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Cost-effectiveness in healthcare
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Nevertheless hospitals need beds to work with the demand of care. And from admittance to discharge can be a long time. If all trusts prioritised elderly care it would free up 5,700 beds across hospitals and ensure elderly people like Mr Bates were not kept in hospital unnecessarily. (Imison, Thompson, and Poteliakhoff, 2012). This would benefit him as long stays prolong the start of recovery and normalisation. To start his recovery sooner he could be admitted him to a step down bed. This is a cost effective way to getting preparing him for home without having a long hospital stay. A stepdown care bed is a less clinical setting and is easier to start returning to normality (Boyd et al, 2012). Getting him back home is only a short term fix
Within the U.S. Healthcare system there are different levels of healthcare; Long-Term Care also known as (LTC), Integrative Care, and Mental Health. While these services are contained within in the U.S. Healthcare system, they function on dissimilar levels.
Another focus for change is that over the years the demand for home and community care over hospital care has continued to grow, as stated by the Queens nursing institute “Recent health policy points to the importance of improving and extending services to meet the health and care needs of an increasingly older population and provide services which may have previously been provided in hospital within community settings”.
Long-term care (LTC) covers a wide range of clinical and social services for those who need assistance due to functional limitations. These limitations usually result from complications associated with age related chronic conditions, from disabilities related to birth defects, brain damage, or mental retardation in children; or from major illnesses or injuries suffered by adults (Shi L. & Singh D.A., 2011). LTC encompasses a variety of services including traditional clinical services, social services and housing. Unlike acute care, long-term care is much more complicated and has objectives that are much harder to measure. Acute care mainly focuses on returning patients to their previous functional level and is primarily provided by specialty providers. However, LTC mainly focuses on preventing the physical and mental deterioration of an individual and promoting social adjustments to suit the different stages of decline. In addition the providers of LTC are more diverse than those in acute care and is offered in both formal and informal settings, which include: hospitals, physicians, home care, adult day care, nursing home care, assisted living and even informal caregivers such as friends and family members. Long-term care services have been dominated by community based services, which include informal care (86%, about 10 to 11 million) and formal institutional care delivered in nursing facilities (14%, 1.6 million) (McCall, 2001). Of more than the 10 million Americans estimated to require LTC services, 58% are elderly and 42% are under the age of 65 (Shi L. & Singh D.A., 2011). The users of LTC are either frail elderly or disabled and because of the specific care needs of this population, the care varies based on an indiv...
Staff nurses in many medical settings such as Skilled Nursing Facilities are at the forefront of patient care. Many patients in these particular settings are typically suffering from some type of cognitive impairment often related to dementia syndrome, behavioral disturbances or prior mental health conditions. Many mental health symptoms are managed by second generation antipsychotics. This class of medication placed the patients at risk for metabolic syndrome.
Linda is a 14 year old girl, who is in respite care. In my role as a carer I have observed that she was previously an outgoing and bubbly girl who mixed well but now appears quiet and withdrawn. I have been told by another resident who Linda confided in, that she was being bullied at school and not eating because of being called fat. This concerns me, as I have noticed Linda seems to have lost a considerable amount of weight. For this assignment I will need to identify who I need to communicate with regarding my concerns, recognise Linda’s physical, intellectual, emotional and social needs and then explain how I would use my interpersonal skills in doing this. I will obtain my information from books and the internet.
The long-term care system consists of an integrated continuum of many institutional and non-institutional providers who deliver extended care when needed. Long-term care providers deliver a variety of care to individuals with chronic, mobility and/or cognitive impairments/limitations. These providers include: nursing facilities, sub acute care, assisted living, residential care, elderly housing options and community based adult services (Pratt, 2010). A great majority of these providers are already taking care of the many baby boomers that are present today and will be present in the future. “Baby boomers” are individuals who were born between the years 1946-1964. Since 2011, every day 10,000 baby boomers turn 65 years old (Pratt, 2010). This
Unsuccessful transitions of care are evident in the statistics related to hospital readmission rates. There has been a numerous amount of studies conducted to examine methods to prevent and improve transitions of care. Naylor et al. conducted a randomized, controlled trial for transitional care of older adults hospitalized with heart failure. While this study didn’t necessary focus on pharmacist interventions in transitions of care, it emphasized important points of transition of care that should be considered to reduce and prevent hospital readmissions. The study utilized advanced practice nurses to manage the elderly patient transitions from hospital to home. They were in charge of developing an individualized plan consisting of the schedule and content of patient care to manage heart failure, comorbid conditions and other health and social problems that contribute to poor outcomes. In another study, Halasyamani et al. developed a discharge
To provide appropriate care, long-term care admissions must be well thought-out and explicit tasks fulfilled prior to the patient’s arrival. There should be a smooth transition between facilities to promote continuity of care (LaMantia, Scheunemann, Viera, Busby-Whitehead & Hanson, 2010). If discharge planning is inadequate, patient safety and health can be compromised. For example, scheduled drug regimens, such as antibiotics and controlled medications, must be available within a timely manner. Most long-term care facilities do not support an in-house pharmacy. In addition, many pharmacies require original hard scripts before filling controlled medications. If admitting orders are inadequate or cannot be carried out within the appropriate time span, the admitting facility may be unable to meet critical needs. I have experienced this first hand on more than one occasion. The most recent o...
