<p> Access to primary health care services is a significant issue for many communities seeking to improve the health of their populations. This single case study describes the 12-year journey of 2 adjoining rural counties in 2 states towards meeting the primary and specialty care needs of the uninsured and underinsured population. Data were triangulated using historical documents, first-person interviews, and health utilization data. The community leadership moved through various models including a free clinic and a university-sponsored health center before finally establishing a federally qualified health center, which now serves 40,000 citizens in these counties. The site is now hosting new programs funded by research grants in alliance with area universities. Success is contributed to an unwavering desire to provide a medical home for the underinsured and underinsured, a shared vision, recognition that continued success was dependent on a funding source, recognition that practices and processes must be in place to assist with navigation for those in need of services to seek care at the appropriate venue, and a belief that the infrastructure built to provide care was sustainable. All participants recognized the importance of funding for sustainability. Positive social change has occurred from the emergence of a multidisciplinary center to serve the community&rsquo;s uninsured and underinsured, thus improving access to care, management of chronic conditions, and access to behavioral health professionals. Findings from this study may inform other communities faced with similar problems and can inform legislators of the importance of federally qualified health centers in the provision of health care to vulnerable populations.</p><p>

<p> At any given time, approximately 4% of women in the United States are pregnant. Planned or unplanned, pregnancy changes the lives, mentalities, and bodies of women. Health and care are not only limited to the mother, but now extends out to the child as well. Pregnant women and their children require specialized care before and after the birth but sometimes these services can be difficult to locate, attend, and maintain. Mobile Mother aims to provide expecting mothers with top prenatal and postnatal services conveniently by bringing the clinic to them. The mission is to provide accessible, valuable, and quality care to pregnant women who have limited transportation, access to care, scheduling and time, or simply choose to not attend traditional maternity clinics in hospitals. Mobile Mother's goal is to deliver the best, convenient maternity care to expecting mothers in the Greater Los Angeles area. This proposal will provide detailed insight on how Mobile Mother aims to achieve these goals.</p><p>

<p> The continuously growing readmission rates within 30-days of discharge point toward compromising quality outcomes such as fragmented health care. The purpose of this project was to compare the effectiveness of pre-intervention traditional interdisciplinary rounds (IR)/ progression of care rounds (POCR) members, in comparison to the intervention of modified IR/POCR members, by adding a disease-specific educator (DSE) member to the team, as measured by the 30-day unplanned readmissions rate in patients discharged from a single cardiology unit in Galveston, Texas. A comparison of 30-day unplanned readmissions during two different timeframes was performed using the planned readmission tool. The Iowa model of evidence-based practice and the model of collaborative care supported the project. A comparative quantitative methodology was used to analyze the data. The final sample consisted of 50 (<i>N</i> = 50) patients discharged during the pre-intervention and 53 (<i>N</i> = 53) during post-intervention. The data was analyzed using descriptive statistics and an unpaired t-test. The pre-intervention IR/POCR team members period 30-day readmissions were 7 compared to 3 during the post-intervention IR/POCR team members. The standard deviation of pre-intervention IR/POCR and post-intervention was 3.95980 and 2.12132 respectively. The results show a significant value of 0.106 (95% CI, -1.04243 to 5.04243). The implementation of the DSE to the IR/POCR team assisted in identifying and closing the gap associated with quality patient outcomes and reduced 30-day unplanned readmission rates. Further research is needed due to a limited practice site. </p><p>

