1. Unit 5 HS 499-01 Adrienne Palmer, BSPH, MHA, FACHE

2. Unit 5

3. Health Care and E- Commerce  Vital to economic productivity of any industrialized nation  Healthcare has several supply chains: professional services, pharmaceutical products, supplies, and equipment  One challenge is finding a flexible delivery

4. “Building on a foundation: strategies, processes and outcomes of health promotion in primary health care settings”  Treatment alone is unlikely to help market effects on health equities that underlie many health conditions  To close these gaps, we need greater integration of health promotion and primary healthcare  Need to consider philosophical values for the foundation of health promotion, how they should be incorporated into structures in a supportive environment, and the processes that you need to make this happen

5. Health promotion and primary care  Strategies (types of interventions) and processes (client and community centered care) sees her important health promotion initiatives  Strategies:  medical or preventive medicine approach directed at physiological risk factors  Behavioral or lifestyle approach directed at behavioral risk factors  Socio-environmental approach directed at social and environmental factors

6. Health promotion and primary care  Health promotion approach looks to focus beyond just the individual but also the community  Individual strategies  Focus on her care interventions between an individual healthcare provider with the individual being targeted for change  Group strategies  Usually fewer than 20 participants, include group counseling capacity building outreach and social support  Community strategies  Will affect our community and population, include community and economic development, healthy public policy, medical availability, etc.  Organizational strategies  Target the health setting itself and its practitioners

7. Health promotion and primary care  Process  Proactive approach – addressing presenting symptoms and immediate needs  Individualization and choice – individuals engaged in making their own decisions about their health care  Mutual learning – individuals involved in planning and making decisions  Respectful communication – good rapport between clients and health professionals  Meaningful participation – meaningful valuation of health-related activities or services

8. Developing an integrated primary care practice  Example: Kaiser Permanente  Lack of integration with the girl helped programs  Usually occurs when professionals take care of the same given population (VA)  Important to integrate to reduce unnecessary testing and ensure all providers have all information about the patient

9. Steps to developing an integrated primary care practice  Step one: analyze healthcare system, potential collaborators, and alliances  Step two: assess current status on continuum of integrated care  Step three: identify driving forces and barriers to change  Step four: collaboratively implement a pilot program, evaluate, redesign it, and test it again

10. Discussion question  What do you think are some of the benefits of an integrated primary care practice?  What are some of the negatives/potential risk?

11. Time management strategies in nursing practice  Time budget studies – one of oldest approaches for investigating time  Usually involves task analysis, to show range of tasks and time taken for each  Concern from nursing evolves around “invisible” dimensions, i.e. time with patient  Most time management studies related to nursing focus on that fact that nurses should try to manage their time

12. Time management strategies in nursing practice  This study:  Identified the following time strategies:  Routinization  Concealment  Catch up  Juggling  Extending temporal boundaries

13. Routinization  Helps normalize patterns  Can be taken for granted  Helps reduce “decision time”  Can reduce time pressure  Focuses on need to complete activities within certain time frames  However, can be difficult to change

14. Time management strategies in nursing practice  This study:  Identified the following repertoire of actions:  Focusing  Avoidance  Selective attention  Short cutting  Saying no  Making compromises  Delegation  Synchronizing

15. Prioritizing  Provides structure for time-ordering of work  Must be able to deal with conflicting priorities (patients vs physicians, multiple patients, timelines for other departments, etc)  Methods:  Patient urgency based on clinical needs  Advance timing  Nurse coverage  Delegation  Work sharing

16. Take-aways  Need to challenge how individuals manage their time  Both routines and priorities can be influenced by team and the organization  Individuals should be empowered to have management of their time and workload (within limits) to best accomplish the workload

17. Questions?