The medical high dependency unit concerned is part of the medical assessment unit. Admissions to the medical assessment unit are taken from either the Accident and Emergency department or from General Practitioners (GPs) when patients need assessment and/or investigations before they are discharged home or transferred to other wards in the hospital. The medical high dependency unit is a four-bedded bay with two side rooms. Two of these beds are classed as high dependency beds and the other four are medical assessment beds. However, if three high dependency beds are required, one medical assessment bed could be left empty. Some high dependency patients come from the intensive care unit, not recovered enough to be transferred to a general ward but not requiring intensive care, some from accident and emergency and some are admitted to the medical assessment unit before requiring high dependency care (that is to say the patient has deteriorated).
With the aging population growing faster every year many families must make a difficult decision whether their loved ones should live in assisted living or nursing home facilities. I can relate because I made the decision to care for my mother at my home. Some people do not have the money or resources to care for their parent so they must live in a facility for health and safety reasons.
Warren, M. L., Jarrett, C., Senegal, R., Parker, A., Kraus, J., & Hartgraves, D. (2004). An interdisciplinary approach to transitioning ventilator-dependent patients to home. Journal of Nursing Care Quality, 19(1), 67-73.
...staff would not be required to put in the overtime to compensate for the lack of workers. Patients would no longer have to suffer the neglect of the staff because he or she was too busy. Making sure the patient gets the best quality care reduces the time spent for recovery. Reducing the time spent for recovery increases the organization’s finances. Providing a safe facility also reduces the expenses on the private hospital’s budget. Ensuring a patient is safe can reduce potential use of ongoing treatment and services. Hiring the appropriate nursing staff needed can save the organization money. Instead of cutting back on staff, more staff needs to be hired to fulfil the needs of the patient. In the economy today, private hospitals need to focus on the overall long term effects of each action opposed to quick reactions resulting in financial strain for the facility.
In 1959, the Government passed the Mental Health Act, the Act aimed to reduce the reliance on long stay institutions, sparking the beginning of de-institutionalisation and community care (Blakemore & Warwick-Booth, 2013). Bauduin (2001) defines de-institutionalisation as the “reform process of mental health care, which involves moving patients from larger scale psychiatric institutions towards the community” (p.12). The focus on de-institutionalisation moved away from institutional care and concentrated more on integrating patients or residents into society, in the form of community care schemes. Furthermore, community care was predestined to be financially beneficial to the state, noting that it would be a cheaper method of providing care (Blakemore & Warwick-Booth, 2013). Bauduin (2001) explains that the objective of community care is to give people who are either physically or mentally disabled the opportunity to feel part of society. Alcock, Erskine & May, (1998) also credits the notion that “Care should not take place in institutions, whenever possible care should be encouraged in people’s own homes. Support should be family and community based” (p.310). One of the main issues that burdened institutions was the growing number of elderly patients; therefore, the government implemented the Health Services and Public Health Act 1968. This Act required local authorities to provide services such as home help, residential care, day centres and community hospitals for the elderly and the mentally ill (Blakemore & Warwick-Booth, 2013). Subsequently, the National Health Service Act 1977 prioritised homecare services, making them compulsory for those that wanted to stay in their own home. However, Tinker (1981) highlights the fact that the Government was not forthcoming with funds; consequently, local authorities could not afford to meet all of their objectives
Small sample size (n=201) taken from elderly medical wards from a single hospital in 1994 limiting generalization to other
Griffiths, P. & Wilson-Barnett, J. (1998). The effectiveness of 'nursing beds': a review of the literature.