Week 2 you decide
What’s this?
Scenario/Summary
You are the chief executive officer of Southside HMO, which
serves 495,000 members throughout the eastern region of the United States. It
has come to your attention that several members or patients who participate in
your plan have filed a complaint that your HMO plan does not provide quality
healthcare delivery. Several patients have been denied healthcare services to
see specialists to whom they were referred by their primary care providers.
Your Role/Assignment
The board of directors has asked that you provide a 750-word
report detailing your strategies and recommendations to investigate the
complaints and to identify strategies to ensure that quality management
initiatives are in place to make sure that quality healthcare services are
provided to all members. The strategies and recommendations should be as
specific as possible and include the resources needed for implementation. Your
primary text and journal and website research must be used as a reference to
support your analysis.
Key Players
Review the points of view of the following people to obtain
further insights on this assignment.
Dr. Waters Primary Care
I have been providing healthcare to patients at Sunnyside
Hospital for 5 years, and the hospital recently started contracting in network
with Southside HMO. Southside is denying referrals to specialists for medical
treatment.
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Mrs. Brown Patient Advocacy Group Representative Sunnyside
Hospital
I represent patients at Sunnyside Hospital, and more than 30
patients have informed me that Southside HMO is not complying with primary care
provider referrals to see a specialist.
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Mr. Robins Mr. Robins CEO Southside HMO
I have been the CEO of Southside HMO for 10 years, and I
ensure that our organization is in compliance with all quality management
initiatives.
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Category Points % Description
Content 10 20 Content
is excellent, completely consistent, and appropriate for audience and purpose;
content contains excellent internal integrity; detail is rich and specific.
Organization 10
20 Organization is excellent;
ideas are clear and arranged logically and the transitions are smooth; there
are no flaws in logic.
Design and Format 10
20 Document format is excellent,
with strong visual impact, design, and format.
Style and Readability 10
20 Readability is excellent, with
strong attention to audience, appropriate tone and style, and good transitional
language; there is good use of figurative language.
Grammar and
References 10 20 Grammar,
referencing, punctuation, mechanics, and usage are correct and idiomatic,
consistent with Standard American English; content demonstrates competent use
of mechanics.
Total 50 A
quality paper will meet or exceed all of the above requirements
