Course Title: BU 5490-AU2 Capstone: Health Care Topics CRN 30200: May 23 rd to July 29 th, 2011

Transcription

1 1 Course Title: BU 5490-AU2 Capstone: Health Care Topics CRN 30200: May 23 rd to July 29 th, 2011 Name: Office location: Office hours: Dr. Robert J. MacLeod I will not have office hours at Plymouth State University for this course. Please me any questions and/or any other information that may pertain to this course. Biography: A.S.; North Shore Community College B.S. Plymouth State College M.B.A.; Plymouth State College D.H.A., Medical University of South Carolina Fellow, American College of Health Care Executives Regents Advisory Committee, American College of Health Care Executives Former Chief Operating Officer for an acute care hospital Former Director of Medical and Forensic Services, State of New Hampshire CEO, New Hampshire Hospital Adjunct Professor, Plymouth State University ADA Policy Plymouth State University is committed to providing students with documented disabilities equal access to all university programs and facilities. If you think you have a disability requiring accommodations, you should immediately contact the PASS Office in Lamson Library ( ) to determine whether you are eligible for such accommodations. Academic accommodations will only be considered for students who have registered with the PASS Office. If you have a Letter of Accommodation for this course from the PASS Office, please provide the instructor with that information privately so that you and the instructor can review those accommodations. Course Description: As the capstone course for your graduate health care program, I will promote the recognition and encourage discussion regarding basic components of the United States health care system. You will learn various aspects of the industry, global alternatives and how a multitude of internal and external factors impact and shape our delivery system. Topics included will be supported by information provided in text books, articles and related Power Point presentations. Students will use this material in preparation for written essays, final project and Moodle discussions. I have created a reading section on Moodle and it corresponds with the syllabus sections for handouts. Other than a literature search you will do for your final project all weekly materials for this course are under its respective reading link. The only materials you will have to obtain for this course are the Kovner and Perry texts.

2 2 Your grade for this course will be based upon: Final Project 40% Brief Assignments (Total of four) 30% Participation (based on online discussions-minimum one posting per question with your own opinion and minimum one response per question to other student/instructor comments.) 30% Total 100% As you can see, all components of your grade are weighted. The sum of the weights will equal your final grade based on the following scale: A A B B B C C C D D D- <60 F The grade for assignments will be based upon an average of all grades attained in the Assignments Section of the course. All assignments are weighted equally. Each assignment is worth 100 points. All grades for this section are based upon the 100 point scale stated above. The final project will be due on Week 10. Required Reading Materials: Texts: Kovner, Anthony R., Knickman, James R., Jonas and Kovner s Health Care Health Care Delivery in the United States, Springer 9 th Ed. ISBN # 13: (Hardcover). ISBN # 13: (Softcover) Perry, Frankie, The Tracks We Leave, Health Administration Press, 4 th printing, ISBN , 2010 Material: Other related publications and articles (all of which can be found in the handout section of Moodle). Course Schedule: Class Discussion May 23 Week 1: Course Introduction and Historical Readings Texts: Kovner, Chapter 1 (all) and Chapter 7 (Section entitled The History of Acute Care pp

3 3 Overview of Health Care in the U.S. Introduction PowerPoint Presidents and Health Reform (2010) National Health Expenditures: National Health Expenditures by Category ( ) National Health Expenditures by GDP ( ) National Health Expenditures by Highlights (2009) Definitions for CMS data (2009) Health in the U.S (CDC) Health Care Consumer Confidence (RWJ) Kaiser Health Tracking Poll (2010) Summary of the Latest Federal Individual Income Tax Data (2010) May 30 Weeks 2: Health Care Policy Texts: Kovner et al: Chapters 5 (all) Policy PowerPoint Affordable Care Act PowerPoint America Under the Affordable Care Act (RWJ) Legal Challenges to ACA (2010) Could We have Covered More People (2010) Making Reform a Reality (2010) Payment Reform Alone Will Not Transform Health Care Delivery (2009) Extra Federal Support for Medicaid (2010) Health Status of New Medicaid Enrollees Under Health Reform (2010) States Making Harsh Cuts in Medicaid (2010) Reimbursement Delays and Physician Participation in Medicaid (2009) June 6 Week 3: Private Insurance Why the Individual Mandate Matters (RWJ) Grandfather Report (RWJ) Insurance Exchanges (2010) Who are the Uninsured Eligible for Premium Subsidies (RWJ) National Health Insurers Report Card (2008) Tax Exclusion for Employer Sponsored Health Premiums (2009) Tax Debate for Employer Sponsored Health Insurance (2009) Myths and Misconceptions about Health Insurance (2009) June 13 Week 4: Medical Malpractice CBO Report on Malpractice CBO Report on Tort Reform (2009) Claims, Errors, Compensation Payments in Medical Malpractice Litigation (2006) Mass Medical Society

