Fundamentals of Healthcare Professions HCT 101 PDF

Fundamentals of Healthcare Professions HCT 101 Topic 2 - Systems and Trends in Modern Health Care Section 1,2 and 4: Maya Tannoury, MS; Bioanalytical Toxicology; College of Healthcare Technologies...

Fundamentals of Healthcare Professions HCT 101 Topic 2 - Systems and Trends in Modern Health Care Section 1,2 and 4: Maya Tannoury, MS; Bioanalytical Toxicology; College of Healthcare Technologies [email protected] 1  Main Learning Objectives Become familiar with the major discoveries in health care history Identify the six domains of health care quality Understand the cost of care Identify the various approaches in the provision of care to patients Identify modern-day challenges in health care 2  3 Taken from Dakota Mitchell and Lee Haroun 2021, Introduction to Health Care, 5th Edition, Cengage.  History of Western Health Care Health care changed gradually until the beginning of the 20th century. At the beginning of the 20th century, the major killers were infectious diseases, particularly influenza and pneumonia: o Between 1918 and 1919, 20-40 million people across the globe were killed by an influenza pandemic. o Treatment options were very limited. o With the discovery of penicillin and other antibiotics, along with the use of immunizations, many infectious diseases have been controlled. Pharmaceuticals are the leading prevention and treatment options today 4 Question 1 True or False: Penicillin and antibiotics were discovered in the mid-1800s. Penicillin and antibiotics were not discovered until the 20th century 5  Technological Advancements Recent advancements: o Organ transplants o Microscopic and robotic surgery o Nanotechnology o Gene therapy o Targeted drug therapy for cancer treatment o Artificial intelligence in medicine o Stem cell therapy o Synthetic biology o Therapeutic advances in chronic disease 6 Question 2 The purpose of targeted drug therapy is to _____. A. Prevent drug abuse Targeted drug therapy aims to destroy cancer B. Destroy cancer cells cells or prevent them from dividing C. Create personalized pharmaceutical products 7 Highlights of Health Care History (1/6) Medicine in Ancient Mesopotamia 400 B.C. - 2200 B.C. 8  Highlights of Health Care History (2/6) Life span was only 20-35 years. Ancient times Hippocrates of Cos (460-379 BCE), Greek physician and the father of (???-A.D. 400) medicine, established that the body consisted of four humors. Two plagues let to breakdown in civilization. Medieval The title of Doctor became official Times (A.D. In 1224 medical studies were designed into a 9-year curriculum. 400-1350) Quarantine was adopted as a preventive measure. Printing press was invented. Renaissance Botany (the study of plants) expanded, and the first modern (1350-1650) pharmacopeia was written. 9  Highlights of Health Care History (3/6) Experimentation was optimized and the microscope was invented. Psychology became of interest. The brain was investigated, and simulation of muscles was 17th Century discovered. William Harvey discovered blood circulation; however, the injection of medications into the circulatory system was unsuccessful. Surgery became a respected form of treatment in France. Techniques to measure body temperature and blood pressure were developed. 18th Century Sanitary reforms were implemented in hospitals, prisons, and military and improved disease prevention. Edward Jenner developed the cowpox vaccine and described the theory of immunization. 10  Highlights of Health Care History (4/6) Industrial Revolution let to the great expansion of cities; large hospitals were built. Many first-time surgical operations were performed, such as tracheostomy and the removal of uterus or thyroid. 19th Century Cells could be observed under the microscope. Louis Pasteur developed the germ theory of diseases. Life span was increased from 40 years in 1850 to 70 years in 1950 due primarily to preventive, not curative, measures (vaccination, pasteurization, asepsis…) 11  Highlights of Health Care History (5/6) In 1921, Karl Landsteiner discovered blood groups and blood transfusion became a safe procedure. Insulin was extracted and injected into diabetic patients. New diagnostic and therapeutic tools were developed including X-rays , electrocardiographs, ultrasound and pacemakers… Vitamins were discovered and it was understood that their deficiency could lead to diseases. 20th New synthetic drugs were developed, including chemotherapy and Century antibiotics, to treat non-communicable and communicable diseases. Mental illness became a major modern societal problem; shock treatments were replaced with new drugs and psychotherapy. Terminally ill patients expressed their wish to die with dignity (voluntary euthanasia). In 1978, the first “test tube” was born in England. Acquired immunodeficiency syndrome (AIDS) was identified as a disease. First animal was cloned in 1997. 12  Highlights of Health Care History (6/6) Hopes for the millennium: Vaccines to prevent diseases such as AIDS. Cure for diseases such as AIDS, Alzheimer’s diseases, or Parkinson’s disease… 21st Cloning of organs for transplantation. Cure for life-threatening non-communicable diseases such as cancer and Century heart disease. More effective treatment and cure for mental illnesses. Less invasive diagnostic and therapeutic treatments and interventions. Drugs with fewer side effects. 