Randal Cebul, James B. Rebitzer, Lowell J. Taylor, and Mark Votruba
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780195390131
- eISBN:
- 9780199775934
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195390131.003.003
- Subject:
- Law, Medical Law
The financing and provision of health care in the United States is distributed across many distinct organizations, each with its own objectives, obligations and capabilities. These fragmented ...
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The financing and provision of health care in the United States is distributed across many distinct organizations, each with its own objectives, obligations and capabilities. These fragmented organizational structures produce disrupted relationships, inadequate information flows, and misaligned incentives that combine to degrade the quality of health care and increase costs. This chapter analyzes the causes and consequences of organizational fragmentation in the health insurance and care delivery systems. It also assesses the ability of modern information technology to mitigate the costs of fragmentation by enhancing coordination across organizations.Less
The financing and provision of health care in the United States is distributed across many distinct organizations, each with its own objectives, obligations and capabilities. These fragmented organizational structures produce disrupted relationships, inadequate information flows, and misaligned incentives that combine to degrade the quality of health care and increase costs. This chapter analyzes the causes and consequences of organizational fragmentation in the health insurance and care delivery systems. It also assesses the ability of modern information technology to mitigate the costs of fragmentation by enhancing coordination across organizations.
Ann M. Callahan
- Published in print:
- 2017
- Published Online:
- January 2019
- ISBN:
- 9780231171731
- eISBN:
- 9780231543187
- Item type:
- book
- Publisher:
- Columbia University Press
- DOI:
- 10.7312/columbia/9780231171731.001.0001
- Subject:
- Palliative Care, Palliative Medicine and Older People
Many hospice social workers must address spiritual issues with their clients, but do not feel competent to do so effectively. This targeted volume draws upon multidisciplinary theory and research to ...
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Many hospice social workers must address spiritual issues with their clients, but do not feel competent to do so effectively. This targeted volume draws upon multidisciplinary theory and research to advance a relational model of spiritually sensitive hospice care. The book will help readers elevate their spiritual competence and foster a relationship with their clients that will enrich the experience for all involved. Spirituality and Hospice Social Work helps practitioners understand various forms of spiritual assessment for use with their clients. The book teaches practitioners to recognize a client's spiritual needs and resources, as well as signs of spiritual suffering. It also discusses religious and spiritual practices that clients may use to enhance their spiritual coping. Spirituality and Hospice Social Work stresses the need for interdisciplinary collaboration with other members of the hospice team, along with the value of maintaining professional ethical standards when addressing spiritual issues. Throughout, the importance of spiritual sensitivity and its effect upon client well-being is emphasized.Less
Many hospice social workers must address spiritual issues with their clients, but do not feel competent to do so effectively. This targeted volume draws upon multidisciplinary theory and research to advance a relational model of spiritually sensitive hospice care. The book will help readers elevate their spiritual competence and foster a relationship with their clients that will enrich the experience for all involved. Spirituality and Hospice Social Work helps practitioners understand various forms of spiritual assessment for use with their clients. The book teaches practitioners to recognize a client's spiritual needs and resources, as well as signs of spiritual suffering. It also discusses religious and spiritual practices that clients may use to enhance their spiritual coping. Spirituality and Hospice Social Work stresses the need for interdisciplinary collaboration with other members of the hospice team, along with the value of maintaining professional ethical standards when addressing spiritual issues. Throughout, the importance of spiritual sensitivity and its effect upon client well-being is emphasized.
Ann M. Callahan
- Published in print:
- 2017
- Published Online:
- January 2019
- ISBN:
- 9780231171731
- eISBN:
- 9780231543187
- Item type:
- chapter
- Publisher:
- Columbia University Press
- DOI:
- 10.7312/columbia/9780231171731.003.0002
- Subject:
- Palliative Care, Palliative Medicine and Older People
Chapter 1 highlights how important it is for hospice social workers to operate as champions of spiritual care with and on behalf of their patients. This begins with exploring why it is important to ...
