https://nursingpaperspros.com/wp-content/uploads/2020/05/logo-nursing--300x60.png 0 0 Hector https://nursingpaperspros.com/wp-content/uploads/2020/05/logo-nursing--300x60.png Hector2020-06-07 14:53:172020-06-07 14:54:03Describe the skills you will need to develop to manage the hospital of the future.
please Identify the key points and main thesis of the article
2. Describe the skills you will need to develop to manage the hospital of the future.
use critical analysis doing these questions
Suggestion for writing assignmemnt make believe the reader has never read the article -what are the key points you would want the reader to know in order to understand the hospital of the future. In addition, managers, executives do not have time to read–so again what key points do you need to identify so that the reader very quickly has an understanding of the article.
Reference the article using examples even direct quotes to expand and substantiate the discussion.
The Hospital of the Future TECHNOLOGY OF ALL KINDS IS TRANSFORMING HOW MEDICAL SYSTEMS WORK rates, and to reduce patient stress, encouraging healing. Ironically, one of the most anticipated developments is that technology will allow hospitals to do a better job of keeping people out of them. “By 2015, home will be the hub of care,” prediets Naomi Fried, vice president of the in- novation and advanced technology group at Kaiser Per- manente’s Sidney R. Garfield Health Care Innovation Cen- ter in San Leandro, Calif. Five years ago, when Kevin Reynolds of Corona, Calif., developed congestive heart fail- ure (the No. 1 reason for hospitalization and readmission), he at first was in and out of the ER or urgent care center nearly every month, plagued by shortness of breath and dizziness. Now, doctors at Kaiser Permanente Riverside Medical Center can check his vital signs with the aid of a device the size of a clock radio connected to a scale and other By Michelle Andrews atherine Thomas doesn’t remember much about the 19 days she spent in the intensive care unit at Methodist Hospital in Houston. Recovering from emergeney surgery to re- move part of her colon, Thomas, 63, drifted in and out of consciousness. But one vision stands out: the 5-foot robot that stopped in for a visit. “I thought it was something from outer space,” she recalls. Piloted remotely by her doctor from a com- mand center on another floor, her alien-which looked like an oversize carpet cleaner with a computer monitor stuck on top-allowed her medical team to do their rounds, “secing” how she was doing and “reading” her vital signs, without unsettling her or the other extremely ill patients in monitoring equipment in his home. He weighs himself each morning and checks his heart rate, blood pressure, and blood oxygen levels; the data are sent in automatically. intensive care. Robots that glide through hos- pital halls may offer the most visually arresting example of the future of patient care. But they’re just one of many dramatic ad- vances changing how hospitals function. Radio-frequency ID tags that track every doctor, nurse, and piece of equipment in the hospital in real time, for ex- ample, can enable a faster emer- gency response. “Smart” beds that automatically transmit patients’ breathing and heart rates to their charts can alert nurses to developing prob- lems more quickly. One day in the not-too-distant future, any doctor in the country may have access to the complete medical history of an unconscious trauma patient-per- haps through an identifier implanted under the skin. Ac- cording to industry analyst Datamonitor, spending on telemedicine, which now entails everything from remote- ly monitoring patients to analyzing medical images from afar and someday could even inelude long-distance surgery, will reach $2.4 billion this year and nearly triple to $6.1 billion by 2012. The investment hospitals are making in change has ba- sically two goals: to improve clinical care and slash error If Reynolds’s weight is up, indicating he’s retaining fluids, he’ll get a call from a nurse sug- gesting a diuretic. Once, when his blood pressure dropped too low, the nurse called him to the hos- pital immediately, but overall, Reynolds’s time at the medical center is way down. “It’s helped me with discipline and with taking care of myself,” he says. Remote diagnosis. In rural areas, where specialist cov- erage is sparse, telemedicine’s contribution grows ever more sophisticated. Take ultra-time-sensitive stroke man- agement, for example. In Michigan, 31 hospitals in far- flung locations now use robots identical to the one in Houston to allow a remote specialist to rapidly diagnose stroke and determine, before a patient’s very narrow win- dow of opportunity closes, whether he or she is a good can- didate for tPA, a drug that dissolves clots. A neurosurgeon at St. Joseph Mercy Oakland Hospital in Pontiac can ob- serve and talk to patients using the robot’s video camera, as well as review the CT scan and other lab results. “After one year, 18 hospitals had administered the drug tPA that Doctors at Methodist Hospital in Houston conduct morning rounds remotely with input from their robot (left). 69 U.S. NEWS & WORLD REPORT • www.USNEWS.COM • AUGUST 2009
