Posted: May 1st, 2025

assigment

This week, you will begin integrating your additional research and feedback received from your peers to update and consider improvements to the continuum of care for the settings outlines in your initial Community Profile and Continuum of Care document.

To prepare for this Assignment:

Refer to your Community Profile and Continuum of Care document that you developed in Week 2 and return to your continuum of care scenario.

Return to your Improvement Plan: Part 1 document, which you should have downloaded in Week 3 and continued to update during the past 2 weeks.

Revisit the peer-review feedback that you received during the past 2 weeks and update your Improvement Plan based on the feedback you received.

  • By Day 7
  • Submit your Improvement Plan: Part 1 to address the following:
  • Summarize the original continuum of care plan submitted in Week 2, as well as the healthcare settings that you identified.

Summarize the feedback that was provided to you for each week from your colleagues.

Incorporating your peer-review feedback, propose at least one improvement for each of the following value-based care elements and IOM Aims.

  • Week 3: Organize care around medical conditions
  • Week 3: Be patient-centered

    • Week 3: Measure outcomes and cost for every patient
    • Week 3: Be effective
    • Week 4: Aligning reimbursement with value

    Week 4: Be safe

    • Compare your community’s model of healthcare delivery to the delivery model of other countries that closely align with the following value-based care elements, including an explanation of what lessons—positive or negative—your community could learn from the other countries:
    • Week 3: Organize care around medical conditions
      Week 3: Measure outcomes and cost for every patient
      Week 4: Aligning reimbursement with value

    • Provide a summary and conclusion for your paper.

