Democratic Governance and Global Health

It is not the number of pages that make a book great, but it is the content found on the pages that capture the reader. My focus here is on the standards within the healthcare field and how the ever-changing and ever-growing list of standards call for much-needed and desired collaborations, due to unsuccessful attempts of development efforts, which have contributed unsatisfactory results (Hammond, Jaffe & Kush, 2009). It is through these collaborations that quality, not quantity, is thought to enhance the respective practices. I would like to discuss three topics: the actors, democratic governance influence, and relationship.

In the international theatrical called Global Health, you will find a list of over 40 organizations that contribute to standards on healthcare IT. Hammond, Jaffe & Kush (2009) acknowledge top ranking organizations that have influence on international standards. In the United States (US), the major federal contributor is the Department of Health and Human Services (HHS), along with organizations such as the American National Standards Institute (ANSI). The global counterpart to the ANSI would be the United Kingdom’s National Health Service. Other players include the Joint Initiative Council for the Joint Initiative on SDO Global Health Informatics Standardization and the International Health Terminology Standards Development Organization. This network of organizations work together to ensure quality of care and best practices are carried out in their specialty.

Within a network exists relationships between physicians and insurance companies, who continually accuse each other for the rising healthcare costs (Kornwitz, 2011). It is also within these networks that policy and standards are created. Klijin (1996) makes note about the policy processes within a network and the mutual dependency that the actors (i.e. clinicians and insurance companies) share with one another. The interaction setting, referred to as the network, in this context is the international arena. Within this network are variables that constantly change, such as government leaders and political situations that affect the entire process of policy. From the individual committees and their freedoms to attend international meetings, from the disclosure of national information from their respective countries, this network has many boundaries.

Democratic governance is found in environments that embrace participation of political parties, civil societies, and media access. To sustain this type of governance, separation of government powers exist and are exercised within the contents of law, through the respect for human nature and liberties, and demonstrating responsibility through civil service. It is within standards that you see Democratic governance exercised. Within elections of government officials, who enforce new agendas, place influential leaders over organizations that create standards, and build and destroy relationships with not only global organizations, but other nations. It is through this governance that one day a standard could be recognized, and the next day, due to a new law, the standard could be obsolete and disregarded.

Overall, I believe that the field of global health is a network of its own right, but many pieces of a pie that are represented by different nations and organizations. Democratic governance plays a strong part in the establishment of many of these organizations, as well as the participation of the standards introduced by these organizations. This internetwork is blessed and hindered by the very diversity that has established it. It is that diverse city, along with the mission, that must have collaboration in order to be effective, and in this case, save lives.

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Mystery Shopping Home Healthcare

Mystery shopping audits are an excellent way for home health care providers to gain insight into the level of customer service that prospective patients and their families experience during appointments. In fact, many professional medical organizations are actually encouraging the use of mystery shoppers.

In 2008, a report from a professional medical association endorsed mystery shopping as a way to improve patient care. The report said “physicians have an ethical responsibility to engage in activities that contribute to continual improvements in patient care. One method for promoting such quality improvement is through the use of secret shopper ‘patients’ who have been appropriately trained to provide feedback about physician performance in the clinical setting.”

Because of the deep level of trust that patients and their families wish to establish, the home healthcare industry can benefit greatly from mystery shopping audits. During home healthcare visits, a licensed nurse will visit the patient’s home and assist them with their daily needs — bathing, meals, chores and ensuring patients are taking their prescribed medications. The patient and their family must be able to trust the home healthcare agency, and that trust will begin during the initial meeting.

When it comes to evaluating a home health care agency, mystery shopping audits provide invaluable third-party feedback. The mystery shopping auditor poses as a family member of a prospective patient and inquire about services and attending appointments. During these appointments, the mystery shopping auditor will not just evaluate the level customer service that the agency provides; rather, it will evaluate every client facing aspect of the business. Does the staff work to establish a solid level of trust? Are they informative and helpful? Is the base of the operations well-maintained?

In addition to the standard client facing aspects of the business, there are plenty of obstacles that can affect patient satisfaction with home health care agencies. This may include scheduling issues, pricing discrepancies, brusque staff, lack of communication and confusing paperwork. All of these aspects of the home healthcare agency should be streamlined in order to help develop a level of trust with prospective patients.

The success of a home health care agency is dependent on customer satisfaction; if patients are not happy with the level of service they receive, they will go elsewhere. Mystery shopping audits for health care services can also take into account the agency’s handling and measurement of customer concerns. Additionally, a mystery shopping audit can provide insight that aids home healthcare services in identifying problem areas early, allowing them to respond appropriately to make sure small problems do not become large-scale compliance issues.

Because much of the business relies on trust, home healthcare agencies must continually re-evaluate their customer experience management plan through mystery shopping audits. Not only can these be extremely helpful in providing insight from the customer’s perspective, but they can also help to identify potential compliance issues before they arise.

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Public Healthcare Nursing

Healthcare is not only about treating diseases and administering medications. With the knowledge we have today, healthcare is becoming more of a preventative medicine than an after the fact treatment. Public health nursing is becoming one of the more popular ways to educate whole communities and to improve the neighborhoods overall safety and health.

Preventative medicine has been around since the ancient times, and is referenced frequently in Greek mythology. Though for many centuries healthcare was viewed as caring for those who were already sick, public health nursing has helped to bring preventative care back into the spotlight. Public health nursing, or PNH, really emerged with Florence Nightengale when nursing became a bonafide occupation. Caring for the sick and the poor soon led to programs like the Lillian Wald Henry Street Settlement in New York City, where the nurses went on to educate the patients as well as organizations on preventative techniques and practices.

As a public health nurse, you are able to work with diverse populations, often in somewhat downtrodden settings that can range from a school, to a worksite, to a neighborhood. The goal is to make the community a safer place by helping people learn about health issues and increasing their access to healthcare. There are many duties that a public health nurse will tackle in the course of a job, but the main ones are:

- Pinpointing health risks unique to particular communities
- Unveiling and monitoring health trends
- Propose health-related interventions that are accessible and affordable
- Work with the government and authorities at the federal, state and local level to give poor communities greater access to health services
- Create health education campaigns and offer disease prevention like screenings and immunizations
- Find a way to offer health care services to at risk and vulnerable communities
- Educate populations about imminent health risks and prevention practices

Education is definitely the key focus of a public health nurse. They will give presentations in assisted care centers, in schools, at community centers, and to any local group that will take the time to listen. Of course, most of the information being given is available online or in a library, but the goal is to make it accessible and understandable, in an effort to encourage people to take control of their health and future.

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