Interdisciplinary Perspectives in Healthcare

The Community Health Center has emerged as an increasingly important setting and focus for a collaborative, interdisciplinary approach to delivering health care. Political and economic realities promise to magnify the role of this institution.

To prepare:

For this Discussion, review this week’s Required Resources and reflect on the ramifications and potential for collaboration in community health centers.

Post a comprehensive response to the following:

• Identify what you believe are the two key benefits of collaboration for community health centers.
• How do you feel health care reform will promote or hinder collaboration and an interdisciplinary approach at community health centers?

Support your arguments with specific citations from this week’s readings.

_________________________________________________________

RESOURCES

Dieleman, S., Farris, K., Feeny, D., Johnson, J., Tsuyuki, R., & Brilliant, S. (2004). Primary health care teams: Team members’ perceptions of the collaborative process. Journal of Interprofessional Care, 18(1), 75-78.
Note: Retrieved from the Walden Library databases.

This article reports the results of an experiment to measure the impact on a variety of providers working on a collaborative health care team in a noninstitutional, community setting.

Fewster-Thuente, L., & Velsor-Friedrich, B. (2008). Interdisciplinary collaboration for healthcare professionals. Nursing Administration Quarterly, 32(1), 40-48.
Note: Retrieved from the Walden Library databases.

This article considers a number of factors that can help or hinder the cause of interdisciplinary collaboration, especially those associated with patient outcomes. This is an especially important matter as it has been estimated that nearly 70% of adverse effects suffered by hospital patients are caused by the lack of communication and collaboration between doctors and nurses.

Grumbach, K., & Bodenheimer, T. (2004). Can health care teams improve primary care practice? JAMA, 291(10), 1246-1251.
Note: Retrieved from the Walden Library databases.

The authors identify and discuss five essential characteristics that teams must possess to work together successfully, namely: defined goals, clinical and administrative systems, division of labor, training, and communication. Case studies of a local and a regional primary care practice are used to advance the argument.

Hennessy, C. (2010, January 7). Hospice provides compassionate end-of-life care. CT Post. Retrieved from http://www.ctpost.com/health/article/Hospice-provides-compassionate-end-of-life-care-312784.php

When we think of interdisciplinary health care, we generally wouldn’t think of hospice. But, as this article demonstrates, hospice care is a perfect example of the coordinated, compassionate, and efficient model of providing needed health care services.

Huang, B., & Perroud, T. (2003, January 17). Our protocol for a successful interdisciplinary collaboration. Science Career Magazine. Retrieved from http://sciencecareers.sciencemag.org/career_magazine/previous_issues/articles/2003_01_17/noDOI.11449521753182219153

Two physical chemists describe the benefits of collaboration in their lab research. While their work has no direct bearing on health care, their observations and experiences collaborating with others provide useful lessons that can be applied to any endeavor.

Leaders of major national organizations collaborate on approaches to health reform. (2009, March 27). Targeted News Service.
Note: Retrieved from the Walden Library databases.

This press release announces the formation of a task force committed to cooperating to find solutions to difficult issues involved in reforming the nation’s health care system. The intent is to facilitate the process in a nonpolitical way. The committee is composed of leaders representing different industry stakeholders in the process, including doctors, hospitals, insurers, consumers, and public health professionals, among others.

Mitchell, G., Tieman, J., & Shelby-James, T. (2008). Multidisciplinary care planning and teamwork in primary care. Medical Journal of Australia, 188(8), 61-64.
Note: Retrieved from the Walden Library databases.

Systematic reviews of research on the effect of a multidisciplinary approach to treating patients with chronic disease confirmed that such an approach improved patient outcomes. Before it can become widespread, this approach will require structural and practical realignment.

Senators urge review of barriers to collaboration. (2010, January 11). AHA News, 46, 1.
Note: Retrieved from the Walden Library databases.

In an effort to expedite and encourage the adoption of collaborative care models for patient-centered health care, nine Democratic U.S. Senators petitioned the Department of Justice and the Federal Trade Commission to create guidelines and offer advice to hospitals, doctors, and other interested care providers.

