Developing a Stroke Network and Ensuring Hospital Accountability

This report addresses key aspects of public health emergency medicine, focusing on the establishment of effective stroke networks and ensuring hospital accountability. It details the essential factors in setting up a stroke network, including patient transportation, necessary medical equipment, and communication systems. The report emphasizes the importance of minimizing transport time and identifying suitable medical facilities along transport routes. To hold hospitals accountable, the report suggests regular service quality reviews, clear disciplinary actions for malpractice, and the employment of medical practitioners who understand national healthcare standards. It proposes written policies, patient safety rules, and federal surveys to ensure compliance. External pressure strategies, such as public participation, progress reports, and social media engagement, are also discussed. Finally, the report addresses the issue of bypassing comprehensive stroke centers, highlighting the need for strategic planning, cost considerations, and alternative hospital options to optimize patient care and network efficiency. Desklib offers a wealth of resources, including past papers and solved assignments, to support students in their academic pursuits.

Running Head: PUBLIC HEALTH EMERGENCY MEDICINE 1
Public Health Emergency Medicine
Names
Institution

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Public Health Emergency Medicine
How to set a stroke network
To set a stroke network, in this case, it will be essential to find out how patients will
conveniently reach the available care centres. Therefore, it will be vital to consider various
factors such as ensuring the patients get to the facilities within minimum time possible. This
implies that the fasted and most comfortable means of transport must be used ( Brigham &
Johns, 2012). Because patients will require medical attention while on transit, the network should
also include medical practitioners who will be traveling with the patients from one facility to the
other, so as to offer services if an emergency arises.
To facilitate maximum care, the vehicles will be fitted with all equipment that the
caregivers will require to attend patient needs that may arise. The vehicles will also comprise of
air conditioning systems and will be serviced on a regular basis to ensure limited chances of
breakdown. There will also be other vehicles on standby to assist in case the one ferrying a
patient develops a mechanical.
Because critical equipment lack in some of the facilities, the network will also entail the
provision of all equipment required by the medical practitioners to attend the patients effectively.
Other key factors that will be considered when creating this network will be hiring a group of
experts who will be responsible for servicing this equipment to enhance reliability (Gostin,
2010). Moreover, technology will also be considered while implementing equipment in the
health centres to ensure they match the modern technological advancements

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For the network to work better, communication system will be required to link the people
ferrying the patients with other medical practitioners in different areas. This means all vehicles
used to transport the patients will be fitted with communication gadgets that will help the
transportation personnel to pass information regarding various aspects such as the condition of
the patient and what they feel should be prepared before arrival. This communication system will
also play a key role in alerting other people when an emergency arises while n transit.
According to Holsinger (2013), time is always fundamental when dealing with medical
issues that require fast actions to be taken. Therefore, because this network will include patients
who need quick medical attention, it means transporting the patient from one facility to the other
will require little time to be utilized. For this reason, it will be essential to analyze the shortest
route possible and one which will not lead to inconveniences.
Identifying the medical facilities that can offer assistance along the routes is also
fundamental in making the network to work effectively. This is because, in some incidences,
emergencies that require specialized treatment arise while in transit, forcing the medical
practitioners to seek aid from the nearest hospitals (Chow, 2013). This means identifying the
health centres along the way and collaborating with them will be an ideal way of accessing their
assistance when such needs arise.
How to hold hospitals accountable
For the committee to hold hospitals accountable to ensure care is given to patients
according to national standards, there will be time to time review of the quality of services
offered to the patients. This will comprise of requesting patients to rate the quality of services
and what they think should be changed to ensure care is provided to their satisfaction (Carolyn,

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2013). In case of malpractice, the person/s involved will be requested to appear before a panel of
the committee to give a clear explanation concerning what transpired. In case the person is found
guilty, a proper disciplinary action which amounts up to being fired will be taken.
Employing medical practitioners who understand the national standards regarding the
provision of healthcare services will also play a key role in making the hospitals to be
accountable (Scheneider & Lilienfeld, 2013). The reason why this strategy will be effective in
this case is that when a person understands what he/she should do, the chances of doing wrong
things are limited, and in cases of being involved in malpractice, the person knows he/she is
responsible for what happened.
Establishing written policies and standards, as well as disciplinary measures is also a
right way of holding the hospital accountable to ensure patient care is provided according to
established standards (Jurg, 2013). With written policies and standards, it is easy to question the
hospitals when improper care is provided, or when incidences associated with negligence arise.
According to Aaron (2016), one of the best ways of holding hospitals accountable for
malpractice is having patient safety rules. When the hospitals have these rules, it will be possible
to identify the ones that have been broken and take actions based on disciplinary measures that
have been. The rules should be unbiased and should relate to customer safety, quality services
and the standards that guide provision of healthcare.
According to Rebecca (2013), one of the best ways of holding hospitals accountable is
ensuring care is provided based on the national standards, and allowing the federal departments
concerned with public health to conduct time to time surveys to find out if there is full
compliance. In the events where they realize the doctors have engaged in any form of

