Long Term Care Management and Planning

       Long Term Care, Nursing Homes, and Medicare need funds. The aging population of America also will need this care at some point. Both the care and the funds are essential for older population. But the question of where the funds will come from has no concrete answer. Many people do not realize the importance and costs of long term care until they are presented with a problem that correlates a family or friend with long term care. Unfortunately, The United States struggles with the costs of long term care because they are extremely high. The reason these costs are so high is because Americans do not like the idea of paying for this long term care in advance, or at a younger age.

The Older American Act is in place which could help elders by providing things like meals on wheels and elderly support in general. These precautionary measures and care could save money in the long run.  Medicare will slowly be pushed to a universal health care system but funding could make this impossible, however, I believe it could work with proper financial planning.  

Maggie Hassan, William Thomas, and Marco Rubio all bring an interesting view on how to provide funds for long term care. William Thomas created the Green house project which Maggie Hassan and Marco are in favor of, however, Marco believes premium support systems could be the answer that allows elders to have the choice of whether to spend their money on private insurance or Medicaid. Maggie Hassan also disagrees with the private funding aspect of the Green House Project. All this controversy of how funding should be accumulated, whether it be through the government or private insurers is the face of the problem. Ted Cruz is so against federal funding and social medicine. We face the problem of how to settle somewhere in the middle to find funding for the health care of the aging population. The question of whether or not we should make this long term care insurance mandatory in the United States is presented. I find it critical that we make this decision and decide how to start saving up funds to put towards our care in the future. I believe that acting and taking precautionary measures such as taking a percentage of our pay and putting it into an account to accumulate and gain interest could be the answer. Taking such precautionary measures and a primary approach could be essential. There needs to be a plan or some form of collecting money for long term care to help deal with the costs and provide the elderly with the care they deserve.

How Sugar Sweetened Beverages Effect Our Health

     Time after time we see science and health care changing. This change is inevitable and that is why it is necessary we recognize the change and work with the change. A simple public health crisis 20 years ago was tobacco and cigarette use. Although there is still some challenge ending tobacco use, there are new problems our society is facing such as childhood obesity. A small group of students that I have been working with have been doing some research on sugar sweetened beverages and how they affect the obesity of our population. 

     Beverages such as soda are becoming a health risk today and no one would have expected this, just as no one had known or expected cigarettes to cause as much harm as they do. Numerous studies have shown the correlation between sugar sweetened beverages and childhood obesity. Recently Mexico has implemented a tax on sugar sweetened beverage and there has already proven to be a drop in the number of purchases of these sweetened drinks. There are hopes that people will soon see a drop in childhood obesity and obesity rates all around. The idea of implementing this tax on sugar sweetened beverage is fairly new to the United States. Philadelphia has talked about implementing this tax and requiring that all funds collecting from this tax go directly to healthcare programs or schooling programs for children. 

     With concrete data from Mexico, perhaps the U.S. will be more likely to follow through. I do not believe this taxation will take place anytime soon in the U.S. because many people are likely to fight it. However, I believe if a small amount of tax is put on these sugar sweetened beverages in the United States it will beneficial for many. Some people will not continue to buy soda, and hopefully sugar sweetened beverage sales will drop and so will obesity rates. Those who do not mind paying the tax will continue to buy sugar sweetened beverages and the tax will help fund education and health promotion as well as contribute to primary prevention of obesity and diabetes. It is important for many of us to see numbers and exactly where the money from the tax is going so that we support it. For me personally, I would not mind paying a few extra cents on things if I knew it were going to benefit and improve the health of our community. "According to the city of Philadelphia, a three cent per ounce excise tax could raise approximately $400 million over the next 5 years" (Sugar-Sweetened Beverage Tax, Philadelphia). Even this one example can show just how much money can be raised if this plan is executed. 400 million dollars is an incredibly large amount of money to be made and used in health care from something that is currently making $0 on tax. In addition to the fact that the intention of this is to improve the health of our people. Making the change with health and medicine is often difficult but essential. 

