The model trends in the healthcare system have been changing over the period of time. The old trend gave importance to the individual patients and the emphasis was on treating illness. The goal of the hospitals was to do inpatient admissions, fill up the beds and more emphasis was given to acute inpatient care. The role of managers in the old paradigm was to run the organization and coordinate services. In the old system, all providers were essentially the same. The hospitals, physicians and health plans were separate and not integrated.The newer trends that evolved gave importance to the population as a whole. It not only treated illness, but emphasized on promoting the wellness of the people. The goals of the healthcare system after being transformed over the years is to provide care at all levels which is continued. The role of managers in the new paradigm is more broad. They see the market and help in quality and continued improvement. They not only run the organization, but also go beyond the organizational boundaries. In the evolving system, the providers are differentiated according to their ability. The hospitals, physicians and health plans have formed an integrated delivery system.One of the current trend in the healthcare delivery model is that continued care is emphasized. The key professionals are not only treating patients for their illness, but they are promoting and managing quality of health. For example, a patient with high cholesterol visits a doctor. He is not only given one-on-one medical treatment, but he is also offered to attend a group session where information is provided on how lifestyle and behavioral change can help. The patients learn from the clinicians and also from each other. Another current trend is to take care of the health of the defined population and not only individual patients. All the health needs of the population as a whole are identified and served. It is emphasized that the community uses the health and social services provided. Healthcare has become more population-based. Another trend that has evolved is that the hospitals, physicians and health plans have got connected and have formed an integrated delivery system. More investments are being made with a goal of providing services to the customers and retaining them.There is a beneficial impact in the transformation of healthcare towards emphasizing continued health. The way healthcare has been viewed in the past has been changing. The shifting of care from treating acute illnesses to providing continued care is resulting in enhancement of the health of the people. The only appropriate and feasible model is to provide a continuum of care with the emphasis firmly on the family and community. The health of the population and community is considered as a whole. This is advantageous as it creates value in the healthcare delivery system. The healthcare providers work with the community as a whole and consider to improve the health of the general population. Even though this requires new kinds of ways of organizing and managing healthcare services, it helps in understanding the health needs of the target population. By studying their needs, the right health and social services could be provided to them. Examples of promoting wellness of the whole community are organizing health campaigns and providing preventive education to the people in general. Another example is providing awareness about flu vaccines and encouraging people to get the vaccination.Integrating the healthcare delivery system has led to certain advantages to the patients. For example, they can be offered alternative sites of care depending on their convenience. It helps in meeting the needs of the customers and their preferences which is taken into account. The number of providers are expanded and the patients get to have a choice. The relationship between providers and health plans are organized in the current trend and this ensures that the right care is provided in a convenient way to the customers.There are defined budgets and expenditure targets for the populations which implies that there is a need to be efficient and productive. The formation of strategic alliances, networks, systems and physician groups can also add value. There are capitated payments and budgets allotted to the healthcare organizations. These are used to provide care to the defined population. The organization might like to improve on the payments and budgets as the expenditures of the companies increase. This results in the management to make decisions like forming strategic alliances with other organizations and increase the total resources. The growth of such networks will help in providing better care to the customers. Financial resources greatly influence the efficiency and productivity of the organization.The aging population is influencing the healthcare delivery. There is increased demand for primary care of people over 65 years and for chronic care of people over 75. The ethnic and cultural diversity is also influencing the healthcare delivery. This provides a challenge in meeting patient expectations on one hand and diverse workforce on the other. Biological and clinical sciences have met with technological advances and have led to new treatment modalities. This has led to open new treatment sites and manage across the organization. External forces change the supply of certain areas of health professionals like physical therapy and some areas of nursing. The management needs to compensate for such shortages and they need to develop different teams of caregivers at different work sites. Changes in education of health professionals implies that the management be more creative in offering healthcare services. With an increase in diseases like AIDS and morbidity from drugs and violence, there is more and more need to work with community agencies, form social support systems and there is a need for more chronic care management. Advances in information technology is another area where there is a need to train the healthcare employees in new advances. They also need to manage issues of confidentiality and rapid information transfer. Increasing expansion of world economy has led to more competitive management of strategic alliances, care of patients across the nations and of different cultures.Current environmental trends impact the healthcare delivery model. Organization’s success depends on its external and internal environment. The complex environments made up of uncertainties and heterogeneity of components leads to different organizational designs. The current environmental trends influence managerial and organizational decision making. The unique challenges facing the healthcare delivery organizations should be analyzed in order to develop and implement new and effective operational processes and strategies. As an impact of current environmental trends, the healthcare delivery system needs