Do individuals have the right to self-determination, the right to have access to health education and medical treatment and/or nursing care? Is freedom to live without fear of stigma, discrimination, and violence a right that should be expected and protected? What, if any, obligation do resource-rich countries and governments have to respond to disease and poverty in resource-limited regions?

/in /by

The authors of chapter 8 discussed disclosure of HIV/AIDS status in regard to human rights. They posed these questions, which serve as starters for discussion: “Do individuals have the right to self-determination, the right to have access to health education and medical treatment and/or nursing care? Is freedom to live without fear of stigma, discrimination, and violence a right that should be expected and protected? What, if any, obligation do resource-rich countries and governments have to respond to disease and poverty in resource-limited regions? Acknowledging the overwhelming data that link HIV/AIDS-related stigma, discrimination, and punitive sanctions to the spread of HIV infection (UNAIDS, 2007b, 2008c), does the need to stigmatize and isolate those who are viewed as “other” serve the global public health?”
In the 1990’s HIV/AIDS was a topic of great concern to people in the U.S. As information was disseminated, fears about HIV/AIDS decreased. Many people in the U.S. no longer consider HIV/AIDS a serious health threat. What do current statistics reveal? Has HIV/AIDS been eradicated in the U.S.? Are those with HIV/AIDS in the U.S. today only those considered marginalized? What would health care in the U.S. today be like if HIV/AIDS had become the pandemic it is in other countries?

Discuss what nurses, acting as change agents and/or a political body, can do to improve knowledge of and access to palliative care in developing countries.

/in /by

A nurse in the United States volunteers to join a medical mission to teach local health care workers how to provide palliative care services in India. Discuss what aspects of palliative care will be most culturally acceptable, and what barriers the nurse will face in teaching and providing care.
“And in the end, it’s not the years in your life that count. It’s the life in your years.” Abraham Lincoln
This statement begins the chapter on end of life care. Discuss what is meant by the life in your years. How would health care professionals manage end of life care differently for people in a culture that values long life even if quality of life is less optimal.
There is discussion in Chapter 6 about the vast number of people who do not have palliative care at end of life. Discuss what nurses, acting as change agents and/or a political body, can do to improve knowledge of and access to palliative care in developing countries.

A comprehensive reentry plan based on your assessment and analysis of Drew’s case and your examination of the history of juvenile treatment. What recommendations do you make for Drew’s case? How do elements of Drew’s plan fit into the continuum of juvenile corrections?

/in /by

Juvenile reentry is defined as programs, services, and supports intended to assist youths transitioning from (juvenile corrections) residential placement back into the community (Gies, 2003). Reentry represents a small but crucial part of the corrections continuum as the proper coordination of substance abuse, mental health, educational, vocational, and other services is critical if the youth in question is to successfully rejoin the community. In this exercise, you will consider a wide assortment of contributing factors in one juvenile’s situation and will select the most salient points to determine how best to successfully reintegrate this juvenile into the community.
Scenario
You are a reentry specialist at the Centervale Juvenile Detention Center. John Drew is a seventeen-year-old male who has been detained in the facility for the previous nine months. His first offense on record was running away from home when he was twelve. Since then, he has appeared in juvenile court for a number of offenses, including trespassing, breaking curfew, shoplifting, and possessing prescription drugs illegally. His most recent offense, and the one responsible for his stay in the Centervale Juvenile Detention Center, was an unarmed assault on another youth. Drew is quite behind in his studies, having completed course work only through his eighth-grade year.
During his time at the detention center, Drew was given a mental health assessment and found to have bipolar disorder. He has a history of substance use, using marijuana, methamphetamine, and cocaine; Drew recently indicated that he now prefers prescription drugs. Upon release, Drew will serve two years on probation. Drew’s parents have stated that he will live in their home upon release, though he has in the past stated his intentions to live on his own. He has expressed remorse for his previous behaviors and says he’s anxious to get a fresh start.
Here’s What You Need to Do . . .
For this assignment, you have been directed by your supervisor to write a reentry plan based on the scenario above. Specifically, you’ve been instructed to develop a reentry plan for Drew that includes the following:
• The context for Drew’s reentry plan. Offer an examination of the history of juvenile treatment. How did the notion of juvenile treatment begin, and how has it changed since? Describe some of the major trends in juvenile corrections and explain the effect of each. Examine and describe the current state of juvenile treatment.
• An assessment of Drew’s current state, including a review and summary of Drew’s scenario given above. Given that you have limited information from which to draw conclusions, make assumptions based on your knowledge of juvenile treatment issues where data for Drew is missing or incomplete. Be sure to clearly note when you make an assumption and give clear, well-reasoned examples as support. Also, make sure to draw from research, including digital assets and resources suggested by this course, when appropriate.
• An analysis of your initial assessment. What are the most important factors affecting Drew’s successful integration into the community? How might Drew’s co-occurring disorders or issues play into one another? What other factors might affect Drew’s return to the community? Explain your answer using examples and reasoning.
• A comprehensive reentry plan based on your assessment and analysis of Drew’s case and your examination of the history of juvenile treatment. What recommendations do you make for Drew’s case? How do elements of Drew’s plan fit into the continuum of juvenile corrections? Which approaches, if any, should be avoided for Drew and why? What sorts of actions and behaviors do you want to minimize or emphasize? How will you maintain Drew’s accountability? What other resources might you recommend for Drew?

Clinical Documentation for Value-based

/in /by

Clinical Documentation for Value-based
Reimbursement: Why It Takes a Village to Ensure
Success
By James P. Fee, MD, CCS, CCDS, and Wendy Clesi, RN, CCDS, CDIP
Like it or not, the transition to value-based healthcare is well underway. In January 2015, the Department of Health
and Human Services (HHS) announced its Better, Smarter, Healthier campaign with clear goals and a timeline for
shifting Medicare reimbursement from volume to value. Through a variety of programs, HHS set a goal of tying 85
percent of all traditional Medicare reimbursement to quality or value by 2016, and 90 percent by 2018.
Providers, payers, and patients alike are working towards the same three-fold vision as stated by the campaign’s
October 2015 update: incentivize quality of care over quantity of services, promote coordination and integration, and
share health information.1
So far, the industry is ahead of schedule as verified by HHS’s March 2016 announcement.2 But what is the impact
of value-based reimbursement on health information management (HIM) and clinical documentation professionals?
This article outlines immediate impacts for health information workflow and physician relationships within the era of
pay for performance. It also lays out three practical steps for hospitals and health systems to move closer to value based care.
From Jog to Sprint
In the years to come, the gradual jog toward value-based payments will likely become more of a sprint. Physician
documentation will play an even bigger role in four areas: capturing patient severity, identifying risk, justifying
resources, and demonstrating outcomes. Organizations must ensure their clinical documentation accurately reflects
the care provided across the continuum—or run the risk of jeopardizing their reimbursement.
This monumental change in reimbursement methodologies has direct implications for HIM workflow. Organizations
that weather the storm successfully will be those that make a concerted effort to integrate coding, quality, and clinical
documentation improvement (CDI) with the goal of complete and accurate clinical documentation for every patient,
every encounter, every claim.
It will take an entire team of professionals to drive the changes necessary to be successful under value-based
reimbursement models. Collaboration is the key, with these initial priorities:
CDI spearheads documentation improvement across all care settings.
Coding professionals apply consistent coding guidelines and establish stronger communication with non-acute
care peers.