References: 

-Afzal, Stephen C. Resch and Angie L. Cradock J. Ward, Jessica L. Barrett, Erica L. Kenney, Kendrin R. Sonneville, Amna Sadaf  Steven L. Gortmaker, Y. Claire Wang, Michael W. Long, Catherine M. Giles, Zachary. 2015. "Than They Cost To Implement Three Interventions That Reduce Childhood Obesity Are Projected To Save More"."Than They Cost To Implement Three Interventions That Reduce Childhood Obesity Are Projected To Save More". Retrieved 11 November 2017. http://content.healthaffairs.org/content/34/11/1932.full.html

-Choices Project. Sugar-Sweetened Beverage Tax, Philadelphia. 2017. Retrieved 11 November 2017.
PA BRIEF_Cost-Effectiveness-of-a-Sugar-Sweetened-Beverage-Tax-in-Philadelphia-PA_CHOICESproject.org_5.20.16.pdf.

Millennial's in Health Care

     I had the opportunity to attend the Northern New England Association of Health Care executives this weekend in Ogunquit, Maine. This conference took place at the Cliff House and I was fortunate to be surrounded by many intelligent and upper level health care executives such as CEO's, CNO's, COO's and more. The amount of knowledge in the room was incredible. One man, however, really stuck out to me and all the things he had to say were important in my eyes.

    Josh Luke is a well developed and experienced health care futurist and has had some of the best opportunities in the game. Josh has a lot of strong beliefs in health care and how to improve healthcare as a whole. Much of what he said came back to Millennials and how we do things as a generation. He said " When I ask baby boomers to jump, they say how high, but when I ask millenials to jump, they say why?". We as millennials will always ask why and that is how we think. Why would we do something? Why would it help us, hurt us, improve us? We want to know why. We constantly ask questions and we want an explanation for most things. I think that this is important because we all think this way and function this way. We do and will think this way in our future healthcare jobs as well. I think many of our "why's?" have led to new techniques, discoveries, and advances in health care and they will continue to do so. Josh then proceeded to say that "there is nothing wrong with the way the millennials think but it is different and we need to learn and adjust to it because they are going to be running our health care system soon". Josh Luke made so many great points about fixing the bad, fixing the problems, and working to improve. It is essential that current healthcare professionals and millennials work together to advance health care and understand one another's mindset. We use technology in everything we do, for example every hospital is implementing EMR's if they haven't already. A millennials train of thought and technological skills are already being seen throughout the healthcare world. As millennials trickle into health care systems and spread their "why's" and technology knowledge things will continue to change. Adjusting current views and working the two generations into one another is key for success in running any healthcare system. Millennials have a different way of thinking that has the potential to improve healthcare systems as we face the challenge of continuous change in healthcare.  

Stress Management

     Stress is a huge weight on the body for many people and can lead to poor health. Things such as work, school, and other life factors are often major causes of stress. Managing stress is essential to a clear and healthy mind and I believe stress management should be practiced more. Stress management should be promoted more, emphasized more, and utilized more.
     Some of the  negative effects of stress on the body include poor health with the heart, immune system, muscles and more. The following symptoms can occur from too much stress as well; elevated heart rate, migraines, unhealthy eating patterns, sleep deprivation and more (Stress Management, Web MD). As time goes on, things will continue to grow on one another. One's health could continue to decline and stress levels could increase.
     A few ways that one can begin to cope with stress and lower stress levels include writing, meditating, and exercising. All of which help me relieve stress as well. I took a class called 'Promoting a Happy and Healthy Work Place' and one of the main focuses of the class was to work through stress. Everyday in class we meditated and performed mindful activities that would help each student relieve stress and improve their performance.  I found this to be a great instrument in creating a healthy mind and body. Promoting healthy behavior and working with stress management should be advertised to the public more often. I have found many students and and young adults to face enormous amounts of stress while not being aware of the success and power of stress management. Educating more people on stress management as well as promoting meditation and other exercises could help lower stress for thousands of people. This decline in stress levels could then improve the health of thousands and promote a happier and healthier environment.