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Chapter 1 highlights how important it is for hospice social workers to operate as champions of spiritual care with and on behalf of their patients. This begins with exploring why it is important to understand a patient’s experience of spirituality. Spirituality is described as having significant implications for life quality and delivery of hospice care Hospice social workers are essential members on interdisciplinary teams charged with the responsibility of ensuring patient access to quality hospice care, which for some patients necessitates spiritual care. To lay the foundation, hospice social workers need to understand how to engage in spiritually-sensitive hospice social work so they have the capacity to coordinate, if not deliver, spiritual care.Less
Chapter 1 highlights how important it is for hospice social workers to operate as champions of spiritual care with and on behalf of their patients. This begins with exploring why it is important to understand a patient’s experience of spirituality. Spirituality is described as having significant implications for life quality and delivery of hospice care Hospice social workers are essential members on interdisciplinary teams charged with the responsibility of ensuring patient access to quality hospice care, which for some patients necessitates spiritual care. To lay the foundation, hospice social workers need to understand how to engage in spiritually-sensitive hospice social work so they have the capacity to coordinate, if not deliver, spiritual care.
Ann M. Callahan
- Published in print:
- 2017
- Published Online:
- January 2019
- ISBN:
- 9780231171731
- eISBN:
- 9780231543187
- Item type:
- chapter
- Publisher:
- Columbia University Press
- DOI:
- 10.7312/columbia/9780231171731.003.0009
- Subject:
- Palliative Care, Palliative Medicine and Older People
Chapter 8 suggests that social workers can evaluate spiritually-sensitive hospice social work by drawing from models of spiritual competence. Evaluation in the practice setting is essential to ensure ...
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Chapter 8 suggests that social workers can evaluate spiritually-sensitive hospice social work by drawing from models of spiritual competence. Evaluation in the practice setting is essential to ensure that patients experience hospice social work as being spiritually sensitive, rather than spiritually insensitive or, even worse, spiritually destructive. This chapter presents several models of spiritual competence with a focus on Hodge (2011) and associates (Hodge & Bushfield, 2006; Hodge et al., 2006) to evaluate spiritually-sensitive hospice social work. Such evaluation not only reflects the importance of understanding the spiritual quality of hospice social work, but the need to ensure that hospice social workers have the necessary spiritual competence. This includes assuming leadership in sensitizing interdisciplinary team members to patient spirituality.Less
Chapter 8 suggests that social workers can evaluate spiritually-sensitive hospice social work by drawing from models of spiritual competence. Evaluation in the practice setting is essential to ensure that patients experience hospice social work as being spiritually sensitive, rather than spiritually insensitive or, even worse, spiritually destructive. This chapter presents several models of spiritual competence with a focus on Hodge (2011) and associates (Hodge & Bushfield, 2006; Hodge et al., 2006) to evaluate spiritually-sensitive hospice social work. Such evaluation not only reflects the importance of understanding the spiritual quality of hospice social work, but the need to ensure that hospice social workers have the necessary spiritual competence. This includes assuming leadership in sensitizing interdisciplinary team members to patient spirituality.
Dallas Forshew
- Published in print:
- 2014
- Published Online:
- May 2014
- ISBN:
- 9780199686025
- eISBN:
- 9780191765940
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199686025.003.0015
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
The nurse is a generalist who needs the ability to be all things to all people at an ALS centre and must have the qualities of flexibility, creativity, warmth, empathy and more, acting as a ...
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The nurse is a generalist who needs the ability to be all things to all people at an ALS centre and must have the qualities of flexibility, creativity, warmth, empathy and more, acting as a specialist practitioner, manager, counsellor, coordinator, educator, supporter, researcher, mentor, and innovator. The nurse has an essential role in the support of the person with ALS, their family and the other members of the multidisciplinary team.Less
The nurse is a generalist who needs the ability to be all things to all people at an ALS centre and must have the qualities of flexibility, creativity, warmth, empathy and more, acting as a specialist practitioner, manager, counsellor, coordinator, educator, supporter, researcher, mentor, and innovator. The nurse has an essential role in the support of the person with ALS, their family and the other members of the multidisciplinary team.