4 4 June 20 June 27 July 4 Week 5: Public Health Week 6: Health Care Organizations and Workforce Week 7: The Mandate for Health Care Quality National Costs of Medical Liability (2010) Sleepless in the Surgical Ward (2009) What s the Verdict (2009) Healthcare Consumer Beliefs about Malpractice Lawsuits (Chandra et al.2009) An Attorney s Perspective on what Drives Patients to sue (2009) Kovner; Chapters 2, 4 and 10 Handout: Preliminary Data for 2008 (CDC) Beyond Health Care: New Directions to a Healthier America (RWJ) For the Public s Health: The Role of Measurement (RWJ) Americans Conflicting View About The Public Health System (2010) Ready or Not: Protecting the Public s Health (RWJ) Kovner, Chapter 7 sections entitled Kinds of Acute Care Today, Hospitals in the US, Current Issues in Acute Care, Future Challenges pp Kovner, Chapter 8 (Section entitled, Dissatisfaction with the Current System pp ; The Evolving Health Care System pp Kovner, Chapter 9 (Section entitled Long-Term Care Needs and Demands pp ; Providers of Long Term Care pp ; Challenging Issues pp Kovner, Chapter 12 (all). Kovner, Chapter 14 (all). Medical School Applications and Students From 1982 to 2010 GAO Report on Primary Care Professionals (2008) The Physician Workforce (2008) Physician Workforce Diagnosis: Wrong Diagnosis, Wrong Prescription (2010) Physician Employment: How Can It Work This Time (2010) The Adequacy of Pharmacist Supply (2004 to 2030) The Future of Nursing: Leading Change Advancing Health (IOM/RWJ) Emergency Room Visits Likely To increase Under ObamaCare (2010) How Will Hospitals Be Affected By Health Care Reform (RWJ) How Long Can Hospitals Survive with Negative Margins (Schuhmann.2009) Kovner et al; Chapter 15 (all)

5 5 July 11 July 18 July 25 Week 8: Ethics and Leadership Week 9: Ethics and Leadership continued Week 10: Health Care Topics Project Top Ten Quality Issues for 2011 (Health Leaders-2011) How does the Quality of US Healthcare Compare Internationally (2009) Improving Patient Flow and Reducing Emergency Department Overcrowding (RWJ) Realizing Patient Centered Care: Putting the Patient in the Center not the Middle (Frontiers-2011) Delivering the Goods (Dartmouth-2010) Dartmouth Atlas: Spending, Quality and Outcomes (2009) Dartmouth Atlas: Policy Implications Variations in Medicare Spending Growth (2009) States With More Physicians Have Better Quality of Care (Cooper.2009) Cooper s Analysis is incorrect (2009) Letting Go (2010) Perry; Introduction and Paradise Hills Medical Center Case pp xix-30. Perry; QualPlus HMO Case pp Perry; Rolling Meadows Community Hospital Case pp An Organizational Ethics Decision Making Process Time To Do Everything Except Think Hear That Long Lonesome Whistle Blow Why Good People Behave Badly Beth Israel CEO Perry; University Hospital Case pp Perry; pp and Disruptive Behaviors in Physicians Fulfilling Disruptive Behavior Policy Objectives o Metropolitan Community Hospital Case Hospital Mergers o Richland Case IT and the Board o Heartland Healthcare Case Submit final and summarize your paper online. Final thoughts Brief Assignments: Assignment 1: Write a three-page paper on the following policy question (Due June 13 th ): On March 23, 2010 President Obama signed into law the Patient Protection and Affordable Care Act. Since that time much discussion has ensued in Washington, DC and