    1
    Health System Delivery Improvement Plan: Part 1
    Student Name
    Master of Health Administration, Walden University
    WMBA 6602: Contemporary Topics in the U.S. Healthcare Delivery System
    Instructor Name
    Month XX, 20xx
    2
    Title of the Paper in Full
    In this paragraph, write three to five sentences as an introduction to your paper.
    Throughout this document, be sure to include in-text citations to support your work. Any in-text
    citation should also be included—formatted as full references—on the reference page at the end
    of the document. The entire paper should follow the formatting guidelines of the APA 7th
    edition. For this document, you should expect to include at least four references.
    Review of Community and Original Continuum of Care Plan
    In this section, write three to five paragraphs that summarize the original continuum of
    care plan submitted in Week 2. Be sure to include in-text citations to support your work. Any intext citation should also be included—formatted as full references—on the reference page at the
    end of the document. The entire paper should follow the formatting guidelines of the APA 7th
    edition.
    Description and Analysis of the Community
    In this section, summarize the information identified in the heading in three to five
    sentences about the community that you originally described in your Week 2 paper. Be sure to
    include in-text citations to support your work.
    Social Determinants of Health for the Community
    In this section, summarize the information identified in the heading in three to five
    sentences about the community that you originally described in your Week 2 paper. Be sure to
    include in-text citations to support your work.
    3
    Leading Causes of Death for the Community
    In this section, include two to three paragraphs that describe the leading causes of death
    for your assigned community. Be sure to focus on the cause of death that you were assigned, as
    well. Be sure to include in-text citations to support your work.
    Healthcare Settings in the Community
    In this section, in four to five paragraphs, summarize the healthcare settings that you identified in
    your Week 2 paper submission to address the health issue and related diagnosis assigned that is
    related to one of the top five leading causes of death. Be sure to include in-text citations to
    support your work.
    Health System Delivery Improvement Plan – Part One
    In this section, summarize the information identified in the Level 1 heading in three to
    five sentences that deals with the health system delivery improvement plan related to valuebased care. Be sure to include in-text citations to support your work.
    Week 3: Value-Based Care and Organized Care Around Medical Conditions (Element 1).
    In this section, in three to five sentences, provide an overview of this week’s topics.
    Synopsis of Peer-Review Feedback
    In this section, summarize the feedback that was provided to you from your colleagues
    regarding the improvements based on value-based care, the improvements based on the IOM
    Aims, and recommendations and lessons learned based on country comparisons. Explain which
    aspects you incorporated into your Improvement Plan and/or which aspects you did not
    incorporate. If they provided in-text citations to support their recommendations, be sure to
    provide those references as well.
    Recommended Improvements Based on the Value-Based Care Model
    4
    In this section, propose at least one improvement for your assigned community based on
    the following element of value-based care: “Organize delivery of health care based on medical
    conditions.” Be sure to include in-text citations to support your work.
    Recommended Improvements Based on the IOM Aims
    In this section, propose at least one improvement for your assigned community based on
    the following IOM Aim: “Be patient-centered.” Be sure to include in-text citations to support
    your work.
    Country Comparison Based on the Value-Based Care Element
    In this section, summarize the information identified in the heading in three to five
    sentences, focusing your comparison of another country based on the following value-based care
    element: “Organize delivery of health care based on medical conditions.” Be sure to include intext citations to support your work.
    Week 3: Value-Based Care by Measuring Outcomes and Costs for Every Patient (Element
    2)
    In this section, in three to five sentences, provide an overview of this week’s topics.
    Synopsis of Peer-Review Feedback
    In this section, summarize the feedback that was provided to you from your colleagues
    regarding the improvements based on value-based care, the improvements based on the IOM
    Aims, and recommendations and lessons learned based on country comparisons. Explain which
    aspects you incorporated into your Improvement Plan and/or which aspects you did not
    incorporate. If they provided in-text citations to support their recommendations, be sure to
    provide those references as well.
    5
    Recommended Improvements Based on the Value-Based Care Model
    In this section, propose at least one improvement for your assigned community based on
    the following element of value-based care: “Measure outcomes and cost for every patient.” Be
    sure to include in-text citations to support your work.
    Recommended Improvements Based on the IOM Aims