13 Question 3 Chronic illnesses were rare in ancient times because _____. Chronic illnesses are long-term and most A. The average person did not live longer than 35 years common in older adults B. The environment did not contain synthetic chemicals as it does today C. Physicians were unable to diagnose most diseases 14  Specialization Over the last 50 years, medicine has increased in specialization. Effects on health care: o Improvement in diagnosis and treatment o More fragmented medical care, especially in chronic illness o Increased health care costs o Breakdown of patient-provider relationships since patients are often treated by a team of multiple care providers o Increased job opportunities for health care professionals 15  Aging Population The aging of the population is consequent to: oThe development of new drugs o“Baby boomers” (the generation born in the US between 1946 and 1964) have reached third age Older adults are the heaviest users of health care services. Their needs include: o Long-term care facilities o Home care services o Treatment for chronic conditions o Assistance in case of Alzheimer’s disease 16 Question 4 True or False: “Chronic” describes a health condition experienced as a result of aging. Conditions and illnesses that cannot be cured quickly 17  Healthcare Services and Facilities (1/3) Healthcare facilities are physical locations where healthcare services are provided to individuals. These facilities can vary in size, scope, and services offered, and they play a crucial role in delivering healthcare to communities.  Healthcare Services and Facilities (2/3) Healthcare Facility/Service Properties Hospitals Provide a wide range of medical services, including emergency care, surgeries, specialized treatments, diagnostic tests, and inpatient care Outpatient (ambulatory) clinics Offer outpatient care, usually for non-emergency conditions May be specialized (e.g. dental, dermatology, women's health,…) Long-term care facilities/ Nursing Residential institutions that provide care and assistance to individuals who are unable to live independently due to age, chronic illness, or disability facilities Rehabilitation centers Help individuals recover, regain skills, or manage disabilities resulting from injury, illness, or surgery. Provide physical therapy, occupational therapy, speech therapy, etc… Diagnostic centers Specialize in performing various medical tests and imaging procedures Play a crucial role in diagnosing/monitoring medical conditions Hospice Provides palliative care and support to terminally ill patients Make the patient’s last days as pain-free and meaningful as possible Home healthcare Bring medical care, nursing, therapy, and support services to individuals in their own homes  Healthcare Services and Facilities (3/3) Hospital Unit Properties Emergency department Provides immediate medical care to patients with acute illnesses, injuries, or other emergencies Intensive Care Unit (ICU) Provides intensive monitoring, treatment, and care for critically ill patients Cardiac Care Unit (CCU) Provides care for patients with cardiac conditions, such as heart attacks, congestive heart failure, or arrhythmias. Neonatal intensive Care Unit (NICU) Intensive care unit specializing in the care of ill or premature newborn infants Definitive Observation Unit (DOU) similar to ICU or CCU, however with less frequent care Step-down Unit Rehabilitation unit Treatment for neurological, musculoskeletal, and orthopedic conditions are offered Trauma Center Provides treatment for life-threatening injuries Question 5 A patient who is hospitalized following a myocardial infarction (heart attack) would most likely be cared for in the _____. A. CCU B. ICU C. Trauma center 21 Question 6 True or False: Palliative care provides comfort and pain relief but does not offer a cure. 22 The Six Domains of Healthcare Quality (1/7)  The Six Domains of Healthcare Quality (2/7) Medication error can have severe consequences and lead to death (Source: NurseLabs) 1. Safety: Reducing the risk and impact of incidents that can harm patients while providing care that is intended to help them ▪ Incidents: unplanned events, pressure injuries etc. ▪ Human error: medication error etc. ▪ They do not have to be clinical (e.g. mistyping information)  The Six Domains of Healthcare Quality (3/7) 2. Timeliness and accessibility: How quickly patients receive the care they need ▪ No barriers to receiving healthcare ▪ Reducing wait times and delays ▪ Reducing geographical, financial, and social barriers  The Six Domains of Healthcare Quality (4/7) 3. Effectiveness and appropriateness: providing services/treatments based on scientific knowledge and evidence-based practice ▪ Avoiding the provision of treatment/tests who are unlikely to benefit the patient ▪ Avoid over-treatment and under-treatment  The Six Domains of Healthcare Quality (5/7) 4. Patient-centered care: providing care that responds to the patient’s preferences, needs, and values. In this type of care, the patient is placed at the center of the care system Remember, the patient is a fundamental part of the healthcare team!  