Qualtiy Management Wild Card Blog #4

The Use of Innovative and Emerging
Technologies to Help Meet the Healthcare
and Quality of Life Needs of an Aging
Population

Primary Author
Jim Albert, Masonicare

I found this article to be very interesting. This article brings to mention the “baby boomers” and how they will put a strain on our healthcare system. This we all much know for certain will happen. In fact we here several ideas that might come to pass, for example, raising the age to 67 or maybe raising taxes on the working population. The question asked is how can we provide the best for our aging adult population? How can we give them the “golden” years? This article mentions one way they deem will help with this problem and that is, “to includes an increased reliance and use of emerging technology tools to improve the efficiency and effectiveness of the healthcare industry, enable faster communication, build new caregiver support networks and assist seniors with their activities of daily living”.

The article mentions seeing a day not to far in the future where low cost, non-evasive technologies will help with seniors live a better and longer quality of life at home. They hope that with this new technology, less utilization of professional healthcare services will be needed. One example they provided is the use of “invisible” sensors around a senior citizens home so they can provide professional caregivers important information on how they are going about their daily activities like sleeping, eating and taking meds. As technology improves they are hoping that it will dramatically change the paradigms of patient care.

Also in addition to this they bring up “telehealth systems”. These systems will hopefully be able to take important daily vital signs at home or away from home. The information would be able to be downloaded over the telephone through cable to a secure web site relaying the information to the physician office. This would make managing chronic conditions like Diabetes much easier, and hopefully will be able to notice if anything is wrong before something major would happen. In addition, it mentions adding video technology so the patient would be able to talk face-to-face directly to their physician or family if the need be.

The article also goes on to mention that more so in the future technologies will be located in their cars, called “smart” cars that will help them drive more saftely, or “smart” wheelchairs that will be able to climb stairs, or even “smart” walkers enabling seniors to get to the grocery store or friends home and back.

I feel that this new technology will defiantly help our seniors to live a more productive independent lifestyle. Hopfully, it will save money in the long run, however my question is how are they going to be able to afford all the new technology. Cost will still come into play. Maybe in the long run it will save our system, then again maybe not

My Visit to the Carriage Club, Blog #3 LTC

The Long Term Care facility that I had the privilege to visit is The Carriage Club. I have been there several times in the past because my daughter dances there every year during the holiday season. I didn’t however, have the chance then to really investigate and look around in the facility at that time so I recently went back to be shown around.

The Carriage Club is not only a nursing home but also an assisted living facility. It is located in the Baymeadows area off of Southside Blvd. It is nestled under towering trees set back from the main road. I was impressed to see that it was a gated community, the gates closed at 10:00 pm and the only way into the facility after hours was by security code. The entrance way was beautiful, very clean and with a homey type of atmosphere. I immediately noticed a room that had bright yellow tape laid on the floor resembling that of a parking lot. I was informed by one of the residents that the area was for them to park their electric carts, too cute!

I was fortunate enough to be able to have a tour of the facility by the administrator himself. There were things there that seemed to be quite obvious, yet it still surprised me because I tend to take my ability to get about for granted. The residents had access to a mail room, hair stylist, mini mart, physical activity room, arts and crafts room, and even they had a small bar where the residents could go and socialize to get a drink. They seemed really impressed by that! Also just like a gym, they had classes every day for different types of exercises, for example, yoga or low impact aerobics. Oh, did I forget to mention the nice pool. Yes, they even like to get a little rest and relaxation out by the pool side.

The facility was split into two different parts the assisted living side and the nursing home side. The assisted living side resembled the apartment style living. Some were exactly like apartment and others were some what like dorm living. Both had access to all of the amenities that Carriage Club offered and both had beautiful carpet and décor throughout. The nursing home was a little different. It reminded me of a hospital. There was nothing elaborate, even the floors were different. It also appeared to surprisingly be much dirtier than the assisted living side. Go figure??? The nursing home side also had a completely different cafeteria, very small and run down. I did not like it. I was also surprised to hear that it also did not have an RN on staff, just LPN’s. That to was disappointing. Overall, the people were nice and the residents seemed to enjoy there place called home.

Wild Card Blog #3, Quality Management

Blog #3 Wild Card

Medicare's compare databases with a long-term care mission: because consumer perceptions of quality today may substantially affect tomorrow's healthcare revenues, hospitals should learn about and use Medicare's new long-term care databases
Healthcare Financial Management, Oct, 2004 by Paul L. Grimaldi

When doing research about quality, I ran across an interesting site that was very interesting to me. It was an article titled above that mentioned that now more than ever before people are not getting the quality they expected to receive when it came to placing there loved one in a long term care facility, aka nursing home. In the article it mentions hospitals that share a joint venture with long term care facilities “struggle” because the LTC facility did not even come close to what the expected revenue should be. The article also mentions that a second hospital is looked down upon because it has referred patients to a LTC facility that was of poor quality according to the patients, causing them to pull out and find other facilities. Also it states that negative comments were made from consumer advocates about sub-acute care facilities because of the poor quality.