had never done so before,” says Yulun Wang, the chairman and CEO of InTouch Health, which developed the robot. Robots are inereasingly making their mark in the oper- ating room, too. Originally approved for general abdomi- nal procedures like gallbladder removal, robotic surgery- the surgeon manipulates computer controls rather than a scalpel-is now used for heart and prostate cancer surgery, gynecologic procedures, and bariatric surgery, among others. With the help of a tiny camera inserted through an incision “port,” a surgeon can see the surgical field onscreen as he sits at a console in the operating room, from which he guides the robot’s instruments, also insert- ed through ports. Someday, the doctor guiding the robot could be sitting at a console literally across the world from the patient. If remote surgery eventually becomes com- England Journal of Medicine in April. An additional 7.6 per- cent have a basic system in at least one unit. But putting patient records into digital form and into the massive na- tional database envisioned by President Obama has the po- tential, assuming it happens, to provide a wealth of infor- mation about which treatments work and which don’t-and to speed diagnosis and medical care and eurtail unnecessary tests and procedures. Anumber of institutions offer a hint of what is possible. In the emergency department at Kaiser Permanente’s Oakland Medical Center, doctors and nurses carry flat computer tablets about the size of a piece of paper that can access every Kaiser patient’s entire medical record. If a patient has previously vis- ited any Kaiser Permanente facility, ER staff can immediately call up his or her medications and any recent test results. They can also sit down next to a bed and show patients an X-ray, say. When Palomar Medical Center West near San Diego opens in 2012, patients will sleep on “LifeBeds” covered in “smart” fabrie that records their heart rate, pulse, and respiration and sends the info directly to their medical record. On a medical/surgical unit at the University of Pittsburgh Med- ical Center, a flat-screen monitor is mounted on the wall near the foot of every bed. Hospital staffers wear ultrasound ID tags, and as soon as they walk into the room, their name and job title pop up. The system then makes the ap- propriate chart information avail- able onscreen-a phlebotomist would see what blood draws to do, for example, while a nursing as- sistant might see what medica- tions are due. The patient has ac- cess to the information as well. Surgeons increasingly will operate robotically, manipulating a computer rather than a scalpel. mercially available, many lives might be saved in hard-to- reach locations, from remote islands to battlefields. Proponents of robotie surgery note that the robot’s “hands” are steadier and have a wider range of motion than human hands and that the instruments are more flexible than traditional laparoscopic instruments. This can lead to less pain and blood loss, and potentially better clinical out- comes, they say. But results of studies on outcomes are mixed, says Richard Satava, a professor of surgery at the University of Washington. “If it costs more to do the same operation with the robot, that will slow down the adoption somewhat,” he says. Records reform. Meanwhile, a slow but sure transformation in the way patient records are gathered and stored gained momentum last winter when the economic stimulus pack- age set aside $19 billion for healthcare information tech- nology. Currently, just 1.5 percent of private hospitals can claim a comprehensive electronic medical records system in all clinical units, according to a study published in the New “Everyone’s engaged, sharing the same information,” says Tami Minnier, chief quality officer for UPMC. That’s im- portant, say experts. Whereas medical practice has tradi- tionally tended to be paternalistic, practitioners now believe that the sense of empowerment that patients get from being engaged in their care can lead to better outcomes. It’s the I think I can” approach. Besides engaging people in decisions about their own care, hospital administrators are exploring ways that physical strue- ture and environment can ease anxiety and promote well- being. “Evidence-based design” is inspired by studies sug- gesting that patients heal better if they have access to nature, natural light, and artwork, for example. In one oft-cited study, researchers found that surgical patients whose rooms looked out on trees used less heavy medication, suffered fewer minor complications, and went home nearly a day sooner than pa- tients whose rooms looked out on a brick wall. The plans for Palomar Medical Center West call for a plant-filled central atrium and gardens at each end of every floor, and rooms with 72 USNEWS A WORLD REPORT www. USNEWS.cOM- AUGUST 2009
