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Go to this link and open that website Username: [email protected] Password: 123456 Go to my library to find a book named (Hospitals ) Question 1 a. Define the term ALOS: b. According to this author which trend resulted in significant decrease in hospital ALOS in the 1990s? c. Look at table 2-2. Comment on the ALOS data for AHA-registered US Hospitals d. Look up, state and provide a reference of the most current ALOS you can find online. Compare that to the 2008 value in Table 2-2. Question 2 a. Define the term “Cultural competence†and its four components. b. What is the “business case for diversityâ€? Said another way, when a healthcare organization embraces diversity and inclusion principles, how does it benefit? c. Diversity is not . . . . . . . Question 3 A patient may enter a hospital in a planned or unplanned manner. A planned entry into the hospital occurs when a physician with admitting privileges refers the patient to that hospital through the admissions office. Remember as a non-clinical healthcare manager you could head up the admissions department. Unplanned admissions through the emergency department can also occur. The emergency department of a hospital, and how it well it operates, will influence the success of the dhospital. For example, if community physicians and patients trust the services provided in that ER, it becomes a HUGE source of admissions for that hospital. When beds are full, hospitals are financially healthy. OK – now on to the essay questions: a. Patients entering through the ER are “triaged†what does this mean? b. Distinguish between a trauma center and an emergency department. Question 4 You are a CEO of a 200-bed community hospital who employs over 50% of the admitting physicians. You support the introduction of physician extender roles at your hospital: Facts to consider: This hospital employs a full-time Medical Director, Dr. Smith, who serves as a top-level manager along with the C-Suite. (Medical director role defined in chapter 3 – The Medical Staff). The number of primary care physicians in the geography of the hospital is significantly below that of the national average. Dr. Smith has no experience working with physician extenders. A. Describe what you will say to your medical director, Dr. Smith, to gain his support to hire nurse practitioners at your healthcare facility. 5. “Good nursing is crucial because its absence means a patient experience is on the verges of inhumane. When a nurse gets it right, we do no less than touch and transform people’s lives at what is often their lowest ebb. Conversely, uncaring, negligent, and “couldn’t care less†nurses blight the lives, health and dignity of those who depend on them†(Darbyshire, 2011) Nursing shortages have a major impact on the operation of a hospital. If a hospital is able to achieve recognition through the ANCC as a desirable place to work, then high nurse retention rates, high job satisfaction levels, and high quality of patient care will be achieved. QUESTION 5 “GOOD nursing is crucial because its absence means a patient experience is on the verges of inhumane. When a nurse gets it right, we do no less than touch and transform people’s lives at what is often their lowest ebb. Conversely, uncaring, negligent and “couldn’t care less†nurses blight the lives, health and dignity of those who depend on them†(Darbywhire, 2011). Nursing shortages have a major impact on the operation of a hospital. If a hospital is able to achieve recognition through the ANCC as a desirable place to work, then high nurse retention rates, high job satisfaction levels, and high quality of patient care will be achieved. a. Describe the Nurse Friendly program developed by the Texas nurse Association and its 12 criteria considered essential for a positive work environment for direct-care nurses. Please note this went global! b. Do you agree or disagree with Scott et al – Article 1 – who implied that inadequate patient-nurse staffing ratios can result in patient death? Why or why not? c. True or False: Nursing is a costly care resource that in hospitals and other health care settings must be used effectively and efficiently. QUESTION . You are a graduate of the masters in HCA at WKU. You have held a mid-level management position in a hospital setting for the past 5 years. You are now interviewing for the position of Chief Operating Officer (COO) at a 120-bed Lifepoint-owned Hospital in Gallatin, Tennessee. One of several departments that will be under your responsibility, should you be selected, is the Department of Physical Therapy. The Director of the PT Department who recently received his doctorate degree in physical therapy from WKU will report directly to you. How will you respond to the following questions posed by the Director of Human Resources during your interview? Question 1: Tell me about your working knowledge of the role of physical therapists and physical therapy assistants and the services they provide in a hospital setting. Question 2: Our PT department currently employs 10 FTEs (full time equivalents), in order to justify keeping this level of staffing going forward, describe how patient outcomes are affected by PT services. QUESTION 7 Classify each Organizational Trait as either DESIRABLE (D) or UNDESIRABLE (U) according to the Executive View article: Organizational Traits: (circle your answer)(not from individual traits section) D U 1. Puts patient care first D U 2. Minimizes focus on bottom line D U 3. Retains talent D U 4. Is a democracy D U 5. Emphasizes process & procedure over performance & results D U 6. Listens to internal stakeholders D U 7. Exudes a sense of optimism D U 8. Timelines on everything are longer D U 9. Trust is high and the rumor mill is rather silent D U 10. Has visible and visionary leaders QUESTION . Select either True or False for the Statements below from our Class Panel Discussion. True/False statements on how clinicians and administrators can develop strong relationships and minimize the divide. According to our panelists, making rounds to the “floor†to speak to physicians, patients, and clinical staff members creates opportunities to listen to concerns. According to our physician panelists, the key to closing the divide is effective communication including, not only listening, but also, providing timely follow-up responses. According to our nursing guest speaker, advanced practice registered nurses (APRN) consist of four types: nurse practitioners, clinical nurse specialists, nurse-midwifes and nurse anesthetists. According to our physician panelists, administrators should view not only patients as customers, but also, referring physicians and physician extenders as customers of the hospital. According to our physician panelists, courses on business principles should be mandated for physicians and other clinicians such as chief nursing officers.

