Sunday, January 26, 2020

EHR Implementation Issues

EHR Implementation Issues Melchor Abejon Any adverse event that obstructs the development and success of an organization should be investigated to discover and understand the initiating cause of such event and to consequently establish corrective actions to prevent its recurrence in the future. This paper intends to: Identify the approach to be taken to address the reporting problem at Western Heights Hospital (WHH). To create a flowchart outlining the process to be taken in finding a solution to the organizations reporting problem. Approach to Address the Reporting Problem at Western Heights Hospital As stated in the given scenario, the WHH is unable to report on various state and federally mandated quality measures. Definitely, this problem needs immediate attention as this process is essential to the organization to improve and maintain quality. As the clinical content manager and leader of all reporting efforts in the organization, it is my primary concern to address and find solution to the problem. My approach would be to perform a Root Cause Analysis (RCA). Conducting an RCA would help me discover and understand the initiating cause or causes of the problem and to develop corrective actions to prevent its recurrence in the future. Root Cause Analysis Below is a flowchart showing my steps to performing an RCA for the problem. Identify the problem Charter and appoint team facilitator and members    Describe the incident Identify the contributing factors Identify the root cause or causes Eliminate the root cause or causes Evaluate and measure Identify the problem. This step will include determining the problem to be investigated. The problem statement from the scenario would be, The organization is unable to report on various state and federally mandated quality measures. Also, included in this step is to gather preliminary information about the problem which can be discussed later by my team. Charter and appoint a team facilitator and members of the team.   In this step, a team facilitator will be designated who will work with the leadership to launch a project charter that will guide the team in managing the scope of the project and in implementing changes that are linked to the root causes identified in the RCA process. Also, team members will be selected who are familiar with the systems and processes involved in the problem. Describe the incident. In this step, facts surrounding the problem will be collected and organized, on why the organization fails to do quality reporting measures. The preliminary information gathered in step 1 will be shared and discussed with the team. Identify contributing factors.   The knowledge gained in step 3 will be used to dig deeper into what happened and why it happened. Also in this step, the conditions, circumstances and situations that caused the organization not to be able to report will be identified. A thorough investigation of the organizations current data systems and the processes from patient data capture to electronic reporting will be carried out to determine any lacking or faulty process that have resulted to the incomplete generation of data. Identify the root causes. The contributing factors will be examined to find the root cause of the problem. In the given scenario, there could be many underlying reasons that had caused the organizations failure to report. Contributing factors could be due to (a) incomplete data as mentioned, (b) failure of systems to communicate, (c) poor data quality, (d) lack of data standards. These contributing factors are interrelated to each other to significantly affect the interoperability of systems. Identifying the root cause should be dug deeper by asking repeated why questions of the contributing factors. Eliminate the root causes. This step will also include the design and implementation of changes to eliminate the root cause and to reduce and or prevent the recurrence of the same event in the future. If there are multiple root causes, there will be corrective actions to address each root cause. In the given scenario, the failure to report could probably be due to lack of interoperability or failure of systems to communicate due to poor data quality as manifested by incomplete data generated by the organizations system. This problem could be addressed by improving patient data capture and by developing an efficient data dictionary. Data integration would probably be needed to cleanse all dirty data, and as well as to employ data standards to improve clinical documentation,   and data interchange standards to enable the systems to achieve full interoperability and be able to exchange and integrate data among healthcare applications in a state , regional and nationwide level. Evaluate and measure. In this step, the success or improvement of actions will be evaluated and measured and will be monitored overtime. Reference Center for Medicare and Medicaid Services (CMS) (n.d.). Guidance for performing root cause analysis (RCA) with performance improvement projects.   Retrieved February 20, 2017 from https://www.cms.gov/medicare/provider-enrollment-and-certification/qapi/downloads/guidanceforrca.pdf

