Healthcare EnvironmentLearning ObjectivesStudents will:Analyze current national healthcare issues/stressorsAnalyze the impact of national healthcare issues/stressors on healthcare organizationsAnalyze strategies for addressing national healthcare issues/stressors Learning ResourcesNote: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.Required ReadingsMarshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.Chapter 2, “Understanding Contexts for Transformational Leadership: Complexity, Change, and Strategic Planning” (pp. 37–62)Chapter 3, “Current Challenges in Complex Health Care Organizations: The Triple Aim” (pp. 63–86)Read any TWO of the following (plus TWO additional readings on your selected issue):Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians—Implications for the physician workforce. New England Journal of Medicine, 378(25), 2358–2360. doi:10.1056/NEJMp1801869Note: You will access this article from the Walden Library databases.Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN-prepared workforce goal. American Journal of Nursing, 118(2), 43–45. doi:10.1097/01.NAJ.0000530244.15217.aaNote: You will access this article from the Walden Library databases.Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231–245. doi:10.1097/NAQ.0000000000000303Note: You will access this article from the Walden Library databases.Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner–physician comanagement: A theoretical model to alleviate primary care strain. Annals of Family Medicine, 16(3), 250–256. doi:10.1370/afm.2230Note: You will access this article from the Walden Library databases.Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses' work settings, roles, and education preparation? Journal of Professional Nursing, 33(6), 400–404. doi:10.1016/j.profnurs.2016.11.005Note: You will access this article from the Walden Library databases.Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple Aim. Journal of the American Board of Family Medicine, 31(4), 588–604. doi:10.3122/jabfm.2018.04.170388Note: You will access this article from the Walden Library databases.Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14(56), 1–15. doi:10.1186/s12960-016-0154-3. Retrieved from https://human-resources-health.biomedcentral.com/t... Poghosyan, L., Norful, A., & Laugesen, M. (2018). Removing restrictions on nurse practitioners' scope of practice in New York state: Physicians' and nurse practitioners' perspectives. Journal of the American Association of Nurse Practitioners, 30(6), 354–360. doi:10.1097/JXX.0000000000000040 Note: You will access this article from the Walden Library databases.Ricketts, T., & Fraher, E. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874–1880. doi:10.1377/hlthaff.2013.0531Note: You will access this article from the Walden Library databases.Required MediaLaureate Education (Producer). (2015). Leading in Healthcare Organizations of the Future [Video file]. Baltimore, MD: Author. Review of Current Healthcare IssuesIf you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.To Prepare:Review the Resources and select one current national healthcare issue/stressor to focus on.Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting. QUESTION1 Write a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples. Assignment 1 Analysis of a Pertinent Healthcare IssueThe Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.To Prepare:Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.The Assignment (3-4 Pages):Analysis of a Pertinent Healthcare IssueDevelop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.Looking AheadThe paper you develop in Module 1 will be revisited and revised in Module 2. Review the Assignment instructions for Module 2 to prepare for your revised paper.

Diversity and Organizational CulturalDiversity is likely one of the most shifting and evolving concepts, influenced by situation and environment, thus reducing it to a fluid dogma. Diversity, as recognized through the lens of governance and leadership, is an anchor providing a point of reference in a changing social environment. While the expansive horizon of diversity can be witnessed in the once narrow view of race and gender, diversity today also embraces religion, gender (including life experiences), lifestyle choices, ideas, socioeconomic status, and sexual orientation and gives consideration to the social determinants of sickness and health. The climate of the healthcare organization must balance the ideals of diversity and cultural competency. Organizational culture encompasses a wide range of social phenomena and can be expressed in behavior, beliefs, values, and modes of difference and subversion. It is the philosophy of an organization. Culture is slow to develop and change, but it is essential for an organization’s culture to maintain a strong moral compass. Organizational culture affects all aspects of expectations and performance as well as customer and employee satisfaction (Spataro, 2005). As such, a supportive organization culture in a healthcare setting must be inclusive of diversity and cultural sensitivity and competency. Organizational culture establishes the guiding beliefs shared by members of the organization and is transferred to new members.Healthcare organizations face unique challenges due to the changing demographics of its members (employees) and the increasing diversity of society. The