ISCUSSION ASSIGNMENT Reply INSTRUCTIONSThe student must then post 2 replies of at least 250 words but no more than 400words by 11:59 p.m. (ET) on Monday of the assigned Module: Week. For each thread and eachreply, students must demonstrate course-related knowledge and demonstrate a thoughtfulanalysis of the material. The students must support their assertions with citations from thetextbook, a biblical integration or Christian world view, and at least 2 peer-reviewed scholarlysources in current APA format. Any sources cited, with the exception of the Bible, must havebeen published within the last five years. Each reply should be unique and not include repeatedquotes and sentences from the thread or the other reply. Less than 25% of the thread or replies isto be directly quoted material.
Discussion: ePatient, Social Networking, Personal Health
Personal healthcare records are health records that patients can access and use to engage in their
own health care to improve the quality and efficiency of that care. This type of record has the
ability for the patient to provide individuals with ways to create a healthcare history log/agenda
and may include some common information such as medical diagnoses, medications, and test
results, making it easier for the indivuial to control their own quality of care to their liking. Yes, I
do see a minor problem between these two principles because I feel as if the patient’s information
should be allowed to be in control of their records. There is difference between the data sharing
and data ownership, control, and privacy because individual users should be considered the:
owners of data” in personal health records. “For this to be possible, it is necessary that hospitals,
academia and industry work together to bridge the ‘valley of death’ of translational medicine.
However, hospitals and academia often are reluctant to share their data with other parties, even
though the patient is the owner of his/her own health data.” (Hulsen,2020). This can be resolved
by having some sort of merger agreement. Data is important, and we are constantly sharing our
data with different apps, and devices. If we merge everything with the hospital, I believe PHR
would be a fine organizational tool. (Hebrews 10:25 ESV (English Standard Version)) states that
“Not neglecting to meet together, as is the habit of some, but encouraging one another, and all
the more as you see the Day drawing near.” A merger is a great agreement to allow for PHR to
grow each day, and I believe if organizations stop hiding essential data that could be beneficial to
patients, then I believe there will always be some sort of secret. The big opportunities that are
associated with PHR are that it allows self-care, and self-diagnosis. This is important because
there are a lot of tools available such as google, WEB MD, and the holy grail of YouTube, to
diagnose and show the most common medicine to combat different medical issues. The more
complicated challenges are that with PHR some entities are not covered by HIPAA. HIPAA
would supply weak privacy protection for PHRs offered by employees and some internet
companies. “There are talks about how there are stronger conversations to supply stronger
protection to those that need it. “Bringing third-party PHRs under the scope of HIPAA
authorizes the disclosure of highly sensitive data outside of the healthcare system, with each such
disclosure subject only to patient authorization.” (HIPAA). Patient information being secured is a
huge deal in the healthcare industry due to HIPAA, and if there are any violations then that
organization would be under fire for the violations.
Hulsen T. (2020). Sharing Is Caring-Data Sharing Initiatives in Healthcare. International journal
of environmental research and public health, 17(9), 3046.
https://doi.org/10.3390/ijerph17093046 (Links to an external site.)
Hebrews 10:25 ESV, Bible verse retrieved from
https://www.biblegateway.com/passage/?search=Hebrews+10%3A25&version=ESV (Links to
an external site.)
HIPAA (2008). “Why the HIPAA Privacy Rules Would Not Adequately Protect Personal Health
Records,” retrieved from chromeextension://efaidnbmnnnibpcajpcglclefindmkaj/https://cdt.org/wp-content/uploads/pdfs/HIPAAPHRs_0.pdf
“Take possession of the land and settle in it, for I have given you the land to possess” (Numbers
33:53). The very definition of ownership is to have total control over something and decided
whether to keep it for yourself or share with others. In the aspect of personal health records,
“users should control access to their PHR, be able to annotate data created by others (e.g., data
from EHRs), be able to create new data fields, and be able to assign a proxy who can control and
use the system on their behalf” (Nelson & Staggers, 2018). This is where data sharing comes into
play. Data sharing with personal health records (PHR) is about allowing another authorized
person to gain access to either some or all of your medical records. Usually, a patient would need
to sign off on legally giving another medical professional access to their medical records. So
really, I believe that data ownership and data sharing can go hand in hand.
