Trace Elements in the Human Body

Trace Elements in the Human Body CHAPTER: 1 INTRODUCTION 1.Introduction 1.1 Trace Elements in Biological System: In recent years scientists from a variety of disciplines have directed their attention in an aggressive manner to a long neglected area of biochemical research i.e. the role of trace elements for the etiology of disease. Most of the elements present in the periodic table are considered to be trace elements. They are defined as various chemical elements that occur in very small amounts in the body of organisms (and are referred to as trace elements). These elements are essential for many physiological and biochemical processes. A trace element is an  element  in a sample that has an average  concentration  of less than 100  parts per million (ppm) measured in atomic count or less than 100 micrograms per gram (1). Similarly, if the body needs less than 100 milligram (mg) of an element in a day then it is labelled as a trace element. However, their concentrations may be as low as less than 100 mg of 1 kilogram (kg) of body weight or 65 kg of a body weight of an adult should not contain more than 7 gram (gm) of a trace element (2). 1.2. Role of Trace Elements in Human Body: All living organisms possess a certain amount of various trace elements in their body in order to process their body functions properly. It is incredibly important that optimum balance level of these elements in every organ, tissue and cell of the human body is maintained that serves as a primary reason to keep an organism healthy and functional. These trace elements can be in any chemical form such as inorganic salts or as biochemical agents. The trace elements are ubiquitously distributed all over the earth crest. They play several roles in human body. (However, their role varies,) such as (the element) iron, which is important for the transportation of oxygen in the body, whereas calcium is the basic component of the bones. Both plants and animals require them for their proper functioning, growth, and propagation of their life (3). It is evident that the trace elements are present in the human body in very minute quantity, and if the processes of supply and demand are interrupted due to any reason for example, the intake of these elements is not sustained up to an adequate amount, or the metabolic disorder fails to absorb these elements up to the required limit for a chemical reaction (and) the body becomes deficient of these trace elements. In case of deficiency, the body uses its reserves, but these reserves have to be replenished. The trace elements are the components of various enzymes, hormones and are a part of complicated physiological and biological mechanisms, through which a body generates other biochemicals, and proteins which help a range of systems to come out of this demanding state of affairs unscathed. This ability of a body to keep the level of its nutrients and chemical agents within optimum range despite its supply is called homeostasis. This critical process provides the body sufficient supp ort in order to sustain that pressure, which builds up due to the deficiency of trace elements. However, a lot of damage occurs within the body during this turmoil. The frequency of these types of episodes leads the body towards the development of many diseases and makes it vulnerable for the formation of various disorders. Lifestyle, environmental exposure, and diet can directly influence the concentration of trace elements in the body. There are numerous and essential metabolic activities which can not be instigated without the presence of these trace elements. Such functions may include protein metabolism, red blood cell production, development of healthy bones and teeth. It may also include growth that depends on thyroid hormones, and proper functioning of nerves and muscle (functions). Furthermore, fertility, maintenance of the integrity of cell membranes, hair coat growth, and electrical stabilization of the cell (electrically) involves directly or indirectly certain trace elements for their proper functioning. Additionally, trace elements serve as a component of B-12, which is critical for proper heart functions, regulation of heart beat, and pigmentation. The trace elements are also required for some other functions that carried out inside the body of organism such as reproduction, maintenance o f fluid balance, (aid in) intercellular communication (which is) needed for structure of most proteins and crucial for proper energy processing in the body,( reproduction, act as catalyst,) etc. Another example of such deficiencies or excessiveness of the amount of trace elements can be seen in iodine intake, where such a deficiency (or excess (ive)) can cause goiter (an enlarged thyroid gland). This trace element is efficiently concentrated by thyroid glands in fish, amphibians, reptiles, birds, and mammals for the distinctive purpose of producing thyroid hormones (4). It is stated that selenium can be stored in the cells of body and then become part of the victuals series. It starts when carnivorous grazed in the fields where soil is reach with selenium and consequently the growing crops have received a great amount of selenium and eventually high selenium levels become the part of the body of the animals. Initially, selenium was considered to be a toxic element, however with the progression of scientific research and refined consensus has led to the strong belief that selenium is not toxic, and it is essential to several functions