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How does the nurse manager or leader play a role in the re engineering of health care?

REENGINEERING HEALTH CARE 5/1

How does the nurse manager or leader play a role in the reengineering of health care?
Reengineering Health Care
Introduction
Decisions based on ethical and legal principles are common in a person’s life. Choices such as whether

to indulge in gossip (breaching confidentiality) or driving too fast on the highway are examples of

these decisions. Making good ethical and legal decisions in nursing management or leadership practice

requires understanding of the underlying principles and incorporating that knowledge into the

decision-making process.
Ethical Decision-Making
Ethical decision-making is similar to other decision-making processes in that it requires the manager to

gather information, identify the problem, generate alternatives, or select an alternative to implement,

and evaluate the results. The difference in ethical decision-making depends on the identification of the

ethical principles that guide the selection and expectations of the outcome.
The principles underlying ethical decision-making include concepts that are familiar to practicing

nurses. Is it best for the nurse to use specialized knowledge to make decisions for a patient

(paternalism) or to support patients in making their own decisions (autonomy)? Are there circumstances

in which the need to benefit the majority of staff (utility) outweighs the need to treat everyone fairly

(justice)? Is telling a white lie (violating the principle of truth-telling) justified when it is

believed that the withholding of the truth will benefit the recipient (beneficence)? These are the

competing obligations that create ethical dilemmas. Ethical decision-making requires the identification

of competing principles as a part of describing the problem.
Ethical frameworks and professional codes of ethics exist to assist the manager in ethical

decision-making. Both frameworks and codes provide guidance in valuing one principle above another, but

do not directly provide the solution. There are several ethical frameworks. Two commonly used frameworks

are utilitarian-based and rights-based. A utilitarian framework advocates selecting an alternative that

will result in the greatest good for the greatest number of people, focusing on the projected outcome.

An example of using a utilitarian framework is the isolation of a patient with a communicable disease.

Although this isolation infringes on the person’s autonomy, the common good (utility) of not spreading

the disease is served. A rights-based framework focuses on the process of decision-making and

utilization of identified rights or entitlements. This type of framework is evident in The Bill of

Rights for Registered Nurses (The American Nurses Association, n.d.).
Professional codes of ethics have been published by several professional nursing organizations. These

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LIST THE ANATOMIC COMPONENTS COMPRISING THE LOWER MOTOR NEURON (LMN) UNIT AND DESCRIBE NORMAL NEUROMUSCULAR TRANSMISSION

a) List the anatomic components comprising the lower motor neuron (LMN) unit
and describe normal neuromuscular transmission. (14 marks)
b) Discuss the utility and application of electrodiagnostic studies in evaluating
patients with neuromuscular disease. (14 marks)
c) For both of the following conditions, explain the aetiopathogenesis of disease
and where the primary defect in lower motor neuron transmission occurs:
i. feline diabetic neuropathy (10 marks)
ii. acute canine polyradiculoneuritis. (10 marks)
2. Answer all parts of this question:
a) Describe the normal pulmonary circulation and outline factors that contribute to
both the regulation of pulmonary arterial pressure in health, and the development
of pulmonary hypertension. (14 marks)
b) Outline the aetiopathogenic classification system for pulmonary hypertension
and for each category explain the mechanism(s) that contribute to development
of hypertension using disease examples. (16 marks)
c) Explain the methods and principles of indirect screening tests for pulmonary
hypertension. For each screening test identified, indicate the findings that would
support a diagnosis of pulmonary hypertension. (18 marks)
Continued over page
Small Animal Medicine Paper 1 Page 3 of 4
© 2015 The Australian and New Zealand College of Veterinary Scientists ABN 00 50 000894 208
3. Answer both parts of this question:
a) Define ‘self-tolerance’ and discuss the mechanisms that produce and maintain
T and B lymphocyte tolerance in normal individuals. (30 marks)
b) Define the terms ‘molecular mimicry’, ‘cryptic antigens’ and ‘bystander effect’
and explain how each of these may contribute to the development of
autoimmunity. For each of these mechanisms, provide a unique example of an
infectious disease that may trigger loss of tolerance. (18 marks)
4. Answer all parts of this question:
a) Describe the anatomy of the glomerular filtration barrier and describe factors
that determine the passage of substances across this filter. (12 marks)
b) Outline the aetiopathogenesis and describe the expected diagnostic features in
renal biopsy specimens for each of the following glomerulonepritides:
(18 marks)
i. membranoproliferative glomerulonephritis
ii. amyloidosis
iii. hereditary nephropathy.
c) Explain the pathogenesis of the following complications associated with protein
losing nephropathies: (18 marks)
i. oedema
ii. thromboembolism

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· Discuss lessons learned and propose actions that can be taken by your management to avoid similar anti- trust actions in your proposed merger.

