Communities around the world face health care issues; therefore, a need for the establishment of health care facilities is inevitable (Community Health Nursing, 2010). Extraordinary care services should be availed to every individual in society as far as the context of health care is in question. Government institutions and international organisations concerned with the welfare of the people should devote themselves and take the responsibility of providing high-quality health care services. This can be achieved by establishing facilities with modern equipment and skilled human resources in communities for easy access. However, it is important to involve other stakeholders in creating health care facilities rather than depending on government agencies entirely. Based on the critical background on the need for health care services in communities, this article will discuss in details construction of an efficient community health care organisation model to address the health issues.
Mission Statement, Vision and Values of the Agency
The community Health Care Agency is a committed organisation with a focused mission of providing high-quality health care services at favourable cost, respecting the dignity of the people for the betterment of all in the community including the disadvantaged and the have-nots. The organisation vision supports the mission statement. The system is determined and dedicated to maintaining the community culture and values. The health care agency in conjunction with other medical service providers will grow to be a prominent and integrated health care system in the community and the region. Through integration, the organisation will make the most of out of the opportunities to increase the growth, improve efficiency in operation, and more importantly realise capital resources effectively to serve the community, patients, employees, and physicians (Community Health Nursing, 2010).
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To achieve the mission of the organisation and accomplish the horizon of the vision, the organisation is guided by core values. These core values acts as the backbone of the operations carried out by the caregivers and other employees of the agency. Dignity is one of the core values. Every human being deserves to be treated with dignity because life is sacred and demands respect and fairness throughout the phases of existence. Another fundamental value in the system of the organisation is providing care services with unspeakable compassion. Compassionate care to the patients is the driving force to a better care provision thus upholding the degree of kindness, concern and exceeding the expectations of professionalism.
The community the organisation serves provides the third core value. It is the responsibility of the agency to meet the needs of the community and take the leadership initiative in improving the quality of health and life. The objective of the health care givers in the agency is to minimise the incidences of ailments through education, clinical services, and prevention (The Dartmouth Atlas of Health Care, 2016). Integrity is the fourth core value guiding the agency in delivering its mandate of quality health care to the people. Trustworthy of the stewardship and adherence to the highest code of ethical standards is not negotiable among the employees of the agency. There is absolute transparency in the execution of duties in the system involving the human resources, financial assets and material assets. The fifth core value is the quality proportion. The excellence of the organisation is dictated by the quality portion of its services. The quality desired by the general public is achieved by the combined efforts of every employee and other stakeholders who exceed what one individual in the organisation can accomplish alone.
Core Competencies of Community Health Care Professionals
In order to address the needs of the community as far as health matters are apprehensive, profound changes in designing health systems are required (Nardi & Petr, 2003). The social workers are at the heart of the implementation and execution of duties and responsibilities pertaining health care services. Consequently, this calls for a model made up of competent human resources with a plethora of experience in the field. To prepare and achieve utmost professionalism among health care professionals requires a common vision across all the concerned parties centred on a commitment to meeting patients' needs in the community. To this end, the model proposes all professionals ought to be educated and sensitised on delivering patient-oriented care emphasising practices that are evidence-based, application of improvement of quality approaches and informatics (Nardi & Petr, 2003). The following are general but simple core competencies applicable to all health professionals in the agency's health care system.
All clinicians should be able to provide care that is patient-centered. It is expected that caregivers have the ability to identify, care and respect patients' values, preferences, differences, and articulated needs. Moreover, they ought to have the capacity and methods of relieving pain and suffering; coordinate the provision of continuous care; attentively listening and effectively communicating to patients; share and manage decision making; and relentlessly advocate prevention of diseases, wellness, improvement and promotion of lifestyles that are considered healthy focused on population health (Nardi & Petr, 2003).
To ensure care is reliable and continuous the need for working together in necessary. Interdisciplinary teams should cooperate, communicate, collaborate, and integrate with each other with a common goal and aligned passions in the provision of quality health care to the patients and their families. The system should be integrated to achieve the goals of the organisation. Human resources hired in the system should be able to work in a team; therefore, interpersonal skills is a must have.
This model advocates for employment of practice that is evidence-based. Integration of appropriate research with the clinical expertise and optimum care for patient values creates a feasible scenario in the application of evidence-based practices. Also, research activities and learning should be encouraged to achieve optimum results in health care provision. This approach should be objective to the improvement of quality (Community Health Nursing, 2010). This means that risks and errors in the deliberation of care should be minimised at the lowest levels possible. The model understands and implements basic safety principles, such as simplification and standardisation. There are protocols to measure and determine the quality of care provided regarding structure, results, and processes in the relation to community and patient needs. Conversely, all clinicians should be able to utilise the informatics. Communication, mitigation of risks, management of knowledge, and decision-making processes should be done using information technology.