The goal of the healthcare community is to ensure a patient’s experience of care, quality of care,
and costs of care are all within their perspective limits. These are the possible opportunities to
better medical care. According to Nelson & Staggers (2018), “evidence demonstrating the
positive impact of PHRs across these three dimensions is increasing” (Nelson & Staggers, 2018).
The challenges related to the PHR system are listed as follows, “awareness of PHRs, usability,
interoperability of current systems, individuals’ concerns over privacy, and the digital divide. In
addition, providers’ promotion of PHRs and integration of them into the clinical workflows will
likely affect adoption and long-term use” (Nelson & Staggers, 2018). However, as time moves
forward, PHR are gaining in popularity with patients. Opening up a whole new world of
possibilities for both the patient and the medical professional.
Nelson, R., & Staggers, N. (2018). Health Informatics: An Interprofessional Approach, 2nd Ed. .
St. Louis, MO.: Elsevier Inc.
The Holy Bible, New International Version (NIV). (1973, 1978, 1984, 2011). Biblica, Inc.
Management of Human Resources and Health Professionals
Discussion: Healthcare Shortages
The sole purpose of health care is to enhance the quality of life by enhancing the health of each
patient. Nursing is an essential role in the healthcare industry, especially while having to meet all
healthcare needs with a significant growing number of patients. If one were to ask a nurse today,
why they enjoy doing what they do or why they chose the career they did, they will tell you they
chose their career to care for and to help others because that is what they enjoy doing. Many
nurses do not express their opinions as they should, creating many frustrations in the workplace.
Nurses’ workflow would be better if patient ratios were set in place. Without ratios a nurse can
have any number of patients which can become unsafe. “Encouraging nurses to express their
opinions is essential for creating a psychologically safe nursing work environment and an
organizational climate that supports open communication” (Yalcin & Turkmen, 2021). Nurses
are the core to many health organizations, and it’s vital to ensure they have safe working
conditions, to provide the best quality of care. Niles (2020) states that, “A high patient/nurse
ration also causes lower quality of care because nurses do not have time to provide quality care,
and if they are dissatisfied in general, the quality of work suffers”.
There is a significant increase of staff shortages, especially within the nursing sector. There are
many reasons why there are staff shortages such as, shortage of staff members to train new
nurses, lack of equipment for training purposes, job satisfaction, and most importantly burnout
and/or work overload. Being overworked and experiencing burnout can lead many nurses to give
up and leave their careers. It’s vital to gain insight and obtain opinions from nurses who are
overworked and what they need to fulfil their job duties effectively. It’s essential to know how
the shortage has influenced current nurses and not only in the United States, but in other
countries as well; because what may be working for them may work for others. Philippians 4:13
teaches, “I can do all this through him who gives me strength. Never give up, for that is just the
place and time that the tide will turn” (The Holy Bible, ESV, 2001). Giving up seems to be very
easy, but with Gods strength and guidance, one should be able to fight that urge. Turning to the
Bible for encouragement is very motivational.
Implementing a nursing residency program for newly licensed nurses would be an effective
strategy in rectifying this employment issue. Nurse residency programs would prepare newly
licensed nurses for the challenging health care environment. “Data suggest that NRPs increase
nurse satisfaction and retention while reducing expenses incurred in environments with high staff
turnover within 1-year post residency” (Legor et al., 2022). Enhancing the clinical training’s and
modifying policies and procedures for newly licensed nurses before beginning work would put
major relief on current staff members.
The Holy Bible, English Standard Version (ESV). (2001). Crossway
Legor, K. A., Caparrotta, C. M., Sze, C. K., Killion, L. J., & Gross, A. H. (2022). Development
and implementation of an oncology clinical research nursing residency program for newly
licensed nurses. The Journal of Nursing Administration, 52(6), 371-376.
https://doi.org/10.1097/NNA.0000000000001162 (Links to an external site.)
