with the help of the healthcare reference model. This model gives benefit in creating awareness about all the data in the hospital systems. The model made it easier to access the healthcare data; in fact, several employees of the hospital (MUMC) were surprised because they were able to find more data ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"bYyJPOSm","properties":{"formattedCitation":"(Mans, Schonenberg, Song, van der Aalst, & Bakker, 2015)","plainCitation":"(Mans, Schonenberg, Song, van der Aalst, & Bakker, 2015)","noteIndex":0},"citationItems":[{"id":497,"uris":["http://zotero.org/users/local/F0XOCTdk/items/EZ95DSP3"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/EZ95DSP3"],"itemData":{"id":497,"type":"paper-conference","title":"Process Mining in Healthcare","container-title":"International Conference on Health Informatics (HEALTHINF’08)","page":"118-125","author":[{"family":"Mans","given":"Ronny S."},{"family":"Schonenberg","given":"M. H."},{"family":"Song","given":"M."},{"family":"Aalst","given":"W. M. P.","non-dropping-particle":"van der"},{"family":"Bakker","given":"P. J. M."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Mans, Schonenberg, Song, van der Aalst, & Bakker, 2015).

There was only one article review, which is Process mining in healthcare: A literature review, is discussed below.

Discussion on the review of the article

In this article, the Hospitals Information System is discussed which states that there is a need to enhance HIS to be able to understand the processes in the healthcare system ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"3sVRBsy3","properties":{"formattedCitation":"(Purnawan & Surendro, 2016)","plainCitation":"(Purnawan & Surendro, 2016)","noteIndex":0},"citationItems":[{"id":503,"uris":["http://zotero.org/users/local/F0XOCTdk/items/25T5G8MC"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/25T5G8MC"],"itemData":{"id":503,"type":"paper-conference","title":"Building enterprise architecture for hospital information system","container-title":"2016 4th International Conference on Information and Communication Technology (ICoICT)","publisher":"IEEE","page":"1-6","ISBN":"1-4673-9879-9","author":[{"family":"Purnawan","given":"Dilla Anindita"},{"family":"Surendro","given":"Kridanto"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Purnawan & Surendro, 2016). This article focuses on the implementation strategies, which are commonly used and these strategies may help in the execution of algorithms and the techniques. The direct execution of these algorithms, which are built on the event log manually, and this will allow medical staff and experts to implement the process mining without asking for area specialists.