PATIENT CARE 2.0 stations outside rooms, where a nurse checking in can see the patient. Some design ehanges and concepts speak more to hospitality than healthcare: plush furnishings, parking spaces near the door, a self-serve kiosk check-in system that-like a global positioning system- instructs you where to go (“take 10 steps forward and turn right down the corridor labeled ‘east wing”). Such a focus on com- fort “ereates a healing environment and helps people feel like they have some con- trol,” says Bruce Schroffel, CEO of the Uni- versity of Colorado Hospital. (Skepties note it may also give facilities a competi- tive edge in attracting affluent patients with good insurance.) One day soon, pa- tients may be able to order meals, adjust the room temperature and lighting, surf the Internet, and videoconference with family using a remote control in bed. Or it may take a little bit longer than an- ticipated. According to an April survey by the American Hos- pital Association, nearly 8 in 10 hospitals report that they have stopped, postponed, or sealed back facility upgrades or information technology projects because of the economy’s recent woes. The recession is elearly slowing construction projects down,” says James Bentley, a senior vice president at the AHA. “How much, wellsee.” At whatever pace, though, When Kevin Reynolds checks his vital signs, the hospital gets the readings. floor-to-ceiling windows looking out on the mountains, fur- nished so that family members can stay overnight. Room change. Palomar’s rooms will also be “acuity adapt- able,” meaning that as the patient’s condition changes, the room ean, too-becoming an intensive care unit tem- porarily, say. Studies show that moving patients less fre- quently results in fewer falls and medication errors. The traditional centralized nursing station will be replaced by change is coming. Out on Medicine’s Edge to be reimbursed. On telemedicine at Penn: Some of the intensive care units here are telemedical ICUS, where a patient’s vital information is tran- scribed automatieally from bedside monitors and sent to a remote loca- tion, where an intensive care physi- cian covers elose to 100 beds in five places. Smart software in the sys- tem alerts the remote doctor to trouble. It’s more proactive than old-fashioned ICU care. On persenalized medicine: We’re on the edge of a revolution in the way we treat diseases. In the next era, we’ll take a sample of your prostate cancer, and we’l be able to deter- mine which machinery is broken in your DNA. In the next five years well begin to see real personalized therapies. -Megan Johnson filliam Hanson, head of telemedical intensive care at the University of Penn- sylvania Health System, is the au- thor of The Edge of Medicine: the Technology That Will Change Our Lives. He described for US. News the future he sees. Edited excerpts: On electronic medical records: The EMR should be thought of as a key infrastructure component, which will allow us to provide more reli- able care as data are available al- most instantaneously. EMRS will form the basis of what will eventu- ally be the medical Internet, allow ing a continuous sharing of infor- mation between patients and their providers. Without identifying pa- tients, EMR data about outcomes will feed databases, and as that in- formation becomes trans- parent, people will be able to “shop” for the best hos- pitals much more readily. On hospital care under health reform: At present, we have a lot of duplicative serv- ices. It has become apparent, for example, that there’s no need to have radiologists spread all over the country. Concentrated in pock- ets, they work more efficiently turning through a bunch of films. Now, many smaller hospitals do procedures that they don’t do in enough volume to do well. In the future, we’re likely to see cardiae services, say, stratified the way trauma care is now. There’s likely to be an emphasis on hospitals demonstrating good outcomes
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