OMOO6 APA INTEXT CITATION GRADE A Needed

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PINEY WOODS STRETCH GOALS 7

Piney Woods Hospital Stretch Goals Continuum Care

Olufunmilayo Adeleke

Walden

OM006

10/26/2018

PART II: STRETCH GOALS Comment by Chris Miller: Headings should not be in all caps. And they should be centered

Goals in an institution have a pervasive influence on the employees and the management of the institution as well to get the best of the resources available and hence organizational performance. To get the best of the goals created for an organization, the goals should be assigned in consideration to the content and the intensity of the goal. Furthermore, Vainieri et al. (2016) state that when a goal is specific and challenging, it leads to improved performance compared to an easy goal, a general goal, or no goal. In the bid to improve the performance of Piney Woods Hospital, there is a need to have the specific and challenging goals that best improves the performance of the hospital as a whole. In setting the stretch goals for the hospital cost and waste management, the goals should be specific and lead to goal-achievement. Comment by Chris Miller: in APA format we indent the first sentence of each new paragraph Comment by Chris Miller: grammar – goals are Comment by Chris Miller: grammar should be possesses

The stretch goals include:

a) Use of washable utensils in the cafeteria Comment by Chris Miller: these don't really seem goals – these are more along the lines of processes. This is more of a function rather than a goal. The goal would be something that is attainable. Such as improved infections, reduction in cost waste in the cafeteria, Comment by Chris Miller: all of these seem to be more along the lines of specific functions or items. You don't have any of the keywords related to a goal such as improve, increase or decrease, make more efficient etc.

b) Re-usable medical and surgical supplies.

c) Reprocess and remanufacture single-use devices and instruments through third-party reprocessing companies.

d) Recycle plastics, including sterile water and saline bottles.

e) Bulk buying of products

1. Use of washable utensils in the cafeteria

The hospital needs utensils to serve the staff members and the patients alike. In most cases, the hospital has used disposable utensils to serve the patients and the staff. However, a change to the use of washable utensils will help to achieve a better cost reduction goal. The goal should be assigned specifically to the cafeteria staff. The cafeteria should choose to buy washable plates, eating utensils, glasses, and cups for the cafeteria and patient service. According to the New York City Department of Sanitation estimates that a l,000-bed hospital switching from disposable to reusable food service items would achieve a cost savings of $500,000 per year and 400,000 pounds of waste prevention in a year. Mercy Healthcare of Sacramento found that purchasing reusable liquid-proof surgical gowns and towels at six facilities: saves per year: $60,000 and waste prevention in pounds per year is 50,000 (BR Efficiency, 1999). Comment by Chris Miller: in APA format we intend the first sentence of each new paragraph Comment by Chris Miller: using a 1999 references very outdated. Especially when you're talking about costs. There have been so much changes and shifts in costs since 1999. This reference is close to 20 years old

2. Re-usable medical and surgical supplies Comment by Chris Miller: these are not proper APA heading

The Hospital needs to eliminate the unused items from custodial surgical packs. The surgeons need to identify the items in their packs that they need not use as often and order for them only when they need them. Switching from disposable to reusable medical instruments like stainless steel trays and laparoscopic instruments should be considered. The hospital should purchase washable surgical and isolation gowns and sterilization trays.

3. Reprocess and remanufacture single-use devices and instruments through third-party reprocessing companies

Hospitals need many items to use in the daily provision of their services. Piney Woods Hospitals need to find a way to reuse items locally or let some of the items be reused in other organizations. For example, old towels could be sold to companies that reuse rags to manufacture other products (Chartier, 2014). This way, the hospital can find themselves a few opportunities to get money from waste materials. The management has to find a professional who could help them find suitable companies for the products.

4. Recycle plastics, including sterile water and saline bottles Comment by Chris Miller: this is not a proper APA heading

Plastics are one of the most recyclable items, and the hospital can tap into this option. The hospital needs a lot of these plastic items. Mostly, after the use of the plastic items, they are disposed of. More than half of all wastes generated in health-care establishments are various kinds of packaging (noharm.org, 2005) most of which are plastics. Most of this waste does not have any direct contact with infectious agents or hazardous substances. Thus, it can be subject to recovery and recycling and should not be mixed with infectious or hazardous wastes. Empty packaging can be used to collect other wastes, reducing both the costs involved in the purchase of waste containers and the number of wastes generated.

