In this journal article, (Thomas &Kottke, 2010) it is clear that there is poor health status in the US and the health costs are increasing constantly. Due to the above factors, there have been a call for payment based on performance system as this is believed to cause an improvement in the people’s health. This case study proposes that people be tested in various areas. According to (Thomas &Kottke, 2010), testing of the five behaviors namely smoking, the physical activity, nutrition, smoking, the levels of drinking and lastly the use of condoms by the youths who are sexually active. This is a step to a good health of the populations. The health service providers should provide health plans that will ensure that there are preventive measures that will make people minimize undertaking these behaviors.
Another suggestion is that an independent organization should be established to evaluate the performance of the healthcare in the eight county levels. This performance should be based on The health care expenditures that are incurred in the services delivery, the extent by which the insurance coverage have been embraced, the rates by which the medical, drug prescriptions and the dental requirements are meant, the rates at which the preventive services are delivered, the rates of the vaccination, most probably in the young children, the existing rates of hospitalizations that would have been preventable, the extent of affordability of the health services and lastly the disparities that exist in the healthcare as dictated by race and income,(Thomas & Kottke, 2010). In order to promote, having access to the work areas to evaluate the wellness when it comes to the health related matters is a wise activity. Through this, the health programs put in place are assessed. To add on the quality of the services offered by the clinical personnel’s, the provider of this service should be assessed to prove if he/she is a member of an organization that is accountable.
The clinical service providers also require some encouragements. This can be done by assessing how the organization looks at the welfare of the community. This may be through community based programs, (Thomas & Kottke, 2010). There is lack of the clinical tools that can be used to measure to measure the effectiveness of the clinical services in the US. According to (Thomas & Kottke, 2010), this can be traced from historical developments of the American health services. The development is seen to evolve to mainly cater for only the acute needs of the patients. This include the relief of pain, carrying out therapies, diagnosis and reassurance. The fact that the clinical care covers a small area in the heath sector does not mean that it cannot promote the health of the population. The clinical service can formulate plans on health which may help in promoting the health of the population. This can also be done by promoting some health behaviours and facilitating preventive programs, (Thomas & Kottke, 2010).
Thomas &Kottke (2010) suggests for four strategies that the clinical care system should adapt. This are increasing numbers of the heathy behaviours and ensuring timely delivery of preventive services. Secondly, they can support a healthy lifestyle and increase the access to the medical services to the population. The third idea is ensuring cooperation among the clinical service providers. This will ensure that there is good communication among the service providers and this will impact positively the health of the population. The fourth step is giving the clinical service providers some incentives as this will make them carry out their functions efficiently.
Geletko et al, (2009) states that a volunteer health program was put into practice in 1992. The project is ineffective up to the present day although its level of success is still high. This was in an attempt to strengthen the safety net that was in existence. Due to this program, above one billion of people have been provided with the health services. This people do not deserve and are uninsured. Today, more than two hundred thousand volunteers participate in the program. According to (Geletko et al, 2009) volunteerism does not solve the health care crisis. Instead, it has served as a hindrance to better health care reforms. This have been attributed by the fact that there have been many malpractices in the program. At 2008, about 8 malpractices were reported to have taken place. However, the program has been a success.
In this program, the regional coordinators help in recruiting healthcare providers who fit in their area where they are qualified. The volunteer providers come and signs a two-page contract and outlines the patients that they may be willing to get the service and in need. The provider of the service is designated the role of an agent of the state and as a result, the agents are eligible for the sovereign immunity protection,(Geletko et al, 2009). In order to enjoy the service, the patients are evaluated to see if they are eligible and if they are so, they are taken to the healthcare provider. The services offered to the patients depend on the resources that come from the available volunteers.
When the health care providers are given strong incentives, they are able to participate effectively in the VHSP program. Inability to offer sovereign immunity discourages the volunteers and as a result they are fail to offer the assistance as thy fear occurrence of some malpractices. In the past fifteen years, there has been a significant sustainability. The program has been challenged by maintaining the interests of the volunteers,(Geletko et al, 2009).
This study aimed at looking at the impact of the of the VHSP program on the health sector. As per the observations, the program has assisted many personalities in securing health services at no cost as all the costs are meant by the volunteers. The major critics on this program arises in the matters relation to malpractices as reported in the past. This has made the program ineffective as in the end, those who are supposed to benefit from the same do not. The program is therefore irrelevant to them; this malpractice also sends the volunteers away. In conclusion, better policies are needed to ensure that there are no instances of this malpractices and as a result, the program will be more effective.
According to Hain & Fleck (2014) nursing practitioners plays an active role in ensuring continuous improvements in the health of the population. Nurses should always be provided with an environment where they can make the use of their education and training to the fullest. However, they encounter some barriers.
The first barrier is seen to come from the US government. The state controls the practices carried out by nurses through license and some laws that affect the nurses directly. For instance, the American Association of nurse practitioner stipulates the activities that nurses are supposed to carry out. This includes evaluating the patients, having diagnosis tests and interpreting diagnostic tests.
The next barrier arises from physician related issues. For instance, the American Medical Association in conjunction with the other personalities believe that Physicians are more experienced and have a broad training than the Nurse practitioners, (Hain & Fleck, 2014). They therefore say that nurses are not capable of providing quality and proper care like the physicians do. The payer policies have an impact of linking the nursing practitioners to the state rules and regulations, mainly through licensing. The restrictions in the practice have an impact of affecting the payer policies and tis may limit the nurses from practising independently.
To deal with this barriers, there should be adequate discussions to determine whether nurses are qualified just like the physicians. This should address whether the training provided will enable the nurse practitioners provide quality services in a cost effective manner. The nurses should also be provided with advanced education and practice in nursing as this will eliminate the doubts which make the concerns being raised about their qualifications, (Hain & Fleck, 2014).
In this study, it is clear that there are barriers to nurses practice. The barriers can be solved using various ways as discussed above.
Geletko, K., Beitsch, L., Lundberg, M., & Brooks, R. (2009). Reducing the Impact of the Health Care Access Crisis Through Volunteerism: A Means, Not an End. Am J Public Health,99(7), 1166-1169. Retrieved from: http://dx.doi.org/10.2105/ajph.2008.145623
Hain, D. & Fleck, L., (2014) “Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign” OJIN: The Online Journal of Issues in Nursing Vol. 19, No. 2, Manuscript 2, Retrieved from: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Barriers-to-NP-Practice.html
Thomas, E & Kottke, G. (2010). Peer Reviewed: Measuring Health Care Access and Quality to Improve Health in Populations. Preventing Chronic Disease, 7(4). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901571/