“Your Healthcare. Your Choice.”

By Shain Waugh

China’s Emperors

According to ancient history, emperors of great wealth compensated physicians only when the emperors were well, and charge them when sick. The development of illness at this time meant the medicine did not work and the physician was failing at their job. The emperors vision was to remain health at all times regards of the efforts of the physician. In many cases, the influences of the great emperor’s vision exist in an array of universal healthcare system such as England, which the government compensates the physician for the total number of patients that remain healthy (i.e. stopping smoking).

United States

In the United States, the concept of the informed consumer will in turn lead to enhance quality of service within a medical facility. This means that purchaser, consumer, or general public will get better care if the proper care is designed to meets one’s needs and expectations. The vision for the health care industry is that health plans, clinicians, and institutions will provide better care to attract more patients. However, in most cases, the process still doesn’t make a significant difference. (Refer to Right Medical Physician)

What is Health Care Quality?

As a health care provider, there are an array of definitions of health care quality and the definition lye in the perception of the evaluator. There are some cases that good quality involves the wait time to see the doctor, the quality of food within the hospital, doctor response in calling back, type of medication prescribed, number of referrals from other doctors, or the amount of time the doctor spends with the patient.

The quality of healthcare must be evaluated as taking your brand new 2008, red, GMC Arcadia to the dealership to evaluate an abnormal sound coming from the engine. The technicians in the shop are the nurses, doctors, pharmacists, and physical therapists for this vehicle. These people are either friendly or not, knowledgeable or not, license or not, but the true questions is if they can fix the car right the first time or over time with multiple visits.

Oregonian Reports

According to the Oregonian reports, there are an array of hospitals and physician practices that are increasingly releasing cost and quality data, but reports along with surveys illustrate that the data is not yet affecting the consumer decisions The performance ratings remain crude, potentially misleading, and difficult for experts to understand. For example, “Oregon’s hospital quality rating Web site details hospitals’ experience with procedures, but consumers are limited when trying to select a top performer, in large part because mortality ratings for hospitals are similar.” In most cases, a medical facility with a high morality rates doesn’t make the facility a bad, unsafe, and dangerous facility to be admitted.

The reasoning is that most facilities with high morality are trauma centers and/or crisis centers that are best fit to address a critical situation. On the other hand, facilities with low morality isn’t a good indicator as well because many of these facilities push patients out once stabilized. In recent studies, New York and California showed that public reporting barely affected the flow of patients to hospitals with high death rates and that some hospitals with low death rates did not increase their patient flow.

According to studies, “most patients are not aware of quality comparisons and that those who are familiar with them seem distrustful and find them confusing.” The challenge with this quote from the Oregonian reports is that the general public is over load with healthcare information and left without a reliable source of information involving healthcare trends, changes, and helpful information. It’s proven via surveys that patients prefer advice from trusted friends, family, and personal physicians over published data or government sources.

Tying it Up

The health care providers including the U.S. government, insurance companies, and many pharmaceutical are working to improve the quality of healthcare today. However, the challenge will be for the general community to play a strong role in demanding the level of quality for yourself, friends, and family members. According to a 2004 study of 12 large U.S. communities, 54.9% of the people actually received the care the they designed, needed, and researched.

The Oregonian reports are a true indicator of how the U.S. health industry is in an uncontrolled status of confusion. We as a health community are so concerned with rising health cost, large premiums, medical errors, and so forth that we as a community become overwhelmed with unreliable healthcare information. Health information should come from one reliable source regulated by the government in a sense. These are many of the challenge the American people face within the land of opportunity, but the quality health care helps people feel better and enjoy a better quality of life, which is what is most important.

by Shain Waugh

In waving bye to 2007 and welcoming 2008, the presence of 2007 still is fresh in the minds of us all. In looking beyond health care and at the world in general, we have achieved so much as globalized nation. However, we have also lost a great deal as well including our respect as an Americans among other countries, the lost of a great politician in Pakistan’s Benazir Bhutto, lost for respect for George W. Bush, decline in the value of the U.S. dollar, and lost a great son, daughter, mother, and father in the Iraq war.

For the industry of health care, 2008 will integrate a great deal of technological integrations the will improve patient safety, reduce medical errors, improve physician evaluation process, justify the difference between medical facilities, reduce the shortage of medical professions, and the possibility of universal health care system in U.S.A.

