During this course, I was able to learn a lot about nursing leadership and how everyone can be a leader in one way or another. I also learned a lot about conflict resolution, budgeting, and how there are so many different counterparts that go into running a floor and motivating employees and coworkers to work hard and efficiently, as well as when dealing with conflicts. I liked the team activities that we were able to do, mainly because my team was amazing. We always worked ahead to decrease the amount of stress on anyone and every single person played a huge part in all of the assignments and we worked together as a team. It helped me to feel like each of us were leaders in our own way. I will apply this to my nursing career by trying to be a leader in my own way and help to increase moral and motivation on the floor. I liked the material covered in this class. I think that this class is a great contribution to the BSN course, as leadership is a huge thing that every nurse should be able to do in one way or another.
This article my Modern Health discussed the largest HIPPA settlement ever where more than 79 million people were affected by a 2015 data breech. Anthem has agreed to pay the federal government $16 million over the breech. Hackers were able to get through the firewalls and security in order to steal names, birthdates, social security numbers, and even home addresses, along with other personal information. As further contribution to the settlement, Anthem will also create an action plan to conduct a risk analysis and fix any deficiencies found. HHS will oversee this work and ensure that it is followed as meticulously as needed. Though Anthem was not able to implement sufficient measures in order to detect hackers, they did not admit liability for the incident, as there has not been any identity theft that came out of the 2015 attack. Additionally, Anthem agreed to shell out $115 million in order to settle the class-action lawsuit over the breach. Furthermore, the company agreed to offer class-action members two full years of credit protection added on top of the two years they already had. They also put aside $15 million for customers’ out-of-pocket costs related to and stemming from the breach. This is a helpful article in that it gives a sort of a reality check – that not everything is fireproof and that there are still big breaches that can occur and information is never considered completely “safe.”
I will be able to apply this information by being careful about who I give information to and make sure I keep my personal information and identity information in a safe place where hackers are unlikely to get it. Furthermore, I will be able to apply it to the workplace by understanding that no one’s information is completely safe. I will also be able to more fully apply the laws implemented and put in place by HIPPA.
The article I read this week was about four people that were indicted for a telemedicine fraud scheme of $931 million in Tennessee. The team of four were able to submit at least this much money in fraudulent claims through tricking thousands of patients and over 100 different doctors. Peter Bolos, Michael Palso, Andrew Assad, and Larry Everett Smith were the four men working for the telemedicine company HealthRight that were indicted and charged with conspiracy to commit healthcare fraud, mail fraud, and “introducing misbranded drugs into interstate commerce.” This was all according to the U.S. Justice department. The way they went about this fraud, was they would get approvals for invalid prescriptions for doctors then bill companies such as Blue Cross and Blue Shield of Tennessee for their greatly marked prescriptions and taking in the extra payment. This went on for over three years until it ended in April of 2018. This affected not only these four men, but also Scott Roix, the CEO of HealthRight pleaded guilty to felony conspiracy. As this article was quite tragic and shows how scheming is a real thing and can affect not only those involved, but those that are deceived by the lie. This is good to know because it shows that we should always check our sources and make sure we are not being scammed by companies. I will be able to apply this by knowing what companies I am dealing with and researching where I am getting my information from. I will also advise my patients against getting things from companies that they are not familiar with or have not done their research on.
The article that I read this week shed light on February 17, 2009 when “President Barack Obama signed legislation that created the federal government’s meaningful use electronic records incentive program.” After almost 10 years and $35 billion in federal incentives, hospitals and health systems are still struggling with EHRs due to new installations as they disrupt the workflow and cost hospitals millions. The article titled, “No end in sight: EHRs hit hospitals’ bottom lines with uncertain benefits.” This really tells how the rest of the article explains that there really is not end in sight and the government keeps trying to adjust things through legislation, and it simply seems to keep costing them money and not further progress to where it should be. In 2016 the federal government poured an astounding $34.7 billion into incentives for adopting EHRs which ended up split among health systems to install new health record-keeping software. For example, the Mayo Clinic made up a chunk of the $1.5 billion investment in new technology. Partners HealthCare additionally spent $1.2 billion on an Epic EHR. These EHRs are meant to help hospitals and health systems more efficient, both clinically and financially.
