Submit your final project of a healthcare delivery systems research paper.
HCM 340 Final Project Guidelines and Rubric
Overview
Since the turn of the century, there has been an increased focus on transforming the U.S. healthcare delivery system. Several reports have cited the enormous
divide, or chasm, that exists between the healthcare system as we actually receive it versus the ideal system that we strive to achieve. While there have been
numerous efforts aimed at optimizing the care delivered to all individuals in our society, many gaps still remain that prevent us from fundamentally reaching that
ideal.
For your final project, you will research a gap in the access to quality, equity, or efficiency of care (including existing initiatives involving economic and regulatory
factors currently in place).
• Option One: A gap in quality related to care coordination for individuals with chronic illnesses
• Option Two: A gap in equity related to mental health access for veterans
• Option Three: A gap in efficiency related to rising cost of pharmaceuticals for the aging population
This assessment addresses the following course outcomes:
•
•
•
•
Draw connections between current healthcare delivery systems and the context in which they were developed
Describe the impact of economic and regulatory drivers on healthcare delivery systems
Identify major gaps in access to healthcare for determining areas of opportunity for improved access to quality healthcare
Explain initiatives targeted at maintaining or improving the health status of specific populations
Prompt
After choosing the topic for your course project from the options provided in the overview, you will work to develop your healthcare delivery systems research
paper. Within the final research project, you will address your chosen gap in access, including existing initiatives in place to address the gap and economic and
regulatory factors that are currently in place to address the gap.
Specifically, the following critical elements must be addressed:
I.
Introduction
A. Describe a specific gap in the delivery of healthcare. Include the specific population affected by the gap.
B. Briefly describe the history of this gap in access to healthcare. Has this been an issue historically, or is it a modern issue?
C. Explain the impact that the socioeconomic background of the population has on their access to healthcare.
D. Describe how the healthcare delivered to the population is affected by the gap in access.
E. Predict any potential implications if this gap in access is not addressed.
II. Existing Initiatives
A. Explain an existing healthcare initiative that was put in place to address this gap in access.
B. Explain the specific goals of the existing initiative in place to address this gap in access.
C. Describe the circumstances around the development of the existing initiative. Consider when it was developed and what factors were
considered.
D. Describe the resources required to fund the existing initiative.
E. Explain why the existing initiative is not meeting its intended purpose and now requires improvement.
III. Regulation
A. Explain a current regulation regarding the existing initiative that has been identified and the context in which it was developed. Why is this
regulation important?
B. Describe the regulatory level that the existing initiative is being addressed at. Consider the potential for multiple levels of regulation.
IV. Conclusion: Explain the effectiveness of the existing initiative and associated regulations in addressing this gap in the delivery of healthcare to the target
population. Does the initiative align with initiative in place to support other gaps? Are there conflicting interests to be aware of?
Milestones
Milestone One: Topic Selection
In Module Three, you will submit a 2- to 3-page paper explaining why the topic you chose is a gap in healthcare and analyze the specific population impacted by
the issue. This assignment will be graded with the Milestone One Rubric.
Milestone Two: Existing Initiatives
In Module Five, you will submit a 2- to 3-page paper in which you will identify and analyze an initiative that addresses the gap you chose as the topic for your
final project. This assignment will be graded with the Milestone Two Rubric.
Final Submission: Healthcare Delivery Systems Research Paper
In Module Seven, you will submit your final project. It should be a complete, polished artifact containing all of the critical elements of the final project. It should
reflect the incorporation of feedback gained throughout the course. This submission will be graded with the Final Project Rubric.
Final Project Rubric
Guidelines for Submission: Your healthcare delivery systems research paper should be 5 to 8 pages. It should be double-spaced, include one-inch margins, use
12-point Times New Roman font, and at least three sources cited in APA formatting.
