Cultural Advocacy, Constraints, Determinants and Technology in Health Care
1. Cultural competency and advocacy are listed as skills necessary for effective case management. Define cultural competence and advocacy and then provide an example from your practice that demonstrates your skill level in that area.
2. Reimbursement challenges in healthcare increase the need for case management services to reduce the cost of care, but also to ensure care is delivered in a safe and efficient manner. Conduct a literature search focused on health promotion and illness and injury prevention; identify an article that addresses the effectiveness of case management on these priorities. Summarize the article.
3. Identify a situational constraint that might prevent a client from following through on a referral to an outside agency. Discuss how the case manager can take action to eliminate or minimize the effect of the constraint so that the client can benefit from the intervention.
4. You are a home health nurse, and your agency has received a referral for an elderly male with congestive heart failure. Discuss how the determinants of health (biological, psychological, environmental, sociocultural, behavioral, and health system) can influence the client’s overall health status.
5. Discuss how pay-for-quality performance initiatives are influencing home health care delivery.
6. Discuss how telehealth technology is influencing the practice of home health nurses and transforming home health agency operations.
7. Changes to reimbursement and payment structures over the last few years have proven to be challenging to home health agencies. Discuss why home health agencies must examine their practices and payor mix to remain viable in today’s environment.
Short Essays
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Short Essays
Question 1
Cultural competency refers to the ability of healthcare workers to provide care that is respectful to diversity and cultural factors that affect the delivery of care (Garrido, Garcia-Ramirez, & Balcazar, 2019). These factors include cultural beliefs, values, attitudes as well as language and communication style, among others. To be culturally competent, healthcare workers need cultural awareness, skills, and knowledge about their own culture as well as that of others. Cultural competency and advocacy involve promoting cultural competence through learning and interactions with people from different cultural backgrounds.
An example that demonstrates my skill level in cultural competency and advocacy is my ability to adjust my communication style to fit the different cultural contexts. For instance, when dealing with an American patient and a Chinese patient, my approach to eye contact while communicating with them is different. I adjust accordingly because I understand that among the Americans, maintaining eye contact during communication is important and is considered a sign of respect while among the Chinese, maintaining eye contact is considered a sign of disrespect.
Question 2
Assessing the effectiveness of case management services in reducing healthcare costs is important. The study by Wansink et al. (2016) investigated the cost-effectiveness of a case management intervention in promoting the quality of parenting among children of parents with mental illness (COPMI). According to the researchers, COPMI experience poor parenting, which negatively impacts their development and increases the risk of developing behavioral issues. Participants were randomly assigned to an intervention and a control group in a randomized controlled trial. The intervention, known as preventative basic care management (PBCM), provided preventative services to families of COPMI. The results of the study revealed that the intervention promoted better parenting quality and as such, was an effective approach to reducing/preventing the negative effects associated with poor parenting quality. However, when compared to standard care, the intervention was more costly. The researchers concluded that the study provides insights that can be helpful to community policymakers regarding healthcare policy in the context of limited financial resources.
Question 3
Referrals ensure that clients receive appropriate care and support to help promote their well-being. Yet, clients do not always follow through on a referral to an outside agency. One of the situational constraints that affect clients is related to the long waitlists before they can receive care in an outside agency. Most referrals are necessary but long waitlists affect access to referral services. According to Lewis et al. (2018), the time that clients wait from the time of referral to their first visit influences their patient experience. This may affect their attitude towards referrals and hinder them from following through on a referral.
A case manager can eliminate or minimize the effect of this constraint by assessing the wait time before deciding where to refer the client. Case managers have the responsibility of reassuring their clients that they will receive the care they need in good time. A case manager also needs to have a streamlined referral process that communicates the services needed from the outside agency promptly.
Question 4
The health of the population differs due to the determinants of health. The interrelationship between biological, psychological, environmental, sociocultural, behavioral, and health systems influences individual and population health (Healthypeople. gov, 2021). When it comes to congestive heart failure (CHF), especially in elderly people, these determinants of health can affect their overall health status. Joseph et al. (2017) indicate that the risk of mortality and poor health outcomes among patients with CHF increases with age, which is a biological determinant of health. Also, behavioral determinants of health, such as smoking, poor diet, and physical inactivity would negatively impact the client’s overall health.
The physical environment, such as the built environment, affects the health outcomes of patients with CHF. As Joseph et al. (2017) reveal, access to walkable destinations such as recreational facilities and parks increases physical activity, which would positively impact the health outcomes of the client. The client’s socioeconomic background, access to healthcare, and access to social support would also impact their overall health outcomes. Finally, the health system factors such as healthcare co...