Health Management in Long Term Care Focus On Reducing Health Provider Workload
Subject Area:Health Care
National Quality Strategies form one of the common strategy implemented by Norway, Denmark, and England (World Health Organization 20). The need for these countries to adopt NQS was to ensure that health care providers observe internal controls and quality improvements and regulations. Furthermore, WHO (23) notes that the idea behind the adoption of health quality management strategies was to ensure improvement in systems of care and reduction of workload among care providers. Health management focuses on six areas (Sheng-Lun 50); prioritization of quality, the involvement of leaders, the orientation of processes, measurement of performance, participation of employees, and focus on customers. Traditionally, Taiwan has seen a majority of women and families serve critical roles in the delivery of long-term maintenance amenities. While on the other hand, the total birth rate for every single, married couple has continued to decline more than the global rate.
Hence, a majority of families face trials of upholding maintenance for the ageing and long-standing care (Ferry par. Currently, the statistics show that Taiwan has 339,000 people that require long-term care needs. Out of these, 54. 1% are aged above 65 years. Research Methodology Sample and Data Collection The project will acquire primary data from three municipalities (Kaohsiung, New Taipei, and Taichung). Before collecting any data, however, the sample of the municipalities will be stratified based on their geographical locations and the population size. Currently, Taiwan has six towns; Kaohsiung, New Taipei, Taichung, Tainan, Taipei, and Taoyuan. The study will sample out small, medium, and large municipalities depending on the number of population of households. Furthermore, the study will also adopt an approach used by (Kjos et al.
In overall, the interview guide will have a total of 23 closed and 13 open-ended questions. I will record all conversations and transcribe the responses to allow coding and analysis. Interview Design The interview guide will use structured closed and open questions. In overall, the entire telephone interview will cover four sections. Section 1 will include five list questions that offer informants a list of questions. However, Saunders et al recommend that researchers can also design interviews to follow a series of statements while maintaining the order of categories. Section 3 will use a similar approach as used in section 1. Instead of allowing informants to rate items, the questions will be designed in a way to allow informants to select a multiple of responses among the closed questions.
The study will do this with the understanding that some informants are likely to select more than one response to the question. Proposed Data Analysis The study will use descriptive statistics to analyze primary data from the telephone interviews. For example, for crucial lists will include not coercing participants, the use of inducements like benefits and finances to make respondents participate in the study. The risks and freedom of informants will also help assess the overall research. Findings The current workload of health care providers The general workload of the Taiwan medical doctors and nurses is currently high with the use of the national health insurance system. All citizens of Taiwan are registered in the system and demanded to use it to access medication.
However, since the budget of the system is controlled and monitored by the political class and the government, the Taiwanese people can see the doctor without any referral and at any moment. This is so different to the public hospitals which only have the main doctor mandated with the major operation and two nurses aiding in the service delivery. Contrary to the health caregivers at the hospitals and the clinics, the Taiwan government through the National health insurance system, adopted a mechanism, top help in providing long-term health care services to the elderly. The long-term health care is provided to reduce the workload of the hospital, and clinic doctors and physicians’ and the services can be done at homes or the places of convenience for the elderly.
The current workload of the health care providers offering long-term health provision in South Taiwan varies significantly. To (Greenberg Np), the health care professionals are majorly concerned with practice, education, and research on the most appropriate health care services that will ensure that the elderly and the disabled people in south Taiwan live a more comfortable and healthy life like any other person in the country. The directorate of health of Taiwan specifies that the applicants for the care are mostly not employed and those employed have a considerably lower income (Hsu, S Np). It thus means that the health providers receive very low income. The applicants for the care services only pay for the services based on the level of incapacitation and their level of income.
With the growing number of elderly population in Taiwan, the need for more services to the population is increasing and the government is not catering for the increase in personnel. The workload is not evenly distributed based on the seniors who need more hours’ attention and those who need few hours. The disabled clients are given the health care providers by the government and the nongovernmental organizations to help them in close monitoring on how they can eat, spend their leisure and observe personal hygiene. Therefore, the general workload of the health providers in Taiwan varies depending on the kind of duties that the client needs. The clients in need of the nonmedical services are given a health care provider with a specialty in such a field.