Critical Elements
Introduction: Gap
Exemplary (100%)
Meets “Proficient” criteria and
description demonstrates keen
insight into the healthcare
delivery processes
Proficient (85%)
Describes a specific gap in the
delivery of healthcare, including
the specific population affected
by the gap
Introduction: History
Meets “Proficient” criteria and
description demonstrates a
nuanced understanding of the
premise of the gap
Meets “Proficient” criteria and
the explanation demonstrates a
sophisticated awareness of the
relationship between
socioeconomic status and
access to healthcare
Meets “Proficient” criteria and
description demonstrates a
nuanced understanding of the
healthcare delivery processes as
they relate to consumer access
Meets “Proficient” criteria and
predictions demonstrate a
sophisticated awareness of the
interrelationship between
healthcare access and other
variables
Briefly describes the history of
this gap in access to healthcare
Introduction:
Socioeconomic
Background
Introduction: Affect
Introduction:
Implications
Explains the impact
socioeconomic background has
on a population’s access to
healthcare
Describes how the healthcare
delivered to the population is
affected by the gap in access
Predicts any potential
implications if this gap in access
is not addressed
Needs Improvement (55%)
Describes a specific gap in the
delivery of healthcare, including
the specific population affected
by the gap, but the description
is cursory or contains
inaccuracies
Describes the history of this gap
in access to healthcare, but
description is verbose or
contains inaccuracies
Explains the impact
socioeconomic background has
on a population’s access to
healthcare, but explanation is
cursory or illogical
Not Evident (0%)
Does not describe a specific gap
in the delivery of healthcare to
a specific population
Value
7.9
Does not describe the history of
this gap in access to healthcare
7.9
Does not explain the impact
socioeconomic background has
on a population’s access to
healthcare
7.9
Describes how the healthcare
delivered to the population is
affected by the gap in access,
but description cursory or
contains inaccuracies
Predicts any potential
implications if this gap in access
is not addressed, but
predictions are unrealistic or
unrelated
Does not describe how the
healthcare delivered to the
population is affected by the
gap in access
7.9
Does not predict any potential
implications if this gap in access
is not addressed
7.9
Critical Elements
Existing Initiatives:
Address Gap
Exemplary (100%)
Meets “Proficient” criteria and
explanation demonstrates keen
insight into the needs for
addressing the gap
Proficient (85%)
Explains an existing healthcare
initiative that was put in place
to address this gap in access
Existing Initiatives:
Goals
Meets “Proficient” criteria and
explanation demonstrates a
nuanced understanding of the
purpose of the existing initiative
Explains the specific goals of the
existing initiative in place to
address this gap in access
Existing Initiatives:
Development
Meets “Proficient” criteria and
description demonstrates a
sophisticated awareness of the
elements involved in the
development of initiatives
Meets “Proficient” criteria and
description demonstrates a
complex grasp of the funding
requirements of healthcare
delivery initiatives
Meets “Proficient” criteria and
explanation demonstrates keen
insight into the needs of the
initiative and its shortcomings
Describes the circumstances
around the development of the
existing initiative
Meets “Proficient” criteria and
explanation demonstrates a
sophisticated awareness of how
context influences the
development of regulations
Explains a current regulation
regarding the existing initiatives
that have been identified and
the context in which it was
developed
Existing Initiatives:
Resources
Existing Initiatives:
Improvement
Regulation: Current
Regulation
Describes the resources
required to fund the existing
initiative
Explains why the existing
initiative is not meeting its
intended purpose and now
requires improvement
Needs Improvement (55%)
Explains an existing healthcare
initiative that was put in place
to address this gap in access,
but explanation is cursory or
contains inaccuracies
Explains the specific goals of the
existing initiative in place to
address this gap in access, but
explanation is cursory or
contains inaccuracies
Describes the circumstances
around the development of the
existing initiative, but
description is unclear or
incomplete
Describes the resources
required to fund the existing
initiative, but description is
illogical or contains inaccuracies
Not Evident (0%)
Does not explain an existing
healthcare initiative that was
put in place to address this gap
in access
Value
7.9
Does not explain the specific
goals of the existing initiative in
place to address this gap in
access
7.9
Does not describe the
circumstances around the
development of the existing
initiative
7.9
Does not describe the resources
required to fund the existing
initiative
7.9
Explains why the existing
initiative is not meeting its
intended purpose and now
requires improvement, but
explanation is cursory or
contains inaccuracies
Explains a current regulation
regarding the existing initiatives
that have been identified and
the context in which it was
developed, but explanation is
cursory or contains inaccuracies
Does not explain why the
existing initiative is not meeting
its intended purpose and now
requires improvement
7.9
Does not explain a current
regulation regarding the existing
initiatives that have been
identified and the context in
which it was developed
7.9
Critical Elements
Regulation:
Regulatory Level
Exemplary (100%)
Meets “Proficient” criteria and
description demonstrates a
