Write an answer based on this essay, do not answer one by one, just in general. use at least 2 references but not the same that appear here. 1. In the last century, what historical, social, political, and economic trends and issues have influenced todays health-care system? The rapidly changing health care delivery system is driven by many forces that are influencing the current movement toward improved quality and safety. Some of these forces include economics, societal demographics and diversity regulation, technology, healthcare delivery and practice, and environment and globalization. Economics: US health care delivery has been affected by many economic trends and issues. Businesses, government, and the media decry the cost of health care within the United States when compared with that of other developed nations (Whitehead, D., & Weiss, S. 2010). The cost of research and the cost to develop new treatments and technology are rising. Educated consumers will expect safe, quality care with associated satisfaction and health outcomes. Societal demographics and diversity, increased numbers of racial and ethnic groups will influence health care delivery. Increased numbers of elderly people increase lifespan and improvements in technology mean an emphasis on specialized geriatric care. Both the elderly and ethnic minority are at risk population who suffer disadvantage in access payment and quality of care. 2. What is the purpose and process of evaluating the three aspects of health care: structure, process, and outcome? A Continuous Quality Improvement evaluates three aspect of health care: the structure within which the care is given, the process of given care, and the outcome of that care. Structure: refer to the setting in which the care is given and to resources that are available. There are aspects of the health care organization that can be evaluated: facility, equipment, staff, and finances. Although none of these structural factors alone can guaranty quality care, they make good care more likely. Process: Process refers to the activity carried out by the healthcare providers and all the decision made while a patient is interesting with the organization. For example: setting of appointments, conducting a physical assessment, ordering a radiograph (Taylor, M. 2013). Each of these processes can be evaluated in terms of timeliness. When process data are collected a set of objectives, procedures, or guidelines id needed to serve as a stand or gauge against which to compare the activity. Outcomes: An outcome is the result of all the healthcare providers activities. Outcomes measures evaluate the effectiveness of nursing activities by answering such questions as: Did the patient recover? Outcomes standard address indicators such as physical and mental health, social and physical function, health attitudes, knowledge, and behavior. It is necessary to evaluate the process as well as the outcome to determine why an intervention such as patient teaching succeeds or fails. A comprehensive evaluation includes all three aspects: structure, process and outcome. 3. How does technology improve patient outcomes and the health-care system? Nurses must embrace technology and integrate it into their nursing practice. Technology will not go away. It will continue to transform health care delivery systems. Because of technology, individual and groups communicate in new ways; the way health care is delivery and acquired has changed. Nursing must continue to take a leadership role in the incorporation of technology in health care. Nursing informatics will provide the tools and skills to assist health care to move ahead in the ever changing world. Advances in technology may make vaccines for cancer and medications to prevent vascular disease available someday(Taylor, M. 2013). New organs and body parts that correct or improve function may be commonly accessible. It is conceivable that bloodless surgery will be performed and drugs without side effects will be developed. Computer programs and clinical simulator will be universally used for practice in health education. This all advanced technology will contribute to improve patient outcomes and health care system. 4. How can you intervene to improve quality of care and safety within the health-care system and at the bedside? To achieve safe patient care a culture of safety must exist. Organizations and senior leadership must drive change to develop culture safety blame free environment in which reporting of error is promoted and rewarded. A culture of safety promotes trust, honesty, openness, and transparency. Teamwork and involvement of the patient contributes to promoting a culture of safety. When a culture of safety exists individual providers do not fear reprisal and are not blamed for identifying or reporting error. Reported errors provide data and information necessary to understand why or how the error occurred, thus improving care and preventing harm. 5. Select one of the nonprofit organization or one government agency that influences and advocates for quality improvement in the health-care system. Explore the Web site for your selected organization/agency and answer the following questions: The National Patient Safety Foundations vision is to create a world where patients and those who care for them are free from harm. A central voice for patient safety since 1997, NPSF partners with patients and families, the health care community, and key stakeholders to advance patient safety and health care workforce safety and disseminate strategies to prevent harm. NPSF is an independent, not-for-profit organization. a) What does the organization/agency do that supports the hallmarks of quality? The Agency for Healthcare Research and Quality (AHRQ) is a U.S. government agency that functions as a part of the Department of Health & Human Services (HHS) to support research to help improve the quality of health care. It uses a system of quality indicators to determine the standards of quality health care and if a provider is meeting those standards(Tappen, R. M., Weiss, S. A., & Whitehead, D. K. 2004). These indicators are divided into four subcategories that each monitor a different aspect of health care quality. Hospital performance results based on these quality indicators are reported on an HHS site called Hospital Compare and are published in an annual AHRQ survey. However, as a research organization, the AHRQ lacks the authority to penalize organizations who receive low marks for the quality indicators. In addition to its quality indicators, the AHRQ publishes the results of its research as reports, toolkits or other resources for health care providers. One AHRQ project, for example, is a toolkit that helps standardize health information exchange and the storage of personal health information The AHRQs document helps provide a more streamlined approach to health information technology data storage and exchange. b) What have been the results of their efforts for patients, facilities, the health-care delivery system, and or the nursing profession? The health care sector in the United States consists of an array of clinicians, hospitals and other health care facilities, insurance plans, and purchasers of health care services, all operating in various configurations of groups, networks, and independent practices. Some are based in the public sector; others operate in the private sector as either for-profit or not-for-profit entities. The health care sector also includes regulators, some voluntary and others governmental. Although these various individuals and organizations are generally referred to collectively as the health care delivery system, the phrase suggests an order, integration, and accountability that do not exist. Communication, collaboration, or systems planning among these various entities is limited and is almost incidental to their operations. For convenience, however, the committee uses the common terminology of health care delivery system c) How has the organization/agency affected facilities where you are practicing and your own professional practice. The health care sector in the United States consists of an array of clinicians, hospitals and other health care facilities, insurance plans, and purchasers of health care services, all operating in various configurations of groups, networks, and independent practices. Some are based in the public sector; others operate in the private sector as either for-profit or not-for-profit entities. The health care sector also includes regulators, some voluntary and others governmental. Although these various individuals and organizations are generally referred to collectively as the health care delivery system, the phrase suggests an order, integration, and accountability that do not exist. Communication, collaboration, or systems planning among these various entities is limited and is almost incidental to their operations. For convenience, however, the committee uses the common terminology of health care delivery system Reference Whitehead, D., & Weiss, S. (2010). In Essentials of nursing leadership and management (5th ed.). Philadelphia: F.A. Davis. Tappen, R. M., Weiss, S. A., & Whitehead, D. K. (2004). Essentials of nursing leadership and management. Philadelphia: F.A. Davis. Taylor, M. (2013). Shared governance in the modern university. Higher Education Quarterly, 67(1), 80-94.