Activity 8 Regulatory Environment  Explain how healthcare exchanges change the concept of outpatient treatment.  Many clinical information systems now embed practice guidelines and clinical pathways into their electronic medical record systems.  Discuss some of the advantages and disadvantages of this.  Describe demand management and how it can increase consumer involvement in care.  Compare and contrast disease management and case management.  Reading and Resources Ferrier, G. D., & Trivitt, J. S. (2013). Incorporating quality into the measurement of hospital efficiency: A double DEA approach. Journal of Productivity Analysis, 40(3), 337-355. https://search.proquest.com/docview/1448800469?accountid=169658 Search the site for US Department of Health and Human Services “Hospital Compare” and use the interactive database to compare and contrast health plans, hospitals, etc. How might you use this site with patients as a case manager? Chapter 16 pages 297-316, Chapter 23 pages 395-404, Chapter 20 pages 367-375, Chapter 26 pages 439-447 in Fundamentals of Case Management Practice. Review clinical guidelines of the AHRQ Pizzi, Michael A,PhD., O.T.R./L. (2014). Promoting health, wellness, and quality of life at the end of life: Hospice interdisciplinary perspectives on creating a good death. Journal of Allied Health, 43(4), 212-20. Annicka G M van der,Plas, Vissers, K. C., Francke, A. L., Donker, G. A., Jansen, W. J. J., Deliens, L., & Onwuteaka-Philipsen, B. (2015). Involvement of a case manager in palliative care reduces hospitalisations at the end of life in cancer patients; A mortality follow-back study in primary care. PLoS One, 10(7) Meyer, Star,R.N., B.S.N. (2012). Care management role in end-of-life discussions. Care Management Journals, 13(4), 180-3. Review the National Committee for Quality Assurance certification criteria. Additional Instructions: All submissions should have a title page and reference page. Utilize a minimum of two scholarly resources. Adhere to grammar, spelling and punctuation criteria. Adhere to APA compliance guidelines. Adhere to the chosen Submission Option for Delivery of Activity guidelines. Submission Options: Choose One: Instructions: Paper 4 to 6-page paper. Include title and reference pages. Microsoft PowerPoint Presentation 8 to 10 slides. Add title and reference slides. Follow Rules of 7. Other media (Prezi, etc.) presentation 8 to 10 slides with speaker notes. Add title and reference slides. Follow Rules of 7. Video Presentation 5 to 8-minute video presentation. Attach reference page or include in video. Professional appearance and background. Video submissions must include a script in Word format, submitted through Turnitin for an Originality Report. Table Table with appropriate columns and headers. Include title and reference pages. Graphs or other illustrations Graphs or illustrations with appropriate labels. Include title and reference pages. Poster Poster utilizing any applicable poster template. Include visual graphics/images/other formats for visual appeal. Include appropriate title and references on poster.

3-year-old Sally decided to throw a temper tantrum, holding her breath, and stomping her feet. However, it is known that she can only hold her breath for a limited time before she will involuntarily begin to breathe again. Describe the feedback mechanism and anatomical structure that initiates involuntary breathing. Include how an increased level of CO2 affects this mechanism. For example, does pCO2 increase or decrease? Does pO2 increase or decrease? Does H+ concentration increase or decrease? What triggers Sally’s respiration?