nuanced understanding of
regulatory control levels
Proficient (85%)
Describes the regulatory level at
which the existing initiatives are
being addressed
Conclusion
Meets “Proficient” criteria and
explanation demonstrates a
complex grasp of the
relationship between individual
initiatives and the healthcare
system
Explains the effectiveness of the
existing initiative and associated
regulations in addressing this
gap in the delivery of healthcare
to the target population
Articulation of
Response
Submission is free of errors
related to citations, grammar,
spelling, syntax, and
organization and is presented in
a professional and easy to read
format
Submission has no major errors
related to citations, grammar,
spelling, syntax, or organization
Needs Improvement (55%)
Describes the regulatory level at
which the existing initiatives are
being addressed, but
description is cursory or
unrelated
Explains the effectiveness of the
existing initiative and associated
regulations in addressing this
gap in the delivery of healthcare
to the target population, but
explanation is cursory or
unrelated to the overall
healthcare system
Submission has major errors
related to citations, grammar,
spelling, syntax, or organization
that negatively impact
readability and articulation of
main ideas
Not Evident (0%)
Does not describe the
regulatory level at which that
the existing initiatives are being
addressed
Value
7.9
Does not explain the role of this
gap in the delivery of healthcare
to the population or the
initiative in place to address this
gap
2.6
Submission has critical errors
related to citations, grammar,
spelling, syntax, or organization
that prevent understanding of
ideas
2.6
Total
100%
1
Healthcare Delivery Systems
Courtney Roberts
Southern New Hampshire University
HCM 340
October 1, 2022
2
Healthcare Delivery Systems
Healthcare providers and patients have struggled for many years to overcome gaps in
coordinating care for chronic illnesses, which are the major causes of death in the United States.
Six in every ten adults in the United States have a chronic disease. The aged are vulnerable to
adverse outcomes, and their care incurs high costs. Research in 2005 proved that more than a
hundred and thirty million people live with chronic disease. The number increases by more than
one percent yearly, leading to an increased population needing chronic disease management.
There has been a concern between policymakers and practitioners regarding how to care for
individuals living with chronic diseases. The Chronic Care Model is a framework for providing
care for patients with chronic illness across different health care settings.
The Chronic Care Model initiative consists of six essential areas that form a system to
enhance quality disease management. Healthcare facilities must focus on these areas and start
productive interactions between the providers who possess the required resources and the
patients. To address the gap, healthcare facilities must focus on clinical information systems,
decision support, delivery systems, healthcare organization, management support, and the
community. The Model was published in 1998 in its current form. It was developed by Wagner
of MacCo11 Institute and the Improving Chronic Illness Care Program members in the early
1990s. After going through review by a panel of experts, a version of the Model was compared
with the qualities of leading chronic disease programs across the United States. The Model’s
sustainability was sometimes likely to fail as it went without adequate funding. Robert Wood
Johnson Foundation is well known for funding the Chronic Care Model tests across different
healthcare settings (Stellefson, Dipnarine, & Stopka, 2013). Community resources are essential
to fund the Model effectively.
3
The delivery system is essential to narrowing the gap in coordinating care for the disease.
Through a well-managed delivery program, providers can plan visits according to the needs of
the patients. Individuals with chronic conditions require adequate information and support to
take charge of their health. Patients should have basic knowledge about the disease and the
support they need from healthcare providers, family, friends, and the community. Organizations
and community programs should support the patient’s healthcare. A clinical information system
is necessary to track individual patients and populations of patients. The system aids in tracking
progress hence anticipating future problems (Schultz, Pineda, Lonhart, Davies, & McDonald,
2013). The entire healthcare organization should be involved in the improvement efforts to
achieve the required progress.
However, this initiative might not be achieved due to reasons such as inadequate training
of patients, lack of patient compliance, failure of provider follow-ups, and the inability of
providers to follow set guidelines. Due to rush, providers may fail to follow all the steps
(Stuckey, Dellasega, Graber, Mauger, Lendel, & Gabbay, 2009). To overcome these issues, there
should be a complete transformation of healthcare systems to make them focus on keeping
individuals as healthy as possible rather than responding when an individual is sick.
In conclusion, implementing the Chronic Care Model requires careful planning and
consideration. Healthcare facilities ought to ensure that individual staff members have the
necessary knowledge to play their roles. Healthcare systems should focus on the different critical
areas to address chronic disease gaps.
4
References
Schultz, E. M., Pineda, N., Lonhart, J., Davies, S. M., & McDonald, K. M. (2013). A systematic
review of the care coordination measurement landscape. BMC health services
research, 13(1), 1-12.