Saturday, January 18, 2020

How to Increase Medication Compliance in Children with ADHD Essay

Attention-deficit hyperactivity disorder, or ADHD, is an enduring mental disorder that may become noticeable in a child’s formative preschool years. According to the Centres for Disease Control and Prevention ADHD affects approximately 7 percent of the school-aged population and, for that reason, has turned into a public health concern (Medical News Today, 2007). Treatment compliance is exceptionally vital in view of the fact that the success of the medication depends on consistent administration. Unfortunately, hardly any children with ADHD are capable of assuming full responsibility for their medication. In view of that, the underlying principle of this study is not just to present another piece of information to the already vast literature on ADHD. Instead, the author aims to specifically examine how to enhance medication compliance in children with ADHD. Existing studies will provide the author an overview on how ADHD medication compliance among children has been approached within the past years. Accordingly, a careful investigation in the current approach, future strategies, and obstacles will be done in this self-effacing research. Moreover, anticipated changes, that will present a forecast on what will transpire in the future if the proposed medication in children with ADHD is effectively complied with, will be done in this research. Background of the Critical Issue ADHD is a form of brain disorder that sets off difficulty in concentration and attention, as well as can cause problems of being compulsive, which is the hyperactivity aspect of it (Reporter News, 2009). Children with ADHD may easily misplace several things or get bored really easily. Sometimes they demonstrate irritability problems when they get anxious and edgy. Moreover, they normally divulge unrelated things during conversations. While symptoms of ADHD may appear to be childlike and merely annoying to observers, if left untreated or medication is not complied with, the pervasive and persistent effects of the symptoms can severely and insidiously interfere with one’s ability to maintain a generally positive self-esteem, maintain and establish interpersonal relationships, carry out one’s potential in the workplace, and to get the most out of education. With that, ADHD has become the most commonly identified and studied psychiatric disorder in children. However, notwithstanding the numerous ADHD studies undertaken, only a handful of articles explain how to increase medication compliance in children with ADHD and, consequently, only pieces and bits of information become known in published sources. At present, what experts know about medication compliances are merely information from few studies and experiences from other chronic conditions. The only interventions directly referable to ADHD are derived from specialty treatment centres that exchange information when clinicians convene at symposiums (Dodson, 2006, p. 1). With this regard, this paper will comprehensively examine current and planned approaches on how to increase medication compliance in children with ADHD. Current Research Management together with medication has been presently believed to be the most cost-effective approach in increasing medication compliance. Some of the known medicines for ADHD are atomoxetine, pemoline, dextroamphetamine, methylphenidate and a combination drug known as Adderall. These medicines are believed to increase medication compliance since they are seen to improve concentration and attention, and decrease overactive and impulsive behaviours among patients. However, with the idea that it is advantageous for children to have a few days per week to be prescription free, many of them take their medication only during school days. These children even experience a drug holiday during holidays or summer; therefore, allowing their bodies to function for a period of time exclusive of the aforesaid medications. In addition, researchers currently recommend a multi-tiered approach to children medication compliance, proposing more exhaustive services to children in greatest need and more traditional services to at-risk children; they believe that this may be the most cost-effective and practical strategy for helping preschoolers prevail over academic and behavioural challenges (Medical News Today, 2007). Accordingly, early medication and intervention compliance techniques generally consist of extremely individualized school programs that normally relies reinforcement behaviour on positive supports. For instance, in consultation with preschool teachers the National Institute of Mental Health researchers attempted to increase medication compliance and provide effective intervention by modifying the school environments, such as altering classroom activities and tasks in order to accommodate ADHD students (Medical News Today, 2007). Proposal for Change  Treatment adherence and compliance are vital issues in the management