Long-Term Healthcare Capstones in the US - Assignment Example

Long-term Care: Discussion Questions Question Long term care Government regulation of long term care includes provisions for regulation of both quality and cost. Although this regulation has been put into force in order to eliminate different issues in healthcare and thereby to improve care quality, evidences suggest that this policy has done nothing to improve long term care or its image. Furthermore, the government regulation of long term care caused the providers to experience a series of operational issues. Firstly, this policy change adversely affected an environment of innovation and experimentation as this regulation greatly discourages creativity. According to an opinion, “regulations thwart creativity, especially those based largely on professional beliefs unsupported by empirical evidence” (Kane, 2000). The author argues that this regulation does not allow bearing any level of risk and hence it may not encourage providers to use their creative abilities. More precisely, the regulatory response gives great emphasis to measurable targets and this strategy would seriously impinge on quality of both care and life. Secondly, care providers argue that outcome-based operation would be necessary to ensure the quality of care. However, it is evident that outcomes always depend on probabilities and they (probabilities) can never guarantee cent percent risk free outcomes. Since the new regulative approach does not foster innovation and experimentation, such a practice is possible under the current regulative environment. Finally, payment for services rather than care may negatively affect the quality of care and thereby patient safety. Physicians may not give much priority to patient safety if they are paid on the basis of services. In total, the government regulation of long term care threatens the viability of the US health care. Question 2 – Long term care There are a lot of differences and similarities between Quality Assurance (QA) and Continuous Quality Improvement (CQI). In the opinion of Dever (1997, p.64), while the quality assurance aims to improve patient care and community health status, the continuous quality improvement tries to improve the quality of services and products provided and effectively compete to meet customer needs. The author adds that QA considers quality as a separate activity whereas CQI views quality as an integrated activity. Likewise, the scope of QA is limited to selected departments and functions while CQI takes organization-wide functions into account. It seems that QA is only outcome oriented while CQI focuses both on process and outcomes. Finally, QA is more concerned with solving problems whereas CQI gives specific emphasis on process improvement. However, in practice, one can find a number of similarities as well. First of all, both QA and CQI are intended to improve the functioning and communication across the system, though the former stresses on outcomes and the latter stresses on both processes and outcomes. Secondly, both facilitate revisiting program goals and procedures, thus promoting better service. Thirdly, both QA and CQI have role to show the public that the system is willing to, and interested in, further improvement and learning. Lastly, both result in the refinement of service quality. There is a lot of scope for QA in long term care and assisted living facilities. To illustrate, there is a QA model developed by Hospital Corporation of America. known as FOCUS-PDCA. The Acronym stands for Find, Organize, Clarify, Understand, Select, Plan, Do, Check, and Act. Similarly, the American Health Care Association has introduced a Continuous Quality Improvement program and related guidelines for long term care facilities to adopt CQI. Along with the guidelines, the Association provides the CQI Climate Survey that can be used by facilities to check their compliance with the CQI procedures. Question 3 Capstone  Evaluate how health care organizations restructure through mergers and affiliations. Identify at least three reasons health care organizations seek to restructure. Research, cite, and discuss an example from real life. Every organization, irrespective of its nature and size, exists for making profit. If an organization fails in reaping profit for a while, its existence will be questioned. Most health care organizations go for mergers and affiliation when their very existence is threatened by another organization through stiff competition. It is a strategy adopted by an organization to improve efficiency and scale of operation. An organization is said to have merged into another when the latter undertakes more than 50% of the shares of the former. When two companies are combined together to form a new one, these two are no longer separated ones but a single organization. In a sense, it is a form of restructuring as both the companies have to undergo changes to become one. According to Zimmerman and Dooley (2001), the various reasons why a health care organization pursues merger and affiliation are; a health care organization that is confined to a local area will never develop itself to the fullest, so it is natural that small organizations together try to increase their size and area of operation and thus attract more customers through merger, mergers and affiliations are undertaken to improve the sustainability of the organizations by bringing together resources and data for the benefit of providing improved profit and to reduce costs and thus to increase the revenue of the organization, other reasons for mergers and affiliation of health care organizations may be the desire to reduce the managerial staff, gain access to new facilitators and benefactors apart from the existing ones, the desire to gain and implement new and improved technology and to reduce tax obligations (Source: Zimmerman & Dooley, 2001) Question 4-Capstone  Evaluate the impact of change on health care organizations within the U.S. Analyze the function of the manager to the healthcare workplace, as they serve as change agent. Identify two effective ways in which managers handle change in the workplace. What are three difficult challenges health care managers face when encountering change in the workplace? As a result of the reengineering that took place, most of the organizations could perform well in the US. The combined resources and knowledge of the organizations made them mighty that they could face their rivals together with a renewed punch. Being a change agent, a manager in the health care organization has to change the organizational systems to achieve improved outputs or the desired results and thus to achieve self actualization for which merger took place. Bearing in mind the aims of the merger and affiliation, he has to enable people to work earnestly. Fuelled by passion, he should be able to inspire passion in his subordinators as well. To make the changes effective, the manager can use a three staged strategy. In the first step he can ask the subordinates to create new definitions for change and improved goals. As the second step, they must be asked to find out new tools which will achieve the goals already set. In the third step, the manager should work on winning the employees and motivating the organization to acquire those tools and skills which may meet the new objectives. As Harding (2004) points out, the most important challenge for a manager in the health care organization may be to convince the need for change because people are not willing to change for the fear of unknown. This is so because the workers of the health care organization may fear that the merger with another organization may result in retrenching them from work. Harding (2004) adds that sometimes the organization may not be having sufficient funds to ensure that the process of merger takes place; and thus the shortage of funds for the compliances of formalities may be another problem that a manager may have to face. References Dever, G. E. A. (1997). “Public health practice and continues quality improvement”. In Improving Outcomes in Public Health Practice: Strategy and Methods. USA: Aspen Publishers. Harding, P. (2004). Resource Efficiency and Corporate Responsibility: Managing Change. Government Office for the South West. Kane, K. L. (2000). Changing the image of long-term care. Age and Aging, 29, 481-483. Zimmerman, B & Dooley, K. (2001). Mergers versus Emergers: Structural Change in Health Care Systems. Emergence, 3(4): 65-82. Read More