Stellefson, M., Dipnarine, K., & Stopka, C. (2013). Peer reviewed: A systematic review of the
chronic care model and diabetes management in US primary care settings. Preventing
chronic disease, 10.
Stuckey, H. L., Dellasega, C., Graber, N. J., Mauger, D. T., Lendel, I., & Gabbay, R. A. (2009).
Diabetes nurse case management and motivational interviewing for change
(DYNAMIC): study design and baseline characteristics in the Chronic Care Model for
type 2 diabetes. Contemporary clinical trials, 30(4), 366-374.
1
Healthcare Delivery Systems
Courtney Roberts
Southern New Hampshire University
HCM 340
October 1, 2022
2
Healthcare Delivery Systems
Healthcare providers and patients have struggled for many years to overcome gaps in
coordinating care for chronic illnesses, which are the major causes of death in the United States.
Six in every ten adults in the United States have a chronic disease. The aged are vulnerable to
adverse outcomes, and their care incurs high costs. Research in 2005 proved that more than a
hundred and thirty million people live with chronic disease. The number increases by more than
one percent yearly, leading to an increased population needing chronic disease management.
There has been a concern between policymakers and practitioners regarding how to care for
individuals living with chronic diseases. The Chronic Care Model is a framework for providing
care for patients with chronic illness across different health care settings.
The Chronic Care Model initiative consists of six essential areas that form a system to
enhance quality disease management. Healthcare facilities must focus on these areas and start
productive interactions between the providers who possess the required resources and the
patients. To address the gap, healthcare facilities must focus on clinical information systems,
decision support, delivery systems, healthcare organization, management support, and the
community. The Model was published in 1998 in its current form. It was developed by Wagner
of MacCo11 Institute and the Improving Chronic Illness Care Program members in the early
1990s. After going through review by a panel of experts, a version of the Model was compared
with the qualities of leading chronic disease programs across the United States. The Model’s
sustainability was sometimes likely to fail as it went without adequate funding. Robert Wood
Johnson Foundation is well known for funding the Chronic Care Model tests across different
healthcare settings (Stellefson, Dipnarine, & Stopka, 2013). Community resources are essential
to fund the Model effectively.
3
The delivery system is essential to narrowing the gap in coordinating care for the disease.
Through a well-managed delivery program, providers can plan visits according to the needs of
the patients. Individuals with chronic conditions require adequate information and support to
take charge of their health. Patients should have basic knowledge about the disease and the
support they need from healthcare providers, family, friends, and the community. Organizations
and community programs should support the patient’s healthcare. A clinical information system
is necessary to track individual patients and populations of patients. The system aids in tracking
progress hence anticipating future problems (Schultz, Pineda, Lonhart, Davies, & McDonald,
2013). The entire healthcare organization should be involved in the improvement efforts to
achieve the required progress.
However, this initiative might not be achieved due to reasons such as inadequate training
of patients, lack of patient compliance, failure of provider follow-ups, and the inability of
providers to follow set guidelines. Due to rush, providers may fail to follow all the steps
(Stuckey, Dellasega, Graber, Mauger, Lendel, & Gabbay, 2009). To overcome these issues, there
should be a complete transformation of healthcare systems to make them focus on keeping
individuals as healthy as possible rather than responding when an individual is sick.
In conclusion, implementing the Chronic Care Model requires careful planning and
consideration. Healthcare facilities ought to ensure that individual staff members have the
necessary knowledge to play their roles. Healthcare systems should focus on the different critical
areas to address chronic disease gaps.
4
References
Schultz, E. M., Pineda, N., Lonhart, J., Davies, S. M., & McDonald, K. M. (2013). A systematic
review of the care coordination measurement landscape. BMC health services
research, 13(1), 1-12.
Stellefson, M., Dipnarine, K., & Stopka, C. (2013). Peer reviewed: A systematic review of the
chronic care model and diabetes management in US primary care settings. Preventing
chronic disease, 10.
Stuckey, H. L., Dellasega, C., Graber, N. J., Mauger, D. T., Lendel, I., & Gabbay, R. A. (2009).
Diabetes nurse case management and motivational interviewing for change
(DYNAMIC): study design and baseline characteristics in the Chronic Care Model for
type 2 diabetes. Contemporary clinical trials, 30(4), 366-374.