Duties of Professionals involved in Health Care Needs
The agency may have doctors or specialists taking care of the patients. Doctors are required to be good managers of health prevention and promotional programs besides their cardinal duties of clinicians. It is expected of the doctors to be competent in administration functions of the hospital, qualified trainers, and good researchers. Doctors have a noble responsibility to support other health personnel and operations in the entire health care facility.
Nurses provide essential support to the patients and doctors as well. They provide physical care whenever it is needed by the patients. Advising and supporting patients and their families it is their responsibilities. They are responsible for offering medication and more fundamentally they share the feelings and emotions to families and patients altogether.
Social workers are crucial in a health care setting as they help one in understanding what happens in the system. Any issues to be tackled, it is the duty of a social worker to help you out. These issues can be emotional, practical or socially. The main duty is to help patients and family members adjust to changes and experiences.
Physiotherapists and Occupational Therapists
The community health needs go beyond the doors of the hospitals. Occupational therapists are there to look at any changes needed by the patients at their homes, for example, handrails in the lavatories. Conversely, physiotherapist helps the patients to function as well as they can in their daily lives. The occupational therapists and physiotherapists most of the time work together with a common objective of helping people at homes.
Mortality is expected in a healthcare or hospital setting. Technically, it is a difficult time when a family lost one of their own through deaths. They may need emotional support during grief period. A trained bereavement counsellor can offer the much-needed support by people experiencing these feelings. They often work hand in hand with the team providing palliative care as they may support families of the patients before the actual occurrence of deaths.
The affairs of a hospital are not only centred on care provision but also involve other professionals who assist in the administration functions. These other professionals include accountants and secretaries (Nardi & Petr, 2003). Like discussed earlier, the integration of disciplines in the system will play a major role in the success of the health care agency. Regardless of their duties of managing financial tools in the facility, accountants are supposed to be conversant with hospital setting operations. The secretaries help in the coordination and preparation of minutes during board meetings and other clerical functions.
Health Needs Assessment Tool
Health needs assessment is a method for reviewing health issues systematically that faces a population. The systematic methods lead to agreed priorities and allocation of resources that improves the health standards and reduce inequities (Royse, Staton-Tindall, Badger, & Webster, 2009). In this particular health care model, practitioners pack tool is used to assess health needs in the community. This pack offers nurses with practical aid and guidance in undertaking health needs assessment of the community. The practitioner's pack provides advice and information on the stages of assessing needs, additionally, it helps the caregivers complete the process within a short period of time and realistically. Needs assessment of community health is a dynamic process rather than a one-off activity. It is a very vital process because it helps in planning health care and programs of public health in the future. The following are steps used in community health assessment:
Profiling: it is a process used by nurses to collecting relevant information about the state of health needs and health of a population. The information analysis of profiling identifies the major health concerns
The second step in this tool of assessment is making a decision on priorities for action.
Planning health care programs and public health is the third step to address the issues of priority.
The fourth step is to implement the activities planned
And the last step is an evaluation of the health results.
The need assessment enables nurses conducting the process to plan and provide the most effective care services to those in need, employ the principles of social justice and equity while in practice, and ensure allocation of scarce resources where the maximum benefit of health matters is derived (Community Health Nursing, 2010). What is more, enables a nurse to work collaboratively with other professionals, community and agencies to determine health issues that cause utmost concern and draw interventions to solve those issues.
The practitioner's pack applies a user-friendly dimension to community health needs assessment. Part one outlines the sort of information a nurse is required to think of when creating the community profile (Nardi & Petr, 2003). For the inclusion of each piece of information, a rationale is given. The second section provides practical advice on how a practitioner might get the information. The third section helps a nurse to make analysis and use information to decide on priorities and make action plans.
The use of resources in healthcare is highly localised in the United States. Most services of physicians are used by the Americans who are close to their premises. As a result, medical practitioners are affiliated with health care facilities near their practices. However, there are medical cases that most of the health care centres are beyond their abilities to handle due to reasons such as lack of operating medical equipment and diagnostic machines, lack of specialised skilled human resources or even the sensitivity of the malady of the patient. The community health care agency in this model is no exception to seek referral services from more established hospitals. Some of the referral services used by this healthcare agency are listed below:
Brookwood Medical Center (Birmingham, Al) is one of the Agency's referrals for patients who need intensive care. The Agency has no machines in place yet to take care of patients requiring medical care at an intensive level. With the help of the centre, patients can get high-risk operations for instance; kidney transplant operation can be carried out with minimal risks that the health care agency cannot afford to conduct.
Dale Medical Center (Ozark, Al) is a medical center with a fully equipped cardiovascular unit. The healthcare management uses the centre to refer patients with needs concerning heart complications. The health care facility is not well equipped to carry out operations concerning the heart.