<p> <b>Background:</b> Stroke is the leading cause of disability in the US, affecting approximately 795,000 persons annually. Stroke care is delivered across multiple settings from hyperacute care in a hospital through chronic stroke management in the community. Considerable advancements have been made in the delivery of hyperacute and acute stroke care. Science and practice gaps exist in providing stroke transitional care across multiple providers and settings once an individual is discharged from an in-patient care facility to home. </p><p> <b>Purpose:</b> Using a qualitative descriptive design, this study engaged and elicited descriptions from stroke survivors and caregivers affected by stroke to inform the refinement and tailoring of a stroke-specific model of transitional care. </p><p> <b>Sample:</b> A purposeful sample of 19 individuals affected by stroke and their caregivers was required to attain data saturation. Participants provided rich descriptions regarding the postacute stroke transition from an inpatient care facility to home. </p><p> <b>Methods:</b> The investigator conducted five focus group discussions using a semi-structured interview format to elicit participant descriptions of their stroke transitional care experience. Interviews were audio-recorded, transcribed, organized using Atlas.ti 8.1 software, and analyzed using the content analysis method. </p><p> <b>Findings:</b> Stroke transitional care is generally not provided, and a host of unmet survivor and caregiver needs persist. The findings of this study inform stroke-specific exemplars for essential transitional care components. Stroke-specific findings emerged from the data that could not be explained in the context of the transitional care model, such as self-determination and self-efficacy, transportation challenges, and neuropsychiatric management. There is considerable healthcare system passivity in delivering postacute and transitional stroke care, leaving stroke survivors and their caregivers feeling abandoned and marginalized. The findings from this dissertation study and the literature inform refined, stroke-specific components and a stroke transitional care model. </p><p> <b>Conclusion:</b> This dissertation study is the first of its kind to engage primary stakeholders in developing stroke-specific refinements to and exemplars of stroke transitional care components. Study findings describe an urgent need for <i>active</i> stroke transitional care delivery, discusses stroke-specific exemplars of core transitional care components, and identifies refinements for a stroke transitional care model. The findings of this study are innovative in describing a community stroke nurse-led transitional care model that &ldquo;reaches back&rdquo; to the hospital. The unique findings from this study can inform a community-centric, stroke-specific transitional care model that aligns with the American Heart Association/American Stroke Association&rsquo;s guidelines for adult stroke rehabilitation and recovery, from which community stroke nurse-led interventions can be developed and examined. </p><p>

<p> Trade fairs have long been considered great platforms emerging and established businesses use as an effective way to help drum up business as well as learn and study the activities of competitors. A lot is usually going on at these events. Anywhere from (1) meeting with industry partners and prospective customers, (2) testing and studying new products, as well as (3) examining recent market trends and opportunities among other functions. The common factor in majority of trade fairs has been that they are looked at as organized little convenient stores that specific companies, within a specific industry, utilize to showcase and demonstrate their latest products and services for the purpose of boosting their market share and sales of their products and services. Through some research on trade fairs and the health industry, I found that most of the available platforms under the health care trade fair moniker are only done as single industry fairs with the purpose of just competing for sales and market share. </p><p> The goal of this paper is to showcase a new business venture under the name Health Guardians Exhibition Incorporation as a uniquely designed platform comparable to what common fairs are known for, a platform through which two different industries (technology industry and health care industry) will be tasked to work alongside each other for the purpose of developing ideas in the products and services through which accessibility to health services for the consumers of care will be made affordable and efficient for the purpose of improving community health.</p><p>

<p> The Diabetes Wellness Center is a health promotion and education center located in East Long Beach, California. This Wellness center is for individuals diagnosed with type I or type II diabetes. Its focus is to improve the overall health of those living with diabetes by educating these individuals on how to manage their condition, teaching them the basics of self-management, and providing care recommendations. This project plan will provide an in-depth analysis of the Diabetes Wellness Center marketing plan, feasibility and SWOT analysis, legal and regulatory issues, and financial assumptions.</p><p>