State Government of Victoria Department of Health. (n.d.). Achieving best practice cancer care, A guide for implementing multidisciplinary care. Retrieved from http://docs.health.vic.gov.au/docs/doc/Achieving-best-practice-cancer-care–A-guide-for-implementing-multidisciplinary-care—Mar-2007

This site presents a model for multidisciplinary cancer care in the state of Victoria, Australia.

Taylor, T. (2009). The role of community-based public health programs in ensuring access to care under universal coverage. Issue Brief. American Public Health Association.

“The Role of Community-Based Public Health Programs in Ensuring Access to Care Under Universal Coverage” by Tia Taylor. Copyright October 2010 by AMERICAN PUBLIC HEALTH ASSOCIATION. Used by permission of AMERICAN PUBLIC HEALTH ASSOCIATION via the Copyright Clearance Center.

This monograph published by the American Public Health Association addresses the importance of community-based public health programs and how the rising tide of health reform may, in fact, jeopardize some essential services, putting already vulnerable populations at greater risk.

U.S. Department of Health and Human Services. (2010). Recovery Act (ARRA): Community health centers. Retrieved from http://wayback.archive-it.org/3909/20130926130202/http://www.hhs.gov/recovery/hrsa/healthcentergrants.html

As part of the American Recovery and Reinvestment Act, $2 billion was designated for the creation of Community Health Centers. Some of the key provisions of the program are provided on this site.

Vazirani, S., Hays, R., Shapiro, M., & Cowan, M. (2005). Effect of a multidisciplinary intervention on communication and collaboration among physicians and nurses. American Journal of Critical Care, 14, 71-77. Retrieved from http://ajcc.aacnjournals.org/content/14/1/71.full.pdf+html

Perhaps the most compelling argument for interdisciplinary health care is that it has been demonstrated to improve patient outcomes. This article describes a 2-year experiment to measure the effect of a multidisciplinary intervention on health care providers at an acute inpatient medical unit.

U.S. Department of Health and Human Services. Increased demand for community health center services (IDS) grants by state. Retrieved from http://wayback.archive-it.org/3909/20130926131407/http://www.hhs.gov/recovery/programs/hrsa/ids.html

This website keeps a constant running count of the effect of new grants for community health services under the American Recovery and Reinvestment Act of 2009. The number and value of grants, jobs created, and patients covered is tabulated by state.

Click on your state to look for the grants in your state.

Community Medicine and Community Health Centers

U.S. Department of Health and Human Services. Recovery Act funding for commmunity health centers. Retrieved from http://wayback.archive-it.org/3909/20130926130349/http://www.hhs.gov/recovery/programs/hrsa/index.html

This page provides links to ARRA Community Health Center grants by state.

Find an example of community centers in your state.

The University of Texas Southwestern Medical Center at Dallas. Family and Community Medicine, Division of Community Medicine. Retrieved from http://www.utsouthwestern.edu/education/medical-school/departments/family-community-medicine/divisions/community-medicine/index.html

This is the website for the Department of Family and Community Medicine at the Southwestern Medical Center in Dallas, TX. Explore the site to familiarize yourself with the kinds of services and research being conducted here, as it relates to an interdisciplinary approach to community health.

______________________________________________________________

Current Issues in Healthcare Policy and Practice 

Discussion: Access to Care

One of the biggest complaints about the U.S. health care delivery system revolves around access to services. More specifically, too often, the high cost of health care is a barrier to its access. A key objective of health care reform efforts has been to expand access to quality care to more people. What will the effects of increasing access to health care be?

To prepare for this Discussion, consider this week’s Learning Resources.

Find an article in the Walden Library that illustrates the potential positive and/or negative impact of increased access to health care services as a result of health care reform.

Post a comprehensive response to the following:

• Cite and summarize the article.
• What are two effects of increased access to care on the providers of that care (i.e., hospitals, physician practices, or long-term care facilities)?
• How do you think the impact of increased access might be mitigated? Should it be? Why or why not?

Note: Initial postings must be 250–350 words (not including references).

_____________________________________________________________________

ASSIGNMENT …. DUE SUNDAY BY 11:59 PM (CITE ALL REFERENCES IN ASSIGNMENT)

The Practical Role of Policy

What has health policy done for me lately?