nursing shortage increases diversity in the workforce but exacerbates the challenges of cultural sensitivity and competence. This influx potentially creates an issue of organizational commitment (OC) among the existing professional staff, which challenges the loyalty to the organization. A challenge for the strategic human resource management (SHRM) is the ability to assess and maintain OC within its professional staff (McNeese-Smith, 2001). Read the article titled “Nursing Shortage: Building Organizational Commitment among Nurses.” Nurses from around the globe migrate to countries experiencing a shortage of healthcare professionals, seeking professional opportunity and personal growth. This influx of multicultural integration creates pressure with healthcare professionals and the efforts to deliver care. The divergence of sickness and health combined with culture, religion, and language must be considered. In addition, as healthcare struggles to meet the needs of a diverse patient population with respect to cultural competency, it must also meet the patient’s demands with a care provider, which is amenable to their culture and expectations. References:McNeese-Smith, D. (2001). A nursing shortage: Building organizational commitment among nurses. Journal of Healthcare Management. 46(3), 173–186.Spataro, S. (2005). Diversity in context: How organizational culture shapes reactions to workers with disabilities and others who are demographically different. Behavioral Sciences and the Law, 23, 21–38. doi:10.1002/bsl.623Organizational Commitment Healthcare organizations are challenged with maintaining an effective workforce. The dearth of qualified healthcare professionals is most recognized with the nursing shortage created by an increased demand for health services and an aging population resulting in the retirement of health professionals. This nursing shortage increases professional performance pressures and introduces a competitive environment for the existing workforce seeking the highest wages and benefits. In addition, this shortage also provides an incentive for foreign-educated nurses to gain lucrative employment through migration to the United States. The overall effect of the resulting pressures challenge the notion of organizational commitment.‹123›Additional Materials From the South University Online Library, read the following: McNeese-Smith, D. (2001). A nursing shortage: Building organizational commitment among nurses. Journal of Healthcare Management. 46(3), 173–186. Retrieved from http://www.biomedsearch.com/article/Nursing-Shortage-Building-Organizational-Commitment/75373174.html From the Internet, read the following: Spataro, S. (2005). Diversity in context: How organizational culture shapes reactions to workers with disabilities and others who are demographically different. Behavioral Sciences and the Law, 23, 21–38. doi:10.1002/bsl.623Globalization of HealthcareThere is little doubt that healthcare is the “Grand Business,” and its ability to adjust and realign to, identify, and seize the opportunity for growth and profit is unmatched. The genesis of innovation in healthcare is served by the free market concept. Many recognize the US healthcare industry as second to none with respect to innovation, quality, and outcomes. To support this fact, there is a long history of dignitaries and statesmen who seek healthcare at leading teaching institutions in the United States. To further this point, leading healthcare organizations in the United States have established international care centers designed to provide care to this select population. A number of leading healthcare organizations have established satellite healthcare facilities, which provide care at locations around the globe. This globalization of healthcare services interconnects the world but poses cultural challenges. The western medical education has some challenges in other cultures and the conceptual idea of globalization in healthcare can present a countercurrent of diversity. The ideas of diversity and difference rest within the individual as well as how he or she perceive their difference and barriers. By no means is it inferred that the issue or idea of diversity does not exist. It, in fact, is real and a challenge for many for a multitude of reasons.There is an estimated global healthcare workforce shortage of almost 4.3 million consisting of physicians, midwives, nurses, and other professionals. This shortage has spurred the migration of healthcare workers from around the globe to the United States. Healthcare professionals pursue opportunity through the migration process, seeking education, training, compensation, and quality of life. However, while the migration patterns might alleviate the problem for the host nation, they could exacerbate the problems for the country of origin, increasing the healthcare and disease burden. To address the shortage of health professional, education programs and the development of new programs must be a priority. Satellite Healthcare ServicesThe United States is renowned for its excellence in healthcare around the globe. Dignitaries and Royalty have been known to access healthcare through international care clinics at leading healthcare centers in the United States. Many of the foremost teaching healthcare organizations offer international care to the world’s elite. These facilities are present, but