Analyzing Medical Erros in the Health Care Organization

     There are always medical errors being made in health care organizations and analyzing data on these mistakes is essential. Medical errors are inevitable for humans but it is important to try to improve them any way possible because people's lives are at stake. Recently, NORC at the University of Chicago released a study that showed twenty one percent of people reported a personal experience with medical errors (Science Daily, 2017). The article went on to talk about how patients are affected by these errors and briefly how the medical mistakes are dealt with when they are noticed. I was happy to see that the following data reported. According to Science Daily, " Among the survey's other notable findings:
* Nearly half of those who perceived that an error had occurred brought it to the attention of medical personnel or other staff at the health care facility. 
* Most respondents believe that, while health care providers are chiefly responsible for patient safety, patients and their families also have a role to play.
* When asked what caused the medical error they experienced, people identified, on average, at  least seven different factors."(Science Daily, 2017). I was impressed with how many patients were seen to actually speak up and say they had noticed an error. This means that the patient had a concern, addressed it, and felt comfortable enough to talk to the doctor about it. Making hospitals and health care settings a comfortable place is important for someone who may be stressed and worried about their health or a loved one's health. Patients also seemed to agree that their families as well as themselves, play a role in their own patient safety which I think is key to success. Many of these patients felt comfortable in the setting and with the doctor they were seeing. Creating this bond, connection, relationship with the doctor and patient is not always easy. I was happy to see that many patients were able to have this relationship with the doctor and I believe that if doctors continue to make that bond and create a happy and calm environment, then medical errors can be brought to the attention of one another and fixed. In the long run, these kind of relationships could improve medical error rates. 

Infection Control

     Infection Control is a huge concern in hospitals that must be taken into account. I had the opportunity to see the infection control protocol for an emergency depart at a local hospital in New Hampshire. This opportunity really opened my eyes to how important managing the spread of infectious disease in hospitals and health care settings really is. Hospitals are one of the most dangerous places because there are so many sick people around. I looked at a protocol specifically for the spread of Ebola for this hospital. There were multiple different guidelines for each different department. For example, there were different guidelines for the ED walk in, coagulation clinic, obstetrical department, offsite locations, and outpatient walk in. With each different guideline there is another layer of details and steps that must be followed when a patient presents with the disease. It was interesting to see that with Ebola, a patient can be more or less severe and this is determined by the patient's symptoms. These protocols range from initial screening questions to treating a patient who is showing symptoms and has been infected. I never thought about how much work goes into these protocols in case there is an outbreak. Infection control is a very important aspect of managing hospitals that looks out for the patient's overall health and is essential to keeping a well managed and healthy organization. There are many different pieces that come together to make a well managed health care organization run successfully and I believe it is important to have different people focus on each different area to specialize and act as a liaison. I have found that education in different departments with a special focus on things like infection control is paramount to the success of a healthy organization.

Understanding Who Your'e Working With

      Managing a successful healthcare organization like a hospital can be difficult due to many different factors. One of the most problematic relationships is between the administration and the clinical side. This has been an ongoing conflict for quite sometime now. I personally can speak from experience and say there is a misunderstanding between the patient and the medical staff sometimes as well. The patient has a different perspective and understanding of things than the medical staff does and I believe this is the same situation with the administration side and clinical side of the hospital. The CEO and administration side wants everything to run smoothly and provide the best outcome for the patient but this isn't always easy when the administration starts telling the clinical side how to do things. A Chief Physician Executive at a hospital presented to my health management class. He spoke a lot about this conflict. The physician made a comment that really caught my attention and that was, " Physicians are the best judges of one another because we understand what the other physicians are doing and how to best critique each other.". I find this to be extremely important because physicians are not trying to ignore other's ideas and critiques but physicians can provide the best advice to other physicians.  They may have experienced the same situation or one very similar and have first hand experience. Many physicians know how one another feel and understand situations the same way.
     Spreading knowledge and educating all medical staff that new ideas are welcomed but staff in similar specialities will critique each other best could be an important step towards closing this conflict gap. Understanding that nurses know nurses best, physicians know physicians best, and administration knows administration best, may help ease change and improvement. Educating nurses, physicians, and administration on each other's understanding is also essential to closing the gap. Understanding who you're working with and understanding the patient's best interest is critical in all health care organizations.