Patient Safety and Quality Improvement in Healthcare

Description

Please respond to these 2 students

The National Healthcare Quality and Disparities Report (NHQDR) is an annual report that provides an overview of the state of healthcare in the United States. The most recent 2022 report focuses on four key areas: maternal health, child and adolescent mental health, substance use disorders, and oral health. The report has shown an increase in the median age of Americans and an increase in racial and ethnic diversity. Additionally, the percentage of Americans living in metropolitan counties has increased. The COVID-19 pandemic has had an impact on healthcare quality and disparities in the United States. Life expectancy in the United States decreased for the first time in 2020 due to COVID-19, and the decline was greater for Hispanic and non-Hispanic Black groups than for non-Hispanic White groups, widening a health disparity among these groups (National Healthcare Quality and Disparities Report, 2022). The leading causes of death in the United States in 2020 were heart disease and cancer, followed by COVID-19 and unintentional injuries. Social determinants of health, such as social, economic, environmental, and community conditions, may have a stronger influence on the population’s health and well-being than services delivered by practitioners and healthcare delivery organizations. The percentage of people with health insurance coverage has increased greatly in the past decade, but it varies by race and ethnicity. Many rural areas in the United States have been designated as primary care health professional shortage areas, indicating a lack of primary care professionals that threaten access to services when needed. Moreover, there are geographic variations in care, with some states having higher overall quality scores than others.

The recent 2022 NHQDR Report highlighted trends in healthcare quality and disparities in the United States, including an increase in the severe maternal morbidity rate, poor outcomes for hospitals in larger metropolitan communities, and inadequate access to treatment and recovery programs for substance use disorders. These trends highlight the need for further efforts to address healthcare quality and disparities in the United States. The report also identified some worrying trends in the state of healthcare in the United States. The severe maternal morbidity rate, which measures serious health complications during childbirth, increased by 11.1% from 2016 to 2019 (National Healthcare Quality and Disparities Report, 2022). Additionally, the rate of eclampsia/preeclampsia, a high blood pressure complication of pregnancy, also rose by 30.3% during the same time period (National Healthcare Quality and Disparities Report, 2022). Furthermore, the data indicates that hospitals in larger metropolitan areas tend to have worse outcomes. Child and adolescent mental health have become a pressing issue as more adolescents report persistent feelings of sadness or hopelessness. Opioid use disorders are also a concern, with inadequate access to treatment and recovery programs. The overall rate of overdose deaths involving any opioid increased by 36.8% between 2019 and 2020, and deaths related to synthetic opioids increased by 55.0% during the same time period (National Healthcare Quality and Disparities Report, 2022). These trends point to the need for further efforts to address healthcare quality and disparities in the United States.

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The purpose of this paper is to offer a summary of the state of healthcare quality and disparities in the United States of America. Suarez-Balcazar et al. (2018) describe “health disparities” as differences in health that emanate from being socioeconomically disadvantaged. Lavizzo-Mourey et al. (2021) assert that in spite of the increase in understanding of healthcare disparities and their underlying causes witnessed in America in the last five decades, the disparities persist. As indicated by the Agency for Healthcare Research and Quality (AHRQ) (2021), the National Healthcare Quality and Disparities Report offers summative information regarding the burden of disease and the healthcare system, access to care, the quality of care, and disparities in healthcare.

According to the AHRQ (2021), disparities in the American healthcare system occur as a consequence of several parameters. These include race and ethnicity, income levels, insurance status, and residence or location. The AHRQ (2021) reveals that these four factors bring about disparities in healthcare because they affect a person’s likelihood of receiving care when they need it, having a continuous source of healthcare, and receiving care on time. In regards to race and ethnicity, White Americans have better health care and outcomes in comparison to populations such as African Americans, Hispanics, Asians, American Indians, and Pacific Islanders. When it comes to income levels, the report reveals that individuals from low-income or poor households “experience worse care than people in high-income households” (AHRQ, 2021, p. ES-3). The report also reveals that, when compared to people who have private medical insurance, people with public insurance received the worst healthcare in 27 out of 69 healthcare quality measures. Finally, in America, a person’s geographical location or residence influences their access to quality healthcare because the best care is received by those in large fringe (suburban) metropolitan counties. Those in nonmetropolitan areas, or small and medium cities, receive the worst care.

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2. Describe how the following example illustrates one or more system characteristics contributing to dynamic complexity.

Example:

Medical Associates is a for-profit medical group of 40 physicians that operates two facilities and offers services in several medical specialties, including cardiology; ear, nose, and throat; family medicine; gastroenterology; general surgery; pediatrics; and obstetrics and gynecology. Medical Associates is open six days a week in each location from 8:00 am until 6:00 pm. Plans are being developed to extend its hours to 9:00 pm two days a week. For several years Medical Associates discounted its listed fees by 3 percent to 5 percent for its managed care contracts. Still, a few years ago, it had to accept larger discounts to remain in the networks of health plans.

Lower reimbursement led Medical Associates to change its staffing from relying solely on registered nurses (RNs) to hiring medical assistants (MAs). Currently, all physicians assigned to primary care services are assigned one RN or MA to assist with patient care. Physicians assigned to surgery are assigned one RN for every two physicians. As RNs retire or reassign, they have been replaced with MAs. On five recent occasions, when an RN assigned to a senior physician resigned, the senior physician demanded that the RN assigned to a junior physician be reassigned to him and that a new MA is hired to fill the vacancy with the junior physician. This ad hoc system of job switching has subsequent resignation of two RNs who did not want to be reassigned…Confusion exists around staff reporting relationships and who has the authority to change job assignments. (Seidel and Lewis 2014, 215)

–Post the initial response

–Respond to 2 of your classmates‘ initial posts

Grid View

	Excellent	Good	Fair	Poor
Main Postinga	45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness	10 (10%) – 10 (10%) Posts main post by day 3.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%) Does not post by day 3.
First Response	17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.
Total Points: 100