The Six Domains of Healthcare Quality (6/7) 5. Efficiency: getting the most out of available resources to deliver the best quality of healthcare available. ▪ Models of care must be clinically appropriate and cost-effective  The Six Domains of Healthcare Quality (7/7) 6. Equity (Equitable care): providing care that does not vary in quality because of the personal characteristics of the patients (socioeconomic status, gender, ethnicity, geographic location etc.). Access to healthcare must be fair for everyone Health Equity Video Series | Health Equity | CDC 30 Question 7 True or False: The concepts of “equality” and “equity” are identical. 31 New Trends in Health Care Search for alternatives to surgery and synthetic drugs. Desire to use natural products. Belief in mind-body connection. Focus on prevention rather than cure. More personal responsibility for health. Patients accessing first-hand to health information. Desire for increased humanization of medicine. 32  Promotion of health through preventive measures and practice of good habits. The leading causes of death are induced by bad lifestyle habits. Wellness Patients take responsibility for their own health. Developed by Margaret Newman The theory of expanding Wellness is more than the absence of disease or disability consciousness: Encourages patients to focus on life possibilities rather than limitations Question 8 True or False Wellness means not having an illness or injury. Wellness means more than the absence of disease or injury. It includes the practice of good lifestyle habits and promoting good health through preventive measures. 34  Western Medicine Western medicine relies on evidence-based medicine to diagnose and treat symptoms and conditions. Western medicine has its roots in the Western part of the world, namely Greece. Experts credit the Greek physician Hippocrates as being the father of Western medicine. Western medicine uses scientifically proven methods to improve your overall health. Focuses on pathology and curing disease. Common treatments are drugs and surgery. It has evolved from the use of herbs, to the isolation and use of the most active ingredient in herbs, to the use of semi-synthetic compounds Other names for western medicine are allopathic medicine, biomedicine, conventional medicine, mainstream medicine, Orthodox medicine, and traditional medicine. 35  Traditional/Eastern/Indigenous Medicine Traditional medicine, as defined by the World Health Organization, is the “sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement, or treatment of physical and mental illness.” It includes Traditional Chinese Medicine: o More than 3,000 years old o It includes: ▪ Acupuncture: the application of needles and pressure to your skin ▪ Cupping: the placement of warmed cups to your skin. Cupping creates a suction force that draws blood to your skin ▪ Herbal remedies: the use of plant-based teas, pills, ointments and other herbal supplements 36 Complementary, Alternative, and Integrative Medicine (1/5) Complementary and alternative medicine (CAM) refers to all practices that are not traditionally used by western medicine. Complementary medicine or therapy: o Used along with conventional medicine. It “complements” these traditional medical approaches. Alternative medicine: o Used instead/in place of conventional medicine Integrative medicine: o It considers your entire health and wellness, not limiting the therapeutic approach to the specific disease or organs involved. o It focuses on the mental, emotional, functional, spiritual, social and community aspects of your health. o It is a combination of Western, complementary, and alternative medicine 37  Complementary, Alternative, and Integrative Medicine (2/5) About 40% of Americans use at least one type of CAM. Some complementary treatments being incorporated into Western medicine: massage therapy, chiropractic. Trusted source of information about CAM: National Center for Complementary and Integrative Health. CAM has been the subject of health fraud. 38  Complementary, Alternative, and Integrative Medicine (3/5) Whole medical systems: Mind-body medicine: o Homeopathic medicine (“like o Patient support groups cures like”) o Meditation o Naturopathic medicine o Prayer o Traditional Chinese, including o Guided imagery acupuncture o Creative activities o Ayurveda – traditional Indian o Yoga CAM 39  Complementary, Alternative, and Integrative Medicine (4/5) Biologically-based practices: Manipulative and body-based o Aromatherapy practices: o Herbs o Chiropractic manipulation o Dietary supplements o Osteopathic manipulation o Natural products o Massage therapy E.g., shark cartilage o Reflexology o Relaxation exercises Energy therapies – includes biofield therapies 40  Complementary, Alternative, and Integrative Medicine (5/5) Susceptible to fraud Signs of fraudulent products: o Claims to cure a variety of problems o Claims to be miraculous and/or secret o Uses terms for which no definition(s) exist o Provides undocumented case histories o Requires payment in advance o Make appealing offers 41 Question 9 Which of the following health care practices involves manipulating the spine to relieve pain or correct dysfunction? A. Naturopathy B. Acupuncture Based on belief that pressure on nerves leaving C. Chiropractic