in the human body. Such as selenium acts as an antioxidant and sometimes it is present an integral constituent of enzyme glutathione peroxidase (5-6). Regular cellular metabolism is responsible for most of the production of reactive oxygen species (ROS) in normal cells. Therefore, ROS are neutralized, engaged, or destroyed by the action of antioxidants. Similarly, the malignant cells also contribute in production of ROS and demonstrate the low levels of antioxidant enzyme in the blood of most cancer patients (7). Beyond, the optimum limit of chromium in the blood of an organism can be linked with onset of diabetes and cardiovascular disease as well (8). Similarly, selenium influences the development of copious degenerative diseases, and its deficiencies among human beings as well as animals are being recognized worldwide as it has some association with number of pathologies (9). 1.3 The Concept of Essentiality: Those elements that are indispensable, necessary, and incredibly important for the metabolisms of living organisms are called essential elements. It has been widely accepted and established fact that without the presence of these essential trace elements no biochemical metabolism can be initiated properly, and (on the other hand) the outcome of these chemical reactions does not meet the requirements. Consequently, the concept of ‘essentiality’ is a leading cause for scientists today to focus their efforts in this field. Furthermore, explore the circumstances through collected data to discern actual facts and reasons for the significance of trace elements required in several metabolic activities in animals. However, special attention must be directed towards how their low or high blood levels, can initiate the development of disease, and the optimum blood levels of these trace elements necessary for the metabolic processes to proceed in a proper manner. This is important because some trace metals which are necessary for growth of an organism may be harmful if their specific concentration is even slightly raised. The essential trace elements act as catalyst and the body of an organism can not produce them itself. The only source of these elements in the body is our diet. However, the presence of most of these elements is higher animals is just an expression of geochemical origin or the indicator of environmental contaminations. All cells receive their nourishment from extracellular fluid. The activities of all these trace elements biologically furbish optimal implementation by commencing a series of metabolic reactions in each cell. A lack of any step in the series can lead from mild to severe problems to the health of an organizm. The following elements such as zinc (Zn), copper (Cu), selenium (Se) chromium (Cr), cobalt (Co), iodine (I), manganese (Mn), and molybdenum (Mo) are considered to be as essential elements for human body. Although they play incredible roles such as being active sites of enzymes, or control the bioactivity of the metabolism though these elements are present in very small amount of the total body weight. The core consequences of low levels of trace elements are the reduced activities of the concerned enzymes. An element is recognized as essential when it has a well defined function as a stabilizer, structural, hormonal or an enzymatic cofactor, when it is always present in tissues and organs in well precise concentration range. When it induces reproducible physiological effects, and when it is possible to prevent and treat consequences due to its deficiency through its supplementation. The effects of the essential elements cannot be completely eradicated by any other element. Nevertheless, another concept of essentiality defines an element as essential when a deficient intake produces an impairment of function. The elimination of an essential trace element produces similar physiological or structural abnormalities apart from type of variety. The restoration of these essential trace elements invalidates or precludes respective abnormalities. Consequently, these abnormalities are accompanied by specific biochemical changes that can be prevented or remedied when the deficiency is prevented and remedied and restore the physiological level of that element. The symptoms of deficiency (is) disappear(s) and body functions becomes normal (10-11). Therefore, the physiological levels are restored and the symptoms which indicate such deficiencies are also vanished and the body functions return to their normal state. Trace elements are essential components of biological structures. To deal with this necessity, biological systems have developed the ability to recognize a metal and deliver it to the target without allowing the metal to participate in toxic reactions. Proteins are primarily responsible for such recognition and transport, and prevent most of the associations of trace elements with other molecules that leads to undesirable chemical modià ¯Ã‚ ¬Ã‚ cations of these molecules (12). 1.4. The Transition Metal: Chromium: Chromium is the basic element used in various industrial processes such as paint, construction, chrome plating, (and the) production of stainless steel as well as leather tanning, wood preservation, textile dyes and pigments. Besides the use of chromium in varieties of industries, trivalent (Cr (III)) and hexavalent (Cr (VI)) chromium compounds are thought to be the most biologically imperative (13-14). For example, the Cr (III) is an essential dietary mineral in low doses. It is required to potentiate insulin for the normal glucose metabolism (15-16). Since 1971, the International Agency for Research on Cancer (IARC) has been interested to categorize carcinogens and ascertain occupational association with high rate of cancer risk. Some chemicals used in shoe, tire, and furniture manufacturing, as well as nickel refining, diesel fuel, and dry cleaning have been classified as â€Å"probable carcinogens. Arsenic, asbestos, benzene, benzidine, chromium, 2-Naphthylene, oils, and vinylc hloride show occupational exposures causally associated with cancer in humans. 