Because of all these issues about poor quality and not being able to meet the needs of the patients care Medicare has come out with a program called “Medicare compare”. This is a site that enables the consumer or patient to be able to access online different types of LTC facilities and it lets them compare it to other nursing homes and facilities of specialized adult services. Medicare is hoping that this information will help educate the consumer in making the best choice to prevent future problems. This site is interesting because it provides basically anything you would want to know from type of ownership to number of beds all the way to what types of insurance it will accept. It also contains information on any place within the facility that is lacking, for example not meeting certain codes. If any one is thinking of putting a family member into a long term care facility, the best way to get the best quality is to be armed with knowledge about the facility.

Personally, I would highly recommend anyone to obtain as much knowledge on a facility before they place there loved family member in it. Make sure it has everything that you are looking for in a facility that will meet the patient’s individual needs.

The web site address is listed below; it is called Nursing Home Compare.
www.medicare.gov/NHCompare

Blog #2 LTC Financial Exploitation of the Elderly

Keeping the Wolves from Grandma’s Door: Financial Exploitation of the Elderly

It is crucial that we understand that financial exploitation is already happening at and astonishing rate and will keep on spreading. We as Americans need to look out for the elderly in every way possible. I believe that with the rapid growth of the baby boomers hitting elderly age 65, more and more exploitation will probably be occurring. This is a speech taken from International Network for the Prevention of Elder Abuse, World Elder Abuse Awareness Day, United Nations New York, New York on June 15, 2006. In this speech Sally Hurme, Coordinator, Outreach & Service, AARP Financial Protection makes us aware of the facts on financial exploitation of the older population. “Financial exploitation is considered to be illegal or improper use of a vulnerable adults funds or property for another persons profit or advantage.” She brings to our attention how AARP, which is the largest membership organization for people over the age 50, intends to help the older generation all over the world to live happier, healthier, and more financially secure lifestyles. She goes on to mention how her corporation collaborates world-wide to help prevent the elderly from being financially robbed. In the United States, sadly this is happening to far too many elderly people. Supposedly, what is reported to AARP is only a small percentage. There are about 5 million elderly that are taken advantage of each year, which is roughly about 1 out of every 25 elderly. This is devastating to the people who get robbed from their life savings and because of its disturbing consequences lasting scars are left.
So how does this happen to such innocent people? Well, we all know that it could happen through telemarketers, con artists, or even tradesmen, but most shocking of all to me was that not only do “strangers” take advantage of them but also “the trusts” as what Sally mentions. These are people that the elderly know. Scary huh? People like friends, neighbors, or even family members that they have even given birth to! People that would have a huge advantage to them, the elderly would have complete trust in them, believing in them and even depending on them for help. How would they do this? Well they could walk away with their jewelry, take personal checks for their own pleasure or even borrow an ATM card for personal pleasures. Sometimes as noted, they would use words to threaten them or even play trick with their minds in making them get stuff that they want. This to me is shocking. Do not people have a conscious anymore? The trusted literally takes control of all personal belongings and controls everything that comes in and out of that person’s life, including other people. According to Sally, even though there are no bones broken, the effects of this can be devastating financially and emotionally. Their assets can be wiped out quickly leaving them dependent on family and/or federal income for help. They are no longer independent. According to Sally, “Financial abuse isn’t just about loss of money. Its ramifications go far beyond the dollars. It causes fearfulness, loss of confidence, depression, hopelessness, and suicide.” What a sad way for a person to end their life with being taken advantage of. I am glad to see that people all around the world are helping save the older generation!

Dr. Avedis Donabedian

(1919-2000)





A leading scholar on health care quality who conceptualized the vocabulary used to define health care quality today. The management of an episode of health care can be divided into a technical domain and an interpersonal domain. The technical domain involves “the application of science and technology of medicine to the management of personal health problem.” The interpersonal domain involves, “the management of the social and psychological interaction between client and practitioner.” Dr. Donabedian understood the system of health care, and went on to mention that most of the problem was that many people did not understand this relationship between quality and systems, because they were not trained in medical school or nursing school. He talks about system awareness and system design are vital for health professionals; however he insists it is not enough. In the end he mentions the secret of quality is love.