LaTonya J. Trotter
- Published in print:
- 2020
- Published Online:
- September 2020
- ISBN:
- 9781501748141
- eISBN:
- 9781501748172
- Item type:
- chapter
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9781501748141.003.0009
- Subject:
- Political Science, Public Policy
This concluding chapter argues that, although created as a solution to physician scarcity, the nurse practitioner (NP) is just as often working on the front lines of the care crisis. The Forest Grove ...
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This concluding chapter argues that, although created as a solution to physician scarcity, the nurse practitioner (NP) is just as often working on the front lines of the care crisis. The Forest Grove Elder Services ostensibly hired its NPs for their medical expertise, but in practice, it deployed them as much more than substitute physicians. In addition to the mandates of medical work, the Grove held its NPs uniquely responsible for care coordination. Ultimately, the NPs' performance of organizational care work had become the cornerstone of the Grove's goal of comprehensive care provision. Yet it was equally clear that the work and expertise required to meet this goal were largely unacknowledged. Indeed, NPs' work often goes unrecognized, but their performance of it has the potential to transform how patients experience the health care encounter. The chapter then suggests that NPs are often not doing the same work as physicians. In this account, the aim is not only to reveal the hidden work of yet another location of feminized labor but also to shine a light on the central importance of that work for patients.Less
This concluding chapter argues that, although created as a solution to physician scarcity, the nurse practitioner (NP) is just as often working on the front lines of the care crisis. The Forest Grove Elder Services ostensibly hired its NPs for their medical expertise, but in practice, it deployed them as much more than substitute physicians. In addition to the mandates of medical work, the Grove held its NPs uniquely responsible for care coordination. Ultimately, the NPs' performance of organizational care work had become the cornerstone of the Grove's goal of comprehensive care provision. Yet it was equally clear that the work and expertise required to meet this goal were largely unacknowledged. Indeed, NPs' work often goes unrecognized, but their performance of it has the potential to transform how patients experience the health care encounter. The chapter then suggests that NPs are often not doing the same work as physicians. In this account, the aim is not only to reveal the hidden work of yet another location of feminized labor but also to shine a light on the central importance of that work for patients.
Steven D. Pearson
- Published in print:
- 2014
- Published Online:
- November 2014
- ISBN:
- 9780199989447
- eISBN:
- 9780190207489
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199989447.003.0020
- Subject:
- Philosophy, Moral Philosophy
Health care reform through the Affordable Care Act in the United States contained specific measures to encourage rapid reform in the way that physicians are compensated, moving away from the ...
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Health care reform through the Affordable Care Act in the United States contained specific measures to encourage rapid reform in the way that physicians are compensated, moving away from the historical norm of fee-for-service payment to global payments to existing or new “accountable care organizations” (ACOs), combinations of hospitals, and physician groups. The shift to ACOs is intended to bring greater coordination to care while changing the underlying financial incentive for physicians so that they are rewarded for prevention of illness and for more efficient, less costly care overall. Questions remain about how the global payments to large ACOs will be translated into incentives for individual physicians working within these organizations. This chapter emphasizes that the term “bedside rationing” obscures the important distinction between the random variation in rationing possible across individual physicians and a more organized approach to making allocation decisions and treatment guidelines for the population cared for by a physician organization.Less
Health care reform through the Affordable Care Act in the United States contained specific measures to encourage rapid reform in the way that physicians are compensated, moving away from the historical norm of fee-for-service payment to global payments to existing or new “accountable care organizations” (ACOs), combinations of hospitals, and physician groups. The shift to ACOs is intended to bring greater coordination to care while changing the underlying financial incentive for physicians so that they are rewarded for prevention of illness and for more efficient, less costly care overall. Questions remain about how the global payments to large ACOs will be translated into incentives for individual physicians working within these organizations. This chapter emphasizes that the term “bedside rationing” obscures the important distinction between the random variation in rationing possible across individual physicians and a more organized approach to making allocation decisions and treatment guidelines for the population cared for by a physician organization.