Niles, N. J. (2020). Basic Concepts of Health Care Human Resource Management. Jones&
Barlett Learning. (p. 3). Retrieved from
https://www.jblearning.com/catalog/productdetails/9781284149463 (Links to an external site.)
Yalçın, B., Baykal, Ü., & Türkmen, E. (2022;2021;). Why do nurses choose to stay silent?: A
qualitative study. International Journal of Nursing Practice, 28(1), e13010-n/a.
There is an increase of nurses retiring and with that increase, the number of new nurses filling
those slots cannot keep up with the rapid loss of retiring nurses. Many schools have a waiting list
for nursing school but do not have the educational staff to fill those seats for nursing school.
Another hot topic as to why there is a nursing shortage is the pay for staff nurses many nurses
especially during the pandemic went into the travel nursing sector which oftentimes does pay
more than staffing jobs at the hospital. There are a variety of topics that are being discussed
throughout the health care system as to why there is a nursing shortage. Still, I would like to
highlight one of those topics being a lack of nursing school availability in some areas. Nursing is
a career that many want to get into but for example, states like California have a long waiting list
to get into the nursing program and sometimes you lose people to other career paths due to that
long waiting list. I think one of the ways that we can help to improve the nursing shortage is to
have more access to nursing programs and have them be flexible to people from all walks of life
can get into them and participate in the program. Offering additional hybrid programs where
people can take many of the classes online can help to attract more students to want to apply to
the programs. In addition to offering more flexibility with the nursing program expanding the
locations where the programs are available such as rural areas having access to continuing
education could also improve the nursing shortage. Having more educators teaching nursing as
many are retiring can help to decrease the shortage because we must keep up with the rate at
which people are retiring or leaving the medical field. To relate this to a biblical perspective
would be to always want to learn more about the bible and that can help to improve your walk
with Christ and never stop learning about the goodness of God “If you abide in me, and my
words abide in you, ask whatever you wish, and it will be done for you” (John 5:39).
Nursing Workforce. American Nurses Association. (n.d.). Retrieved June 8, 2022, from
Online, K. J. B. (2019, September 20). King James Bible online. John 5:39.
Student enrollment surged in U.S. schools of Nursing. American Association of Colleges of
Nursing (AACN). (n.d.). Retrieved June 8, 2022, from https://www.aacnnursing.org
Research and Evidence Based Practice in Healthcare
Discussion: Quality Improvement
Health care is rife with the need for quality and safety improvement activities.
“The degree to which health services for individuals and populations increase the chances of
desired health outcomes and are consistent with current professional knowledge”3 (p.1161) how quality health care is defined. The bulk of medical errors, according to the Institute of
Medicine’s (IOM) report, To Err Is Human4, are caused by flawed systems and processes, not by
individuals. The complexity of health care is exacerbated by inefficient and changeable
processes, changing patient case mix, health insurance, disparities in provider education and
experience, and a slew of other factors. With this in mind, the IOM argued that today’s healthcare business is operating at a lower level than it might and should be, and it proposed the six
health-care goals of effective, safe, patient-centered, timely, efficient, and equitable treatment. 2
The goals of efficacy and safety are targeted through process-of-care assessments, which assess
whether health-care practitioners follow methods that have been shown to meet the desired goals
and avoid those that are inclined to damage. The goals of assessing health care quality are to
determine the effects of health care on desired results and to assess the degree to which health
care complies to methods based on scientific evidence or agreed upon by professional consensus,
as well as patient preferences because system or process failures create errors. 5 It’s critical to
apply diverse process-improvement strategies to uncover inefficiencies, poor care, and
preventable errors, and subsequently influence system modifications. Each of these methods
entails evaluating performance and using the results to guide improvement.
This chapter will go over quality-improvement strategies and tools that have been used to
improve the quality and safety of health care, such as failure modes and effects analysis, PlanDo-Study-Act, Six Sigma, Lean, and root-cause analysis.