of every chronic psychiatric and medical condition. ADHD shares a number of the barriers to adequate compliance that is common to all chronic conditions. For instance, many people believe that children would â€Å"grow out† ADHD as symptoms of the disorder generally get better as children learn to adjust and grow older. Apparently, however, this is not true for the majority of children. A noticeable number of children who have ADHD continue to be hot tempered, have mood swings, easily distracted, and are incapable of completing tasks. In addition, many people believe that ADHD is a school-based disorder. As a result, the consequences of non-treatment adherence and compliance take place mostly outside the school environment, when children with ADHD are least expected to have been prescribed medication. Strategies The good thing about finding out Attention-deficit hyperactivity disorder early and treating it early is that children are more expected to live to their full potential (Reporter News, 2009). However, children who have ADHD may have trouble and difficulty in understanding directions, particularly in complying medications. This can be very challenging not only to doctors and teachers, but also to parents, as it can cause a great deal of time, patience as well as trouble to the family. Parents need to adjust their home life to some extent in order to assist their child. In view of that, parents should make a schedule by setting specific times for going to bed, waking up, playing video games or watching TV, doing chores, doing homework, playing, eating and taking medicines. Schedule should be placed where the child is most expected to see it always, and if there are intended changes to the routine, parents should clarify the aforesaid changes in advance. Parents should also make simple house rules, and to spell out what will happen when the rules are broken as well as when they are obeyed. Likewise, parents should ensure that the rules are understood by their child. They should get their child’s attention by making an eye contact with them. Parents should then tell their child in a calm and clear voice what they want the child to follow. Nevertheless, parents should keep all instructions short and simple, and must ask their child to repeat the said instructions back to them. Finally, parents should ensure that their child is appropriately supervised all the time, as well as commend their child when the latter completes a task. For that reason, parents should reward these excellent behaviours. Obstacles Most people, including healthcare providers, still perceive ADHD as a strictly academic dilemma. This observation is reflected in medication patterns showing a large number of school-age children being exclusively treated Monday through Friday, from 7 in the morning to 3 in the afternoon but not on weekends, evenings, or during summer vacations and holidays (Dodson, 2006, p. ). This is particularly depressing given the extensive study on the alarming consequences of non-treatment. Anticipated Changes If left untreated, children with ADHD have significantly greater possibility of being involved in illegal activity, becoming divorced or separated, having an unexpected pregnancy, contracting a sexually transmitted disease, being involved in serious accidents, and developing substance use disorders. However, a growing amount of evidence reveals that successful medication reduces the possibility of these untreated ADHD outcomes to be found in non-ADHD general population (Dodson, 2006, p. 2). Accordingly, children who have supportive and loving parents who continuously work for the their wellbeing at home alongside mental health workers, school staff, and their doctor have the most excellent chance of becoming normal upon reaching adult age. Conclusion Up to 7 percent of American students suffer from Attention-deficit hyperactivity disorder, or ADHD. However, this research concludes that ADHD is not just a school-based disorder in view of the fact that children with ADHD can also cause and experience troubles at home. Unfortunately, considering the high level of research in children with ADHD, little information is available on out of school interventions that help improve patient medication compliance. Children with ADHD require continuous encouragements and clear structure, both in school and home, in order for them to experience behavioural changes and, consequently, increase medication compliance. Therefore, aside from medicines, doctors and teachers efforts, parents must also make a religious endeavour in taking care of their child with ADHD at home since it is strongly believed that ADHD medication does not end at school or clinics. Children who have ADHD tend to need clearer and more structured guidance, and home environment presents an enormous weight of realizing this appropriate guidance. Suggestions for Additional Information Tics and Tourette’s Syndrome, Changing Your Childs Behaviour, ADHD Medicines, Parenting Tips, Treating ADHD Medication.

