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What Other Information Suggests That John Hopkins Medical Center Makes an Effort to Generate Positive Emotions for Employees?

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The health care sector in the United States consists of an array of clinicians, hospitals and other health care facilities, insurance plans, and purchasers of health care services, all operating in various configurations of groups, networks, and independent practices. Some are based in the public sector; others operate in the private sector as either for-profit or not-for-profit entities. The health care sector also includes regulators, some voluntary and others governmental

Although these various individuals and organizations are generally referred to collectively as “the health care delivery system,” the phrase suggests an order, integration, and accountability that do not exist.

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The CHNA process for The Johns Hopkins Hospital (JHH) and Johns Hopkins Bayview Medical Center (JHBMC) included the collection and analysis of primary and secondary data. Both public and private organizations, such as faith-based organizations, government agencies, educational systems, and health and human services entities were engaged to assess the needs of the community. In total, the extensive primary data collection phase resulted in more than 1,460 responses from community stakeholders/leaders and community residents. The 2016 and 2013 CHNAs served as a baseline to provide a deeper understanding of the health as well as the socioeconomic needs of the community and emerging trends. In order to collaborate with the Baltimore City Health Department and a coalition of Baltimore City hospitals, The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center accelerated their CHNA process and are providing an updated CHNA in 2018, one year ahead of the three-year cycle required by the Internal Revenue Service (IRS). The 2018 CHNA is designed to be an update to the 2016 report by using similar methodology to build upon the previous work and findings while participating collaboratively with the larger coalition of hospitals. The development of the CHNA and the Implementation Strategy was led by the Office of Government and Community Affairs (Tom Lewis, Vice President), Dr

Redonda Miller (JHH President), and Dr. Richard Bennett (JHBMC President), and involved the contributions of over 1,460 individuals through direct interviews, surveys, and focus groups. Key stakeholder groups included, but were not limited to, community residents, members of faith-based organizations, neighborhood association leaders, health professionals, Johns Hopkins Medicine leadership, and other experts, both internal and external to Johns Hopkins.

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Barriers to error reporting are found at many levels in the health care system. Moskop et al4 assert that US health systems are not generally designed to encourage error recognition, reporting, and remediation. Teaching hospitals have focused on the sequelae of errors rather than teaching ways to prevent them or the value of disclosing them (Amalberti R, Auroy Y, 2005). Physicians' training and attitudes place additional barriers to reporting errors. As the gatekeeper for a patient's care, the physician who commits an error, especially one that harms the patient, may feel deep shame, guilt, and a sense of failure. He or she may believe that disclosing the error to the patient will do irreparable damage to the physician-patient relationship and to the patient's trust in the health care system in general. Furthermore, physicians have historically received little or no training in how to communicate with patients and others about errors. Reporting systems have been relatively cumbersome. The process of completing detailed forms, submitting them up the chain of command, and attending meetings and interviews has deterred many health care professionals from reporting all but the most egregious errors. Both institutions and individual practitioners view the threat of malpractice liability as a significant barrier to error reporting (Leape LL, 2002). The disclosure could have a double impact, leading the patient to file suit once informed of the error and providing admissible evidence to the plaintiff's attorney.

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In conclusion, Johns Hopkins Medicine researchers are working tirelessly to find ways to better understand, treat and eventually eliminate COVID-19 and the illness that results from infection. New discoveries and observations from Johns Hopkins that we share here, especially those related to clinical therapies, are almost uniformly early in concept. They will require rigorous research, testing and peer review before solid conclusions for clinical care and disease prevention can be made.

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Amalberti R, Auroy Y, Berwick D, et al: Five system barriers to achieving ultrasafe health care. Ann Intern Med 142:756-764, 2005

Wu AW, Pronovost P, Morlock L: ICU incident reporting systems. J Crit Care 17:86-94, 2002

Billings CE: The NASA Aviation Safety Reporting System: Lessons learned from voluntary incident reporting, in Proceedings of Enhancing Patient Safety and Reducing Errors in Health Care. Chicago, IL, National Patient Safety Foundation, 1999, 97-100

Leape LL: Reporting of adverse events. N Engl J Med 347:1633-1638, 2002

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