spinal column causes pain and dysfunction 42  Holistic Medicine Expanded view of traditional medicine. It emphasizes the idea that all aspects related to a life can impact health: o Physical o Mental (thoughts, including judgement, prejudice, attitudes, etc.) o Emotional (feelings and reactions. Controlled by hormones, events, etc.) o Spiritual (involves the recognition of a feeling or sense or belief that there is something greater than myself. May be of religious nature or not) Emphasizes prevention of disease and personal responsibility for health: o Reduce stress o Proper nutrition o Physical activity o Positive attitude 43  Challenges in Healthcare Rising Healthcare Cost Factors contributing to cost increases include: ▪ Advanced medical technologies ▪ Competition for skilled healthcare providers (results in higher wages, ▪ Increasing number of diagnostic tests recruitment expenses, and increased and treatment options available. staffing levels) ▪ Rising prices of pharmaceutical products ▪ A shortage of healthcare professionals, ▪ An aging population requiring more particularly in certain specialties and complex care geographic areas ▪ Defensive medicine: medical practices ▪ Lack of competition in some areas that that are driven by a desire to avoid legal decreases efficiency and does not liability rather than the best interests of provide incentives to lower costs. the patient. “Is healthcare a right or a privilege?”  Challenges in Healthcare Maintaining Quality of Care High costs encourage cutting expenses Decisions made by insurance companies rather than health care providers (preauthorization) Affordable Care Act gives patients right to appeal denials Medicare covers only certain short-term stays rather long-term stays Medicaid covers long-term, but future funding may be inadequate  Challenges in Healthcare Access to healthcare Financial constraints Geographic barriers (especially in rural or remote areas) Lack of healthcare infrastructure, or limited availability of healthcare professionals.  Challenges in Healthcare Health Information Technology Interoperability The need for training and support for healthcare professionals Data privacy Cybersecurity  Challenges in Healthcare Social Conditions Poverty Homelessness Violence Substance abuse Spousal, child, and elder abuse Malnutrition Racism and discrimination (Implicit racism) Health Equity Video Series | Health Equity | CDC 50  Challenges in Healthcare Mental and Behavioral Health Limited access to mental health services Stigma Lack of resources Shortage of mental health professionals  Challenges in Healthcare Disease Burden Non-communicable Diseases Infectious Diseases Funding for treatment and prevention ▪ Cancer, diabetes, ASCVD… ▪ Much reduced, yet still ▪ World’s biggest killer present a major challenge ▪ A challenge especially in ▪ Outbreaks are difficult to low-income countries ▪ Lifestyle modifications predict ▪ Viruses mutate rapidly ▪ Antibiotic resistance Antimicrobial resistance – 2020 Student Film Prize of the Health For All Film Festival (World Health Organization)  Antibiotic Resistance II Do not memorize slide 54  Challenges in Healthcare Medication-Related Challenges ▪ Prescription drug overuse ▪ Patients diagnosing/prescribing o Create prescribing guidelines (the for themselves opioid crisis) ▪ Antibiotic misuse o Regulate pain clinics o Identify fraudulent prescriptions ▪ Medication adherence (due to o Teach other pain control methods cost or side effects) o Improve access to antidotes such ▪ TV prescription drug ads as naloxone o Incomplete information o Educate patients about risks o Health problems are complex ▪ Non-over-the-counter (non-OTC) o Drug may not be best choice for drugs prescribed over the patient counter o Increases cost of prescriptions  Challenges in Healthcare What can I do as a healthcare professional? PATIENT EDUCATION AND COUNSELING ▪ Lifestyle Choices: diet recommendations and active lifestyles ▪ Smoking cessation ▪ Avoid drinking alcohol ▪ Preventive care: regular screening, early detection and vaccinations ▪ Stress management ▪ Advice within your domain ▪ LEAD BY EXAMPLE: BE A ROLE MODEL Question 10 There is concern about the quality of care in the U.S. because of the A. Poor training of physicians The high cost of health care sometimes B. High cost of providing health care influences the quality of care provided C. Lack of government support for health care research 57  Government Health Services (1/2) Supported by taxpayers Conduct research, regulatory, and educational activities Examples of federal agencies: o National Institutes of Health (NIH) o Centers for Disease Control and Prevention (CDC) o Occupational Safety and Health Administration (OSHA) 58  Government Health Services (2/2) Examples of state services: Examples of local government services: o License personnel and facilities o Collect vital statistics o Provide laboratory services o Conduct sanitary inspections o Establish health data systems o Screen for diseases o Conduct public health planning o Provide immunizations 59 Question 11 Which of the following services is provided by the National Institutes of Health (NIH)? A. Make health care available for the uninsured B. Control the spread of diseases C. Conduct medical research 60