<p> The goal of the project was to implement best-practice guidelines for adults with heart failure (HF) receiving home care. Heart failure is incurable, but can be managed when healthcare providers use evidence-based treatment guidelines and patients comply with routine follow-up and practice a healthy lifestyle. Providing access to care for the elderly in the form of a structured telephone call program to monitor self-care efficacy related to adherence to medication and other treatments and therapies is associated with reduced HF symptoms and improved quality of life. This project implemented a phone call follow-up program to evaluate and improve self-care efficacy in adults with heart failure by monitoring compliance, providing education, and focusing on key indicators of HF symptom exacerbation. The Self-Care of Heart Failure Index (SCHFI) was used in weekly phone calls for a total of 10 weeks. Using the SCHFI tool provided structure and included key best practice content areas with scripting to enhance consistency. The project participants were adults age > 65 year old patients receiving care through a home health care team in central Louisiana who had an established diagnosis of heart failure. </p>

<p> Med-Equip Solutions LLC is an accredited wheelchair distributor start-up company located in the City of Laguna Woods, California, that strives to be a leading provider of manual and electric wheelchairs in the Laguna Woods area. The company is focused on helping improve the quality of life for elderly patients with mobility related disabilities in neighboring regions by providing high-quality equipment and exceptional customer service. Med-Equip Solutions LLC has geographic as well as economic advantages due to the population demographics of Laguna Woods City, socio-economic status of the population and the company&rsquo;s strategy of providing imported high-quality equipment, which creates enormous opportunity for profit and successful business operation in the area.</p><p> Chapter 1 provides detailed information about the company, services, target population, market research, customer analysis, competitor analysis, and marketing strategy. Chapter 2 deals with the feasibility analysis and provides information on company&rsquo;s SWOT analysis. Chapter 3 discusses the legal and regulatory issues pertaining to the business operation in the US abiding by the Regional, State &amp; Federal laws. Chapter 4 gives a description of the pricing structure, expenditure, revenues and detailed financial analysis of the business. In conclusion, Med-Equip Solutions LLC has shown significant potential for success in the market.</p>

<p> Directors of nurses in long-term care are faced with significant changes in the healthcare industry. The responsibilities of the position have evolved and now require director of nurses to have additional skill sets that were not previously associated with the expectations of the position. The purpose of this qualitative descriptive case study was to explore the perception of 8 directors of nursing in long-term care facilities in the Downstate Area of New York State. This research was guided by the following questions: What are the perceptions of directors of nurses or nurse executives in long term care facilities? Who may or may not be educated in graduate level business, particularly in the area of business decision making and fiscal responsibilities? How can registered nurses in leadership and executive positions enhance their educational preparedness as they pursue the responsibilities associated with their roles? A case study is an in-depth examination of individuals, organizations, or processes that seek further theoretical understanding. Several pertinent and relevant themes were identified such as; a) the review of the nursing curriculum, b) the need for standardized requirement to practice as a director of nurses, c) self-direction in ongoing education, mentorship and, d) training in business and fiscal responsibilities. Additionally, sub themes emerged during this qualitative study which included; a) organizational responsibility, b) director of nursing demanding change, and c) accelerated nursing programs. </p>

<p> Sightseers Ophthalmology Services is a mobile medical business that provides concierge vision and ophthalmic services to individuals in Newport Beach and Huntington Beach. The implementation of the Affordable Care Act (ACA) has provided millions of previously uninsured patients with medical coverage, which is causing increased demand for primary and specialty care services, in addition to higher premiums for those who have historically maintained an insured status. A result of the ACA is overcrowding; patients are having more difficulty getting access to care, and are experiencing long wait times in clinic when they actually <i>do</i> get an appointment. Concierge medicine is becoming more popular as many patients are finding that increased costs and inconvenient access to care are not worth their time and money. Newport Beach and Huntington Beach are home to a population who may prefer concierge eye services, and be able to meet the expense of them, if needed. Sightseers is an affordable way to have access to same-day or next-day appointments; and, moreover, we come directly to the patient. Whether the patient has difficulty with transportation, a conflicting work schedule, or if he or she simply does not want to travel to and wait in a busy ophthalmology clinic, Sightseers&rsquo; business plan proves that convenient and high quality services can benefit both the patient and the provider.</p>

<p> The current environment of healthcare requires organizations to look at each department and each employee from an economic vantage and to consider at all viable options for cost containment. An organization&rsquo;s Medical Staff Office has traditionally taken responsibility for providing the credentials and privileging function for organizations. The amount of work and time as well as seasonal fluctuations in the number of applicants proves difficult for an organization from a staffing and budgetary standpoint. For many organizations, the ability to outsource its credentialing functions to a Credentials Verification Organization may prove a cost efficient option. </p><p> Veritas Credentials seeks to remedy this difficulty for healthcare organizations by allowing the credential and privilege function to be outsourced. This business plan will show how Veritas Credentials intends to provide an array of services to ensure that healthcare organizations provide privileges to high quality providers which will ensure patient safety.</p>

<p> The American healthcare system is being overwhelmed with chronic illnesses. These illnesses account for a significant amount of total healthcare expenditures. Medicare/Medicaid and Managed Care Organizations (MCO&rsquo;s) are seeking innovative treatment at cost savings. Disease Management (DM) is an intervention intended to reduce healthcare expenditures and advance the quality of life for persons with chronic conditions by preventing or reducing the effects of the disease through integrated care. Companion Pet Therapy 4 U is proposing Complementary and Alternative Medicine (CAM) which is a fluctuating set of diagnostic and therapeutic modalities that are considered to be unconventional. This approach utilizes a combination of Alternative Therapy (AT) and Disease Management (DM) home care services to elderly chronically ill homebound patients. A companion dog/ trainer and a care coordinator/nurse will visit homebound patients, review patient care plans, and educate patients on DM. Companion Pet Therapy 4 U will reduce healthcare expenditures, produce cost savings by empowering chronically ill homebound elderly patients to become pro-active in the treatment process.</p>