Developing health care policy is often an exercise in balancing competing interests, many of them political. Policy is often the product of elaborate negotiations between many interested parties. It is sometimes difficult for individuals to see the connection between health care policies and their own personal health. In short, people ask, “What does health policy mean to me?”

This Application will give you an opportunity to delve a little deeper into the practical role of policy, by examining a health policy issue that is of particular interest to you.

To prepare for this Application, select an acute or chronic health issue (such as motorcycle accident-related head trauma or type 2 diabetes) that is of interest to you. Using the Walden Library and credible websites, research this issue to analyze a key policy related to the health issue you selected. Select at least three articles about the policy to use in your paper.

To complete this Application, write a 3- to 4-page paper that addresses the following:

• Describe the health care issue you selected. Explain why this issue is important, in terms of access, affordability, quality, and safety.
• Identify a health policy that is related to the health issue you selected. Explain its intended purpose and indicate the source of the policy (i.e., state law, federal law, accreditation organization, etc.)
• Cite and summarize the articles you selected.
• Analyze what the literature says about the impact of the policy, in terms of cost, affordability, access, quality, and safety.

Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from this week’s Learning Resources and additional scholarly sources, as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

_________________________________________________________

RESOURCES

Current Issues in Healthcare Policy and Practice
Chapter 2, “Cost, Access, and Quality” (pp. 45–76 through “Current Indicators of Access”)The cost of health care, access to it, and the quality of the care are often related to one another in a reciprocal and interactive way. This chapter establishes a foundation for understanding health care costs and how those costs are directly related to access and quality. You will finish this chapter in next week’s reading.

Health Politics, Policy, and Practice
Chapter 5, “Medicare: The Great Transformation”Along with Medicaid and Social Security, Medicare is one of the three largest Federal entitlement programs. It is relied upon by millions of American citizens. This chapter looks at the history of this important program and how the politics influence the benefits and operation of this mammoth government program.
Chapter 6, “Medicaid: Health Care for You and Me?”This chapter presents an overview of the Medicaid program, looks at how it has evolved over the years, and considers where it might be going. It presents three commonly held myths about Medicaid.

Goldsmith, J. (2010). Analyzing shifts in economic risks to providers in proposed payment and delivery system reforms. Health Affairs, 29(7), 1299–1304. Retrieved from http://ezp.waldenulibrary.org/login?url=http://proquest.umi.com.ezp.waldenulibrary.org/pqdweb?did=2089628041&sid=6&Fmt=3&clientId=70192&RQT=309&VName=PQD

The unbridled growth of health care costs has been, and continues to be, a significant factor fueling the push for health care reform. This article analyzes some of the cost-containment models that are currently under consideration and assesses the feasibility of their implementation. 

Rosenthal, E., Brownstein, J., Rush, C., Hirsch, G., Willaert, A., Scott, J., et al. (2010). Community health workers: part of the solution. Health Affairs, 29(7), 1338–1342. Retrieved from http://ezp.waldenulibrary.org/login?url=http://proquest.umi.com.ezp.waldenulibrary.org/pqdweb?did=2089628121&sid=9&Fmt=3&clientId=70192&RQT=309&VName=PQD

This article examines the contribution that community-health workers could make to cost reduction, access expansion, and quality improvement of Medicaid and health care, in general.

Heathcare.gov. (n.d.). Understanding the affordable care act. Retrieved October 18, 2010, from http://www.healthcare.gov/law

This web page presents various elements to provide an overview of the Affordable Care Act. Signed into law by President Obama on March 23, 2010.

Optional Resources

“Health Care Reform” (PBS.org)
http://www.pbs.org/now/shows/health-care-reform/

Current Issues in Healthcare Policy and Practice
Chapter 9, “Long-Term Care Reimbursement”

Kristof, N. D. (2010). Access, access, access: [Op-Ed]. The New York Times (Late Edition), A31. Retrieved from http://ezp.waldenulibrary.org/login?url=http://proquest.umi.com.ezp.waldenulibrary.org/pqdweb?did=1985614601&sid=2&Fmt=3&clientId=70192&RQT=309&VName=PQD