Clinical Microsystem Assessment
A clinical microsystem is a “small, interdependent group of people who work together regularly to provide care for specific groups of patients” (Institute for Healthcare Improvement, p.1). It is the goal of this paper to discuss the findings of the Johnson Clinical Microsystem Assessment Tool to the microsystem where I am employed on-call, the Multnomah County Health Department (MCHD), HIV Health Service Center (HSC), a primary medical home for patients with HIV/AIDS. Additionally, I will address each of the 5 P’s of the microsystem; purpose, patients, professionals, procedures and patterns that will then inform a practice change for the clinic.
Purpose:
White & Griffith (2016) define mission as “the central purpose of stakeholder collaboration” (White
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22). Joanne Fuller, (2017), Director of the Multnomah County Health Department outlines the vision of the MCHD “we have a vision that includes you…healthy people in healthy communities” (Fuller, 2017 Welcome, p. 1). The vision, mission, values, and goals listed on the Multnomah County website use words like partnership, promote, protect, and assure the health of people who reside in the catchment area, Multnomah County. Furthermore, the mission is followed by 10 clearly defined values. The HSC clinic as part of the organization would adhere to the same mission and values. Additionally, the HIV clinic focuses the mission further to “serve people living with HIV providing comprehensive and compassionate medical treatment, nursing care and social services” (HIV Health Service Center, 2017, p.1). Values that the clinic and
These team leaders ensure adequate and efficient services are being provided to the local residence of Central West. Scott McLeod the Chief Executive Officer who has “over 25 years of health care management and planning experience in a variety of health-care settings, including hospitals and regional health authorities in Alberta, Manitoba and Ontario.” David Colgan the Senior Director, Health System Integration who “has held positions as Executive Director with the Simcoe York District Health Council; Administrator, Corporate and Clinical Services, Faculty of Health Sciences, McMaster University; Administrator and Vice President, Administration & Finance with the Clarke Institute of Psychiatry; and Assistant Executive Director, York County Hospital (now Southlake Regional Health Centre).” Brock Hovey the Senior Director, Health System Performance who “has worked in the Ontario Health Care System since 1988. He has held various positions throughout his career: Vice President of Clinical Support Services and Chief Planning Officer at Lakeridge Health; Chief Executive Officer, Whitby General Hospital; Director, Accounting and Information Systems, Cornwall General Hospital; and Manager of Ambulatory Care Services at the Dr. Everett Chalmers Hospital in Fredericton, NB.” Shellean Alman the Administrative Assistant, Health System Performance. Lynn Baughan the Director, Health System Integration. Patrick Boily the
There are 9 types of health care facilities that are accredited by the Joint Commission. The Ambulatory Health Care accreditation, encompassing organizations and facilities that provide outpatient services of medical/dental nature as well as diagnostic, surgical, and therapeutic services. Other types of facilities that are accredited are critical access hospitals, hospitals, laboratories, office-based surgical centers, and nursing care centers. There is also Home Care services, the Opioid Treatment Program, and the Behavioral Health Care Program. Critical Access Hospitals meet special requirements regarding patient beds and LOS. Hospitals that are accredited include general and specialty hospitals.
Strategic Planning is an essential first step in the development of a result-base accountability system,” (Schilder, 2013, p. 1). In strategic planning an organization must know their goals, missions, and how to reach them. Health care facilities are in huge demand for the elderly and for people who lives in low-income communities. A person who receives good quality health care services can prevent the spread of contagious diseases. This paper will describe the need of the community, population it is serving, and a brief description of the facility.
Kootenai County has a health department that is involved in health services and provides pertinent information to
Building upon the knowledge gained in its previous attempts, over the next several years, IHC went about creating the infrastructure necessary to support such a model. IHC reorganized its management teams to include “a clinical administrative structure to be the clinical counterpart of the administrative structure at each level of the organization” (Bohmer, 2002). Guidance Councils (consisting of a physician leader and nurse manager) were formed for each clinical program and were responsible for coordinating program goals, management strategies and data collection across the system. Within the Guidance Councils were interdisciplinary Development Teams who identified “the key work processes and medical conditions for which protocols should be developed”, then created, implemented and refined said protocols (Bohmer, 2002). This was made possible by engaging practicing physicians (who were wisely reimbursed for their time) in the process, which gave them both the direct experience of the systems they created (be it paper or computer) and a provided feedback loop within the clinical community. Furthermore, IHC created a culture around process improvement, organizing “everything around value-added (front line) work processes” while offering “extensive training in clinical process improvement” as well as operational process improvement (Clark, 2010).
Multidisciplinary rounds approach calls for various members of the medical profession to synchronize individual skills, knowledge, and expertise in order to provide quality care for patients (IHI, 2015). The team members consist of nurses, physicians, “ancillary clinicians, and staff” (IHI, 2015, p.4). Each member contributes to the care of the patient individually, but in a cohesive manner (IHI, 2015). The multidisciplinary rounds care model strongly encourages and utilizes parental involvement during rounds (IHI, 2015). Multidisciplinary rounds also solicit parents and family members to communicate with the care team care as well as care team communications concerning the patient to the family (IHI, p.4). For each patient, the rounds are conducted daily (IHI, 2015). For each patient, goals are set daily (IHI, 2015). This ensures daily communication among care team and with patient and the families of the patient (IHI, 2015). The idea is to establish good coordination of care; thus, making safe and efficient care more consistent (IHI, 2015). As the protocols or the guidelines are clearly communicated among care teams, risks are identified, and staff are educated, the quality of health care improves (IHI, 2015).