UAB School of Medicine in Alabama is used by the health care agency to provide palliative care. The health care facility is not in a position to provide the community with palliative care services rather they use the UAB centre for palliative and supportive care as a referral. The elderly and the sick in the society are in dire need of palliative care that the community health care cannot provide.
Appropriate Ethical Guidelines in the Agency
The health industry is very sensitive and strict in matters concerning code of ethics. Health care professionals are defined by their commitment to adherence to the deep-rooted standard code of conduct (Community Health Nursing, 2010). Confidentiality is essential for health practitioners as far as relationship management with patients and other professionals are concerned. The dignity of the profession is determined the quality of the health care rendered and the manner in which it was rendered. It is a requirement of every employee of the health care agency to exercise high standards of honesty, integrity, and accountability. Medical profession calls for high degree of honesty and accountability because it is the lives of human beings are at stake. Being honest and competent in the profession helps the practitioner to win the confidence of his or her patients and the other stakeholders in the centre.
Another fundamental code of ethics that the agency should employ is respecting the rule of law. Avoiding issues that will put one on the wrong side of the law and that is the priority for every employee of the agency. False, deceptive or fraudulent activities are totally unacceptable within the agency (Community Health Nursing, 2010). The standards of the profession are not to be compromised at any given time as the management has put disciplinary actions in place, and dire consequences fall after that breaking the laws.
Interpersonal relationship is vital for any organisational setting for operations success and achievement of goals. The human resources are in the health care institution come from different cultural backgrounds and beliefs; therefore, interpersonal relations are to be maintained at a professional level. To achieve set objectives as an organisation team spirit is to be anticipated and it cannot be achieved if every employee is not at the same wavelength or of diverse passions.
Medical practitioners are required to practice, promote and protect the confidentiality of patient records and information (Community Health Nursing, 2010). The agency is responsible for maintaining information concerning patients and their families confidential and protects it from falling into the hands of malicious people. Advancement of coding knowledge and put into practice through continuous education can help protect the confidentiality of patient information.
Community Assessment Survey Instrument Recommended
This research in this model recommends written surveys and questionnaires as instruments to conduct community need assessment survey (Nardi & Petr, 2003). Written surveys inform of questionnaires can be conducted through emails or web pages. They are effective in collecting information from a group of community members in an event. The rationale for the recommendation of this instrument is based on the advantages accrued after using the survey method. Written surveys are helpful tools for information gathering during needs assessment process when the main objective is to have a cost-effective method to gather information from a large population. Apart from basing the recommendation on the cost, there are other advantages the agency can get from using the instrument to assess the community needs with respect to health. Questionnaires are appropriate to collect information and responses to a comparatively large number of questions which are specific to the point. Moreover, data collected can be summarised with much less ado. It is a formal method to collect responses, and its written nature can act as a future reference. The method allows respondents to maintain a high degree of anonymity thus respondents presumably give candid responses (Royse, Staton-Tindall, Badger, & Webster, 2009). However, the instrument has shortcomings that do not outweigh the advantages whatsoever. Gathering responses and information using questionnaires only apply to individuals who can read and write the language used in the questionnaire thus information from illiterates is overlooked by the method (Royse, Staton-Tindall, Badger, & Webster, 2009). This leads to insufficient data collected which consequently, resulting to wrong decision making.
Future Projection of the Position of the Agency
The agency has long term goals set in a projection of 5-10 years. In the contemporary world, technological advancement is taking place at an exceedingly fast rate. Considering this tremendous changes in place and the level of quality expected in the provision of health care to the community, it calls for a need to keep pace with the emerging trends. The management of the health care agency has plans to ensure in a period of 5-10 years the facility is fully equipped with modern machines and equipment to combat health issues affecting the community. Employment of skilled human resources in the agency is as imminent as it should be based on the community demanding needs. The facility plans to be the centre of a medical solution to the entire region and reduce the referral cases currently experienced in the healthcare.
The model has discussed the guiding mission statement of the community health care agency and the values expected to be applied to the employees and the management team in order to achieve the set goals of the organisation. It has gone further to discuss the needs assessment tool appropriate to use and methodology to carry out the needs assessment survey. The organisational structure has been represented diagrammatically in a flow chart. Moreover, the article has stipulated the ethical standards expected to be practised by the professional in the organisation.
Community Health Nursing. (2010). Community Health Care Agency, 23-31.
Nardi, D. A., & Petr, J. (2003). Community Health and Wellness Needs Assessment: A Step by Step Guide. Clifton Park, NY: Thomson/Delmar Learning.
Royse, D., Staton-Tindall, M., Badger, K., & Webster, J. M. (2009). Needs Assessment. Oxford: Oxford University Press.
The Dartmouth Atlas of Health Care. (2016). The Trustees of Dartmouth College: http://www.dartmouthatlas.org/data/region/