1.4.1. Chromium Metabolism: The chemistry of chromium is very interesting and complicated because of having the capability of possessing various oxidation states. However, chromium (III) and (VI) are the most stable forms that exist in our environment. The chromium (III) and chromium (VI) inter-conversion is influenced by numerous factors, such as the concentrations and type of chromium species, nature of oxidizing or reducing agents. Moreover, the electrochemical behavior of the oxidation and reduction reactions, ambient temperatures and pressure, amount of light, sorbents, acid-base reactions, complexing agents, and precipitation and chemical reactions may also play a pivotal roll in support of establishing a specific chromium oxidation state in certain environmental conditions. Chromium can react directly at the site of contact or be absorbed through human tissue. A very important difference is observed that chromate ion (Cr (VI)) slips away through cellular membranes at an exceedingly faster rate than chrom ium (III) species (17). Chromium (III) combines directly to transferrin, an iron-transporting protein in the plasma after entering the body from an exogenous source. In contrast, chromium (VI) is immediately engaged by erythrocytes after absorption and is reduced to chromium (III) inside the cell. Apart from the source, chromium (III) is extensively distributed within the body and measured for most of the chromium both in plasma or tissues. It has been expounded that the reduction of chromium (VI) does not occur in the plasma. Chromium (VI) enters cells through the phosphate and sulfate anion-exchange carrier pathway. However, most chromium (III) present in the blood stream and is substantially bound to amino acids, and with other organic acids. The plasma proteins, such as globulins may also an attractive target for chromium (III) though a portion of it remains in plasma for an extended period of time as well (18). The blood provides a major carrier service for the delivery of chromium to other parts and organs of the body. The substantial concentration of chromium was discovered as a protein-complex in various parts of the human body such as bone marrow, lungs, lymph nodes, spleen, kidney, and liver, though the highest levels of chromium remains in the lungs (19-20). Excretion of chromium takes place primarily through kidneys, with the release of maximum concentration and without leaving traces of it in the organs. However, almost 10% of an absorbed dose is eliminated by biliary excretion. Nevertheless, minute quantities delivered to hair, nails, milk, and sweat. Chromium usually cleared from blood within hours whereas eradication from the organs of body is not prompt as the half life of chromium is several days. In a study chromium (VI) was administered to volunteers and it was observed that it removed more rapidly from the body than chromium (III) (21). The reduction of chromium (VI) to chromium (III) has been extensively investigated and it has been observed that the consumed hexavalent chromium is vigorously reduced to the trivalent form by the action of chemicals present in stomach such as gastric fluid (22). However the results of another study show that chromium (VI) is reduced to the chromium (III) form in the red blood cells (RBCs) as well (23). Moreover, during reduction to the trivalent form, chromium may interact with cellular macromolecules, including DNA (18) or it may be released slowly from the cell (24). After conducting a series of experiments a group of scientists purposed various routs (routes) by which conversion of chromium (VI) to chromium (III) can occurs inside the body of an organism. They discovered that as soon as chromium (VI) enters inside the cell it is immediately incorporated by cellular reductants and converts chromium (VI) to the trivalent form. The reductants may consist of ascorbic acid, glutathione, and flavoenzymes. The example of glutathione is cytochrome P-450 glutathione reductase and the example of flavoenzymes is riboflavin. However, inter-conversion of one oxidation state to another oxidation of chromium instantly occurs when reducing agent is ascorbate instead of glutathione. At some point during the process of conversion from one oxidation to another oxidation state chromium is capable of producing many other types of unstable complexes as well as free radicals such as hydroxyl group (*OH) and single atom of oxygen (1O2). Besides the production of oxidan ts, the presence of DNA abrasions were also observed during this series of experiments. For example these abrasions may consist on oxidative damage of DNA, and production of 8-oxo-deoxyguanosine etc. However, it is still mystery whether to characterize the formation of various intermediate chromium complexes as potential carcinogen with respect to chromium (VI) (25-26). 