Imagine you are a health care provider. Of all the groups discussed in class lectures and presentations, which group do you think YOU would have the most difficulty working with in a health care setting? What do you believe would be YOUR personal and some societal reasons for these difficulties? What barriers does this group face in access to equitable health care in the United States? What SPECIFIC actions would YOU take to ensure that a patient from this group receives equitable care?

Chose from this group:

1- African American refugees.

2- Tibetan and Bhutanese refugee.

3- Cuban Americans.

 

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Baptist Hospital is a 175-bed community hospital serving a rural area of Jacksonville.  It is located 30 miles from a large metropolitan area and has a fine reputation.

 The hospital is fully accredited and is licensed by the state.  The hospital offers general medical/surgical services with a bed complement as follows:

 Medical/Surgical  130

Pediatrics   20

ICCU   10

  OB   15

  Total  175

The hospital has a 10 bed Ambulatory Surgical Unit.  The hospital is in sound financial condition with a physical plant that is 15 years old and in excellent condition.

The hospital has just recruited a new General Surgeon and a Internist.  These recruitment efforts filled two major needs of the institution. It is estimated that in today’s current marketplace surgeons are expected to increase inpatient admissions to a acute care community hospital by 1.5% and Internists by .5%.

 It is expected that admission volumes will increase with the addition of these two new physicians.

The community population has been relatively stable over the past 10 years and there is no expectation that this trend will change.

 The percentage breakdown of patients by payor mix is as follows:

Medicare  51%

  Blue Cross  16%

  Medical Asst  08%

  HMO  10%

  Commercial INS  07%

  Other  05%

 Self Pay  03%

  Total    100%

 The population breakdown is as follows:

                         Under 19    25%

  19 to 64  44%

  65 and over  31%

The primary initiative or goal for the 2014-2015 fiscal year is the establishment of a 15-bed Psychiatric Unit. This new unit will be infused into the current bed complement with no increase in the 175 bed count expected. This unit is expected to occupy space for 15 beds currently not set up and staffed at the hospital.

It is expected that during the year there will be a slight increase in inpatient services as a result of the Psychiatric Unit.  The hospital laboratory is buying two new pieces of equipment at a cost of $400,000 that will allow them to do 35% more tests in house rather than send these tests out to a reference lab. It is also expected that the Radiology Department is purchasing a new CT scanner that is expected to increase current radiology volumes by 3.25%.

The budget calendar and target dates for budget completion are the same in this year’s budget as in years past.

In the new fiscal year, the hospital plans to:

1. Establish a separate distinct 15-bed inpatient psychiatric unit.
2. Install new equipment in the laboratory to enable the hospital to do 35% more tests in-house rather than send them to a reference lab.
3. Recruit a general surgeon and a Internist.
4. Purchase an additional CT scanner which is expected to increase current radiology volumes by 3.25%.

 THREE DEPARTMENTS ARE INVOLVED IN OUR BUDGET EXERCISE.  THEY ARE NURSING, LABORATORY, PHARMACY AND OUTPATIENT/AMBULATORY SERVICES.

STATISTICAL DATA

    2012  2013  2014  2015

Admissions In Pt (Nursing)                      7,395  7,400  7,370

Laboratory Test                                      399,330  411,810  421,564

Pharmacy Rx                                         99,832  100,011  99,642

Radiology Exams                                   68,222  69,124  68,950

Laboratory spent $79,866 on supplies in 2012.  They spent $86,480 in 2013 and $96,959 in 2014.  These figures represent the cost of supplies to do tests at the hospital. The hospital spent $122,000 to perform tests outside the hospital last year.  The cost of lab supplies is expected to increase 10% in the next budget year as a result of inflation. The hospital also had supplies costs in Radiology of $ 395,205 in 2012, $405,222 in 2013 and 410,100 in 2014. There is expected to be an industry wide increase in radiology supplies costs of 6.5% in the next budget year.