Measures and Benchmarks
Efforts to improve quality must be measured to show “if improvement efforts (1) lead to a
desired change in the primary end point, (2) contribute to undesired effects in different sections
of the system, and (3) necessitate additional efforts to bring a process back into acceptable
ranges.” (6) (p. 735). The assumption that good performance indicates good-quality practice and
that comparing performance among providers and organizations would stimulate greater
performance is the justification for assessing quality improvement. There has been a spike in
measuring and reporting the performance of health-care systems and processes in recent years. 1,
7- 9 While public reporting of quality performance can be used to identify areas that require
improvement and assign national, state, or other level benchmarks,10, 11 some providers have
been sensitive to the publication of comparison performance data. 12 Consumers, another
audience for public reporting, have had difficulty deciphering the data in reports and, as a result,
have not used the reports to the level that they wanted to make informed decisions for better
treatment. 13-15 Measurement of quality is difficult due to the complexity of health care systems
and service delivery, the unpredictable nature of health care, and professional differentiation and
interdependence across doctors and systems 16-19. The attribution variability associated with
high-level cognitive thinking, discretionary decision making, problem-solving, and experiential
knowledge is one of the obstacles in employing metrics in health care. 20-22 Another
measurement problem is determining whether a near-miss caused injury or whether an adverse
event was a one-time occurrence or likely to recur. 23 Many national organizations, like the
Agency for Healthcare Research and Quality (AHRQ), the National Quality Forum, the Joint
Commission, and others, support the use of valid and reliable quality and patient safety metrics
to enhance health care. Many of these valuable measurements may be found at AHRQ’s National
Quality Measures, which can be applied to a variety of care locations and processes. These
measures are typically developed through a process that includes assessing the scientific strength
of evidence found in peer-reviewed literature, evaluating the validity and reliability of the
measures and data sources, determining how to best use the measure (e.g., determining if and
how risk adjustment is required), and actually testing the measure. 24,25.
1. Dixon-Woods, M. (2019). How to improve healthcare improvement—an essay by Mary
Dixon-Woods. bmj, 367.
2. Guise, J. M., Reid, E., Fiordalisi, C. V., Borsky, A., & Chang, S. (2020). AHRQ series on
improving translation of evidence: progress and promise in supporting learning health
systems. Joint Commission journal on quality and patient safety, 46(1), 51-52.
Quality improvement initiatives exist at most healthcare companies and focus not just on quality
improvement but improvement of patient outcomes (Hall & Roussel, 2022, p.233).
I reviewed the minutes from the San Francisco Health Plan (SFHP) Quality Improvement
meeting held on August 10, 2017. The meeting lasted an hour and a half and covered follow-up
from the last meeting as well as updates on five current quality improvement projects.
I chose to review the quality improvement plan discussed regarding the Consumer Assessment of
Healthcare Providers and Systems (CAHPS) survey results. The CAHPS survey is a voluntary,
patient experience survey conducted by the Centers for Medicare & Medicaid Services
(CMS). The survey data is then compiled and reported publicly so that healthcare organizations
can use the data for quality improvement (CMS.gov, 2022).
The CAHPS results for SFHP showed that they had met their goals in providing timely care but
missed their goal for coordination of care. SFHP is already participating in quality improvement
projects for open access or patient-driven scheduling and process improvements to streamline
patient flow. They expect that these efforts will positively impact the results of the next CAHPS
survey which will be the benchmark they use to determine improvement.
The Bible encourages us to keep trying to get better at whatever we are doing. In Galatians 6:9 it
says, “And let us not grow weary of doing good, for in due season we will reap if we do not give
up,” (ESV). God created us and wants us to succeed. If we can put in a little bit of effort to
improve the quality of care for our patients, then we absolutely should.
Consumer Assessment of Healthcare Providers & Systems (CAHPS). CMS. (n.d.). Retrieved
June 7, 2022, from https://www.cms.gov/Research-Statistics-Data-andSystems/Research/CAHPS
English Standard Version Bible. (2001). ESV Online. https://esv.literalword.com/
Hall, H. R., & Roussel, L. (2022). Evidence-based practice: An integrative approach to
research, administration, and Practice (233). essay, Jones & Bartlett Learning.
San Francisco Health Plan. (2017, August 10). Quality Improvement