Though this article is quite pessimistic, it does show that there does not seem to be an end to the promises made by the federal government, as the benefits are never quite certain. So much money can be poured into one area, but the rewards are not so plentiful. I can apply this to my current nursing practice by better understanding the benefits promised from the incentives provided by the federal government.
The article I read this week, titled MBA Programs for Physicians: 2018, discussed a list of the nation’s largest business graduate schools for physician-executives. These schools are based off of the number of full-time students from this last year of 2017-2018. The article explains that each graduate program school includes the rank/institution name, degree programs, number of full-time and part-time students, tuition from the last 2017-18 year, number of total graduates of the program to date, length of the program in months, age of the program in years, and comprehensive answers to open-ended questions. All of the information provided in the list is information that is self reported from those institutions that have participated in the Modern Healthcare’s 2018 Business Graduate Schools for Physician-Executives Survey. However, those that did not participate in the study are not listed in the rankings. This is a great article because it lists some of the highest ranking schools in the nation. It gives direction as to where people will want to go based off of the different criteria and helps to really open up ideas to physician-executives.
I will be able to apply this to my current nursing knowledge by teaching people about the ongoing education that happens throughout all of healthcare. Physician-executives are now being urged on to gain more knowledge and pursue their education. This is something that inspires me and will motivate me to further my own education.
I was able to read an article this week addressed the issue of the increasing rate of physician suicides. The higher incidence of suicides among physicians is nothing new; however, the healthcare industry is doing much more about it now than ever. The article outlines a story of a surgeon, Dr. Michael Weinstein from Philadelphia who suffered from deep depression and ended up receiving treatment from a primary healthcare provider. He underwent electroconvulsive therapy and took a leave from work in order to receive treatment and focus on himself. He felt that he could not discuss his issues at work or seek help, in fear of looking weak. This fear is believed to contribute to the reason as to why experts believe that doctors have a higher rate of suicide than the general population. They also explain that in medical school, the idea that physicians should be strong and put the health of their patients before themselves is drilled into their heads, adding to the pressure. Again, though this is not a new concept, the industry is responding more now than ever. They are implementing more awareness in residency and medical school to help future physicians to be ready for such mental trials and to encourage them to seek help and let down the need to look perfect among their peers or even their patients. They too can be patients, and should very well be if struggling with depression or any sort of mental health condition. This is great to know because I will be working with physicians and am also in the healthcare industry. Doctors aren’t perfect and never have been. However, I should do my best to create a positive work environment for the physicians I work with and never set the bar too high or increase the pressure of physicians.
The article I read this week addressed the issue of the increasing rate of physician suicides. The higher incidence of suicides among physicians is nothing new; however, the healthcare industry is doing much more about it now than ever. The article outlines a story of a surgeon, Dr. Michael Weinstein from Philadelphia who suffered from deep depression and ended up receiving treatment from a primary healthcare provider. He underwent electroconvulsive therapy and took a leave from work in order to receive treatment and focus on himself. He felt that he could not discuss his issues at work or seek help, in fear of looking weak. This fear is believed to contribute to the reason as to why experts believe that doctors have a higher rate of suicide than the general population. They also explain that in medical school, the idea that physicians should be strong and put the health of their patients before themselves is drilled into their heads, adding to the pressure. Again, though this is not a new concept, the industry is responding more now than ever. They are implementing more awareness in residency and medical school to help future physicians to be ready for such mental trials and to encourage them to seek help and let down the need to look perfect among their peers or even their patients. They too can be patients, and should very well be if struggling with depression or any sort of mental health condition. This is great to know because I will be working with physicians and am also in the healthcare industry. Doctors aren’t perfect and never have been. However, I should do my best to create a positive work environment for the physicians I work with and never set the bar too high or increase the pressure of physicians.
- How many people do you usually work with in order to manage a budget?
- at least another person who helps with the financial advisory.
- What is the hardest thing about managing a budget?
- sticking to the budget planned. Certain expenses come up and are necessary, even though they exceed the amount set for the month.
- How often do you look over the budget?
- at the beginning of the month and end for sure, as well as at least once a week to make sure things are going according to plan.
- How often do you make changes to the budget?