most people never have the opportunity to have knowledge of the facilities for privacy and security reasons. Individuals from around the globe visit international care centers for specific care. There facilities are designed to cater to healthcare needs for the international client. A partial listing of healthcare organizations offering international care are Mayo Clinic, Cleveland Clinic, Massachusetts General, Slone Kettering, Johns Hopkins, and a host of others. Many facilities specialize in specific medical need areas. In more recent years, geography has played a role in international care venues. Great Britain has been increasing its capability of elite international healthcare and is a matter of convenience for some European dignitaries.In addition, some healthcare organizations have established satellite facilities around the globe. These facilities provide healthcare to millions abroad. A partial listing is given below.Review each image to know more about some leading healthcare organizations that have established satellite healthcare facilities that provide care to millions around the globe. Location: Abu DhabiDescription: This hospital covers over thirty medical and surgical specialties. Moreover, it is equipped with 364–490 expandable beds. Location: Dubai and Saudi Arabia’s capital, RiyadhDescription: This hospital promotes international consulting services. Location: China, Colombia, Brazil, and Saudi ArabiaDescription: Sun Yat-Sen University (SYSU) and its affiliated hospitals in Guangzhou, one of China's leading academic medical centers, partnered with Saudi Aramco on Johns Hopkins Aramco Healthcare. This hospital has collaborations in Peru, Colombia, and Brazil. Location: China, Ireland, Italy, and KazakhstanDescription: China: Pathology consults and healthcare collaborationIreland: Cancer centerItaly: Transplantation, radiotherapy, biotechnology, and preventative medicine centersKazakhstan: Oncology center Additional Materials From the Internet, read the following: Bieski, T. (2007). Foreign educated nurses: An overview of migration and credentialing issues. Nursing Economics, 25(1), 20–34.Stilwell, B., Diallo, K., Zurn, P., Dal Poz, M., Adams, O., & Buchan, J. (2003). Developing evidence-based ethical policies on the migration of health workers: Conceptual and practical challenges. Human Resources for Health, 1(1), 8. Healthcare Ideals and MulticulturalismThe healthcare professional shortage dominates the healthcare industry and is worldwide, furthering the globalization of healthcare ideals and multiculturalism. The supply of healthcare professionals falls far short of the increasing demand in the United States and around the globe.The migration pattern of healthcare workers is dynamic and creates an imbalance between countries of origin and host countries. In many countries, the departure of healthcare professionals creates a dearth of talent considered a “braindrain,” which exacerbates a concern and increases the number of vulnerable populations (Bieski, 2007). Foreign-educated nurses working in the United States comprise approximately 5percent of the nursing workforce.This migration of skilled healthcare professionals, directly and indirectly, affects the health system. Its consequences not only affect healthcare delivery and outcomes but also affect the remaining workforce of healthcare professionals. The portion of the workforce that doesn’t migrate remains poorly paid, poorly equipped, and limited in quality supervision and information transfer and experiences stress. On an interesting note, not all countries view the loss of nurses through migration as a detriment. Some countries view the exportation of nurses overseas as new growth opportunity, with nurses repatriating money to assist struggling families remaining in their country of origin (Stilwell, 2003).It is important to understand that the United States is not the only country faced with an aging population, among other problems. It is also important to recognize that the aging population contributes to the problem, with healthcare workers departing the workforce through the process of retirement. References:Bieski, T. (2007). Foreign educated nurses: An overview of migration and credentialing issues. Nursing Economics, 25(1), 20–34.Stilwell, B., Diallo, K., Zurn, P., Dal Poz, M., Adams, O., & Buchan, J. (2003). Developing evidence-based ethical policies on the migration of health workers: Conceptual and practical challenges. Human Resources for Health, 1(1), 8.Additional Materials From the Internet, read the following: Bieski, T. (2007). Foreign educated nurses: An overview of migration and credentialing issues. Nursing Economics, 25(1), 20–34.Stilwell, B., Diallo, K., Zurn, P., Dal Poz, M., Adams, O., & Buchan, J. (2003). Developing evidence-based ethical policies on the migration of health workers: Conceptual and practical challenges. Human Resources for Health, 1(1), 8.QUESTION:The nursing shortage is a global problem, which affects the host country and the migrating nurse’s country of origin. Please develop a response discussing the motivation for nurses to migrate and the problems migration creates for the host country and country of origin.Describe the process for foreign-educated nurses to achieve credentialing and demonstrate language competency in the United States.To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.