Essay: Health Care Management the CDC )

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Health Care Management

The CDC (2012) defines bioterrorism as "the deliberate release of viruses, bacteria or other germs (agents) used to cause illness or death in people, animals or plants. In addition to each local health care system, there are national bodies responsible for preparedness in the event of a bioterrorist attack. These agencies include Homeland Security, the Center for Disease Control, Health & Human Services, the Red Cross, the Food & Drug Administration and the Environmental Protection Agency. The latter two agencies are responsible for planning for specific types of bioterrorism, while the first three groups each have plans of action to address bioterrorism in general.

The Department of Homeland Security's role is to be alert to potential attacks, and take steps to prevent their possibility and execution. Thus, Homeland Security will take responsibility for intelligence that it has acquired, and work to prevent the wrong people from acquiring the wrong agents, and from stopping plots. The role that Homeland Security plays is generally far removed from the nation's local hospital systems.

The Center for Disease Control plays a more direct role in working with local health systems to ensure that bioterrorist attacks are managed in such a way as to minimize the negative outcomes. The CDC is particularly interested in smallpox and anthrax attacks. The CDC provides guidance on a number of other subjects as well, however, including chemical, biological and radiological attacks (CDC, 2012, 2). Some of the issues that the CDC covers in its planning information sheets include response guidance, educating health care systems about the different types of threats that might occur, and community-based mass prophylaxis.

Health and Human Services (HHS) governs medical care in the United States, and therefore serves as a coordinating agency in the event of bioterrorist attacks. In 2002, HHS established the Hospital Preparedness Program (HPP). This was done to "enhance the ability of local hospitals and healthcare systems to prepare and respond to bioterror attacks and other public health emergencies" (Courtney, Toner & Waldhorn, 2009). This program has a total of 62 entities, including all fifty states, the District of Columbia and the nation's three largest cities. Thus, there is full nationwide participation in the program. The nature of the program is that participants in the health care system would work together on sharing information and building mechanisms by which the different health care providers nationwide can work closely to address the problems that might arise from a bioterrorist attack.

Despite these different agencies having established their roles in managing the threat of a bioterrorist attack, Courtney et al. (2009) argue that the nation's health care system is generally unprepared for such an attack. They argue that "current public and healthcare sector emergency plans will not work during a state of catastrophe, which would result in tens of thousands of individuals or more needing or seeking medical care for a nonroutine illness." They argue that one of the biggest issues is that the current plan is federal, rather than national, and there is insufficient involvement of private-sector health care providers, and these make up the bulk of the United States health care system. The authors make a number of recommendations to upgrade the current level of preparedness, and to this point three years later there is little evidence that such preparedness recommendations have been adopted by the relevant agencies or by the private sector elements of the health care system.

Student #2. The threat of bioterrorist attacks is one that is dealt with by a number of different agencies, including the individual health care providers. These providers and agencies must contend with the possibility of thousands of people seeking medical attention for the same issue all at once, often within a confined geographic area. Some potential bioterrorist attacks are contagious in nature, which complicates the ability of any agency or health care provider to address the issue entirely.

Currently, plans are made through a coordinating body, which in this case is Health and Human Services. This agency has a program, dating from 2002, which lays out the different threats that exist and how they can be addressed by health care providers. These plans are focused on agencies within the control of the federal government, something that is out of necessity owing to the scope of HHS operations.

This is a problem, however, that leaves the health care system exposed (Courtney, Toner & Waldhorn, 2009). The U.S. health care system is primarily made up of private enterprise operations, and there is a low level of coordination between these institutions and the government agencies that have drawn up the plans. Some other agencies include the Department of Homeland Security and the Center for Disease Control. These agencies all play a role in managing this threat, but do not appear to have a high level of coordination with each other, nor do they appear to have a high level of coordination with health care providers either.

As a result, it is difficult to imagine that the nation's health care system and its local providers will be able to manage any sort of large-scale bioterrorist attack. They have a low level of preparation, and are likely aware of the basic issues, but in terms of having the supplies and training to effectively manage such an incident, it appears that for the most part the nation's health care system is unprepared.

Part B. The health care industry is one of the largest industries in the United States and one of the fastest-growing. This growth is going to bring about a number of changes, including changes in technology that will transform how health care is delivered and changes in the legal environment brought about by the Affordable Care Act. Scholars and practitioners alike have already begun envisioning what the health care system of the future might look like. There are several different visions of future health care that exist, and good reasons for each.

The American Hospitals Association (2012) argues that technology will streamline health care delivery in the future. Some examples of changes that it expects are a "greater aligning of hospitals, physician and other providers," improved efficiency and the use of integrated information systems. The focus on efficiency in particular points to a reduction in hospital sizes and an emphasis on forms of care other than the hospital.

At the operating level, some of those changes are already being seen. Every staff member and piece of equipment can be traced, smart beds can "automatically transmit patients' breathing and heart rates so that problems can be dealt with more quickly (Andrews, 2009). The hospital of the future will be smaller because patients will spend less time there, equipment can be better tracked, and developments like remote diagnosis can reduce the amount of visits that patients need to make.

A different argument supports the idea that hospitals of the future will be far more integrated. They will incorporate elements of other aspects of care, such as wellness centers, hospices, nursing schools, and medical groups (Rowe, 2008). Thus, the traditional functions of a hospital might be reduced or altered in ways that will allow them to use their capacity for other functions. Conversely, such a change when envisioned across an entire health system would emphasize greater integration of these different components, which today often operate independent of one another.

Whichever vision becomes dominant, most observers agree that technology is rapidly changing the health care industry, and some of the changes are truly transformative in nature. The result of these changes is likely to be more streamlined hospitals and more integrated care networks, no matter what else changes.

Student #2. Hospitals of the future are likely to emphasize technology, and this is likely to result in their operations being streamlined. The focus on efficiency will lead to fewer hospital visits, and a greater usage of other aspects of the health care system. As a result of this, there is the risk that community hospitals -- especially smaller ones -- could be at risk.

The decision to keep community hospitals open even if they become unviable financially is something of a moral decision, since the quality of care will decline if too many such hospitals close. That said, if the hospital system is a business, that business needs to be able to earn a profit. This is where diversification comes in.

As Rowe (2009) notes, hospitals of the future might respond to budget challenges brought about by their efficient operations by expanding their service offerings. New service offerings are something that will benefit the community and allow the hospital to play a more complete role in the health care of the community. Such a shift in strategy would be aligned with the needs of the community, such that the hospital would ultimately be more responsive to the needs of the community, and this enhanced relevance would be valuable in keeping the hospital alive even if its viability is in question.

Part C. The first question is a good one.… [END OF PREVIEW]

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