Escape Fire Analysis

According to the film Escape Fire, the U.S. healthcare system suffers from multiple aliments. As I watched the film I learned a lot of topics the film covered were previous things we have reviewed or talked about in class. The film talked about how America almost spends 2.7 trillion dollars a year on healthcare, almost twice as much as any other country. Many of the American healthcare field organizations and hospitals are paid base on keeping them full and paying doctors by the patient so they try and see a lot of patients.

Within Victoria there are multiple models of maternity care available to women. An initial discussion with the woman’s treating GP during the early stages of her pregnancy is critical in her decision-making about which model of care she will choose and this key discussion is essential in allowing a woman to make the first of many informed decisions throughout her pregnancy. According to a survey conducted by Stevens et al. (2010) only 43% of women felt ‘they were not supported to maintain up-to-date knowledge on models of care, and most reported that model of care referrals were influenced by whether women had private health insurance coverage.’ Many elements of these models of care differ: from location of care, degree of caregiver continuity, rates of intervention and maternal and infant health, outcomes access to medical procedure, and philosophical orientation such as natural or medical (Stevens, Thompson, Kruske, Watson, & Miller, 2014). According to the World Health Organization (1985) and Commonwealth of Australia (2008) there is a recognition that ‘85% of pregnant women are capable of giving birth safely with minimal intervention with the remaining 15% at potential risk of medical complications’ (McIntyre & Francis, 2012).

Maternity care in the United States is in jeopardy. There is an increasing trend of shortages of obstetrician-gynecologists and family physicians that once provided vital maternity care. With almost half of the nation’s counties lacking an obstetric provider, approximately ten million women are affected. Obstetricians-gynecologist themselves are also feeling the burdens of the understaffed hospitals and clinics with prolonged work hours. These medical professionals who dedicate their very lives to the field and the care of women are under a great amount of pressure and stress due to the shrinking workforce. Furthermore, interest amongst the youth is necessary in order to have an ample amounts of physicians available to replace the increasing

Pregnant mothers are viewed as a business made for doctors and hospitals as insurances typically cover infant birth and hospital bills. As Patricia Burkhardt, Clinical Associate Professor, NYU Midwifery Program could not speak the truth any better, she states, “Hospitals are a business. They want those beds filled and emptied. They don’t want women hanging around the labor room.”

From the results, it is evident that the interventions were effective in increasing ANC coverage and improving other pregnancy related issues that emerged as a result of lack of or insufficient ANC. They addressed the common problems that affected the utilization of ANC, these included: maternal knowledge, accessibility to health care facilities and financial difficulties. Accordingly, as doctors and future practitioners, it is imperative that as we provide maternal and antenatal care, we structure the health care services we provide around the patient and cater to a patient's individual preferences, needs and concerns. We are advised to accommodate the patient as much as we can, which means providing them with care that is specific to them

The video, “Escape Fire,” illustrates the current practice of the health care system in the United States. Multiple issues captured are avoidable. One of the prominent problem is the inability to prevent the progression of diseases. The health care industry spends billions of dollars in the invasive treatment of diseases such as heart catheterization procedure, surgeries, and so on that oftentimes patient do not need. The intervention that the people need at this current situation is empowerment. Pulvirenti, McMillan, & Lawn (2011) emphasized that empowerment is “an enabling process for decision making to achieve change” (p. 307). Providing the patients and families the necessary tools that will effectively encourage them in making positive

In 1993 continuity of care was recognised by the government and was outlined in the department of health policy paper ‘Changing childbirth’ (DH, 1993). The document focused on choice and continuity of the care a woman should receive. Subsequently, a greater shift towards Midwifery Led Care developed. It has been suggested that a midwife should be the first point of contact for women accessing maternity services (Department of Health 2007, Welsh Assembly Government 2002, Scottish Executive 2001). Nevertheless, statics show that this was the case for only 24 percent of women in 2010, with some improvement by 2013 at 32 percent. Conversely, in 2013 63 percent of women first made contact with their family doctor (The Care Quality Commission, 2013). However 98% percent of women had their the remaining antenatal care provided by a midwife, 40% exclusively and with 60% having shared care with a GP or consultant led care (The Care Quality Commission, 2013).