5. Bulk buying of products Comment by Chris Miller: these are not proper APA headings

Bulk buying is another simple stretch goal of achieving a low-cost approach by the hospital. Legacy Good Samaritan Hospital (341 beds) in Portland, Oregon switched from buying juice in 32-oz glass containers to 60-oz plastic bottles that the hospital recycles showed cost saving and waste prevention amounting to Cost savings per year: $125 Waste prevention in pounds per year: 2,500 (BR Efficiency, 1999).

To ensure that the set goals have been achieved, there is a need to have a form of measuring the success of the goals. Each of the stretch goals will be measured differently because they are assigned to different departments of the hospital. For example, to measure the reuse of washable utensils, the measurements would be zero disposing of utensils. The hospital shall help the cafeteria department to buy new plates, mugs, and trays to serve the food and drinks to the staff members and the patients. Since it means that all the disposable utensils will be phased out, there should not be any utensils disposed of in the trash cans and dustbins. After a year, the cost of buying utensils by the cafeteria should have reduced drastically to close to zero after buying of the washable utensils. Comment by Chris Miller: because you're not really siting goals but rather siting processes or daily functions, your measurement doesn't seem to be very well aligned. You're just sort of restating what you're going to be doing.

Bulk buying should be measured differently also. The hospital will start to buy its products in bulk, and it can be measured by a show of increased cost of purchase during a specific purchase. However, the frequency of purchase should decrease drastically also. Reducing the frequency of purchase means that the hospital does not spend recurrently on the purchase of hospital products.

The hospital shall also reuse medical products. The simplest way to measure the success of the goal of reusing the medical products can be measured by the amount of reusable medical trash that is disposed of. A decrease in the amount of the reusable medical product in the trash cans means that there are more of them reused because their use would not decline. The hospital shall also realize a decline in the costs of purchase of the medical products.

The hospital shall also embark on Reprocess and remanufacture single-use devices and instruments through third-party reprocessing companies. The best way to measure the success of the goal is by a show of the number of reprocessed product and devices. The contacts between the hospital and another third party reprocessing company should increase. The movement of refuse products from the hospital to the company should increase as well as the number of products that the hospital receives from the company. Careful measurement of the stretch goals means that the hospital will be willing to follow up on the goals and ensure their success. The success of the goals means that the hospital will have a better cost and waste management scheme for better performance of the hospital.

PART III: CONTINUUM CARE Comment by Chris Miller: Use of proper APA heading

Continuum care refers to the concept that involves an integrated system of care that guides and tracks patient over time through a comprehensive array of health services spanning all levels of intensity of care (Evashwick, 1989). Many patients always find themselves to be in need of the kind of care that tracks their progress to being healthy again. Most of the patients that require the continuum care are the mothers, newborn babies, and children of sequential stages. These kinds of patients always find themselves in emergency situations because of their susceptibility to health risks. The dimensions of continuum care include home, first-level facility, and the hospital. As a hospital, Piney Woods Hospital must be in a place to provide proper Continuum care to its patients at all times (Kerber et al., 2007). Effectively, a continuum would ensure that appropriate care is available wherever it was needed, and linked, where necessary, to other levels of care. Comment by Chris Miller: use proper indentation Comment by Chris Miller: site references that are current within the past 5 to 10 years

To provide proper continuum care, the hospital needs first to build the care with health service packages. Studies conducted show that high coverage and quality of essential packages could avert about 67% of neonatal and child deaths in 60 priority countries worldwide (Kerber et al., 2007). The analyses developed include packages for maternal and child health, basic and emergency obstetric care, and postnatal care. A functional continuum can increase client and provider satisfaction. At the Piney Woods Hospital, linking the continuum care to the packages can maximize the efficiency with which the scarce human and financial resources available for healthcare are used. Comment by Chris Miller: this sentence is very unclear. Try to be more accurate and pointed