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malpractice or overlooked the established standards, proper disciplinary action should be taken.
The committee should also play a role in this strategy by collaborating with the concerned
agencies to visit the facilities on a regular basis and seeking information from reliable sources to
find out if the hospitals work based on the national standards.
How to exert external pressure
According to Molly (2014), external pressure plays a significant role in making medical
facilities to comply with established standards. For this case, various strategies can be employed
to exert external influence to the hospitals. One of the strategies is including public participation.
When the public is allowed to contribute through being given information concerning the
progress of the facility, it will be possible to realize when malpractice arise. It will also increase
the level of external pressure by pushing the facilities to do what is right.
Including public participation will also push the facilities to aim at complying with the
established standards because they will always have an idea that their doings are always under
watch. According to Kathy (2012), the public always wants right things to be done in hospitals
because it is through following established policies that the quality of services offered to them
can be enhanced. This means they will always react when the medical practitioners fail to adhere
to the standards that have been established to guide their work.
External pressure can also be exerted by ensuring progress reports are given to the
committee from time to time. This will aid in monitoring when the standards are not being
followed, and when unprofessional things occur in the health facilities (Mary, 2012). The reports
should be accurate and made by external bodies to ensure they give accurate information
concerning what happens in the facilities. The committee should establish proper mechanisms

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for disciplining those who engage in malpractices to prevent such incidences from occurring in
future.
Allowing the public to express their views including giving their outcry to the committee
is also an effective way of exerting external pressure to the facilities. It is also vital to ensure the
facilities are present on different social media platforms so that it can be easy to notice anything
that goes against the established standards (Chow, 2013). Registering these hospitals in various
social media platforms will allow the public, the hospital management and other stakeholders to
have an open discussion that will aid in exposing the quality of services offered, and if they
match the established standards.
The other way of exerting external pressure, in this case, is allowing the mainstream
media to have unrestricted access to information concerning the level of compliance with the
established standards. By doing so, information will reach all stakeholders concerning all
activities that happen in the facilities and how they are done. In the cases where malpractice
occurs, it will be easy to know because information will reach many people.
According to Patricia (2015), for hospitals to comply with established standards, they
should not work independently. This means having another body mandated with monitoring
compliance is also another way in which the committee can use to ensure the facilities that do
not comply with the established standards get external pressure. This body should work closely
with the public, the committee and other stakeholders to ensure enough pressure is exerted when
these facilities fail to work based on required standards. The body should have written guidelines
on how to deal with such hospitals, including what disciplinary actions to take, and who should
be involved in making the decision surrounding the actions taken.

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How to address bypassing a comprehensive stroke centre
Bypassing a comprehensive stroke centre may not be ideal because it leads to wastage of
time in matters that require fast actions to be taken. To address the issue of bypassing a
comprehensive stroke centre to drive a patient across the county, it is crucial to identify where
these centres are located, the stroke services they offer, their bed capacity and so forth (Kathy,
2012). This will aid in making decisions about where to take a patient when need arises.
The issue can also be addressed by considering various factors such as the seriousness of
the problem, the time taken to transfer the patient from one hospital to the other, and the quality
of services he/she is likely to get (Mary, 2012). If there is a possibility that the patient will
receive high-quality services from hospital which is far away, and his condition does not require
quick action, then it would be better to bypass the ones that do not offer the quality of services
required and transport him/her to the facility where he/she can attain better services.
The issue of bypassing a comprehensive stroke centre can also be addressed by
considering costs and having some of the hospitals as alternatives in cases of emergencies.
Depending on the nature of the condition which the patient is at, it would be essential to have
specific hospitals where their needs can be addressed. The small hospitals along the way should
be used only when eventualities arise. By having this kind of strategy, the committee will make
the network to remain active.

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References
Aaron, B. L, (2016). Managing Acute Stroke in Low-Resource Settings. Bulletin of the World
Health Organization, 94(7), 56-98.
Brigham, K & Johns, M. E. (2012). Predictive Health: How We Can Reinvent Medicine to
Extend Our Best Years. New York: Basic Books.
Carolyn, W. S. (2013). The Experience of Engaging in Occupation Following Stroke: A
Qualitative Meta-Synthesis. British Journal of Occupational Therapy, 76(8), 526-589.
Chow, O. E. (2013). Responding to Lives after Stroke: Stroke Survivors and Caregivers Going
on Narrative Journeys. The International Journal of Narrative Therapy and Community
Work, 4, 58-92.
Gostin, L. O. (2010). Public Health Law and Ethics: A Reader. Berkeley, CA: University of
California Press.
Holsinger Jr, J. W. (2013). Contemporary Public Health: Principles, Practice, and Policy.
Lexington, KY: University Press of Kentucky.
Jurg, S. R. (2013). Multilingualism in Stroke Patients: A Personal Account. International
Journal of English Linguistics, 3(3), 54-86.
Kathy, K. (2012). Female Family Carers for Survivors of Stroke: Occupational Loss and Quality
of Life. British Journal of Occupational Therapy, 75(5), 245-258.
Mary, K. D. (2012). A Review of Measures to Evaluate Participation Outcomes Post-Stroke.
British Journal of Occupational Therapy, 75(9), 245-265.

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Molly, K. K. (2014). Occupational Changes in Caregivers for Spouses with Stroke and Aphasia.
British Journal of Occupational Therapy, 77(1), 245-262.
Patricia, A. D. (2015). Preliminary Reliability and Validity of an Exercise Benefits and Barriers
for Stroke Prevention Scale in an African American Sample. Journal of Nursing
Measurement, 23(2), 78-90.
Rebecca, S. (2013). The Role of Occupational Therapists in Supporting Psychological Wellbeing
after Stroke Using a Solution-Focused Psychological Approach to Mood Assessment.
British Journal of Occupational Therapy, 76(11), 25-50.
Russell, E. (2011). Having a Stroke: Ethical Issues in Medicine and Law. Journal of Information
Ethics, 20(2), 25-56.
Scheneider, D & Lilienfeld, D. E. (2011). Public Health: The Development of a Discipline - Vol.
2. New Brunswick, NJ: Rutgers University Press.