However, the distribution of the healthcare providers is done by the nongovernmental organizations and other agencies working with the same to provide the services. The current workload is not evenly done since one health care provider is assigned more than one client when the client needs more than the allocated time to them. The other problem that health providers face in Taiwan in efforts to provide the service delivery is to do with the payment. The clients in need of the services are eligible to the services depending on the nature of their incapacitation and their income. The low earner or those with serious incapacitation pay less to the government for them to receive the services. As (Monahan 14), explains, the government together with other nongovernmental organizations employs the caregivers and deploys them based on the training they have on the client.
The payment they end up receiving is different from the amount of work they do to the patient. Since communication serves as an ultimate goal or path towards understanding a patient so that they can be best served, the problem with understanding them proves it hard for the nurses to give out their services effectively. The health care providers also face problems with little support from the national health insurance system, lack of clear job transfer and unclear job description or duties to the nurses. The care providers are not promised extra payments with the national insurance health care system regarding the kind of work they undertake. They also do not get clear job descriptions before being taken to the field to partake their duties.
It becomes hard for them to dispatch services effectively to their clients as they lack basic knowledge of what the clients need to what they can offer (Margolis 7). Apart from the heavy workload that comes with an increased number of patients. The health providers in South Taiwan are being faced with other problems such as the control of the fee premiums by the national health insurance system, selection of some services which are offered by the government and lack of control over the way the ratio of patients to the workforce is done. Strategies to reduce the workload Care attendants make up the significant personnel in the nursing homes for the elderly and the disabled. The issue of understaffing creates some mixed feelings in the caregivers that in turn bring out a lot of stress to them.
Work-related stress negatively affects the way they provide their services to the clients and how their relationship to their bosses and the general overview of their profession goes. Currently, the salaries paid to the health caregivers per month range from NT 15,000 to 30,000. Most of the health care providers suggest that they are not enjoying the salary with some of them feeling happy about the salary. However, a considerably good number state that they received were trained before they began the job with others suggesting that they are not trained before being employed. However, all indications show that the caregivers who work in the nursing hospitals attend to about ten beds which is a heavy workload for them. All these indicators imply that; for the services to be improved, the caregivers should be paid reasonably and that the workload should be reduced.
The new system should work in attempts to automate the service delivery service instead of relying on oral service delivery or paperwork done by the healthcare service providers. To improve the working environment, there should be an investment in the technology that requires the highest level of management and leadership, change in the structure and culture of the organizations to bring about a desirable change in the health sector. Project Results Health care provision in long-term care has become too challenging in Taiwan due to increasing cases of several factors that hamper the service delivery by the health care providers. Several initiatives have been brought about to deal with the menace by different countries including which is currently registering a large number of patients suffering from chronic ailments and those of old age.
The measures that are being adopted include improvement in the provision of quality healthcare, reduction in the workload among others. The care providers are then contracted to offer the service to the clients from the nongovernmental organizations and the nursing homes. The current workload of the caregivers is so huge since most of the clients have large needs that need to be sorted out and their source of income is mostly low. The Taiwan health providers face several problems in efforts to provide health services. The primary concern is to do with payment. The clients in need of the services are eligible to the services depending on the nature of their incapacitation and their income. As (Curry L 45) asserts, little education on certain issues like failing to learn a certain language that the client uses makes it hard to provide adequate medical services to the client.
Pre-job pieces of training to the health caregivers should be geared towards addressing such issues so that the clients get satisfaction for the services they receive. After training, the nurses should be consulted on their specialized areas of interests before they are posted there so that the elderly and the disabled receive the most effective quality services that they require. However, new integrated technological devices like telehealth should be used in the health system to improve the quality of health and how the long-term health care providers do their work. Works cited Bente Ødegård Kjøs, Grete Botten, Tor Inge Romøren. Journal of Gerontological Nursing. p. 45 Esmond J. Bowers B (2013). The relationship between staffing and quality in long-term care facilities: exploring the views of nurse aides.
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