Another way of increasing the quality of continuum care and reducing the risks it through operational strategies to strengthen care and linkages between levels of care. One predominant way to do that is the provision of human resource to cover the demand of the care. Community mobilization can increase the demand for care and improve access through communication. Local accountability for delays in seeking care and for sharing successes can be promoted through audits of both facilities and communities (Kerber et al., 2007). Increase in demand for care means that their hospital will have improved its services of continuum care and many of its patients are satisfied by the services they get. Comment by Chris Miller: grammar

To improve the care and reduce redundancy there should be a formula to track and accelerate the coverage of the care. The hospital needs to focus more on actually saving lives rather than just making a slogan out of it. The main barrier to increased coverage of integrated packages for the health of mothers, neonates, and children in most countries is not insufficient knowledge or even unsupportive policy, but inadequate operational management (Kerber et al., 2007). The hospital, therefore, needs to focus on the provision of more information about the emergency information concerning the continuum care they provide. Comment by Chris Miller: I'm not sure that this statement is very accurate. I feel that it's a bit over exaggerated. I doubt that a hospital would simply make a slogan out of it and the ultimate goal would always be to save lives. I don't believe any hospital was purposely trying to not save lives. This statement is a little bit tilted. You need to be more focused. Perhaps focus on the area of stating the hospital needs to live up to its slogan by improving safety measures etc.

For any hospital provision of extensive services to the patients should be the main object. Likely, Piney Woods should focus on providing similar service, ensuring that the patients that visit get proper services and care. Use of continuum care provides more health services to the patients and pulls the patients even closer. Provision of better services means that the patients will spread the word to others and the hospital shall get even more patients. Spread of word to confidence about the hospital through the patients themselves serves much better than even use of media advertisements. The hospital can reach many people through better services without having to invest in advertisements and yet have the best services there can be. Comment by Chris Miller: the sentence does not seem grammatically correct

Information on the care would keep people on the loop while at the same time allowing them to choose whether they would like to get the services from the hospital. The hospital needs to provide the best possible services to gain a competitive advantage over other health practitioners; these services should be tailored to each individual. The hospital receives different people from different backgrounds and cultures which may have a different mindset towards the kind of health care provided. Quality improvement is the best way of achieving the bets that the hospital wishes to obtain. Piney Woods Hospital can use the six dimensions identified in the report “Crossing the Quality of Chasm.” The dimensions are patient safety, care effectiveness, patient-centeredness, timeliness, care efficiency, and equity. The dimensions would help the hospital improve its continuum care and the efficiency of the hospital in the end.

References Comment by Chris Miller: many of your references are out dated

Chartier, Y. (Ed.). (2014). Safe management of wastes from health-care activities. World Health Organization.

Efficiency, B. R. (1999). Waste reduction activities for hospitals.

Evashwick, C. J. (1989). Creating a continuum. The goal is to provide an integrated system of care. Health Progress (Saint Louis, Mo.), 70(5), 36-9.

Kerber, K. J., de Graft-Johnson, J. E., Bhutta, Z. A., Okong, P., Starrs, A., & Lawn, J. E. (2007). Continuum of care for maternal, newborn, and child health: from slogan to service delivery. The Lancet, 370(9595), 1358-1369.

Vainieri, M., Vola, F., Soriano, G. G., & Nuti, S. (2016). How to set challenging goals and conduct fair evaluation in regional public health systems. Insights from Valencia and Tuscany Regions. Health Policy, 120(11), 1270-1278.

Cost and Waste Reduction and Improvement of processes

Third Party Reprocessing Companies

This reduces the costs of buying new products if the hospital can reprocess its waste.

improves the processes of procurement

Reusing medical supplies

creates a reduced amount of waste generated by close to 50% percent as most of the supplies and reusable

Use of Washable Utensils

increases the process of serving foods and drinks as well as cutting the costs of recurrent expenditure on disposable utensils while also reducing the waste products

Bulk Buying

Reduces the costs of singular buyng of products

Reduces the waste generated by 10%