    In this section, propose at least one improvement for your assigned community based on
    the following IOM Aim: “Be effective.” Be sure to include in-text citations to support your
    work.
    Country Comparison Based on the Value-Based Care Element
    In this section, summarize the information identified in the heading in three to five
    sentences, focusing your comparison of another country based on the following value-based care
    element: “Measure outcomes and cost for every patient.” Be sure to include in-text citations to
    support your work.
    Week 4: Value-Based Care and Aligning Reimbursement With Value (Element 3)
    In this section, in three to five sentences, provide an overview of this week’s topics.
    Synopsis of Peer-Review Feedback
    In this section, summarize the feedback that was provided to you from your colleagues
    regarding the improvements based on value-based care, the improvements based on the IOM
    Aims, and recommendations and lessons learned based on country comparisons. Explain which
    aspects you incorporated into your Improvement Plan and/or which aspects you did not
    incorporate. If they provided in-text citations to support their recommendations, be sure to
    provide those references as well.
    6
    Recommended Improvements Based on the Value-Based Care Model
    In this section, propose at least one improvement for your assigned community based on
    the following element of value-based care: “Aligning reimbursement with value.” Be sure to
    include in-text citations to support your work.
    Recommended Improvements Based on the IOM Aims
    In this section, propose at least one improvement for your assigned community based on
    the following IOM Aim: “Be safe.” Be sure to include in-text citations to support your work.
    Country Comparison Based on the Value-Based Care Element
    In this section, summarize the information identified in the heading in three to five
    sentences, focusing your comparison of another country based on the following value-based care
    element: “Aligning reimbursement with value.” Be sure to include in-text citations to support
    your work.
    Summary and Conclusion
    In this final section of the paper, write two to three paragraphs to summarize the various major
    sections of your paper. Be sure to include in-text citations to support your work, if applicable.
    7
    References
    NOTE: For this Week 4 Assignment, you are expected to include at least four new references.
    (Note that the following references are intended as examples only.)
    American Counseling Association. (n.d.). About us. https://www.counseling.org/about-us/aboutaca
    Anderson, M. (2018). Getting consistent with consequences. Educational Leadership, 76(1), 2633. https://www.ascd.org/el/articles/getting-consistent-with-consequences
    Bach, D., & Blake, D. J. (2016). Frame or get framed: The critical role of issue framing in
    nonmarket management. California Management Review, 58(3), 66-87.
    https://doi.org/10.1525/cmr.2016.58.3.66
    Burgess, R. A. (2023). Rethinking global health: Frameworks of power. Routledge.
    Herbst-Damm, K. L., & Kulik, J. A. (2005). Volunteer support, marital status, and the survival
    times of terminally ill patients. Health Psychology, 24(2), 225–229.
    https://doi.org/10.1037/0278-6133.24.2.225
    Johnson, P. (2003). Art: A new history. Harper.
    Lindley, L. C., & Slayter, E. M. (2018). Prior trauma exposure and serious illness at end of life:
    A national study of children in the U.S. foster care system from 2005 to 2015. Journal of
    Pain and Symptom Management, 56(3), 309–317.
    https://doi.org/10.1016/j.jpainsymman.2018.06.001
    Osman, M. A. (2016, December 15). 5 do’s and don’ts for staying motivated. Mayo Clinic.
    https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/5-dos-and-donts-forstaying-motivated/art-20270835
    8
    Shi, L., & Singh, D. A. (2022). Delivering health care in America: A systems approach (8th ed.).
    Jones & Bartlett Learning.
    (Note: This is the course text for WMBA 6602.)
    Sue, D. W., & Sue, D. (2015). Counseling the culturally diverse: Theory and practice (7th ed.).
    Wiley.
    Walden University Library. (n.d.). Anatomy of a research article [Video].
    https://academicguides.waldenu.edu/library/instructionalmedia/tutorials#s-lg-box7955524
    Walden University Quick Answers. (2020, August 18). Webinar recording: Writing literature
    reviews in your graduate coursework [Webinar].
    https://academicanswers.waldenu.edu/faq/358675
    World Health Organization. (2018, March). Questions and answers on immunization and vaccine
    safety. https://www.who.int/mongolia/health-topics/vaccines/faq
    1
    Community Profile and Continuum of Care
    Annet Castillo
    Walden University
    Contemporary Topics in the US Healthcare Delivery System
    07/12/2024
    2
    Introduction
    Adolescence is faced with the emergence of cognitive and sexual maturation that requires
    significant balance to ensure the understanding of issues such as sexual and reproductive health
    (SRH). Maintaining this balance is, however, complex and challenging, resulting in the rise of
    unintended pregnancies among adolescents (Chakole et al., 2022). These teenage pregnancies,
    however, are also expressive of underlying factors in the community. In exploring this public
    health issue of teenage pregnancies, this paper will help Kansas City, Missouri, to contribute to a
    multifaceted approach to improving outcomes for adolescents in their SRH.