- I try to stick to the budget, but it is not abnormal to adjust the budget once or twice a month.
- How far in advance do you prepare a budget?
- at least 2 weeks before the month starts
- Is the budget a yearly plan, quarterly plan, or monthly plan?
- monthly plan
- If you are over budget, what is the first thing you do?
- look at the areas that I clearly spend too much on and make cut backs for the next month.
- How vital is it that you stick to the exact budget? Is there any leeway?
- I try to make room for leeway in case of emergency – that way I can be left with a little more at the end of each monthly budget and if I go over, it is not as big of a deal.
- Are you held responsible if the budget is over?
- Yes, I am in charge of ensuring that the company does not overspend the budget I have set. All company expenses are ran through me.
- What is an example of a factor that goes into budgeting that is less known?
- Where have you noticed that you’re consistently gone over the budget?
- We often create donor projects that we make sure things look perfect for these donors, yet we end up spending too much on that rather than keeping to the budget and putting the money in more essential areas.
- What area is the hardest, yet most necessary to make budget cuts?
- Probably the hardest thing to make cuts on are the little things that keep adding up such as garden supplies and the little ares with donor projects.
Red Butte Garden, Desi Guerrero Financial Analyst Assistant / Garden manager.
I learned that there are a lot of things to think about when it comes to budgeting. There are a lot of things that cross over from non-healthcare related companies to healthcare related companies. There are always areas that are considered unnecessary spending and these areas are often some of the hardest to cut down on.
The article I read this week discussed the recent event of the U.S. House of Representatives passing a large amount of bills aimed at diminishing the opioid crisis in America. It explains how lawmakers are using a loss ratio to pay for the legislation from Medicaid. Over a decade of putting these bills into action, the Congressional Budget Office estimated to save the government about $2.6 billion. Additionally, the CBO estimated another $2 million saved from the opioids package. In the past, addiction treatment advocates and industry lobbyists have felt that the funding in legislation is not sufficient to fight the opioid epidemic. In 2017, over 47,000 Americans died due to this epidemic. In this package that has been signed to reduce these numbers, it requires a mandatory training for nurse practitioners and physician assistants to prescribe medication-assisted treatment. In doing so, NPs and PAs will have a better understanding and be able to join in the fight against the opioid epidemic. This is great information, especially since I am wanting to become and nurse practitioner and will likely be prescribing medications as well. As a nurse, there have been times when the physician has ordered opioids for the patients while in the hospital, but does not prescribe them such heavy pain killers to go home with. Some patients are annoyed at this, but after a thorough explanation, they are compliant and agree with the physicians judgement. This is a sticky and controversial area, as patients feel the need to stay on top of pain. However, joining in the fight against this epidemic can have a great lasting effect on the nation.
The article I read this week discussed how the Centers for Medicare and Medicaid Services (CMS) has made plans to stop big time hospitals from rejecting ambulatory surgery center (ASC) patient transfers. Currently, there is a requirement that surgical centers must have an actual written transfer agreement with potential hospitals or they must ensure all doctors performing surgery have admitting privileges in nearby hospitals The CMS is suggesting that they remove this requirement to make it easier to transfer between surgical centers and hospitals. There are many stipulations that the hospitals must follow and some of the policies have even led to transplant programs avoiding performing transplants, but only for certain patients which uses some organs to go unused and wasted. In addition, the CMS is pushing for streamline access for X-ray services. The article explained that over the last year, “the agency has taken action to address 55% of the 624 topics considered burdensome by the industry. Another 16% of the topics remain under consideration and 29% were either referred to another agency or did not require further action.” This is a large amount of issues and topics that are considered burdensome, and also the large amount that are still under consideration. This is useful knowledge as a nurse to understand that policies are constantly changing. I will be able to apply this information into my practice by educating patients that they should be up to date with the different policies, and that I should constantly be kept up to date as well, as they are constantly changing.
Additionally, we discussed budgeting for hospitals and the floor. It is something that we might not deal with directly as nurses, but is something that we should be aware of as many of us aspire to move to a position where we will deal with such things. It is also important to us as nurses so that we do not contribute to the wastefulness in hospitals in regards to supplies. I will apply this to my nursing career by not being wasteful and being more aware of the hospital budget for my floor.