LABORATORY  EXPENSES

                                                           2012                   2013               2014

Supplies                                           $79,866               $86,480           $96,959

 RADIOLOGY EXPENSES

Supplies                                          $395,205              $405,222         $410,100

NURSING JOB CLASSIFICATION LISTING

POSITION TITLE                                  AUTHORIZED POSITIONS

Director of Nursing                                 1 ft

Assistant Director                                  2 ft

Nurse Supervisors                                  4 ft

Head Nurse                                           8 ft

Staff Nurses RN                                     80 ft

                                                            15 pt

LPN                                                      25 ft

                                                            10 pt

Nurses Aides                                         10 ft

Orderlies                                                6 ft

Unit Desk Clerks                                     6 ft

                                                              4 pt

Secretary                                                1 ft

LABORATORY

Department Head                                     1 ft

Med Technologist                                     12 ft

                                                               2 pt

Lab Tech                                                  4 ft

Lab Assistant                                           2 ft

Secretary                                                 1 ft

PARIENT REVENUE

Gross Revenue Projected for the 2014-2015 budget year is as follows:

  In Patient            $30,675,000

  Out Patient         $36,878,000

 Total                  $67,553,000

Current Reimbursement Formulas:

                                           In PatientOut Patient

 Medicare                              $5760/case  38% of Charge

 HMO                                    $1215.00/pat day                     31% of Charge

 Other Insurance                     $7655.00/discharge  42.5% of Charge

 Expected length of stay (LOS) in 2015 is 3.4

INSTRUCTIONS: 

1. Describe the mission, assumptions and objectives for the upcoming budget year for the departments involved. (Nursing, Laboratory, Pharmacy & Radiology)
2. Establish statistics volume projections for the budget year 2015 for all four (4) departments.
3. Establish a position control plan for the new Psychiatric Unit. (Part of Nursing)
4. Establish a position control plan for nursing and laboratory.
5. Complete expense item for laboratory & radiology for 2015.
6. Project the expected net revenue for all Medicare, HMO, and all Other Insurance patients.

 

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Community Health Nursing 409

Family Health and Assessment Assignment

Overview (6 pages paper)

This assignment is the use of a selected conceptual model to help students in describing, pinpointing an exploring families in community practice. The Friedman family conceptual model is a tool used to assess the “family as a whole, as part of the whole of society, and as an interaction system” (Lancaster & Stanhope, 2008, p. 569). The Friedman assessment is following the nursing process in the context of a family and provides guidelines for nursing interventions (Stanhope & Lancaster, 2008). This methodical process can point to family problem area, strengths and resiliency (Lancaster & Stanhope, 2008). As noted in Stanhope and Lancaster (2016), not all of the Friedman assessment tool will be relevant for the family.

Instruction for Assessment and Intervention:

For this project the student must complete the Friedman family assessment short form during from one to two home visits. You must initially receive approval for the family interview, ensure privacy by using only initials or pseudonym to identify family (no other identifier should be utilized). If you identify an intervention that would of benefit to the family, provide the information as soon as possible and follow-up on intervention. Please discuss all proposed interventions in a summary with the Friedman Family assessment and the tentative benefit/s to the family.

The guiding questions for the Friedman family assessment short form is located in Stanhope and Lancaster, 2016, pp. 1046-1047. It will also be meaningful if you read pages 606-618 in Chapter 27 of Stanhope and Lancaster, 2016. Attached is an example of a Friedman family assessment format short form (note the example paper does not have a title page with the identifying data). The assignment must follow the APA format, including a page 1 (Title page) and a title on page 2.

 

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Directions:

1. Select and describe a specialty that has evolved in a different direction from that of advanced practice nursing (e.g., informatics, administration, health policy, and/or forensic nursing).
2. What key differences do you see in this evolution as compared with developed APN specialties?
3. Describe the future vision and goals each role and relate to emerging healthcare trends and needs.

Your paper must be presented in a single Word document. The paper must be between 2 to 3 pages in length, not including the title and reference list pages. The paper must use proper APA Publication Manual, 6th Editionformatting, including title page, running head, and reference list with properly formatted citations in the body of the paper.

 

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