Program Development Case StudyHappy Valley Hospital is a community-based facility with 288 acute care beds, a twelve suite family-oriented birthing center, a forty four bed long-term care inpatient facility, and a fourteen bed inpatient rehabilitation unit. Happy Valley has a major competitor, GH, which has two hundred beds, a small cancer center, and a kidney dialysis unit.Happy Valley’s director of internal medicine, along with the director of nursing for that department, are considering establishing a new hemodialysis service. GH has a small hemodialysis unit, but they do not have enough beds to properly accommodate the needs of this community.The Happy Valley medical director has surveyed the six nephrologists with staff privileges at the hospital and has determined that all six agree that there is a need for more hemodialysis beds in the community. Moreover, these nephrologists all have staff privileges at both Happy Valley and GH and would prefer that the new beds be added to the GH unit. GH, however, has no plans to expand their unit for at least the next five years, and presently, new patients are being referred to a dialysis unit in another community thirty minutes south of Happy Valley Hospital. Those patients as well as their families find this alternative site and location to be unacceptable.Based on your understanding of the above case, express your views on the following:How should the medical director at Happy Valley try to convince patients now being referred to the dialysis unit thirty minutes to the south to switch their care to Happy Valley Hospital?What steps should the Happy Valley medical director take to ensure that patients will get the proper care and facilities at the Happy Valley Hospital hemodialysis unit, when it is established?Is the approach of GH for not having any expansion plans for the next five years for their unit justified, keeping in mind the interest of the community? Why or why not?APA format

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Answer question 1 & 2 and reply to discussion posts 1 and 2 -constrictive feedback

(Consider nursing practice on all levels in your discussion.).

DISCUSSION POST 1. Nursing is controlled by a variety of people and groups, none of whom control nursing entirely. The public controls nursing by influencing public health issues and by creating different nursing environments such as homeless care, home health, public health clinics, etc. Patients control nursing by creating personal demands for care. Some patients are more or less demanding than others which can control nursing care in addition to the nursing care required by their medical needs. Study participants and researchers for evidence based practice can control nursing care because policies and procedures change based on study results. The nurse controls nursing care because he or she carries out the physical and emotional act of nursing. Doctors and mid-level providers control nursing care by entering orders for the nurse to execute. Management controls nursing care by creating goals for nursing staff such as infection control measures or overtime prevention. Hospital or clinic administration control nursing by creating policies, utilization management, ethics law, etc. that affects day to day nursing. Members of legislature and government agencies affect nursing by passing laws related to healthcare.In summary, there are many many people, groups and other factors that control nursing but none that control nursing as a whole. Nursing it far too comprehensive to be completely controlled by just one person or group.

2.. How do you define quality of care?What factors can you control, as a manager, for your staff to provide high-quality care (which factors are internal and which are external)? If an organization is deciding between several quality management programs which would you recommend and why? MUST RESPOND TO ALL 3 PARTS.

Discussion 2. I define quality of care as how well or how poorly patients are being cared for in a holistic manner. High quality of care is going above and beyond for the patient serving medical, emotional and spiritual needs. Poor quality of care is doing just enough for your patient medically, maybe even neglecting small aspects of medical care.Internal factors: As a manager I can control policies and procedures used by staff that create a high quality of care. I can ensure that staff are following the policies and procedures by administering disciplinary action for refused compliance. I can include topics for high quality of care in staff meetings and get staff members involved in unit based groups or projects that allow them to take ownership of high quality nursing ideas.External factors: Visitors such as friends and family are considered external customers. As manager with health and safety at the forefront of my mind, I can make sure that no ill visitors enter the unit. I can make sure that there are limits on visiting hours so that the patient can rest.I would recommend lean six sigma for quality management. I have worked in two facilities that utilized this management program and it was highly effective, especially when combined with a Kaizen initiative. The concept for lean six sigma is to trim the fat off of processes. The goal is to to reduce waste such as wasted time, wasted money, wasted effort and other wasted resources. Kaizen allows staff members to suggest process improvements within the organization. This leads to not only reduced waste but also happy employees who feel that their suggestions make a a difference.