<p> Today&rsquo;s healthcare system is undergoing numerous changes. As a result of the increased number of insured people throughout the nations under the Affordable Care Act (ACA), primary care physicians do not have the time to provide quality care for patients. This business plan proposes to open up a concierge medical practice in Newport Beach with the mission to provide quality care to patients. The aim of the practice is to limit the number of patient loads to have time to dedicate to the care of patients while focusing on education and prevention.</p>

<p> The purpose of this business plan is to explore the possibility of a community-based adult daycare center in the city of Norwalk, California. The city of Norwalk is experiencing a steady growth of aging seniors (65 years of age and over) in need of a community-based coordinated care program that can assist caregivers with respite time and provide the continuum of care for their aging loved ones. Market research on the aging population of Norwalk indicates that there is currently 10,602 elder adults 65 and over living in the city of Norwalk, with about 1,590 of them at risk of being institutionalized. In addition, the market research also shows that only two licensed adult daycares exist in the city of Norwalk and serve about 2 percent of the aging population that are at risk of being institutionalized. Therefore, We Care Adult Daycare has the potential to enter the adult daycare market and establish a community-based adult daycare in the city of Norwalk. We Care Adult Daycare will operate as a for-profit limited liability company owned by three investors. According to We Care Adult Daycare&rsquo;s business plan, the breakeven analysis shows that the company will be profitable after the first year of operation. Estimated sales are projected to grow at a 2.5 percent monthly rate and at the end of three years, will present a company revenue of about $440,006. We Care Adult Daycare will be able to provide a community-based adult daycare center in the city of Norwalk.</p>

<p> Since 2009, the United States has experienced another wave of hospital mergers. Consequently, health systems are getting larger and increasing their market concentration. How patients benefit from hospital consolidation remains an open issue for policy-makers, economists, health care executives, community leaders, politicians, government agencies, and others. One measure of healthcare consolidation&rsquo;s impact, and its potential benefit/detriment, is how mergers affect patient experience, which, since 2007, has been measured by the standardized HCAHPS instrument. </p><p> Hundreds of studies conducted over the past 50 years have found mergers trigger an internal, socially-disruptive effect in the first 12 to 24 months following the event as the two merging organizations attempt to blend cultures, restructure job assignments, implement merger-related efficiencies, and achieve the overall strategic goals that brought about the merger. Consequently, organizational performance may decline in the short-term as the merger-related changes and accompanying upheaval move through the organization and get resolved. </p><p> Many researchers have evaluated the impact of hospital mergers on quality, safety, access, costs, pricing, and profits. However, no research study has examined the relationship between hospital mergers and patient satisfaction or patient experience. This research attempted to fill that gap with a quasi-experimental design using an interrupted time-series study. Cross-sectional, aggregate mean values of four different HCAHPS ratings (overall, physician communication, nurse communication, and staff responsiveness) of 99 merged/acquired hospitals were compared to that of 99 matched hospitals over a six-year time period (three year prior to the merger and three years post-merger). Fixed effects difference-in-differences testing was applied to evaluate and compare the post-merger rate of change in HCAHPS ratings between the two hospital groups. </p><p> This study revealed a negative relationship between some elements of a hospital&rsquo;s HCAHPS performance and merger status (i.e., completed a merger in the last 12 to 24 months or not). Specifically, a negative relationship was found between the merger group and two of the four HCAHPS domains (overall and nurse communications). Furthermore, a significant difference was found among the merged/acquired hospitals with respect to merger type. Hospitals that were acquired performed worse than hospitals that were part of a merger-of-equals. With the exception of the nurse domain, negative differences were resolved three years after the event. </p><p> Findings from this study will guide and inform hospital administrators, health system boards, state and federal government regulations and policies, and others across a wide spectrum of healthcare industry stakeholders.</p><p>

BACKGROUND. The United States healthcare system is one of the most expensive in the world, equaling approximately one trillion dollars. However, the quality of healthcare is low, as indicated by mortality rates, prevalence of diseases, rates of readmission to hospitals, dissatisfaction rates, and much more. One of the inefficiencies in the healthcare system that is causing errors and a decline in patient care to occur is the current paperwork system. Physicians and nurses spend much more time taking care of patient paperwork rather than giving direct treatment to patients themselves, and it's been shown that patient dissatisfaction levels rise and errors occur more frequently as a result of current physician/nurse workload. In order to change from paperwork to electronic files, hospitals must invest the time and money to look for alternative mechanisms that would decrease turn-around time of paperwork completion by leveraging digital solutions. A study was carried out to observe log back of paperwork by counting the amount of papers for each physician before and after an electronic email message intervention. RESULTS. The results were as expected: a simple email message did not drastically affect the amount of paperwork back log by residents, and numbers stayed consistent throughout. More than 50% of patient paperwork for residents in year 1 and 3 was more than 28 days old, which signifies the lack of paperwork availability and accessibility to the residents while off-site. CONCLUSION. Addressing the problem of paperwork burden to residents requires alternative solutions that include changing the entire paperwork system to a paperless, electronic system. Other solutions that require less effort, time and cost are possible, such as an email reminder as was done in this study, but will most likely not be as effective as switching to a paperless system that allows for physician-patient communication on a more consistent basis even though they may be off site. These changes would significantly improve quality of patient care as well as decrease administrative costs and waste.