<p> In response to climbing health care costs in the United States, many insurers and policy makers would like to eliminate waste in healthcare by steering spending toward the most cost-effective treatments. Obstacles to achieving this goal include identifying specific medical settings where overuse occurs, and then developing strategies to prevent overuse without harming patient welfare. My study examined childbirth, the number one reason for hospitalization in the US, where the overuse of medical resources primarily takes the form of nonmedically indicated cesarean deliveries. </p><p> The financial tools (physician payment differential and patient&rsquo;s cost sharing) and other tools (utilization management, physician profiling, and practice guidelines) of managed care insurance create varied incentives that could affect behaviors of physicians and patients. Using data from the MarketScan commercial database, I proved that in a fee-for-service setting, physician&rsquo;s financial incentives (physician payment differential) and patient&rsquo;s financial disincentive (patient&rsquo;s cost-sharing) affect treatment choices on childbirth delivery method, and other incentives from managed care insurance have little effect. My study also found that more restrictive nonfinancial tools in non-capitated HMOs which are expected to reduce the use of cesarean sections turn out to have little effect, while lower cost-sharing in non-capitated HMOs leads to more use of cesareans. It could provide two health policy implications: (1) health plans with generous benefits may need more restrictions and effective regulations aimed at cost control, and (2) raising patients cost-sharing may prove effective for managing medical expenses. Finally, a &ldquo;What if&rdquo; analysis sheds light on the likely effectiveness of various changes in managed care insurance design intended to reduce low-risk primary cesarean deliveries.</p><p>

<p>Abstract Palliative care (PC) is the comprehensive management of patients diagnosed with terminal illness. Care for PC patients focuses on relieving symptoms. The purpose of this study was to determine the difference between pretest and posttest scores on the Frommelt Attitude towards the Care of the Dying (FATCOD) and the Palliative Care Quiz for Nurses (PCQN) after an educational intervention to emergency department (ED) nurses. The framework for this project was Bandura?s social cognitive theory. The FATCOD was used to assess ED nurses? attitudes toward PC, and the PCQN was used to assess ED nurses? knowledge about PC prior to the educational program. The educational intervention was developed using evidence obtained from the literature review and guided by the PCQN. The program presented to the ED nurses covered the essentials of palliative care and the information and skills needed by the ED nurse caring for the PC patient. The FATCOD and the PCQN were then administered as a posttest. A total of 70 nurses from two ED units volunteered to take part in the project. Results of the PCQN pre- and posttest showed a significant difference (p < .05), and the FATCOD pre- and posttest showed no significant difference (p = .849). The results revealed that education significantly improved knowledge of PC for the ED nurses participating in the project. Attitudes about PC were not significantly changed after the education program. The project promotes positive social change by raising awareness of the need for PC educational opportunities for ED nurses. By improving PC in the ED, patients and their families may experience increased satisfaction with end-of-life care and improved quality of life.

<p> The healthcare industry is ever-changing, with the significant advancement of technology compare to 30 years ago. Access to information has become quicker and paper chart has been reduced to the implementation and the creation of an EMR/EHR system. With patients obtaining a healthcare smartcard and acts as a portable EHR, this can help clinicians communicate better with other clinicians and be able to educate their patients on drug therapies, avoid administering duplicate testing, and thus, reduce cost for both the insurance and patients side. H.O.P.E.S. is making its way in the healthcare industry to alleviate burden for patients carrying papers and lab results, when it can be store using the smartcard system. This allows clinicians to access patients&rsquo; latest results if patients are seeing multiple clinicians (specialists) for their medical conditions. The smartcard allows physicians to educate their patients, getting them more involve and advocate for a healthier lifestyle.</p><p>

<p> GreenCare is a medical waste management facility, located in Los Angeles, California and aims at effectively treating and managing all kinds of medical wastes. GreenCare&rsquo;s business plan elaborates on how it is designed to safely and effectively handle the management of medical waste, by minimizing harmful byproducts, and emissions in the process. The aim of GreenCare is to offer disposal techniques including no-burn technologies that do not emit dioxin, mercury and other fatal pollutants, which differentiates GreenCare from other competitors in the market. The unique value proposition of GreenCare is to provide advanced ecological sensitive medical waste processing, and we aim to do this in a cost-competitive manner. It aims to lessen the ecological burden of medical waste in our communities, that is bound to create a positive impact on community health, in the long run. This business proposal gives the reader a thorough insight into the legal, regulatory issues and financial assumptions based upon which this proposal was designed.</p><p>