Anywhere Hospital’s CFO for the past 20 years, Jim Smith, just retired. He worked for the hospital for 40 years and was greatly respected by his staff. The hospital governing board has hired a new CFO, Todd White.

Jim Smith utilized the silo approach to revenue cycle management during his tenure. He relied on his key management personnel to contact upper management of other departments in the hospital to discuss issues and to resolve problems and vice versa.

Todd White, however, had implemented an integrated revenue cycle team at his former hospital three years ago and strongly believed in the power of teamwork. His previous team had gained numerous efficiencies and improved accounts receivable by millions. So when Todd started at Anywhere Hospital he planned on implementing a similar revenue cycle team.

As with any change, Todd was met with much resistance. But after speaking with many of his managers in patient accounts and finance he realized that the employees did not know how to effectively work in teams. And why should they—the previous CFO had not asked them to do so in several years.

1.      What are some creative ways that Todd can help Anywhere Hospital understand the importance of an integrated revenue cycle team?  

2.   How can a manager improve teamwork amongst his or her employees?

3. Does Todd need assistance from a Changer Management Leader? Please explain your answer.

Workstation security can be an issue in many organizations. What are some of the things a health care organization can do to secure a workstation to ensure no PHI is viewed by someone who is not authorized to view it?

1. Discuss the pathophysiology of type one and type two diabetes. Develop a nutritional education plan for either a type one or type two diabetic. Include in your plan the nutritional considerations for one oral medication and one type of insulin used in the treatment of the disorder.

As medical groups sought capitation payments from health maintenance organizations (HMOs), what was a major problem for these groups?

The Case

In How Doctors Think, author Dr. Jerome Groopman reflects on the reasoning process that doctors use to arrive at a diagnosis. He refers to the problem of physicians becoming “locked in” to a diagnosis so early in the process that they overlook the important clues. The result, very often, is an incorrect diagnosis and inappropriate treatment.

The best example I can recall involved my twin brother, John.

He had developed chronic pain in his right hip and was referred to an orthopedic surgeon for advice. The surgeon obtained a CT scan of the hip. It showed some activity at the head of the femur, suggesting the possibility of a cancerous growth. My brother called me from San Francisco (he was on a business trip) and I advised him to arrange a visit with an oncologist at the university hospital located in his hometown. I flew up to be with him during a day of consultations and examinations.

The oncologist, with knowledge of a possible malignancy involving the head of the femur, ordered a new CT scan of the hip. It showed evidence of increased blood flow, furthering the conclusion that there was a tumor. At that time, I asked whether the pain could be due to aseptic necrosis (bone death caused by poor blood supply) of the hip. The response: “Oh no, the nuclear scan would not light up like this. It would be just the opposite.”

A chest x-ray was obtained as part of the workup for presumed metastatic carcinoma. The radiologist noted numerous tiny densities throughout both lungs. Equipped with the referral note from the oncologist and the interpretation of the CT scan, he said to me, “This has to be metastatic carcinoma.”

Late in the afternoon, the oncologist informed John that all findings indicated cancer that had traveled to his bone and lung. (The three main cancers in men that metastasize to both bone and lung are prostate, lung, and lymphoma.) A biopsy of the hip lesion was arranged, and we returned home where John sat down with his family and shared what the doctors had said. He told everyone that he had enjoyed a good life and was ready to die. Many tears were shed.

But John looked very healthy for a man with a tumor that had metastasized to his lungs and bone. Except for his hip pain, he felt well. Sure enough, when the biopsy was done, there was no cancer found. Evidence of aseptic necrosis was found, however, which was healing spontaneously. This explained the findings on the CT scan. Again, there was much cheering and more tears among the family members—this time, though, it was tears of joy and relief.

(The report of a chest x-ray taken some years earlier in another city was tracked down and found to be identical with that of the current chest x-ray—findings thought to be scarring from old granulomas, small areas of inflammation due to tissue injury.)

Within a matter of weeks, John’s hip pain disappeared!

Please provide an assessment of what the facility can do going forward to create a culture of quality and safety.

At 22/6/2020, Fatma is 31 years old, case of SCD with VOC during pregnandes (scd on Aspirin /peniclin prophylaxis /follc add), currently pregenant at 33 weeks, cames with rt knee joint pain since last night, bothg legs lookes normal, no swelling , no redness, took paracetmol with no improvement, no traum, no bites or Injuries.No SOB, no breathing difficulty, gdm on metformin 500 mgs bid, good fetal movement.
She admission at 7.6.2020 with severe aneamia ,hb was 5.6g/dl pt redeved 2pints of blood discharge on hb 9.
Pregnancy History...
Gravida 3
Surgical History...
Operated on 23/08/16 for g3 p2 preg 36 5 week with previous 2 cs (Lower segment caesarean section). Operated on 13/10/12 for 37 wks   k/c/o scd with (Lower segment caesarean section). Operated on 16/03/10 for primi 37ws scd Iscs for npol LS.CS (Primary}.
Plan:
Invistigation, rehyderation,analgesia, admission at gyne ward
thromboprophylaxis ,antibiotic, vitals monitoring, Intermittent ctg,
physian reffereal (1031) Informed, bsp inform, If needed

Part- 1
1. Analyze and specify the physical and psychological needs for this client? 2. Address the subjective and objective data included in the scenario? 3. Discuss the therapeutic management modalities provided to this client? 4. List the prognosis of this lady and possible complications and how to prevent it? 5. Write one priority nursing care plan and specify the appropriate nursing care should be provided for this client? 6. Specify health education instruction to be conveyed to this lady prior discharge?

Part-2
Discuss the following pharmacological management and justify if it is safe administration for a client suffers from GDM & SCD antenatally and postnatally (information should include the following information, classification, mode of action, indication, pregnancy category, nursing responsibility and a justification for its usage or not to the giving client)

1. Tramadol    2. Metformin 3. Heparin 4. Acetyl salicylic acid 5. Phenoxymethyl penicillin

Make 3 predictions about US healthcare and how it will look in 10 years.

Which nursing theory relates to RN delegation to an Unlicensed Assistive Personnel?

In 75-100 words, explain: how does trauma impacts physical health?