Case Study Cherokee Health System

Western Health System noticed that many of its local clinic managers were leaving to join the competition. Their human resources director, Stephanie Anderson realized that they were losing a lot of talented people who had become demotivated, and she worked on developing a program to increase their motivation in hope that they would remain committed to Western Health System. Her program, Exploration, had many great features, but to truly asses the program one first has to understand motivation, motivational theories, and the current issues at hand.

The Cherokee Nation of Oklahoma (CN) is one of the many Native American tribes that place a great emphasis on health care. There are noticeable efforts and investments in improving the health care system in the Cherokee Nation. Through the building of health care centers, launching health programs, and individually engaged tribal members in the health field, the Cherokee Nation is striving to improve the overall health care of their people.

Choctaw Nation Health Services proudly welcomed Mary Smith, Principal Deputy Director of Indian Health Service; P. Benjamin Smith, Director, Office of Tribal Self- Governance, Indian Health Service; and RADM Kevin Meeks, Director of the Oklahoma City Area Indian Health Service to the Choctaw Nation McAlester Health Clinic and Choctaw Nation Health Care Center. Chief Batton along with Tribal dignitaries, and associates of health services, toured both facilities on October 20.

Carson Tahoe Behavioral Health Services offers comprehensive inpatient and outpatient services for seniors, adults, adolescents and children suffering from mental health and substance abuse issues. Their Category is Outpatient or Partial Hospitalization Mental Health Facility. This Facility uses a holistic approach to treatment.

Views today demonstrate a viable singleton fetus at 31 weeks 0 days in vertex presentation with an anterior placenta. Fetal biometry appears symmetric and corresponds with stated EDD falling at the 56%ile. Interval growth is noted; however, the growth percentage did trend down from the 80%ile to the 56%ile. Follow-up fetal anatomy visualized as normal or was previously documented as normal. Ductal velocity today measured at 69.2 cm/se, which falls within normal limits. AFI remains reassuring at 12.6 cm. BPP 8/8. Doppler studies are normal in value and wave form.

Views today demonstrate a viable singleton fetus at 12 weeks 2 days. Fetal crown-rump length measures 59.2 mm. The best nuchal translucency measurement obtained was 1.8 mm, and the nasal bone was visualized as present. Fetal cardiac activity is visualized. Due to early gestational age, fetal anatomy was not assessed, but 4 extremities are noted. Amniotic fluid and placental location are visualized as normal within limitations of early gestational age. Adnexa are suboptimally seen. No notching is seen on the uterine artery Doppler’s.

Cumberland HealthNET currently serves Cumberland County residents between 18 to 64 years of age diagnosed with hypertension , heart failure or diabetes who do not have access to group coverage or qualify for any government programs such as Medicaid or Medicare . In addition , individuals must have income that is at or below 200% of the federal poverty level . My volunteer experience related to the class concept I found that the organization was very helpful to the unfortunate ones , they go above and beyond to help individuals get the service that's needed .

By dates, the patient is 35 5/7 weeks and the measurements are concordant. The amniotic fluid volume is normal. The fetus is in cephalic presentation. The BPP and Doppler studies are reassuring. A complete fetal anatomical survey was performed and no major malformations were noted at this time within the resolution of the ultrasound equipment other than the fetal abdomen. There is a cystic structure seen in the fetal abdomen that is about 3 cm in diameter with some echolucency surrounding this. It is below the kidney but above the fetal bladder as identified in your office.

On June 22, 2016 to August 4, 2016, I began work at Cape Fear Valley Medical Center in the Infection Prevention and Control department; where I had the pleasure of completing a total of 120 credit hours. Cape Fear Valley Health Systems has four additional hospitals, including Cape Fear Valley Medical Center; with 880 beds regional within the health systems. Cape Fear Valley Health Systems is affiliated to several primary care physician offices located throughout the Cape Fear region and surrounding areas.

This particular case study involves a 29 year old obstetric patient who presented to the labor and delivery unit at 33 weeks gestation with complaints of abdominal pain for the past three days that had become more severe and absence of fetal movement noted since the previous evening. Her obstetric history revealed she has one living child and has had one previous miscarriage at ten weeks

Although the executive committee does not include behavioral health, psychiatrists, Mazhar Munir, MD, and Philip Creps provide critical behavioral health leadership. This team is charged with not only ensuring exceptional care for the underserved, but also keeping the organization afloat amidst the seas of fierce competition from rivals like Spectrum Health and Mercy Health.

On ultrasound today there is a live fetus whose crown-rump length is consistent with prior ultrasound dating. The nuchal translucency measured 2.1 mm, and a nasal bone was present. There was normal ductus venosus flow.

By dates she is 37 ½ weeks and the measurements overall are concordant with an EFW at around the 50%ile. The amniotic fluid volume is normal with an AFI of about 11 cm. The BPP is 8/8 and the Doppler study is reassuring.

On ultrasound, there is a live fetus in cephalic presentation. Initial scanning noted a very large abdominal cyst that appeared to be compressing the thoracic cavity. Intracranial anatomy appeared normal. It was impossible to evaluate the spine and intraabdominal contents in the setting of this large intraabdominal cyst. Measurements for the cyst were 8.4 x 12.6 x 12.8 cm. It appeared to be simple in nature.

Over the past decade hospitals have incurred immense transformation, from the advent of the Affordable Care Act to bundled payments. In response to this reform, hospitals are consolidating to create larger health systems with broader services and strategies to combat economic pressures and regulatory concerns. The principle goal of a health system merger or acquisition is to capitalize on their investment and create a high performing efficient hospital that promotes streamlined care across disciplines. Between 2009 and 2012, the number of mergers and acquisition deals occurring per year nearly doubled from 50 in 2009 to 94 in 2012 (Egan, Kerns, Bartz, & Cassels, 2013). However, while the numbers of consolidations increase, data suggests that