Findings of the review

The increase in the process of mining for checking and execution of the processes will facilitate the monitoring processes to verify the practices with compliance ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"EZgneuYy","properties":{"formattedCitation":"(Mans, van der Aalst, & Vanwersch, 2015)","plainCitation":"(Mans, van der Aalst, & Vanwersch, 2015)","noteIndex":0},"citationItems":[{"id":508,"uris":["http://zotero.org/users/local/F0XOCTdk/items/UWLZK7EA"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/UWLZK7EA"],"itemData":{"id":508,"type":"chapter","title":"Healthcare Processes","container-title":"Process Mining in Healthcare: Evaluating and Exploiting Operational Healthcare Processes","collection-title":"SpringerBriefs in Business Process Management","publisher":"Springer International Publishing","publisher-place":"Cham","page":"11-15","source":"Springer Link","event-place":"Cham","abstract":"Process mining can be used to improve compliance and performance in hospitals and other care organizations. Before analyzing event data, we first provide an overview of the different types of care processes. We distinguish three levels of care: primary, secondary, and tertiary. We characterize five types of healthcare processes and link these to four basic types of data science questions: (a) What happened?, (b) Why did it happen?, (c) What will happen?, and (d) What is the best that can happen? Such questions can be answered using process mining. Using the characteristics of care processes, different questions may be posed. For example, the level of variability may influence the selection of the most suitable process mining technique.","URL":"https://doi.org/10.1007/978-3-319-16071-9_2","ISBN":"978-3-319-16071-9","note":"DOI: 10.1007/978-3-319-16071-9_2","language":"en","author":[{"family":"Mans","given":"Ronny S."},{"family":"Aalst","given":"Wil M. P.","non-dropping-particle":"van der"},{"family":"Vanwersch","given":"Rob J. B."}],"editor":[{"family":"Mans","given":"Ronny S."},{"family":"Aalst","given":"Wil M. P.","non-dropping-particle":"van der"},{"family":"Vanwersch","given":"Rob J. B."}],"issued":{"date-parts":[["2015"]]},"accessed":{"date-parts":[["2019",11,7]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Mans, van der Aalst, & Vanwersch, 2015). The innovative tools, which are used and applied in the healthcare, allow the area specialists to apply the techniques repeatedly for the facilitation of the analysis and datasets required in the healthcare ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"gYUfgwnq","properties":{"formattedCitation":"(Rojas, Munoz-Gama, Sep\\uc0\\u250{}lveda, & Capurro, 2016)","plainCitation":"(Rojas, Munoz-Gama, Sepúlveda, & Capurro, 2016)","noteIndex":0},"citationItems":[{"id":504,"uris":["http://zotero.org/users/local/F0XOCTdk/items/5KG49CVF"],"uri":["http://zotero.org/users/local/F0XOCTdk/items/5KG49CVF"],"itemData":{"id":504,"type":"article-journal","title":"Process mining in healthcare: A literature review","container-title":"Journal of Biomedical Informatics","page":"224-236","volume":"61","source":"ScienceDirect","abstract":"Process Mining focuses on extracting knowledge from data generated and stored in corporate information systems in order to analyze executed processes. In the healthcare domain, process mining has been used in different case studies, with promising results. Accordingly, we have conducted a literature review of the usage of process mining in healthcare. The scope of this review covers 74 papers with associated case studies, all of which were analyzed according to eleven main aspects, including: process and data types; frequently posed questions; process mining techniques, perspectives and tools; methodologies; implementation and analysis strategies; geographical analysis; and medical fields. The most commonly used categories and emerging topics have been identified, as well as future trends, such as enhancing Hospital Information Systems to become process-aware. This review can: (i) provide a useful overview of the current work being undertaken in this field; (ii) help researchers to choose process mining algorithms, techniques, tools, methodologies and approaches for their own applications; and (iii) highlight the use of process mining to improve healthcare processes.","DOI":"10.1016/j.jbi.2016.04.007","ISSN":"1532-0464","shortTitle":"Process mining in healthcare","journalAbbreviation":"Journal of Biomedical Informatics","language":"en","author":[{"family":"Rojas","given":"Eric"},{"family":"Munoz-Gama","given":"Jorge"},{"family":"Sepúlveda","given":"Marcos"},{"family":"Capurro","given":"Daniel"}],"issued":{"date-parts":[["2016",6,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Rojas, Munoz-Gama, Sepúlveda, & Capurro, 2016).

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Ismail, N. I., Abdullah, N. H., & Shamsuddin, A. (2015). Adoption of Hospital Information System (HIS) in Malaysian Public Hospitals. Procedia - Social and Behavioral Sciences, 172, 336–343. https://doi.org/10.1016/j.sbspro.2015.01.373

Mans, R. S., Schonenberg, M. H., Song, M., van der Aalst, W. M. P., & Bakker, P. J. M. (2015). Process Mining in Healthcare. International Conference on Health Informatics (HEALTHINF’08), 118–125.

Mans, R. S., van der Aalst, W. M. P., & Vanwersch, R. J. B. (2015). Healthcare Processes. In R. S. Mans, W. M. P. van der Aalst, & R. J. B. Vanwersch (Eds.), Process Mining in Healthcare: Evaluating and Exploiting Operational Healthcare Processes (pp. 11–15). https://doi.org/10.1007/978-3-319-16071-9_2

Purnawan, D. A., & Surendro, K. (2016). Building enterprise architecture for hospital information system. 2016 4th International Conference on Information and Communication Technology (ICoICT), 1–6. IEEE.

Rojas, E., Munoz-Gama, J., Sepúlveda, M., & Capurro, D. (2016). Process mining in healthcare: A literature review. Journal of Biomedical Informatics, 61, 224–236. https://doi.org/10.1016/j.jbi.2016.04.007

Research Design

Research design

Mireya Carrillo

University of Phoenix

April 1, 2019

Research Question and Research Type

Topic: To measure the frequency of hand washing by nurses in 'The Mount Sinai Hospital' of New York.