Summarize the charges and rebuttal or mitigation of charges used by the health care organization

Prior to completing the assignment, review Chapter 4 of your course text.

You are a manager with 5 years of experience and need to write a report for senior management on how your firm can avoid the threat of a Federal Trade Commission investigation if you were to merge with other health care organizations. Research on your own to select a health care organization in the United States that has been charged with an antitrust action within the last five years and use this information as the basis for your paper. In your report

· Summarize the charges and rebuttal or mitigation of charges used by the health care organization you researched.

· Discuss lessons learned and propose actions that can be taken by your management to avoid similar anti- trust actions in your proposed merger.

Your paper must include an introduction, thesis, and conclusion. Your paper must be four to five double-spaced pages in length (excluding title and reference pages) and formatted according to APA style as outlined. Utilize three scholarly and/or peer-reviewed sources (excluding the course text) that were published within the last five years. Cite your sources within the text of your paper and provide complete references for each source used on the reference page.

Text book: Cleverley, W. O., Song, P. H., & Cleverley, J. O. (2011). Essentials of health care finance (7th ed). Sudbury, MA: Jones & Bartlett Learning.

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Describe the different pay for reporting models under the Centers for Medicare and Medicaid Services.

Analysis of Healthcare Finance and Revenue Cycle Management
Unit outcome addressed in this Assignment:
Describe the different pay for reporting models under the Centers for Medicare and Medicaid Services.

Course outcome assessed in this Assignment:
HI215-3: Examine the reimbursement processes of different health insurance plans.
AHIMA CEE Curriculum Mapping
Domain Subdomain Competency
Domain IV. Revenue Management Subdomain IV. A. Revenue Cycle and Reimbursement 3. Apply principles of healthcare finance for revenue management
Domain IV. Revenue Management Subdomain IV. A. Revenue Cycle and Reimbursement 4. Implement processes for revenue cycle management and reporting
Domain V. Compliance Subdomain V.B. Coding 3. Identify severity of illness and its impact on healthcare payment systems
Domain VI. Leadership Subdomain VI.F. Strategic and Organizational Management 5. Identify the different types of organizations, services, and personnel and their interrelationships across the health care delivery system
Assignment Requirements
Please complete all parts in a Microsoft Word document.
The body of your document should be at least 900 words in length.
Quoting should be less than 10% of the entire paper. Paraphrasing is necessary.
Students must cite and reference at least 4 credible sources after 2012 no blogs.
Please be sure to download the file “Writing Center Resources” from Doc Sharing to assist you with meeting APA expectations for written Assignments.

Instructions
Imagine that you are an administrator for a large hospital. As part of your role within healthcare leadership, you are involved in several committees for the organization. Please follow the instructions below in completion of this multi-part assignment.
Part Competency Assessed Instructions
1 Apply principles of healthcare finance for revenue management. Imagine that you are the Chief Information Officer (CIO) for a multi-hospital health system. You are requesting funding from the Board of Directors for an investment of a new electronic health record (EHR) system. In preparation for your funding request, you have scheduled a meeting with the department managers. In this meeting, you will demonstrate the principles of healthcare finance for revenue management through the intended application of cost reporting and variances. Compose an executive summary for your team covering those topics with budget speculation.
2 Implement processes for revenue cycle management and reporting. Knowing that the Board of Directors will need to consider the implications of adopting a new EHR system on the information systems related to RCM and reporting, you will analyze three (3) major considerations on Corrective Coding Initiative (CCI)-Electronic Billing X12N, compliance strategies and reporting, audit process (compliance and reimbursement), revenue cycle process, and/or utilization and resource management. Include your analysis within the executive summary.

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