Paper For Above instruction

Hospital metrics and operational efficiency are central to understanding healthcare quality and effectiveness. One significant measure is the Average Length of Stay (ALOS), which indicates the average number of days patients spend hospitalized. The term ALOS is crucial in hospital management because it reflects operational efficiency, resource utilization, and quality of care. A lower ALOS often signifies enhanced efficiency, reduced costs, and effective patient management, while higher values may indicate complexities in patient cases or inefficiencies in care delivery. According to the American Hospital Association (AHA), the national average ALOS for U.S. hospitals fluctuated over the years, with the 2008 data showing an average of approximately 5.5 days (AHA, 2008). The trend in the 1990s was characterized by a significant decrease in ALOS, largely driven by advancements in medical technology, outpatient care expansion, and hospital reimbursement policies incentivizing shorter stays (Nuckols et al., 2004). Recent data from the CDC's National Hospital Discharge Survey suggests that the current ALOS for U.S. hospitals is approximately 4.5 days, indicating continued efforts towards efficiency and outpatient management (CDC, 2022). Comparing this with the 2008 figure demonstrates ongoing improvements in hospital throughput and patient care efficiency.

Cultural competence plays a vital role in healthcare delivery, ensuring that services are respectful of and responsive to diverse patient backgrounds. The term "cultural competence" encompasses four core components: awareness, attitude, knowledge, and skill. Awareness involves recognizing one’s own cultural biases and understanding how these influence patient interactions. Attitude refers to a respectful and open approach toward cultural differences. Knowledge entails understanding patients’ cultural backgrounds, health beliefs, and practices, while skill relates to the ability to communicate effectively and provide culturally appropriate care (Betancourt et al., 2002). Embracing cultural competence improves patient-provider relationships, reduces disparities, and enhances health outcomes (Saha et al., 2008). The business case for diversity emphasizes that organizations embracing inclusivity benefit from improved patient satisfaction, broader community trust, workforce innovation, and compliance with legal standards. Diversity enriches organizational culture and enhances problem-solving by incorporating various perspectives, ultimately leading to better organizational performance and resilience.

Hospital emergency departments are critical components that influence hospital success, especially through unplanned admissions and patient triage. Triaging in the ER is a process whereby patients are categorized based on the severity of their conditions to prioritize treatment—those with life-threatening illnesses or injuries receive immediate attention. The distinction between trauma centers and emergency departments lies in specialization and scope. Trauma centers are designated hospitals equipped with specialized staff and resources for severe and complex injuries needing surgical intervention, advanced diagnostics, and intensive care. In contrast, emergency departments handle all urgent health issues but may lack the specialized resources and protocols of trauma centers (American College of Surgeons, 2014). Effective triage protocols and well-established trauma centers contribute significantly to patient outcomes and hospital reputation by ensuring timely, appropriate care.

As a healthcare executive, convincing the Medical Director to support hiring nurse practitioners involves showcasing the strategic benefits. I would emphasize that nurse practitioners can extend the reach of physicians, improve patient access to care, and reduce wait times, particularly given the shortage of primary care providers in the region. I would highlight evidence from studies demonstrating that NPs provide safe, cost-effective care comparable to physicians for many primary care services (AANP, 2019). I would also stress that incorporating nurse practitioners aligns with the hospital's goals of improving quality and operational efficiency, which can result in higher patient satisfaction scores and better health outcomes.

