DQ 1-2

Dq 1-2 RESPONSES

1.

One key factor that influenced the evolution of U.S. healthcare delivery system toward achieving higher standard of care was to set accreditation measure values into healthcare educational institutions (Gay, 2012). “Accreditation is a valuable part of a higher education,” and is seen as a “seal of approval” for professional schools and institutions (Gay, 2012, p. 639). The U.S. healthcare delivery system needs capable professionals who have been prepared in their schooling and can apply those skills in their practice. Abraham Flexner noticed this and claimed that students need to be well prepared in high school and college (Bowman, 2003). Gaining accreditation means that the higher education institution has been publicly recognized because it met certain standards (Gay, 2012). Secondly, accreditation is “a process of voluntary, external peer review in which a nongovernmental agency grants public recognition to an institution or program of study” (Gay, 2012, p. 639). Accreditation means that the program promises to provide the quality of education it claims to offer (Gay, 2012). Lastly, it means that the program has the financial means to follow their claims (Gay, 2012). When a school is accredited, it shows that the curriculum is at the highest standard and will successfully shape exceptional healthcare professionals.

          Challenges that are still relevant are that schools that are smaller or have less funding will not have as much access to equipment, nor will they be able to focus on specialties (Bowman, 2003). Therefore, Flexner states that schools should be compared to the highest regarded institution and all other schools should be set that that standard; and at Flexner’s time, that school was John’s Hopkins (Bowman, 2003).The schools that are in the process of being accredited provide relevant opportunities to those who want to join the healthcare field. Accreditation in healthcare institutions affects healthcare delivery because they provide students with the foundational knowledge to treat patients and provide the best care possible. The information and skills we gain at our professional school will have to be at the highest standards because we aim to provide efficient, effective and safe care.

          Accreditation affects the future healthcare delivery system because curriculum is always changing to create better treatments for patients. For example, pharmacists can be affected in the future because of the constant changes in the Doctor of Pharmacy degree program. More specifically, pharmacy schools are trying to make a change toward integrated healthcare education. Schools such as, Chapman University School of Pharmacy and University of California San Francisco School of Pharmacy, are doing this by having integrated classes with other healthcare students. The change is driven by the fact that “no single health professional—physician, pharmacist, nurse, dentist, physical therapist—can know it all these days” (Jacobson, 2015). Therefore, patients need teams of professionals that share the responsibility of giving “basic care while applying their unique expertise, evaluating the latest data and developments in their fields, and all for the benefit of that patient” (Jacobson, 2015). With this goal in mind, pharmacy schools are trying to bring together professions in ways that were not done in the past. Chapman University has classes with pharmacy and physician assistant (PA) students. I am excited to attend classes with other PA students and work in a team to practice real-life care situations. This integrated approach is the new solution to addressing the “surge in chronic diseases among an increasingly aging population” which will open “new opportunities for pharmacists to expand their scope of practice and lead in new ways through advanced training” (Jacobson, 2015).

 References Bowman, R. (2003) Flexner’s Impact on American Medicine. Retrieved from http://www.ruralmedicaleducation.org/flexner.htm

Gay Utz, D. (2012). Accreditation Measures Value. Radiologic Technology, 83(6), 639-640.

Jacobson, D. (2015). PharmD curriculum transformation. Retrieved from https://pharmacy.ucsf.edu/news/2015/06/pharmd-curriculum-transformation

2.

In my opinion, I think the Affordable Care Act (ACA) was one of the biggest influences in the U.S. health care delivery system and why it is the way it is today. Although the Affordable Care Act is something that has happened pretty recently, since 2010, this was the type of act that needed to be enacted in the U.S. Because of the ACA, in 2016 there was 17.6 million consumers that have gained health insurance which means more than 9 in 10 Americans have health insurance, 129 million Americans, including children, are now protected from coverage denials and reduced benefits, over 14 million Americans have received coverage through Medicaid, and the ACA expands mental health and substance use disorder benefits and parity protections to over 60 million Americans (Office of the Press Secretary, 2016). The biggest challenge is the possibility of still having pretty high premiums even though they have dropped due to the ACA. High premiums means that people are still paying a lot for health insurance even though the premiums have been reduced which means that even under the ACA, some people still cannot afford health insurance. However, I think that premiums will continue to decrease as long as the ACA is in effect.