6 6 across the country regarding the law s effectiveness to address our health care issues including access to all and rapidly rising costs. In addition, there is currently a move afoot in a number of states to challenge its Constitutionality. Using the lessons learned based on your readings and our discussions, please explain how policymaking is done in the US by using this most recent effort to pass and perhaps now repeal health care reform to help illustrate your explanation. Lists and explain the most important health policy elements currently debated in Congress. What aspects of ACA might be modified, eliminated or left whole? Provide a description and analysis of the primary actors (private sector and governmental individuals, organizations and institutions) relevant to these issues, including their likely policymaking predispositions and preferred modes of action and their impact on what is or might be the final outcome. Describes each phase of the health policymaking process (to date), and whether the process proceeded logically or was it at time irrational? Are there any likely unintended consequences to ACA? Who might be the winners and losers? Forecasts the likely problems that might result from such policymaking activities, and suggests what policy initiatives may come about in subsequent years. Who might influence those initiatives? Assignment 2: Write a three page paper on the following health care organization and workforce question (Due July 4 th ): You are the president of a newly formed healthcare recruiting firm. The lifeblood of your business will be to recruit competent healthcare professionals for a variety of healthcare organizations. Confounding industry issues that your firm constantly is challenged with include geographic location of the population, an aging workforce, racial and ethnic diversity, and changing patient demographics. Your top priority is to solicit clients and as such you want to send out a mass mailing that will convince CEO s and human resource directors that you are the firm that understands the problems and will get results. Toward that end, write a letter that describes the many challenges healthcare organizations have in recruitment and retention and explain to prospective clients how your firm can address those issues. Assignment 3: Write a three page paper on the following health care quality question (Due July 11 th ): Throughout this course we have discussed in great detail the issues surrounding malpractice and medical errors estimated to range anywhere from 44,000 to 98,000 unnecessary deaths and 1,000,000 excess injuries each year. Despite the number of technological advances throughout the decades, medical errors and overall quality is still a major industry issue. And to top it off, the impact of poor quality has exacerbated the high cost of health care contributing to longer hospital stays, high readmission rates, and avoidable medical procedures. As a result, ACA is about to implement a number of provisions that will penalize health care providers for poor clinical outcomes.

7 7 As health care professionals, what should the industry do to address this historically vexing issue aside from what has already been implemented by way of quality improvement processes? Will ACA finally be the vehicle that improves quality or will it make it worse by restricting funds while potentially adding more patient demand by improving access? Does our high utilization of services contribute to the problem? Are consumer expectations unrealistic or worse yet, driven by the desire to sue? Assignment 4: Write a three page paper on the following health care ethics question (Due July 25 th ): Describe an ethical issue that you might have personally experienced, witnessed, or heard about. Offer some background for the scenario, the ethical issue(s) that resulted and what if anything was done to address the action and to avoid it from happening the next time. Who were the actors that were involved in the situation and what was their role in the scenario? Capstone Project Health Care Topic Minimum 10 page paper (double spaced not including bibliography 1 please cite references) Due starting July 25 th and no later than July 29 th During the ten weeks of our course we have covered several areas concerning our health care system and the industry at large. Needless to say, the topic of health care is quite complex and intertwined. It can be described as a mosaic of processes and interactions that on the most part produces positive results. Perhaps a better descriptor might be taken from Margaret Wheatley s book Leadership and the New Science out of chaos comes order!! (Not required reading.) Your assignment is to choose a health care topic and examine it relative to its relationship to U.S. policy, the industry, and the consumer. The topic you choose might very well cause you to think about aspects that have both a positive and negative impact. For example, electronic health information enhances patient care, lowers cost but represents significant privacy issues if compromised. 1 For a book author, title, publisher, date of publication; for journal or periodical author, article title, journal title, volume, pages, date of publication.

8 8 Topics that you may choose from are quite endless, so don t feel that you must focus on something directly related to what we covered. It may be a hybrid of such or something that we have not covered at all. Here are some examples (the list is not meant to be exhaustive): Public Health o Opportunities for reform o Healthy communities o Disaster preparedness Quality o Medical errors o Risk management o Patient satisfaction Perception or reality? Information Technology o Industry barriers o Privacy considerations Interoperability o Impact on provider practices Informed consumers Ethics o Multidisciplinary organizations and multiple views on what is or is not ethical Culture Leadership o Legal versus ethical Health Care Recruitment o Shortages in the workforce o Managing difficult professionals Impact on the organization Impact on quality o Workforce retention Cost of Services o Utilization o Reimbursement Paying for outcomes o Geographical variations (Dartmouth Atlas) Health Care Organizations o Its future o Financial viability The Health Insurance Industry o Friend or foe o Single payer system Weekly topics for this course are intended to provide you with information helpful in completing this term paper. The expectation is to address a number of these

9 9 topics in your proposal and include other information that will add value to the breadth and scope of your paper.