A Gap in Equity Related to Mental Health Access for Veterans
Courtney Roberts
Southern New Hampshire University
HCM 340
Gail White
9/7/2022
The topic I have chosen without a second guess for milestone one is the gap in equity
related to mental health access for veterans. I wanted to talk about this talk because I am a
veteran myself and have already served six years and continuing my service with the military. I
have seen firsthand by knowing retired veterans along with just actively serving that “free
healthcare” comes with a price and isn’t the best healthcare. There is a lack in healthcare and
with troops being sent overseas often there are limitations to the amount of healthcare they can
access. In some cases, they must be flown elsewhere to receive the proper treatment. Once the
veterans return home, that are several of them that come back with PTSD and mental health
issues that goes undiagnosed or not taken care of. Veterans go out of their way and sign up to
risk their lives for this country and return to a country that has an unbelievable number of
veterans that are homeless, mental health issues, untreated health problems that stem from their
service in the military. There is a gap between the mental healthcare access for veterans versus
the general population. The healthcare reform needs to be addressed so badly in the United States
that we must focus on the large gaps in equity.
Research regarding PTSD and mental health concerns amongst Veterans became a
critical piece to the creation of the diagnosis. Many veterans would go overseas and experience
things that would leave them scarred and upon return they would just become research studies
instead of given proper care. In 1919 at the end of World War I, soldiers often only received only
a few days’ rest before returning to the war zone. During war treatment was varied and were give
the embrace the suck mentality. Some symptoms of present-day PTSD were known as “shell
shock” which included panic and sleep problems, among other. (Veteran Affairs, 2018). The
Department of Veteran Affairs established research to conduct studies related to neuropsychiatric
disorders which was a step forward of providing mental healthcare, however in 1989 is when the
VA created the National Center for PTSD. Although this program is in place, the action can not
stop there. The access to this program involves a long application and to be approved for the
access which then leads the veteran to not go through the motion of applying because of the
requirements and limitations. “The VA estimates 22,000 veterans with mental illnesses have
received other-than-honorable discharges since 2009. They would be ineligible for mental-health
counseling through the VA.” (Suozzi, 2017).
Socioeconomic barriers come into place for the Veterans because they aren’t always the
best paid while serving. A lot of individuals join the military because they need the money and
join right after high school at an early age and lack the experience of job skills, education, and
civilian life experience resulting in this being the socioeconomic background for them.
Depending on when the Veteran was discharged, and the rank also plays a factor of what the
Veteran is awarded after discharge leaving some of the lower side of the spectrum. With the
Veteran being accustomed to the military life, adjusting to civilian life, structure and finding a
new job can lead to added stress leading other problems untreated and possibly increase the
chances of Veterans being homeless.
The delivery of mental healthcare services is severely affected by this gap for our
Veterans. Research team has found increased 11% of Veterans reported elevated rates of
depression, compared to non-Veterans. (Veterans Affairs, n.d) This rate if steadily increasing
over the years. On May 18, 2017 a man was sitting in his car and needed to clear his head. He
was hearing loud voices that was clamoring his brain and his mind spiraled out of control. He did
a U-turn and slammed his car into a crowd of people in Times Square killing a young woman
and injuring 22 others. This man was later identified as a US Navy veteran suffering from mental
illness. Stories and incidents like this happen every day and just aren’t broadcasted. (Suozzi,
2017) According to Suozzi, an average of 20 veterans commit suicide a day, and out of those 20,
only 6 of the can use the mental healthcare provided to veterans.
If this gap and issue within the mental healthcare for our veterans is not address, we are
going to continue to have danger to the general population, an increase in suicide, and a
revolving door for our Veterans that are desperately needing help. The most we can do is make
sure the services are provided to them since they gave their service to our country. Everything
will become a snowball effect if the issue is not addressed. Suicides lead to others being in
danger along with single family households that will then lead to in a disadvantage. There should
not be any reason why we have such a high rate of veterans that are homeless and aren’t
provided the healthcare they need from day-to-day. The United States and the VA need to work
on improving the system and not just doing the standard that is required of them, but also fixing
the issue and closing the gap.
REFERENCES
History of PTSD in Veterans. History of PTSD in Veterans: Civil War to DSM-5. (2018, August
17). Retrieved September 7, 2022, from
https://www.ptsd.va.gov/understand/what/history_ptsd.asp
Suozzi, T. (2017, May 29). How we fail veterans with mental illness. New York Post. Retrieved
September 7, 2022, from https://nypost.com/2017/05/28/how-we-fail-veterans-withmental-illness/
Depression treatment for veterans. Veterans Affairs. (n.d.). Retrieved September 7, 2022, from
https://www.va.gov/health-care/health-needs-conditions/mental-health/depression/