to improve individual, team, and organizational accountability and performance. The impact of advances in medical knowledge and information technology on the process of healthcare delivery should also be examined, and it should be leveraged to improve quality of care, process and cost controls, and revenue. New strategies would need to be identified and implemented for learning and performance improvement to create a culture that supports accountability, safety, and high-quality care. Innovative models in healthcare delivery would also be required in order to develop and implement strategies that promote organizational success and competitiveness.Due to the current environmental trends, more emphasis is given to the customers and there is more of a patient-focused care. The healthcare delivery model has been shifting to the community based care. There has been an increased modification in care processes. The traditional ways are being challenged and more experiments are being performed to fulfill the demands to improve the quality of care. Due to the shift in the environmental trends in the healthcare delivery model, more emphasis is given to quality improvement. This will help improve the performance levels of key processes in the organization. The performance levels are being measured, the defects are eliminated and new features are being added to meet the customer’s need efficiently.There is a new emerging contemporary trend in the U.S. healthcare system. Presently, the management research and assessment have been offered increased recognition. The emerging trend seen is that this is slowly forming an integral part of managerial and organizational effectiveness. With the emerging efforts in information management, it is leading towards clinical and financial networking. The trend seen among the physicians and nurses is that they are being increasingly involved in managerial activities. The managerial trends are also changing with respect to role performance and changing values. The managers role is getting more and more recognized in managing finance and human resources. Management training, lifelong and distance learning is being offered in preparing future managers.The healthcare executives and managers will be faced with the major responsibility and challenge in the years ahead. They will be working with other healthcare providers and will be creating a competitive future for their organizations. They will not only be managing organizations but also a network of markets, services and joint ventures. Formation of more and more strategic alliances and partnerships will lead the management to manage across boundaries. The management will change from managing a department to managing the continuum of care. The management will be following a community-based approach. Trend in management is also shifting from just coordinating services to providing improvements in quality.As the demands in healthcare are increasing, the management is responsible for forming performance standards. The management is also challenged to maximize the productivity and quality to serve the health needs of the community. The management is looking after the demands of the external environment as well as attending to the performance of the internal environment. The management is responsible for the performance of the organization.Healthcare organization leadership will be responding to new trends and competitive forces. It will respond to continuum of care, overall health status of the population and more complex organizational structures. These emerging trends in the healthcare system will effect the organization’s leadership. The future managers would need leadership skills and vision to integrate the organizations and help in providing the best care. The managers will have to be committed to leadership and work on giving their organizations the best place and help their organizations adapt to the changing circumstances. More value will be given to leaders who will be able to lead the change process. As changes are inevitable for the betterment of the organization, the leaders should be able to identify how the change is to be received and how it is to be communicated at all levels of the organization without damaging the implementation process. The leaders might have to deal with increased pressures due to organizational complexity.The leader in the organization provides strategic direction to the organization, manages diverse stakeholders, becomes mentors for management, is willing to take risks, helps the organization interact with the external environment and attends to the internal needs as well. Where required the leader will involve physicians in governance process and align physician and organizational interests. There will be a need for formation of learning organizations. Transformational leadership will create the required vision for the organization. Leaders will have a greater role complexity and they themselves will have to adjust rapidly to new situations. The healthcare organization leadership will have to live up to the values of the organization and will help in fulfilling the mission of the organization.Individuals and groups within the healthcare organizations require more and more competencies. An enhanced lifelong learning is required due to the fast, changing environment. The individuals and groups within the healthcare organizations will be benefitted as there will be rapidly developing medical technologies which will result in increased services. More sophisticated health services will be provided to the consumers. The range and quality of services provided will be regulated for the benefit of people requiring home care, long term care and ambulatory care. The anticipated future development will also result in the increased competition among the health services organization. The individuals and groups will be involved more and more with the community for issues like drug abuse, teenage pregnancy and violence.Individuals and groups will be faced with increased strategic planning and management in the healthcare organizations as there will be ever increasing involvement by the trustees and physicians. As the future environment in the organizations will be more complex, the individuals and groups in the healthcare organizations might feel more pressurized. They will need to serve the changing demands of the community as the population of elderly patients will increase. These individuals will require more professional training, increased levels of education and should be taking part in continuing education programs.Due to the anticipated future development in the healthcare organizations, those individuals and groups will be valued, who are adaptable, committed, are able to add value and embrace change. These individuals will be required to experiment more and help in redefining the mission and goals of the healthcare organizations.