As well the Monroe County began Health Action initiative 1995 which was instituted to convene “a group of community partners to develop a plan to improve the health” of residents in Monroe County (County, NY Monroe. Similar to the goal of the African American Health coalition, Health Action was created to improve the health outcomes of individuals in Monroe County by “aligning community resources to focus on selected priorities for action” (County, NY Monroe). Aside from this health initiative, another form in which the government is addressing the issues of health disparities regarding living environment and health conditions, specifically through healthcare is the Accountable Health Communities under the Department of Health and Human Services. This model is based on the “emerging evidence that addressing health related social needs through enhanced clinical-community linkages” will lead to improved health outcomes and reduce overall costs (ECFR). There are many tracks through this funding that offer a varied intensity to “better link beneficiaries to community services” (ECFR). The regulation title 24, housing and urban development, under chapter VIII, office of the assistant secretary for housing federal housing commissioner, department of housing and urban development, which focuses on the section 8 housing
The purpose of this lab was to identify an unknown bacteria culture using differential tests. The identification of the unknown culture was accomplished by identifying the bacteria based on its specific metabolic characteristics and morphology. It is suggested that culture 11 is a sample of Enterobacter aerogenes.
The Community Health Center provides a service called Better Health Clinic that can enhance adult health and wellness by providing contraceptive services, pregnancy testing and counseling, achieving pregnancy, basic infertility services, preconception health, sexually transmitted disease services, breast cancer screening, cervical cancer screening, and other preventative health services. Social services can assist with applying for W.I.C. and ACA. They can also render assistance with adoption and stay at home programs.
An organization such as the Pocahontas Memorial Hospital (PMH) is established to be a primary care source for a rural community, serving 5% of the state’s population (Pocahontas Memorial Hospital, 2013). PMH wishes to deliver compassionate care and promote healthy lifestyles through working collaboratively with other healthcare facilities, and delivering adequate patient education, while sustaining financial viability (Pocahontas Memorial Hospital, 2016). This organization would like to offer a comprehensive satellite health clinic within Pocahontas County, as the strategy to intervene existing weaknesses and threats to the health of the community of Pocahontas County.
Health care has evolved and is continuously evolving. The management of care now involves different clinicians to better assess, diagnose and cure a patient. The clinicians evolved from a general practitioner to a team now comprised of Physician’s Assistant, Nurse, License Practical Nurse and Specialists. These health care professionals now compose a team of health care providers that are essential in a patient’s over all health care. The team-based approach is a delivery system that provides a patient an all-encompassing health care delivery system. “ By practicing in a team-based care model, physicians and other
Over the past seven years as a clinical nurse on the McKeen Pavilion (the medical-surgical amenities unit at New York Presbyterian/Columbia Medical Center), I have committed to excelling in a clinical bedside capacity, as well as a member of the NYP community. This combination has allowed me to be a true advocate for my patients, their families, and my colleagues. The unit has afforded me a tremendous amount of hands on nursing experience, as
This lab and its procedures are all about finding out the unknown identification of a given bacteria. The lab consists of specific techniques, tests, chemicals, and vocabulary that are necessary for the finding of the bacterial identity. A bacterium is randomly assigned and it is a group effort to find the bacteria name through many of its specialties and characteristics. An example of classifying it would be to determine whether the bacteria is catalase negative or positive, or if the species is gram negative or positive. This lab is of huge significance because of its medical microbiology connections. Scientists Gurtler and Stanisich explained the connections more eloquently. They stated, in their medical article, that, “Medical microbiology
After discovering my passion for science and math, I pursue a career in Clinical Laboratory Science with enthusiasm. My desire to study this subject originates from the exciting and rapidly-moving subject area that is highly relevant to major issues facing society today. Clinical Laboratory Scientists play a crucial role in the healthcare field; in detection, diagnosis and treatment of disease in patients. My goal is to be involved in the latest advances in medical research and to constantly be expanding my knowledge about my field. On top of this goal, Clinical Laboratory Science remains a challenging, rewarding and inspiring topic that will motivate and shape my career for my entire life.
The mission of Hawaii Health Systems Corporation is to provide accessible, comprehensive healthcare services that are quality-driven, customer-focused, and cost-effective. The vision of the organization is to be the provider of choice for the communities it serves, the employer of choice for its staff, and the system of choice for its physicians (www.hhsc.org, 2014). The organization works with the physician base along with other service providers to plan and implement business ventures that will enhance the services offered to its patients. Employees and community leaders are included in the decision making processes to ensure adequate representation. Each facility has its own separate mission and vision statement that integrates into the overarching statement of Hawaii Health Systems Corporation.