Solve/answer case application questions 1-10. Use Balance Sheet & Pro Forma Cash Flow Template for Questions 1 and 5.
QSEN Individual Essay: Patient Story Interview
Identify a friend, family member or acquaintance and conduct a short interview about an experience with a healthcare system they have had as a patient, caregiver, or family. Document 2-3-page summary of the patient experience interview. The summary should address the positive and or negative experience(s) the patient/caregiver/family member had in the healthcare system. Identify if the experience can be categorized into one (or more) of the Institute of Medicine (IOM) 6 quality domains.
The paper should not exceed 3 pages, provides enough detail for the reader to understand the specific incident or situation that made the experience a positive or negative experience, and includes an analysis of how the experience relates to the IOM quality domains.
IOM Six Quality Domains
Safe: Avoiding harm to patients from the care that is intended to help them.
Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively).
Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.
Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.
Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.
Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.
Rubric for QSEN Patient Story Interview Essay
Topic
Percentage of grade
Clearly describes the patient/caregiver/family member healthcare story – include specific quotations, description of the where, when, how of the story in interviewee’s terms.
Balance Sheet – Richard called and said that he had compiled a list of assets and would send it. It came a few days later. His assets included a home worth $300,000, approximately $350,000 in securities, two cars worth $40,000 with loans of $15,000 against them, and other assets including jewelry (worth $5,000), art ($5,000), and furniture ($7,000). Richard and his wife had money market funds of $2,000, a bonus due of $5,000 net of taxes, and credit card payments due of $12,000. Their house had a $130,000 mortgage. He said to assume that his salary will rise 6 percent a year, and his investment income is 11 percent a year (the investment loss came a year ago). His expenses should rise 3 percent a year except for medical, which will grow at a rate of 6 percent yearly, and taxes, which will grow at about 7 percent a year.
Cash Flow – Richard said he was not worried about the losses taken. He would make them up, but Monica insisted that they save additional monies. He wanted to know what I recommended to help him save. He said he knew Monica was secretly putting away part of her household money into an account in her own name. Richard came in with his cash flow statistics below.
Inflows ($) Outflows ($)
Salary 100,000 Mortgage & Home Maintenance 20,000
Investment Income 8,000 Food 5,000
Clothing 8,000
Health Care 6,000
Transportation 2,000
Personal 3,000
Recreation 4,000
Cars, Entertainment 9,000
Hobby 1,000
Gifts & Charity 2,000
Insurance 6,000
Taxes 26,000
Debt – Richard and Monica have diametrically opposite points of view on debt. Richard views debt as an opportunity to generate cash to make up for past investment losses. He has asked you whether he should remortgage his house and place the proceeds in the stock market. He says the present time may be appropriate to refinance because market rates for mortgage loans of 6.5 percent are well below his mortgage rate of 8 percent. He wants to use an adjustable rate that provides an even lower 4 percent rate for the first year with rates thereafter 2 percent above the five-year Treasury rate.
Richard wants a 30-year mortgage because he said he doesn’t expect “to go anywhere” and the annual repayments would be low. He said he was thinking about buying a new car. While the existing one worked well, he was tired of it. If cash flows get tight, he isn’t at all averse to using credit card debt. He says that whereas credit card rates are high, the overall impact is not great and “people manage to pay money back.” Monica has listened quietly to Richard with a pained expression on her face, occasionally shaking her head. She says she is afraid of taking on more debt and wants a budget to limit spending of all types.
Case Application Questions:
- Construct the balance sheet.
- Would you tell Richard and Monica that it was strong? Why?
- Complete the balance sheet section of the plan.
- What recommendations would you have to help them save more?
- Construct their cash flow statement for this year and the next two years.
- What do the future cash flow figures indicate?
- Complete the cash flow section of the plan.
- What do you think of Richard’s idea of borrowing to place money in the stock market?
- Do you think the couple should refinance their mortgage?
- Complete the debt and future budgeting part of the plan.