Separation of Church and Politics
Most Christians want to go to church to worship and serve, not hear political dogma. Often, however, their attempts to worship are frustrated by religious leaders and/or members who feel that it is important to use the church as a political platform.We are accustomed to hearing news about the Separation of Church and State which is established by the first amendment of our constitution, but we seldom hear anything about ‘Separation of Church and Politics,’ which is unregulated. This is about the freedom to attend worship without being bombarded with single-minded political persuasion. Worshipers should not have to commit to a political party as a requirement of participation in a Christian organization.The first amendment of the US Constitutional mandates that, “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof… ” What that means has been debated in courts and Congress for over two centuries. More recently it has come to mean that freedom to pray or express religious ideas is restricted in public places out of respect for those who ascribe to different beliefs. At the same time as freedom of expression of faith is increasingly being restricted, the Conservative led government has increasingly worked to legislate morality as it is interpreted by a limited group of religious leaders.Some people who believe that they know the political mind of God tend to talk in Christian gatherings as if their opinion is the only one. Those that do not agree tend to feel alienated by the more vocal religious leaders, and as a result many are moving away from the church altogether. According to PEW Foundation the number of people who report hearing politics in their place of worship is decreasing, however there are still many people displaced by the rhetoric.Currently more and more people are saying that they are spiritual but not religious. According to the Pew Foundation, “the number of Americans who do not identify with any religion continues to grow at a rapid pace. One-fifth of the U.S. public – and a third of adults under 30 – are religiously unaffiliated today, the highest percentages ever in Pew Research Center polling.” http://www.pewforum.org/Topics/Religious-Affiliation/Unaffiliated/If you find yourself avoiding your church because of the political rhetoric, I recommend that you continue attending some place of worship. You may want to call potential churches before visiting and just ask, “Does your church support a particular political agenda?” And, “Do your pastor or Bible teachers discuss politics from the pulpit or in Bible study?” There are many grace-centered churches, grounded in the Bible, who respect every member’s right to think for themselves.
Miscellaneous Supplements – Sports
Structured Lipids- Increased Protein SynthesisAdvances in the technology behind lipid synthesis led to the development of structured lipids (SLs). A structured lipid (SL) is a triglyceride that includes both medium (8-12 carbons) and long-chain fatty acids (14-22 carbons) within the same triglyceride. Emulsions including SL have demonstrated increased protein synthesis and increased nitrogen balance (NB) in burned animals The SL has also been superior to medium-chain triglyceride (MCT) and long-chain triglyceride (LCT) emulsions in stimulating muscle protein synthesis in animal studies.The use of SLs has been primarily limited to clinical and experimental settings whereby it has become necessary to develop medical nutrition therapies that minimize the adverse effects of high lipid feedings and maximize the positive outcomes. Such positive outcomes include increased protein synthesis, enhanced immune function, decreased risk for cardiovascular disease, and improved glucose homeostasis. The ability to increase protein synthesis, maintain the health of the immune system, and stabilize blood glucose are factors that can also play a role in improving athletic performance. Research on the application of this clinical technology to athletic performance is not available at this time.Peptides- To Provide Glutamine to TPN PatientsIn an effort to provide glutamine to TPN patients in a form that can remain stable in liquid, the amino acid has been bonded with other amino acids, such as the dipeptide alanyl-glutamine. This combination can preserve muscle glutamine levels and muscle protein synthesis after surgery and improve whole-body nitrogen balance. This finding is supported by research on rats with peritonitis Alanylglutamine increased protein synthesis in the liver and skeletal muscle, protected the morphology of the intestinal mucosa, and improved survival in protracted bacterial peritonitis. The researchers concluded that alanylglutamine supplementation may be useful in septic patients.Role of Glutamine as Glucose RegulationThe role of glutamine regarding glucose regulation may be important in exercise-trained individuals. Its function in gluconeogenesis (formation of glucose) and glycogen repletion may serve as a useful function during and after exercise. Gluconeogenesis from glutamine can occur without changes in plasma insulin and glucagon levels, providing evidence that glutamine itself can regulate gluconeogenesis.Nurjhan et al. compared the contribution of alanine and glutamine to glucose formation in postabsorptive (fasted) normal human volunteers and found that the amount of glucose carbon that came from proteinderived glutamine was 100% greater than from alanine. Varnier et al. studied the effects of glutamine, alanine plus glycine, and saline infusion on glycogen accumulation in subjects who cycled for 90 minutes. Two hours postexercise, glutamine infusion resulted in a twofold greater concentration of muscle glycogen than either saline or alanine plus glycine infusion. In postabsorptive humans, glutamine could be more important than alanine for glucose formation derived from proteolysis. Further, glutamine carbon can be directed to glycogen accumulation in skeletal muscle that had been previously glycogen depleted.In mice that were genetically predisposed to being overweight and hyperglycemic, the administration of glutamine in conjunction with a high-fat diet resulted in a reduction of body weight and a drop in hyperglycemia and hyperinsulinemia. The mechanism for a glutamineinduced weight reduction is not known, though it may be related to the ability of glutamine to lessen the insulin resistance induced by a high-fat diet. Further, the administration of glutamine to lipid-based TPN can prevent glucose intolerance and insulin resistance.