The research topic is to analyze the frequency of Handwashing by Nurses in a Hospital and it can be best measured by using qualitative research method. It is the research design used to measure a study without involving numerical data, just based on the observations and interviews (Merriam & Tisdell, 2015).

Summarizing Qualitative Research Method

There are five major steps involves in doing qualitative research: Settle on an inquiry that is needed to examine.

Question formation: A decent research question should be clear, explicit, and sensible. To do subjective research, your inquiry ought to investigate explanations behind why individuals get things done or put stock in something. The research question is a standout amongst the most vital bits of your exploration structure. It figures out what you need to realize or comprehend and furthermore centers the examination since you can't research everything without a moment's delay. The examination question will likewise shape how you direct your investigation since various inquiries require distinctive strategies for the request.

Literature review: it is a procedure of considering what others have expounded on your examination question and specific subject. You read broadly on the bigger field and inspect ponders that identify with your subject. You at that point draw up an investigative report that orchestrates and coordinates the current research (as opposed to just exhibits a short synopsis of each examination in the sequential request. As it were, you are "exploring the exploration."

Evaluation: this assesses whether subjective research is a good choice for the investigation of the research question. This research method or strategy is helpful when an inquiry does not require a straight answer based on 'yes' or no'. Frequently this type of research is mainly valuable for replying the questions as such what why and how. While considering the decisions based on budgetary, this method is likewise helpful.

Sample size: the qualitative research techniques do not necessarily depend on an already set example amount as like in the quantitative method of research, yet they are able to yield vital bits of knowledge and findings. Such that, since it's not easy or possible humanly to have the entire financing and capacity for thinking about every single person in the United States, therefore restricting the examination to just urban region (like New York).

Selecting a research method: this step involves the selection of a research strategy based on qualitative design. The structure of this type of research is very adaptable among all the other procedures or types of researches, so there is various acknowledged systems inaccessibility.

Specific Research Approach

The specific type of approach of qualitative research that will be employed during this research is ethnographic research type. In this type of qualitative researches, researchers immerse themselves in the target environment of the participants for understanding the challenges, goals, cultures, theme, and motivation (Merriam & Tisdell, 2015). The reliance is not on surveys or interviews, rather a researcher observes the first-hand experience, and it is known as participant observer (Jalalpoor et al., 2012).

Potential Data

Potentially the data was driven from 'The Mount Sinai Hospital' of the New York. 60 nurses were observed under various clinical moments. The convenient sampling method was used, and nurses were selected through this sampling technique. All the nurses taken were those working at the bedsides. Data was collected by direct observational method while nurse was delivering the daily care and it was recorded through a standard checklist which was utilized for observing directly the hand hygiene's five moments. The results showed that the overall compliance rate of hang hygiene was measured to be 10%, as observed in the exposure

Analysis and Interpretation of Data

Each patient in Hospital is open to some microbial agents throughout their hospitalization. The interaction amongst the nurses and patient, in it, doesn’t essentially produce clinical illness, since there are other issues that affect the frequency and nature of nosocomial infections, but can lead to various diseases and allow the dissemination of these pathogens with epidemiological relevance in health centers. Infection by any of these microorganisms can be transmitted by an inert object or by dirty substances from another human (King et al., 2016). The use of a maximum level of hygiene in all care work is essential to reduce both the cross-transmission of any infectious agent. Therefore, this observational study of a qualitative nature has an approach aimed at analyzing the compliance rate of hand washing by nurses in 'The Mount Sinai Hospital', located in the city of New York, USA.

The findings gathered through observational checklists indicated lower compliance rate by the nurses in the hospital. The demographic data was included in the checklist (Mostafazadeh-Bora et al., 2018). Nurses were observed on the bases on hand hygiene's five moments which are accruing to WHO recommendations. The checklist was completed afterward. The nurses are mandated to adhere to the recommendations of guidelines for hand hygiene, which also involves the alcoholic hand rub or sanitizer and hand washing. The samples considered were these constructed moments. The potential data were analyzed by using statistical methods and accuracy of validity and reliability was maintained. All ethical considerations were maintained by properly taking the permission and informed consent of the involved participants and nurses. The duration of each observation lasted from about 10-20 minutes (Mostafazadeh-Bora et al., 2018).