With this in mind, enjoy this new year, be safe, and let’s make 2008 the best year yet.

Happy New Year!  

By Shain Waugh

Primary Issue

The critical nursing personnel shortage in America is nothing new to those affected by the shortage. It is evident that the long waits in the emergency room, medical surgical or telemetry unit’s patients not being seen by a nurse for hours, patient’s given the wrong medication, nursing staff burnout, and so forth is a significant sign of the challenges involving this shortage. A study in the Journal of the American Medical Association predicted a 20% shortage in the number of nurses needed in the healthcare system by the year 2020. The U.S. Bureau of Labor Statistics reports that more than one million new and replacement nurses will be needed by 2012.

The immediate challenge is that as more than 77 million baby boomers approach retirement age, it is anticipated that the demand for healthcare, particularly home and community-based care, will almost certainly outpace the supply of quality caregivers. The key question is to determine do you trust your hospital, physician, clinic, and or pharmacy. For many, it’s a challenging question when there is no true method of evaluating these critical factors.

 Those Affected

The ratios of nurses to patients dictate the number of patients a hospital’s unit can handle in a given day. In some states these ratios have been legislated while in other, unions mandate it. There are exceptions and work conditions for nurses and patients are still poor and unsafe. As case in point, there have been studies that illustrate direct correlations between staffing of nurses and medical errors.  Example:

In the 3^rd quarter of 2007, a South Florida hospital, which will remain unknown among this document, admitted a patient to its medical surgical unit for a non-critical diagnosis. There were two nurses that called off that particular day, which mean the other nurse took on three additional patients totaling ten patients for the night. Due to the stress, limited staffing, and not enough time to evaluate patients, one patient die within the hospital. The patient was not discovered until 7 hours later. The result included the nurse losing her nursing license, hospital being suited for millions, and the facility developing a bad name within its community. The parties involved were affected simply by the shortage of nurses and/or medical professional staff that shift. So, as medical facilities struggle to fill nursing vacancies and other medical positions, the greater the chance for an unsafe working and medical practice environment.

The shortage of nurses is growing worldwide on a global scale. The immediate problem is that for many of the poorer countries such as the Philippines and South Africa, there has been a migration of nurses from these countries to other countries such as U.S., Canada, and Australia. The more financially stable countries have been trying to meet critical needs for nurses by encouraging nurses from these countries to emigrate. Unfortunately, this processes is increasing the problems and not contributing a solution.

Hospitals argue that pressures from their relationships with managed-care providers leave them no choice but to experiment with various staffing practices, which result in varied degrees of success. It is believe that medical facilities cutting back on nursing staff to achieve higher profits. As a medical professional, there have been situations where staff ratios are reduced because the acuity of the patients doesn’t call for such staff. As a case in point, if a nursing in cardiovascular ICU is use to taking care of one open heart patient at a time, then if there are three telemetry patient on the that unit then this one nurse to three patient is efficient.

Possible Solution

In evaluating solutions, there is an array of theories to assist with the challenge. If we take the model of New Jersey hospital, it consists of a two-year program where the students attend one 12-hour clinical day per week at a participating hospital, and the hospital is responsible for training the student. The remaining part of the program consists of online classes.  

The promotion of the nursing profession to men is critical. The nursing profession has a women dominated culture. There are approximately 5.4% of the 2.1 million registered nursed employed in the United States that are men. This is according to the National Sample Survey of Registered Nurses.

The initiation of incentive by the government would assist in the promotion of nurses. A suggestion would be to reduce the amount of taxes that nurse are required to pay. If the normal tax bracket is between 25%-30%, then nurse should be required to pay only 15% tax. This tax reduction will increase a nurse salary without forcing the hospitals or medical facilities to increase wages.

In 2002 the Nursing Reinvestment Act was signed by President Bush to address the problem of our nation’s nursing shortage. This initiative was intended to promote people to enter and remain in nursing careers, thus reducing the growing shortage. The law establishes scholarships, loan repayments, public service announcements, retention grants, career ladders, and grants for nursing faculty. The challenge with this Act is that it has stipulations and not all individuals that become a registered nurse are able to utilize or benefit from the act.