I strongly believe in and support the mutual partnership that is established between Midwives, Wahine and their Whanau. It is an honour to be a part of women and their families journey to welcoming a new family member and I cherish the opportunity to be able to do this with them. Whilst pregnancy and childbirth is a normal, natural process of life, for some this can be complicated and I feel it is my responsibility to be able to walk with low risk and high risk women, injecting as much of my midwifery philosophy as I can into what might be a complex medical picture. By keeping practice hollistic and woman-centred this can be achieved. All women are entitled to make fully informed decisions and granted the time to do this. I am pro-choice and

The movie Escape Fire clearly states the facts that currently affect the healthcare system in the U.S. and proposes solutions that are at our reach as individuals, as a community and as a country. We are a country that sets the tone for almost everything that is popular in the world and something as necessary to our livelihood as healthcare is, we certainly are not on top of how to set that tone in that aspect that should be as popular as the air we breathe. We have the ability to change the game as it is suggested in the movie, and persuade the behavior changes necessary for all Americans to make in order to control the management of diseases culture that we are currently in and turn it into a

The key driver of change in NHS has different factors, demography, new technology that rising consumer expectation and litigation, Even though NHS is one of the largest employers in the world they still shortage of staff, doctors and nurses NHS choices (2014). The rising cost of treatment potentially increase patient satisfaction and promotion of staff safety are invariably restraint poor action plan. That then has an impact of delivery care Gopee and Galloway (2014).

The focus of my leadership initiative is to develop a new, simpler and leaner approach (Fillingham, 2008) to the assessment process, ensuring safe and reliable delivery of right care, in the right place and at the right time, to the patients. Recently we implemented monthly practice governance meetings in our team to regularly reflect on areas of improvement and discuss changes that would improve patient care. I have been using the practice governance meetings to present results from our recent audit demonstrating increased treatment-waiting times, share real stories highlighting the gap between the current and desired state of the service and encourage engagement of frontline staff in delivering this initiative. Staff was given opportunity to perform a Cause and Effect Analysis (figure1) and map patient journey (figure2) to identify activities that add value (Bennington, 2011) and reduce waste. I was hoping to use these meetings to frame and embed a strategy of implementing the improvement initiative and whilst I have been successful in developing a framework of the new leaner assessment process, the process has suffered from poor staff engagement and conflicts with trusts’ agenda of standardising the delivery of care. During these practice governance meetings, the team was unable to come up with any suggestions to improve the assessment process and other agendas related to the new community service review policies were given greater priority. Some clinicians

The midwife as distinguished by Leap (2009) research of the women centred relationship and the Australian College of Midwives (ACM) (2016a) defines the midwife role as meeting “each woman’s social, emotional, physical, spiritual and cultural needs, expectations and context as defined by the woman herself” (para. 7). ACM position the midwife as the primary profession for quality maternity care founded during training, through the direction of the Nursing and Midwifery Board of Australia (NMBA) “Code of Professional Conduct For Midwives In Australia” (CPC) and reinforced by the “Code of Ethics For Midwives In Australia” (ACM, 2015; NMBA, 2008a; 2008b). The boundaries as outlined in the NMBA “CPC” along with meeting the educational

Women make up just slightly over half the U.S population (US Census Bureau, 2010) and should not be even considered a part of a minority group. The female population should acquire the same equal research attention as men do, especially when it comes to health issues. The unavoidable, yet quite simple realities of breastfeeding, menstruation, menopause, along with pregnancy require special scrutiny from medical experts. Those medical specialties are generally referred as gynecologists or obstetrics, who focus on the exclusive needs of a female’s reproductive health throughout their lifespan. Historically, the health needs of women have been disregarded as well as their fundamental rights. However, over the past few decades, it has grabbed the media and the government’s attention causing some major changes in support of women’s rights and health care.

What is the experience of women who are cared for by a general practitioner (GP) obstetrician under hospital shared care as compared to women in caseload midwifery in rural areas?

The World Health Organization reports that “81 percent of women in developing countries have one prenatal visit, but only 36 percent have the recommended four visits”. Prenatal care is important for both mother and fetus. In most countries midwifes are the ones that take care of the expecting mothers and deliver their babies. In the United States however midwifes have become less and less used, due to the rise of OB-GYN’s. Deciding which care provider would be the best for each pregnancy is hard question to answer. Although some experts say that OB-GYN’s have more years of schooling therefor they are more certified to deliver babies, I argue that midwifes receive adequate training and are just as certified to deliver, which could give expecting mothers a more attentive care provider that is a lot cheaper than other care providers.