Case Study Tallahassee Clinic

Metrolina Comprehensive Health Center was started by Dr. Charles Warren Williams in the Charlotte city of North Carolina along with several other medical colleagues of his. Dr. Charles expired when the hospital had just started operating; post his death the hospital was renamed as C.W. Williams Health Centre.

No history of skin disease. Skin is pink, dry, and void of bruising, rashes, or lesions. No recent hair loss; head is normocephalic. Pupils equally reactive to light; no history of glaucoma or cataracts. Ears are in normal alignment; no history of chronic infections, hearing loss, tinnitus, or discharge. Nose and sinus history includes clear nasal discharge “since last October”, and occasional nose bleeds; states she use to get nose bleeds often as a child. Mouth and throat are absent of lesions; no bleeding gums, sore throat, dysphagia, hoarseness, or altered taste. Neck is void of pain, swelling,

The general health of the patient is currently being compromised due to present illness mentioned above, but is stable. L.H. reports his usual health to be, “normal and not too crazy like this”. Patient has some fatigue noted while conducting daily activities; No recent weight change, fever or sweat. The skin noted to some discoloration on upper right side of back. There is no pruritus, rash or lesions present. Bruises noted bilateral on arms. Patient reported taking baby aspirin as daily medication. His hair is greying and thinning with no hair loss.

In the case of Shahine vs. Louisiana State University Medical Center, the plaintiff Ms. Shahine experienced right ulnar nerve damage following a right total hip arthroplasty. She filed suit against the University Medical Center and her anesthesiologist, Dr. W for medical malpractice and requested the court to infer negligence under the doctrine of res ipsa loquitur. Dr. W was fully responsible for Ms. Shahine’s care while she was under anesthesia and Ms. Shahine obviously could not assess the true cause of injury while she was anesthetized. However, Dr. W provided evidence of non-negligence by thoroughly charting in Ms. Shahine’s medical record proper positioning and padding. Another anesthesiologist provided the court with uncontroverted

O: Left Pointer Finger Nail: A Blue colored discoloration, tender to palpation; Left pointer Finger distal phalanx 1 cm in length purple discoloration, small, pin tip size open area, bleeding has stopped. mild edema

With the Cleveland Clinic being nonprofit, they really make sure to engage with the community by getting involved in a broad range of medical research, educational training programs, and supporting the community health initiatives (Community Impact 2017 | Cleveland Clinic). The Clinic is absolutely making an impact in the community, as more companies are developing and gradually growing around them. The bigger challenge is that the community is still very much poor and unhealthy. According to (Centers for Disease Control and Prevention), over one – third of the population that live around the hospital have diabetes. Another big part of the population has Cancer, Heart Disease, and Kidney disease. The hospital can continue to add new things and make changes, but it has no control of what is happening to the city around them. The clinic is ranked second in the world report hospital rankings. It employs over 50,000 people in just the Ohio clinic. They also spend millions of dollars on additional education for their physicians, and also with making community investments. They have also put over $500,000 into a program to get rid of run down homes within the neighborhood. One of the clinics most significant investment was for the Langston Hughes Education Center. They offer free exercise equipment and adult day care. (By: Dan Diamond/07/17/17/ The Clinic is a global success story, but it’s host community remains mired in poverty) So when it comes to economy impact, they truly do go over and beyond and put out quite a bit of money and support other organizations.

West Florida Regional Medical Center (WFRMC) located on the north side of Pensacola, Florida competed strongly with sacred heart and Baptist hospitals for patients. WFRMC’s CEO John Kausch was an active member of the Total Quality Council of the Pensacola Area Chamber of Commerce (PATQC) (McLaughlin, C.P., Johnson, J.K., & Sollecito, 2012).. PATQC’s vision was to develop the Pensacola, Florida area into a total quality community by promoting productivity, quality and economic developments in all area organizations both public and private (McLaughlin, et, al., 2012). John

The Florida Health Care Association is committed to bringing long term care emergency management planning to the forefront of our profession by aiding nursing homes in the development of effective emergency management plans which are comprehensive and aligned with state and local governments. FHCA’s Education and Development Foundation has partnered with the John A. Hartford Foundation, the University of South Florida, the Florida Department of Health and the American Health Care Association in the development of tools to support the emergency response system nationally, at the state and local levels, and at the nursing home.

The patient does state she has a lesion on her left calf that gets red and scaly. Sometimes it is there and sometimes it looks like it is almost gone away. It does not bleed.

I would also point out that the patient is developing a condition called Leukoplakia as evidence by white patches are

A physician can diagnose Blue Rubber Syndrome by doing a clinical examination of a patient who has skin lesions, GI bleeding, or a family history of multiple venous malformations. The GI tract is then viewed through endoscopy (passage of a scope into the stomach and lower intestine). Magnetic Resonance Imaging (MRI) and ultrasound is essential in evaluating massive malformations or deep lesions and their relationship to structures under the skin. MRI is the most sufficient method to determine the extent of deep lesions. MRI can also assess to what degree the underlying bones and joints are involved. The low circulation nature of the lesions is best determined by Doppler interrogation (Kassarjian, et al., 2003).

Cyanosis is the bluish discoloration of the skin. The disease is mostly on the skin but can also be in the mucus membrane due to excessive concentration of deoxyhemogoblin in the blood caused by deoxygenation. There are two different types of Cyanosis which are Central and Peripheral. Central is around the core, lips, and the tongue. The Peripheral is only on the extremities of the body or fingers. Cyanosis comes from the Greek word Kuaneos which means “dark blue”. Cyanosis is caused by the lack of oxygen, when the body lacks oxygen the blood turns bluish purple. The lack of oxygen in the blood supply allows the body parts to turn, such as the ail bed, skin, or mucous membrane, causes that body part to take that bluish tint. When the patient

O: Left middle finger bruising on dorsal palmar between distal and mild phalanx, mild edema, Full active and passive ROM. X- ray no abnormality found; fingers warm, brisk capillary refills.

Cyanosis is a bluish discoloration of the skin resulting from a lack of circulation or inadequate oxygenation of the blood. Red blood cells carry oxygen throughout the body, and mostly all the red blood cells in arteries are provided with a fully supply of oxygen, making them appear with a red hue. Cells who lack oxygen have a blue or purple tint, so when there is an insufficient amount of fresh oxygen in the bloodstream or blood cells are being too slow to reoxygenate quick enough, people with cyanosis's skin appear bluish. It is connected with the circulatory, respiratory, and immune systems.

Cleveland Clinic is one of the largest and most respected hospitals in the country. Our mission is to provide improved care of the sick, investigation into their problems, and additional education of those who serve. Also, learning more about our leadership, vision, values and model of healthcare (Clinic, 2017).