References

Jalalpoor, S., Kasra Kermanshahi, R., Noohi, A. S., & Zarkesh Esfahani, H. (2012). Role and important staff hands and low and high contact hospital surfaces to produce and control nosocomial infections. Iranian Journal of Medical Microbiology, 5(4), 14-22.

King, M. F., Noakes, C. J., Sleigh, P. A., Bale, S., & Waters, L. (2016). The relationship between healthcare worker surface contacts, care type, and hand hygiene: an observational study in a single-bed hospital ward. Journal of Hospital Infection, 94(1), 48-51.

Mostafazadeh-Bora, M., Bahrami, M., & Hosseini, A. (2018). A survey of nurses' compliance with hand hygiene guidelines in caring for patients with cancer in a selected center of Isfahan, Iran, in 2016. Iranian journal of nursing and midwifery research, 23(2), 119.

Merriam, S. B., & Tisdell, E. J. (2015). Qualitative research: A guide to design and implementation. John Wiley & Sons.

Research Designs

Epidemiological studies

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In this case, the assumption of researcher A is reliable than researcher B based on research style, advantages or disadvantages of research design and review of past researches. For the reliable results of epidemiological studies, the following conditions are necessary: 1) representativeness of the sample; 2) a single diagnostic approach in determining a link between cancer and vegetable intake; 3) the use of methods that correspond to the main objectives of the study.

According to a research done by Tao, Zheng, Gao, Ruan, Cheng & Shu (2005) stated that the result of suggesting that high ingesting of some vegetables may decrease the risk of endometrial cancer. (Tao, Zheng, Gao, Ruan, Cheng & Shu, 2005)

Whereas another study proves that, “there is no direct link between fruit or vegetable intake in cancer and consumption of fruit and vegetables was commonly unrelated to total cancer occurrence” (George, Park, Leitzmann, Dowling, Reedy & Subar, 2008).

With cross-design, patients receive both control and test stimuli in a randomized order. (Fallman, 2008). This is the opposite of a parallel-group design, with each patient being the basis for estimating the differences between test exposure and control exposure. Situations where cross-sectional studies may be helpful include chronic diseases that remain stable over a more extended period (such as cancer, diabetes or arthritis, for example), and where the goal of treatment is a palliative effect rather than a cure. (Verhoeven, Goldbohm, van Poppel, Verhagen, & van den Brandt, 2016).

The described study is cross-sectioned, as it represents a particular imprint of the moment, which reflects only the current situation. From here, a design critique is derived using static groups. Unlike strict experiment, there is no means to certify that the compared groups are equivalent before the start of the study. In the absence of a pre-test (and here it cannot be by definition), it is difficult for a sociologist to control the background factors. (Jones & Kenward, 2014).

A case-control study is constantly retrospective, past data, and collect data used to see the link between suspected risk and specific result. Scientists do not need to wait and record the effects that will occur in the future, as is the case in prospective studies. But the main drawback of the case-control study is that they study the events that have already occurred (they are retrospective), which means that they are not as reliable and not as informative as prospective studies.

References

Fallman, D. (2008). The interaction design research triangle of design practice, design studies,

and design exploration. Design Issues, 24(3), 4-18.

George, S. M., Park, Y., Leitzmann, M. F., Freedman, N. D., Dowling, E. C., Reedy, J., ... &

Subar, A. F. (2008). Fruit and vegetable intake and risk of cancer: a prospective cohort study. The American journal of clinical nutrition, 89(1), 347-353.

Jones, B., & Kenward, M. G. (2014). Design and analysis of cross-over trials. Chapman and

Hall/CRC.

Tao, M. H., Xu, W. H., Zheng, W., Gao, Y. T., Ruan, Z. X., Cheng, J. R., ... & Shu, X. O.

(2005). A case–control study in Shanghai of fruit and vegetable intake and endometrial cancer. British journal of cancer, 92(11), 2059.

Verhoeven, D. T., Goldbohm, R. A., van Poppel, G., Verhagen, H., & van den Brandt, P. A.

(2016). Epidemiological studies on brassica vegetables and cancer risk. Cancer Epidemiology and Prevention Biomarkers, 5(9), 733-748.