    Community Profile
    Kansas City, Missouri, is well known for its culture and heritage. However, the city faces
    a concern of high teenage pregnancy rates. In a CDC (2022) data report, Kansas recorded a 16.2
    birth rate per 1000 births of girls between the ages of 15 and 19. These birth rates are three times
    higher than other selective states in the country. However, as a vibrant center, the city is
    influenced by several factors that contribute to the growing number of teenage pregnancies.
    Description of the Community
    Kansas City has the highest population and size among all cities in Missouri. Data USA
    (2022) report shows that this town covers around 320 square miles, and its location holds more
    than 509,000 people. Its vibrancy is one of the reasons why it stands out as a richly cultural city
    across the country. Kansas County has an estimated population of over five hundred thousand
    residents with an average age of thirty-five years, the majority being American citizens.
    However, there is a vast range of cultures in the city; African Americans account for 26% of its
    total population, while white people constitute slightly above fifty-five percent, and Hispanics
    3
    are above twelve percent. A large percentage of the Kansas population is educated, with women
    representing a higher population than men.
    Social Determinants of Health
    According to Chelak & Chakole (2023), the social determinants of health play a
    significant role in accounting for the general health and well-being of the population. For
    instance, one of these factors includes income and economic stability. In Kansas, in February
    2023, 2.1% of the population was employed with a median household income of $65,000.
    However, the city also experiences a poverty rate of over 14%, with a majority of the population
    comprising marginalized groups such as blacks and Hispanics (Data USA, 2022). This limits
    opportunities for these individuals, further contributing to the limited access to health and crime.
    In addition, Kansas is well educated, with a majority of the white population (over 64%)
    graduating at the university level, followed by 11 percent of the Black population, Hispanic, and
    Asian community. According to the Kansas Association of School Boards (2022), quality of
    education in public schools ranked 39th in the country. Despite the ranking providing quality
    education, schools in the rural areas of Kansas, especially among minority populations such as
    Hispanic and the Black community, fail to receive this standard and acquire knowledge of SRH,
    leading to increased pregnancies in these areas. In addition, according to Willeke (2021), Kansas
    City had a violent crime rate with a 9% increase from the previous year. These high crime rates
    limit the general population’s safety, which contributes to severe physical and mental health
    issues. Lastly, there is access to health services. In 2022, 88% of Kansas had health coverage in
    Medicaid, Medicare, or VA plans. This coverage comprises both children and adults. However,
    11 percent of the population lacks insurance coverage, contributing to poor health outcomes.
    4
    Leading Causes of Death
    According to a Kansas report in 2021, the leading cause of death in Kansas was heart
    disease. The reports showed a 176-death rate per 100,000 individuals dying from heart disease, a
    number that is higher than the US population rate. The second cause of death in the city is
    cancer, with the disease predominantly affecting the older population. However, these leading
    causes of death also vary according to the ages of the population. For instance, although heart
    disease and cancer are the leading cause in the city, it mainly affects the older generation, with
    the age group ranging from 45 to 85 years old. This rate is different compared to the younger
    population. Among the younger population, however, the leading causes of death included
    unintentional injuries, suicide, and homicides. This affected mainly 15 to 34-year-olds in the
    region, which significantly accounted for over 68 percent of the deaths in 2022 (Data USA,
    2022).
    Health Care Settings in the Community
    Teenage pregnancies increase the risk factors for health complications and unintended
    injuries (Ray et al., 2024). Addressing these accidents can be complex, requiring a
    comprehensive and multifaceted approach that accounts for the different aspects of the
    community. This comprehensive approach should be applied in the continuum of care, which
    involves essential elements such as education and care.
    HealthCare Setting (1)
    For a hypothetical 13-year-old teenage pregnant patient seeking counseling and guidance
    on her pregnancy care while reducing the complications and accidents related to early
    pregnancies, such as falls, the first healthcare setting encounter in Kansas, for this patient, they
    might encounter would be the EMS. The EMS plays a significant role in the community. They
    5
    provide different services relating to the conditions of the patient. For instance, for ages 10 to 21,
    the EMS can offer guidance and education to young female adolescents on the SRH, thus
    reducing the risk of teenage pregnancies. However, the patient might first encounter the EMS,
    who would assess the risk factors associated with adolescent pregnancy. In addition, they would
    also offer education services on nutrition, injury prevention, mental health services, and guidance
