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Requirement
Village Hospital is experiencing a decline in inpatient utilization. Currently, it is functioning at 86% inpatient utilization and consequently, the Governing Board is concerned about revenue and the hospital’s ability to remain open if inpatient utilization continues to decline. The CEO is considering alternative uses for inpatient beds including converting one med/surgical unit to a palliative care unit.
You have been hired as a consultant to help the senior management team and the Board decides if this is a feasible option.
Answer the following in paragraph form – NO BULLETS! I EXPECT THAT YOU WILL USE YOUR TEXT, PPS AND CLASS NOTES TO WRITE WELL THOUGHT OUT COMPREHENSIVE ANSWERS
Solution
Question 1
Provide the management team with a good definition of Palliative Care.
Answer:
Firstly we need to understand what palliative care is before we set up a palliative care unit. Palliative care is for patients who are seriously or terminally ill. In these diseases, the cure is not possible. In this, there is a requirement of providing relief from the painful symptoms and stress due to the severe disease.
Palliative care is an extra layer of support that is provided to the patient from a specialized team of doctors and nurses. Palliative care is provided along with the treatment of the disease. Palliative care improves the quality of life of the patient.
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Question 2
How would help the management team evaluate whether there is a need in the community for palliative care? Consider here the Epidemiological planning model presented in Chapter 3. Specify the data you would suggest collecting to measure community needs.
Answer:
There are many factors from which the management can decide the requirement for a palliative care unit. Palliative care offers a wide range of flexible approaches that help in reducing the physical, psychological and existential burdens faced by the people suffering from the life-threatening disease.
The Epidemiological Model focuses on community-based and patient-based standards. These standards help in developing programs for the community. The evaluation model is based on obtaining patient data and vital statistics from community data.
It can be applied in any community where the illness trajectory increases. It is important to access main diseases from the people of the community is facing. It is also important to identify the diseases and provide specific palliative care for the disease.
The Epidemiological measure is decided on many factors such as Need, demand, and uses. Here we have to access the need, demand and uses of the palliative care unit. How many patient percentages of the community requires the Palliative Care Unit. How is pollution suffering due to the absence of palliative approach by the hospital? How much demand for palliative care in the community can be noticed? Also, what are the diseases in the community which require a palliative approach? All these questions need to be accessed before setting up a palliative care unit.
Question 3
Using the epidemiological planning model- how would you go about estimating the demand for this new service? ( use formulas presented Ch 3)
Answer:
Demand is a broad term. For health care services it is the need felt, people ask for it. Patients in the hospital are in constant interaction with the staff. If they need something they will ask the hospital staff regarding that service. It can be felt by patient feedback.
The demand is influenced by many factors. It is influenced by illness behavior. Illness behavior depends on age, gender, education, and socioeconomic status. Also patient must have knowledge about palliative care service. The service should be cost-effective for the patient. The need, supply and demands overlap each other. Still, we need to assess the need for a specific service to avoid unwanted expenses.
Question 4
Write a mission statement for a palliative care unit/service.
Answer:
To give compassion, care, and quality to enhance and comfort in the lives of people with life-limiting illnesses.
Question 5
The CEO now tells you that she wants to create a culture that embraces the concepts of transformational leadership. First, what values would this culture be built upon? Second, suggest to the CEO the specific practices, actions she should take to create this culture. ( consider here what palliative care is all about!)
Answer:
Palliative care is all about providing comfort to terminally ill patients. Here a transformational leadership is required. It is mainly based on two values, inspiring the workforce and challenging people to deliver high performance.
The change in culture is not an overnight process. A leader is required who can implement these components and can drive the organization in the correct direction. For the culture change, the leader needs to provide an inspirational vision, which should be communicated by the leader. The inspirational vision can drive the workforce to go beyond their routine work and take proper and holistic care of patients.
Next, it is important to challenge people to deliver high performance. A transformational leader will ask the team to deliver more, achieve higher standards of work. The leader will also encourage to let go fears and find new ways of working together. This will help the institute to provide high levels of palliative care.
Question 6
What organizational structure would you recommend for a palliative care unit and why?
Answer:
Initially, the palliative care organization structure should be short. There should not be many levels. The CEO herself should head the department. There should be constant guidance and suggestions by the leaders for improvement. It is important to monitor the department closely by the leaders hence the levels of an organisational structure should be less.
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Finally, the CEO tells you that she is most concerned about clinical performance. What would you suggest she put in place to achieve clinical excellence? ( consider techniques, tools, approaches learned in Ch. 5. Again, be specific in your recommendations.
Answer:
There are various ways in which clinical excellence can be achieved. The people approaching end life should be identified in time. The patient with a terminal illness and their family should be communicated with all the necessary information. It is important to respond to their changing needs quickly. They should be given in time personal care. Their psychological needs should also be addressed. There must be access to medicine and the required equipment. People with end term illness require special care day and night. In their case, an emergency condition can appear anytime. It is important to be coordinated with the emergency department. So that is a case of emergency required measures can be taken.
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