 References

Office of the Press Secretary. (2016, March 02). FACT SHEET: The Affordable Care Act: Healthy Communities Six Years Later. Retrieved from Obama White House Archives: https://obamawhitehouse.archives.gov/the-press-office/2016/03/02/fact-sheet-affordable-care-act-healthy-communities-six-years-later

3.

Healthcare changes have been influenced by the advances research and new technology but it also with our patient population and their needs.  We are living longer, living with chronic illnesses and dealing with increases in cost of services and insurance.  I believe that the introduction of palliative care has been influential in the choices that are made by patients and their families when facing a chronic and terminal illnesses.  Palliative care is available for any age group, at any point in an illness and can be used alongside medical treatments.  There can be confusion when it comes to the differences in palliative care and hospice.  They are similar in some of the services offered however, hospice is onlynfor those that are terminally ill.  "Palliative care can be received by patients at any time, at any stage of illness whether it be terminal or not." (Hospice vs. Palliative Care, 2017)

Palliative care involves a team of providers that can meet all of the needs of the patient, this team works with any other providers involved in the patients care.  "The goal is to improve quality of life for both the patient and the family."(About Palliative Care, 2017) The ability to receive care not only as an inpatient in the hospital or long term care facility but on an outpatient basis in the home is a benefit to the patient needing this care.  People can live their lives instead of feeling like a sick person all of the time, in addition healthcare costs can be lowered.

As discussed in our lecture (HLT-314V Lecture 1, 2017) healthcare reform increased the need for allied health professionals, to work with the physicians to provide more specialized care.  The palliative care team includes physicians, nurses, respiratory therapists and pharmacy staff to name a few.  As our population continues to age and people are living longer the need for palliative care will increase, this increase will also require more people to enter the healthcare field. Allowing people to stay at home for care not only lowers those costs but can also make a difficult situation better for patient and family alike.

 About Palliative Care (n.d.) Retrieved December 7, 2017 from 

https://www.capc.org/about/palliative-care/

 HLT-314V Lecture 1(n.d.) Retrieved December 7, 2017 from

https://lc-ugrad3.gcu.edu/learningPlatform/user/users.html?operation=loggedIn#/learningPlatform/loudBooks/loudbooks.html?viewPage=current&operation=innerPage&currentTopicname=Evolution of the American Health Care System&topicMaterialId=4361b4d7-1d8a-4d94-ad1b-cdfae0783ad3&contentId=58ef6cbf-372a-426d-b229-b914ca2ffb21&

 Hospice vs. Palliative Care (n.d.) Retrieved December 7, 2017 from 

http://www.caregiverslibrary.org/caregivers-resources/grp-end-of-life-issues/hsgrp-hospice/hospice-vs-palliative-care-article.aspx

4.

I believe technology is one of the leading key factors which has allowed the healthcare system to evolve to what it is today. From ER too outpatient/inpatient, and the operating room technology has improved so much that it allowed treatment to be less invasive and more preventable. We have imaging equipment which is digital now, which means as soon as a tech hits the button an image pops up on the screen. Only 20 years ago facilities were still using film processors to get x-ray images complete. Also nurse’s equipment has allowed us to have very accurate readings of blood pressures, temperature, oxygen levels, and heart rate. These simple things may be taken for granted, however years ago facilities didn’t have this equipment.

Challenges that occur with technology is it is expensive. With hospitals that have end equipment tends to price procedures higher. On average, an MRI in the United States costs $1,119. That same scan costs $503 in Switzerland and $215 in Australia (Kliff, 2017). Also with high tech equipment means more problems that happen. Equipment that run off computers or lots of electrical, break down over time and become more and more of a “lemon affect”.

These changes affect many individuals who struggle getting insurance and can’t be accepted through the government insurance. Hospital bills are already expensive and are ever increasing. This will affect many patients wanting to get procedure done, however will deny it because of the expense.

 Kliff, S. (2017). The problem is the prices. Vox. Retrieved from https://www.vox.com/policy-and-politics/2017/10/16/16357790/health-care-prices-problem.

5. A key factor that has influenced the evolution of the U.S. health care delivery system is growth in the U.S. population, as well as an increasing number and percentage of elderly people in the population (Conklin, 2002). The increasing number of elderly patients affects health care delivery today and it will affect health care delivery in the future because there are simply more patients than there are health care providers that can treat these patients with the quality care they deserve. In addition to provider to patient ratio, healthcare costs have increased because of the growth in population. Abudeen and Hoi (2014) state how population growth increases healthcare costs through increased healthcare utilization and the need for healthcare expansion.