Health Service Administration : Final Take Home Exam

Political: The Governor of Florida appoints seven members to the South Broward Hospital District Board of Commissioners to serve four-year terms. These seven board members then determine the President and CEO that will act as the leader and figurehead of the organization. The President and CEO is the head of Memorial Healthcare System’s executive department. Additionally, the board plays a role in the development of the regulations, policies, and bylaws of the South Broward Hospital District to ensure that the quality of care provided by every hospital remains satisfactory. Additional executive staff members are appointed by the CEO to manage the operation of the various branches of the Memorial Healthcare System located across the South Florida area.

The hospice nurse should evaluate the ability of the patient and the family to cope because through that assessment the nurse can obtain more information about the patient. You can identify risks and symptoms of distress. The hospice nurse, especially the case manager, is responsible for evaluating and managing the care of a patient. Addressing loss, grief, and bereavement needs begin at the time of hospice with the initial evaluation and continue during the course of care.

Hospice care differs from other forms of medical care in that when the patient is dying, hospice works hard to relieve needless suffering. Normally, a patient is approved for hospice care if his or her life expectancy is 6 months or less. Hospice workers treat the person, rather than the disease. They aren't trying to cure a disease, but rather, they are trying to make the patient as comfortable as possible. Family and friends are encouraged to gather round and engage with the hospice patient. Many people have the misconception that the dying want to be left alone, but why would they want to be abandoned? Hospice is good for families, because they educate them on the dying process. Hospice care can be rendered in the family home, a nursing home, or in a hospital. Normally the majority of care is given by the family in the family home, or by nursing staff in a nursing home or hospital; however there are also private in-house hospice facilities-for those that may not have the family support. In the home, nursing home and hospitals the hospice workers come at specified times to work with the dying patient. They spend take vital signs, offer palliative care, and also offer support for family members. If you were to be admitted to hospice care you would find a great team of doctors, nurses, social workers, counselors, home healthcare assistants,

The National Hospice and Palliative Care Organization reported that, as of 2003, there were 3,139 hospice programs in operation in the United States, Guam and Puerto Rico (Wexler & Frey, 2004). The Centers for Disease Control and Prevention National Center for Health Statistics said that, in 2000, there were 11,400 combined home health and hospice care agencies, which served 1.5 million patients. It also reported that, at present, more than 90% of hospice care is delivered at home, although based in medical facilities. Hospital-based programs often provide hospice care in a wing or a

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

Hospice care main goal is to provide comfort then treating the person disease. Normally patients that live in hospice only have 6 months to live. Hospice also gives control to the patient in methods of their own death. Many patients will rather take a liquid substance that will slowly put them to rest, while others will have alternative plans on how they want to deal with their last stages of life. Hospice is also great at giving the patient many options when there trying to make decision on their death. Hospice overall wants to improve the quality of life and their finial wishes.

In a hospice facility, the focus begins to shift to providing a loved one with the happiest, most enjoyable days possible, and away from painful tests and procedures. It's about providing the best days possible of those remaining.

Hospice care is a model of care that focuses on relieving symptoms and supporting patients with a life expectancy of six months or less (Altshuler, 2013). For most nurses, caring for a dying elder (individual aged 65 years and above) is a discrete, time-limited experience that begins with first contact, often in a hospital, emergency room, or long term care facility, and ends with the death itself (Phillips & Reed, 2008).

I appreciate you all mentioning that there is a high turnover rate for hospice organizations. From my personal experience with hospice, it is a very difficult and rewarding field of work that takes a special person. Due to the high turnover rate, this can also impact the quality of care for patients. If an employee is not happy with their position or is feeling burnt out, then the patient and the family can be negatively impacted. While it is a waste of resources for the organization, it can also impact the organizational success on whether or not a patient and/or family members will refer to that particular facility.

Hospice care has not been around for very longs but it is one of the fastest growing medical fields in the country, with over 1.58 million patients being cared for in 2010 alone. Hospice is an important part of caring for terminally ill patients and helps the families and loved ones to grieve.

The first hospice care was established in 1974. A hospice must make physician, nursing, drugs, and medical supply services available 24/7. It must have social workers and counseling services available to the patient and the family. Hospice also provides therapy and homemaker services when needed in order to be qualified under Medicare certification. Hospice is a combination of special services for terminal ill patients. Beside the medical service, hospice care also supports patients and family psychologically and spiritually to put their emotional suffering at ease. The psychological suffering can weight more than physical suffering. Many terminal ill patients cannot accept the bad news and living under emotional distress. Certified chaplains can work with people from different religions, they focus on the world-view of the patient and family. Using patient personal goal as the measurement, chaplains are the

Rather, the hospice staff and the patient understand the patient is going to die and no further treatment options are available. Therefore, hospice care centers direct their attention towards providing a dignified ending to a patient’s life by delivering comfort and emotional support through a palliative care approach designated to alleviate pain and emotional distress. For example, at Hospice of Dayton, each patient residing at the care facility is provided their own room where their family is able to stay with them and the patient is able to receive the pain management and emotional support they need to die a little closer to peace and security. Additionally, at Hospice of Dayton, there are full-time doctors, nurses, counselors, and religious support-staff that provide patients the physical treatment they need to minimize their pain, as well as the emotional support they need to live the last moments of their life with dignity and emotional well-being. Most importantly, Hospice of Dayton because of its volunteers. Volunteers provide the invaluable service of listening, crying, and laughing with those who may not necessarily have someone to spend time with, while they undergo their long, arduous, and painful experience of

1. Administration – He or she carries full administrative responsibility and authority for the entire nursing service of the hospital. The policies and procedures as well as objectives of each unit is always verified by the nursing director so that it will be congruent with the whole organization’s reason for existence.

Caring Hospice will be made up of an inter-disciplinary team that collaborate together to provide holistic, competent, and compassionate care for terminally ill patients and their families. The team will consist of the Medical Director, Patient Care Coordinator, Registered Nurse, Bereavement Coordinator, Social Worker, Chaplain, Certified Nurse Assistant, and Office Manager. Each team member will play a vital role in creating an effective care giving system.

Hospice is a component of palliative care. A person does not necessarily have to be dying in order to see a palliative care specialist. This is where the service is often underutilized in the hospital. In the 18 months I have been a nurse, I have cared for many patients with chronic illnesses who have dealt with symptoms that have severely impacted their quality of life. Most of the time, it seems as though the patient’s care providers are interested in treating the patient’s acute problems. My experience has been that the symptoms are often overlooked or are being treated in a manner that is to the dissatisfaction and discomfort of the patient.