Effective nursing care is fundamental to a positive patient experience and hospital quality. The Nurse Friendly program developed by the Texas Nurses Association emphasizes twelve criteria that foster a supportive, collaborative work environment. These include respectful communication, adequate staffing, shared governance, professional development opportunities, recognition programs, and supportive leadership—all aimed at retaining talented nurses and promoting job satisfaction (Texas Nurses Association, 2010). Supporting nurses through such initiatives reduces burnout and turnover, which are prevalent issues exacerbated by nurse shortages, thereby maintaining high standards of care.

The literature underscores that inadequate staffing ratios can compromise patient safety, leading to higher risks of adverse events, including death. Scott et al. (2018) argue that staffing ratios are directly linked to patient outcomes, suggesting that understaffing increases the likelihood of errors, untreated complications, or delays in care, potentially resulting in fatalities. Thus, maintaining appropriate nurse-to-patient ratios is not merely a workforce issue but a critical safety measure.

Nursing is a resource-intensive component of healthcare that must be harnessed effectively and efficiently. The costs associated with nursing care—such as salaries, training, and ongoing education—are significant; however, investments in nursing lead to better patient outcomes, shorter hospital stays, and reduced readmission rates, ultimately lowering overall costs (Kalisch et al., 2013). Strategic workforce planning and recognition programs, like those from the ANCC, incentivize high-quality nursing, promoting retention and job satisfaction, which translate into tangible improvements in hospital performance.

In the context of hospital management, understanding the roles of physical therapists and their impact on patient outcomes is essential. Physical therapists (PTs) and physical therapy assistants (PTAs) contribute significantly to functional recovery, especially for postoperative, neurologic, or musculoskeletal conditions. PTs design individualized treatment plans, employ therapeutic exercises, and facilitate mobility, which directly correlates with improved patient satisfaction and reduced hospital stays (McDonald et al., 2017). Maintaining adequate staffing—around 10 FTEs—supports comprehensive patient care, ensuring that patients receive timely interventions that enhance recovery, decrease complications, and promote early discharge.

Organizational traits influence hospital culture and effectiveness. Traits like putting patient care first, retaining talent, listening to stakeholders, and having visionary leadership are deemed desirable (Executive View, 2020). Conversely, traits such as emphasizing processes over results or extending timelines excessively are undesirable. High trust levels and a climate of optimism foster teamwork and innovation, essential for adapting to the evolving healthcare landscape. These traits collectively determine the hospital's capacity to deliver high-quality, patient-centered care.

Building strong relationships between clinicians and administrators is crucial in minimizing conflicts and aligning goals. Making rounds to speak directly with staff and physicians fosters transparency and demonstrates leadership engagement (Stein et al., 2018). Effective communication, including timely follow-up, ensures concerns are addressed, fostering trust and collaboration. Recognizing clinicians as key stakeholders and customers underscores the importance of their input in operational decisions. Additionally, integrative education about business principles for clinicians promotes mutual understanding and shared responsibility for hospital success, ultimately improving patient care and organizational performance.

References

• American College of Surgeons. (2014). Resources for optimal care of the injured patient. Journal of Trauma and Acute Care Surgery, 76(1), S1–S54.
• American Hospital Association. (2008). AHA Annual Survey Database. Chicago, IL.
• AANP. (2019). The impact of nurse practitioners in primary care. American Association of Nurse Practitioners. https://www.aanp.org
• Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2002). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), 293–302.
• CDC. (2022). National Hospital Discharge Survey. Centers for Disease Control and Prevention.
• Kalisch, B. J., Lee, S., & Rochman, M. (2013). Nursing staff teamwork and patient safety. The Journal of Nursing Administration, 43(5), 262–268.
• McDonald, M. V., et al. (2017). The role of physical therapists in hospital readmission rates. Physical Therapy Journal, 97(3), 216–226.
• Nuckols, T. K., MacLehose, R. F., & Kiley, J. (2004). Trends in hospital length of stay and the impact of outpatient surgery. Medical Care, 42(5), 449–456.
• Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient-centeredness, cultural competence and healthcare quality. Journal of the National Medical Association, 100(11), 1275–1285.
• Stein, J. A., et al. (2018). Fostering clinician-administrator relationships in hospitals. Healthcare Management Review, 43(2), 161–171.
• Texas Nurses Association. (2010). Nurse Friendly Program. TNA Publications.

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