    to prevent other causes of death, such as suicide. With a specific focus and training in handling
    teenage pregnancy, the EMS effectively addresses the patient needs comprehensively.
    HealthCare Setting (2)
    Another hospital setting they would encounter is the Hospital ER. The Hospital ER is
    particularly tailored to protect patients from death or address trauma-related issues (Mutlu et al.,
    2021). Due to their urgent services, the ER is often open to address the emergency the public
    requires. These services are broad and cater to all individuals of the public. In some institutions,
    these departments can be specialized for patients needing urgent care, such as teenagers who
    require urgent treatment. This is because teenage pregnancies can be critical, such that they lead
    to complications that require urgent treatment for the patient. This ER is also equipped with
    professionals who can help the teenager navigate the pregnancy complexities and the options
    needed for positive outcomes.
    HealthCare Setting (3)
    In addition, the patient might also undergo hospital surgery. According to WHO (n.d.),
    almost 55% of teenage pregnancies result in abortions. This action and choice can be detrimental
    and result in complications during the process, which can contribute to mortality rates. Due to
    their young age, the patient might consider other options such as abortions, which would lead her
    6
    to the surgery, or during delivery, she might opt to deliver the surgical way. The hospital surgery
    offers comprehensive care to the patients. It provides a holistic team specialized in adolescent
    medicine, ensuring a comprehensive treatment plan. These services ensure easy navigation
    through the childbirth or the abortion process.
    HealthCare Setting (4)
    Another setting they might encounter is the hospital rehab center. The hospital rehab
    center is a rehabilitation space that ensures recovery. This center provides a comprehensive team
    that addresses the incident around unintentional injuries. For instance, they offer educational
    services, counseling, and guidance to help the patient deal with the trauma and move on from the
    event, thus ensuring a positive outcome.
    Conclusion
    Addressing teenage pregnancies is a complex and challenging task, mainly when it is
    influenced by significant and different factors in the community (Vieira Martins et al., 2023).
    The paper, therefore, provides a detailed analysis of the high teenage pregnancies in Kansas,
    Missouri. Kansas is a large city with a bustling and diverse population. However, the community
    also experiences socioeconomic challenges such as high poverty rates and inadequate quality
    education, especially in rural areas, that contribute to teenagers lacking efficient education on
    their SRH, contributing to high teenage pregnancies.
    The continuum of care should be comprehensive and holistic. This care should be
    holistic, regardless of the health service setting. Teenage pregnancies can be severely
    consequential, leading to unintended injuries such as falls or miscarriages that could lead to
    increased mortality rates. In the analysis of the continuum of care of unintentional accidents
    7
    among teenage pregnancies, the paper analyzes and describes different hospital settings a patient
    with adolescent pregnancy might encounter in the community.
    8
    References
    Chakole, S., Akre, S., Sharma, K., Wasnik, P., & Wanjari, M. B. (2022). Unwanted teenage
    pregnancy and its complications: a narrative review. Cureus, 14(12).
    Chelak, K., & Chakole, S. (2023). The Role of Social Determinants of Health in Promoting
    Health Equality: A Narrative Review. Cureus, 15(1), e33425.
    https://doi.org/10.7759/cureus.33425
    CDC. (2022). Teen Birth Rate by State. National Center for Health Statistics.
    https://www.cdc.gov/nchs/pressroom/states/kansas/ks.htm#lcod
    Data USA. (2022). KANSAS CITY, MO. https://datausa.io/profile/geo/kansas-citymo#education
    Mutlu, S., Çetinkaya, A., & Yılmaz, E. (2021). Emergency Service Perceptions and Experiences
    of Patients: “Not A Great Place, But Not Disturbing.” Journal of Patient Experience, 8,
    23743735211034298.
    Kansas Association of School Boards. (2022). Kansas Ranks High in Most New Measures of
    Education. https://kasb.org/48409_2?articleID=7241
    Ray, J. G., Fu, L., Austin, P. C., Park, A. L., Brown, H. K., Grandi, S. M., … & Cohen, E. (2024).
    Teen pregnancy and risk of premature mortality. JAMA network open, 7(3), e241833e241833.
    Vieira Martins, M., Karara, N., Dembiński, L., Jacot-Guillarmod, M., Mazur, A., Hadjipanayis,
    A., & Michaud, P. A. (2023). Adolescent pregnancy: An important issue for
    paediatricians and primary care providers-A position paper from the European academy
    9
    of paediatrics. Frontiers in pediatrics, 11, 1119500.
    https://doi.org/10.3389/fped.2023.1119500
    Willeke, B (2021). FBI data: Kansas City ranks in top 10 of highest violent crime rates in U.S.
    Fox News. https://fox4kc.com/news/fbi-data-kansas-city-ranks-in-top-10-of-highestviolent-crime-rates-in-us/#:~:text=Kansas%20City%20reportedly%20has%20the,increase%20over%20the%20pr
    ior%20year.&text=Springfield%20saw%202%2C545%20violent%20crimes,10.
    WHO. (n.d.). Adolescent pregnancy. https://www.who.int/news-room/factsheets/detail/adolescent-pregnancy

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