Friday, January 10, 2020

Top Essay Samples Harvard Choices

Top Essay Samples Harvard Choices The Lost Secret of Essay Samples Harvard Throwing in different accomplishments which don't really relate to the subject of your essay is very likely to detract from your general essay, and admissions committees will see through it. The program can generate an entire essay in under a second, dependent on a few keywords. Figuring out your college essay can be among the most troublesome components of applying to college. This essay or dissertation on this issue of well-being and social care was submitted by means of a student so it may aid you with your research work and dissertation help. Writers often need to do some thorough research on the subject. To accomplish this, the writers would have to set down the facts of their research in the argumentative essay, at the very same time they will need to cite the facts to show the credential of the arguments. Naturally, it is necessary to keep in mind that not everybody is a pure college essay editor, so make sure to follow along with the tips we offer in our guide to choosing readers. It is possible to also ask your professor to clear out controversial problems. Furthermore, the author employs some outstanding imagery in his essay. You will need to ensure your thesis isn't difficult to identify. Academic papers need you to identify a specific angle to pursue in writing, which is going to be the basis of the paper. Essay writing isn't only about composing interesting texts. It is a part of learning process. Essay Samples Harvard - the Conspiracy Levity had Sustained growth depends upon how broadly you define your company and how carefully you gauge your clients' needs. Financial aid is totally available, but it takes a considerable quantity of planning and hard work. The enabling objectives to find the research goal are the next. Early research and application is crucial. Things You Won't Like About Essay Samples Harvard and Things You Will Furthermore, the essays that follow are most likely to supply comfort, that there's no formula or singular approach to craft a prosperous answer. There is likewise an incredible quantity of unseen math present in football. Whether you have experience in your typic al day-to-day job or you must be a little bit more creative make sure you demonstrate how truly great you're at delivering exceptional customer service to each customer, daily. Person goal examples may supply the guidance to a person. The software becomes increasingly better during its job as a growing number of essays are being entered and can eventually offer specific feedback almost instantly. All the sources you refer to in the principal body of your assignment have to be listed at the close of the assignment in a reference list. Make certain that you have specific topic in your thoughts because general subject area is not going to help you. Possessing general topic will let you research on lots of things, which isn't a superior thing. One of the very first things you need to always do is go and have a look at a GRE waiver letter sample. Therefore, such statement should not be excessively large or general, as it defines the essential route for the paper. Any information you believe to be related to your application is acceptable. It's possible to also do some investigating to learn more about the points to discuss as a way to present a logical and compelling review. Citation for each simple fact is s upplied, if not it is considered plagiarism that's a severe offense. The title ought to be written in italics. Citing the authors or the publications in your essay is something that you have to not neglect to do. The introduction then contributes to the thesis statement, which is occasionally underlined, depending upon your professor's preference. In order to properly argue past a topic in an essay, you will need to opt for a topic that you're wholly familiarized with. Fuller details ought to be included in the reference list at the conclusion of the essay. Furthermore, there are different examples of essays which may interest you. Stories are an integral component of the human experience. Even though the author only utilizes a story at the start of his piece, anecdotes may also be a beneficial means of keeping the reader's interest peaked throughout the essay.

Wednesday, January 1, 2020

Make Baking Soda Stalactites and Stalagmites

Stalactites and stalagmites are large crystals which grow in caves. Stalactites grow down from the ceiling, while stalagmites grow up from the ground. The worlds largest stalagmite is 32.6 meters long, located in a cave in Slovakia. Make your own stalagmites and stalactites using baking soda. Its an easy, non-toxic crystal project. Your crystals wont be as big as the Slovakian stalagmite, but they will only take a week to form, instead of thousands of years! Baking Soda Stalactite Stalagmite Materials 2 glasses or jars1 plate or saucer1 Spoon2 Paper ClipsHot Tap WaterPiece of Yarn, about a meter longBaking Soda (Sodium Bicarbonate)Food Coloring (optional) If you dont have baking soda, but you can substitute a different crystal-growing ingredient, such as sugar or salt. If you want your crystals to be colored, add some food coloring to your solutions. You might even try adding two different colors to the different containers, just to see what you get. Grow Stalactites and Stalagmites Fold your yarn in half. Fold it in half again and twist it together tightly. My yarn is colored acrylic yarn, but ideally, you want a more porous natural material, such as cotton or wool. Uncolored yarn would be preferable if you are coloring your crystals, since many types of yarn bleed their colors when wet.Attach a paper clip to either end of your twisted yarn. The paper clip will be used to hold the ends of the yarn in your liquid while the crystals are growing.​Set a glass or jar on either side of a small plate.​Insert the ends of the yarn, with the paper clips, in the glasses. Position the glasses so that there is a slight dip (catenary) in the yarn over the plate.Make a saturated baking soda solution (or sugar or whatever). Do this by stirring baking soda into hot tap water until you get so much added that it stops dissolving. Add food coloring, if desired. Pour some of this saturated solution into each jar. You may wish to wet the string to start the stalagmite/ stalactite formation process. If you have leftover solution, keep it in a closed container and add it to the jars when needed.At first, you may need to keep an eye on your saucer and dump liquid back into one jar or another. If your solution is really concentrated, this will be less of a problem. Crystals will start to appear on the string in a couple of days, with stalactites growing down from the yarn toward the saucer in about a week and stalagmites growing up from the saucer toward the string somewhat later. If you need to add more solution to your jars, be sure that it is saturated, or else you will risk dissolving some of your present crystals. The crystals in the photos are my baking soda crystals after three days. As you can see, crystals will grow from the sides of the yarn before they develop stalactites. After this point, I started to get good downward growth, which eventually connected to the plate and grew up. Depending on the temperature and rate of evaporation, your crystals will take more or less time to develop.