Thus, the two major elements of quality, according to Dr. Donabedian, are “technical competence” and “interpersonal competence.” Technical competence goes to the actual performance of medical procedures and services, and relates to the appropriate application of professional knowledge, training and skill. Dr Donabedian explains that the quality of technical care consists in the application of medical science and technology in a manner that maximizes its benefits to health without correspondingly increasing its risks. The degree of quality is, therefore, the extent to which the care provided is expected to achieve the most favorable balance of risks and benefits. As for Interpersonal competence, Dr. Donabedian explains that it is the relationship between the physician and patient, and includes other aspects of care. He states that s interpersonal relationship meets a defined set of values and norms between the physician and the patient.

So why did I pick Dr. Donabedian? I would have to say that I picked him because my values run closely with his. I believe that quality concerning health care does break down into two catagories, technical aspect and the interpersonal aspect, and both must work and run hand in hand. However most importantly I like the part about him when he talks about the secret of quality being love. I believe that if all people were treated as if they were family then the care and quality would be much higher. In society today I fee the “caring” side has been greatly distorted, and now all professionals just tend to see the dollar signs and how they can make more. Quality care with doctors is now becoming far and few in-between. I would like to see that change.

What Does Quality Mean to Me

What Does Quality mean to me?

The definition of quality can be described in many ways. To me, when I get a quality product I know I have gotten something that is durable and will last, for instance, something that will not break within the first month of purchasing it, but instead know that it will last for quite awhile. Sometimes it is apparent with a brand name, ensuring and guarantying a quality product where the company backs it up with 100% guarantee or your money back. There is nothing I hate more than purchasing a product that is of poor quality and breaks and falls apart easily. Quality to me is when I get total complete satisfaction from the outcome with no complaints.



When talking about quality in means of service from medical professionals, I feel getting accurate information in a timely fashion, with optimal service provided. It means getting a doctor who truly cares about what is concerning your medical needs. To many times I have gone to see a physician where I have felt that I have not gotten quality time with them. It is frustrating when you wait for hours to see a doctor, then when you finally get the chance to see him/her they take only a few seconds to hear what you have to say, diagnosis your condition, and throw a prescription in your hand, on the way out. I want a doctor that will spend the time listening to me not making me feel rushed meeting all my expectations.



Quality is in the eye of the beholder. To some quality might mean something totally different than to others. To me I feel that quality is perceived as fulfilling expectations to meet needs or values, whether it be in products or service, we all want what is best and what we pay for.

What does Long Term Care mean to me?

Well, the first thing that comes across my mind is nursing home care or assisted living care for the elderly or chronic ill patients that are unable to provide the common services for themselves like cooking, bathing, taking medications or even just cleaning, however Long Term Care to me can also could include home health, adult day care and hospice care. It is inevitable that we are all getting older and many of us will need to utilize long term care facilities or services, whether we choose to or not. It also is important to remember that LTC also deals with patients much younger who have chronic illnesses, however most are elderly. A couple of personal examples in dealing with LTC services stay vivid in my mind pertain to both an elderly and young.

The last picture taken with Granny at the nursing home.

My first example left me in gloom. I had my husband’s grandmother pass just recently. I can remember it clearly. We loaded into the van driving to the nursing home to visit her one last time, knowing that it would probably be the last time. When we arrived, we walked the halls to get to the room and several of the residents were just sitting in their wheel chairs starring at the walls, some with drool going down their faces. The smell of urine was incredibly strong. When we got to her room she was in the fetal position laying on her bed, all skin and bones. She had not been able to eat for weeks and slowly her body was starting to shut down. The food that was besides her was all blended to help her eat better, however it looked terrible. I don’t think I would want to eat it either. It was a memory of a nursing home that I try to forget, however is very difficult to erase from my memory. In the end I was happy to see my family put a smile on her face when we walked into her small room. Sadly, a couple of days later she passed away at the age of 93. RIP

This second example of dealing with LTC is quite different Long Term Care not only consists of nursing homes and assisted living facilities, but it also deals with hospice care which consists of helping with chronically ill patients. Around a year ago a friend of mine had a young son who was diagnosed with a brain tumor called ATRT. It was a rare tumor with low success rates. Unfortunately he was referred to hospice care due to the relentless growth of the brain tumor. He was in the best of care at St. Jude Children’s Hospital and the doctors did everything possible to try to save this boy. Sadly, even three surgeries strong chemo drugs along with direct radiation treatments did not stop the cancer from growing. So hospice was called in to give him the best quality of life possible that he had left. Not only did I see how great the hospice services were with helping with the boy’s pain management while the tumor took over, I also got to see how they helped the entire family with counseling in deal with the grief of having a terminal ill child. They were the extra shoulder to lean on, and they were always there with comforting words to the very end. A totally different experience I will never forget. Big Ben may you RIP with all the other angels. (To read more about his story and his courageous fight please visit his site http://www.bigben.com/ ).

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