Forces that Influenced the Clinic’s Development
Social, economic, and political factors are key determinants of people’s health. They influence health care quality and accessibility. The development of the clinic was influenced by the need to establish a medical center that offers primary care to underserved populations. Socioeconomic factors such as poverty, illiteracy, unemployment, residential segregation, and culture, among others, reduce access to care services resulting in poor quality of life (Kovner & Neuhauser, 2004). Health outcomes depend on factors such as eating well, physical activity, and regular medical checkups and screening tests. These services are available in the clinic, which is located in poor neighborhoods that lack hospitals to support healthy living among the residents.
The owners and their wives practice family medicine at the clinic as physicians and registered nurses. Evidently, the proprietors’ medical skills and background influenced the establishment and growth of this clinic. The clinic’s staff also has diverse skills sets. The 69 staff members are drawn from nine specialist areas, providing a perfect skill mix for quality diagnostic, inpatient, and specialist care services.
From a political perspective, the Affordable Care Act that was enacted in 2010 has led to a proliferation of clinics that have made health care accessible to the underprivileged. The law has expanded coverage and provided consumers with flexible and stable health plans (Rittenhouse, Shortell & Fisher, 2009). Thus, political factors influenced the establishment of the clinic, which now stands to benefit from federal funding following the passage of the Affordable Care Act.
Economic forces also influenced the establishment of the clinic in many ways. People’s economic condition shapes their health outcomes by determining their ability to seek quality medical care. Poor people have low incomes partly because of limited access to economic opportunities like employment. In this regard, they have limited health care choices, resulting in poor quality of life. The clinic was established to provide affordable medical care to low-class citizens who cannot access expensive treatment options.
Comprehensive Mission Statement
The primary care clinic offers a wide range of outpatient, diagnostic, and specialist services to rural communities. Its mission statement reads; “At the Wellness clinic, we offer diagnostic, specialist, and outpatient services for low-income families built on ethical standards and a deep understanding of the diverse health care needs of individuals, groups, and communities with an aim of promoting the quality of life of the entire Georgian community”. This mission statement is comprehensive because it gives the name and type of organization as well as the services it offers. Its target population and location are also indicated in the mission statement. According to Kovner and Neuhauser (2004), a mission statement should clearly communicate the agency’s identity and type, its services, target population, and location. Such a mission statement reveals the central goals of the agency to its stakeholders and the community it serves.
Performance Measures
As aforementioned, the clinic provides advanced diagnostic, outpatient, and specialist services. The clinic’s performance in each of these areas will determine the health outcomes of the patients. The evaluation criteria will involve three key performance measures that will determine the quality and effectiveness of the services offered to patients. The performance measures will quantitatively reveal whether our services enhance patient care.
The first performance benchmark will be the quality of care measure. This will entail an evaluation of the rate of infection and mortality, medical errors, child immunization, vaccination against diseases like influenza, misdiagnoses, and re-infections. The rationale for using the quality of care measure is because it reflects the improvement in patient management at the clinic. Swayne, Duncan, and Ginter (2006) associate the quality of care with the health outcomes of patients, which indicate an organization’s performance and effectiveness in service delivery.
The second performance measure will be the utilization of care at the clinic. According to Rittenhouse, Shortell, and Fisher (2009), utilization of care measures clinical activity, which is an indication of efficiency. We will use parameters like “length of stay, admission and readmission rates, cost per patient, and bed occupancy” as indicators of the utilization of care (Rittenhouse, Shortell & Fisher, 2009, p. 2302). This will allow us to evaluate the utilization of the clinic’s outpatient care services. This measure reflects the quality problems that bring additional costs to providers who often compare care costs when selecting a clinic. Thus, the utilization measure will help determine the cost-effectiveness of the clinic’s services.
Patient satisfaction will be another important quality measure. The clinic will use patient satisfaction surveys to evaluate the quality of care offered. Patient reports on wait times, care quality, and staff communication and compassion will indicate their individual experiences with the clinic’s services. Additionally, other domains such as satisfaction with meals, facilities, pain/symptom management, and family involvement will be measured. This measure will indicate the patients’ level of satisfaction with the clinic’s services, which will be a reflection of its efficiency in care delivery.
Expansion Decisions
Decisions to expand clinical services will be made after soliciting input from various stakeholders. As the manager of the clinic, the writer will assume a consultative decision making approach, which entails involving both the owners (the board) and the staff in the expansion planning process. The first step will be to inform the board members and staff about the expansion plan. The key stakeholders, including external ones like sister clinics and funders, will also be informed about the expansion plan. The second step will involve an environmental scan to identify opportunities and threats that may affect the annual expansion plan. Additionally, a scan will reveal the clinic’s strengths in terms of resources and capacities. In conducting a scan, representatives from the local community will be consulted.
Issues identified during the environmental scan will be brought to the board and staff for deliberation with an intention of coming up with an agreeable expansion plan. The plan will indicate the additional specialist services that we intend to offer, the target population, and the budget. The manager will then forward the plan to the board for final approval. The involvement of both the staff and the board will generate a balanced plan that will stand a good chance of being approved and adopted.
The Role of the Clinic in the Health Care Delivery System
Rittenhouse, Shortell, and Fisher (2009) write that the healthcare system consists of the delivery component and the insurance providers who pay for medical care services. The clinic offers primary care to underserved patients living within the two sites that lack adequate hospital services. It has medical specialists, diagnostic labs, and outpatient services, which complement hospital care in the community. The clinic’s two sites offer family medicine, including orthopedics, minor surgery, gynecology, and childbirth services. The clinic also offers nursing care for recuperating patients discharged from other facilities like hospitals.
It also provides follow-up services for discharged invalids. The specialists offer continuous treatment, including visiting the sick in their homes and liaising with families to develop a plan of care for the patient. The clinic also handles emergency cases involving patients with chronic illnesses, such as diabetes and hypertension. It manages acute exacerbations of these conditions within community settings. The clinic also gives social support and terminal care services that are tailor-made for the community’s healthcare needs.
The Influence of Public Healthcare Policy
The enactment of the Patient Protection and Affordable Care Act in 2010 gave way for stable and flexible patient care services. Its intention was to expand coverage for all Americans by presenting patients with diverse health care options. Its enactment caused clinics that specialize in outpatient services to spring up in community settings to reach the underserved. Another law, the Health Care and Education Reconciliation Act of 2010, also sought to make coverage affordable and accessible to all. The two policies increased the number of people covered by the federal-funded Medicare and Medicaid programs, increasing health care accessibility in the country (Rittenhouse, Shortell & Fisher, 2009).
Outpatient clinics have sprung up to provide care services to millions of Americans now eligible for medical cover. They benefit from federal funds disbursed through the Medicare and Medicaid programs that cater for a range of services, including specialized care for chronic illnesses. Clinics have fewer beds than hospitals, but offer the same services. Due to the low number of beds, clinics specialize in outpatient care. In this view, the health care financing policies enacted since 2010 have transformed the healthcare delivery landscape by making outpatient services accessible to more Americans.
References
Kovner, A. R. & Neuhauser, D. (2004). Health Services Management: Readings, Cases, and Commentary. Chicago: Health Administration Press.
Rittenhouse, D. R., Shortell, S. M. & Fisher, S. (2009). Primary care and accountable care-two essential elements of delivery-system reform. The New England Journal of Medicine, 361(24), 2301–2303.
Swayne, L. E., Duncan, W.J. & Ginter, P. M. (2006). Strategic Management of Health Care Organizations. Boston: Blackwell Publishing.