1.4.2. Chromium Deficiency: Chromium deficiency has been associated with many factors such as impaired glucose tolerance, fasting hyperglycemia, glucosuria, elevated body fat percentage, decreased lean body mass, maturity-onset diabetes, cardiovascular disease, decreased sperm count, and impaired fertility etc (27). A recent comparative study revealed that supplement chromium (III)-picolinate is an excellent source of chromium towards its own deficiency as compared to chromium (III)-niacin (19). However there is a long list of fresh food and nuts that are available in the market that are considered to be a rich source of chromium (III) such as cereals, spices, fresh vegetables, meats, and fish etc. 1.4.3. Chromium Toxicity: Generally the toxicity of an element is measured on the basis of its lethal dose, where the tolerance limit of the body is exhausted and the consequences of high levels of particular element appear in the form of signs, symptoms, and medical impairments. These elements are estimated for their toxicity or carcinogenic potential exclusively by measuring their levels present in the blood of an organism for instance, tin and lead. However, chromium is exceptional among the list of carcinogens due to its versatile nature of retaining various oxidation states such as chromium (IV), chromium (V), chromium (IV), and chromium (III) etc. Therefore, chromium oxidation states have also been taken into account for the evolution of chromium carcinogenicity. For example, consideration of a hazardous waste material is dependent on the concentration of chromium present in the form of chromium (VI) while the other forms of chromium are classified as non carcinogens, according to the United States Envi ronmental Protection Agency (USEPA). Furthermore, it has been recommended that the measurement of toxic levels of chromium is also reliant on the availability of biological form of chromium (28).

Beneficial Effects of High School Sports on Athletes, Families, and Communities Essay

The beneficial effects of high school sports on athletes their families and communities are large. First of all I think there is a lot of pressure from parents when their kids are young to get involved in some sort of sports. For boys it is usually football they are throwing the ball with their dads when they are young and from there they go into a pop Warner league. So by the time they get to school most of these boys know how to play the game already. By playing the game of football in school it teaches boys how to play together as a team and to get along with their team mates. As football is a team sport they must learn to all focus on the same goal and that is winning. This is drilled into them from a very young age starting with the parents to the teachers and coaches. The team sport also teaches them how to be good sports when they lose as they learn from this that you can’t win all the time so you need how to lose as gracefully as you win. The sport also keeps the kids off of the streets and out of the gangs and gives them something to focus on and to look forward to. And in high school football these kids do not play for money they are playing to beat their rivals and for pride to be the best they can be. It also brings the community together in many ways first of all they all come together on Friday nights to watch the game. It’s like a social event where everybody gets to get together to talk and socialize. The community always comes together to support their high school football team, they have bake sales, car washes and many other events to help support their team. To be close to and involved in their children’s lives and the sports events they choose to support. The more support that the child gets the harder they try to be the best they can. Which is a good lesson for them to learn, something that will carry over into their adult life? The community also travels to away games to help support and cheer on their teams, and the money that is given to schools to help support the football team not only benefits the football team but the community by helping improve the facilities. This is money that the school board won’t have to charge to the community by way of higher taxes. So all in all everyone benefits from the donations that the boosters and alumni make to the school’s football programs and facilities. The children in the programs benefit because they learn leadership skills, communication skills they learn discipline they learn to be team players and they learn how to win and lose these are all skills that will help them all through their lives. At the games when half the town is there at the game and the school is playing their biggest rivalry all of the people there are all focusing on the same thing as the players and that is beating their rival. They feel like they are part of something big and important for the town and this bring everyone together as one.

My Grandmother Is An Artist - 897 Words

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She described how many artists such as Picasso, Van Gogh, and Dali were not considered to be true artists when they first started out, but ended up revolutionizing not only their own style of art, but the art world as a whole. She discussed how one of her first major pieces, Guns, a sculpture made entirely of plastic guns in the shape of a coffin, was lauded by critics for its political and social commentary, but never considered to be true art due to its style and material. My grandmother is right in her assessment that art is anShow MoreRelatedWhen I first read about Marina Abramovic, I found her performance art can be both shocking and hold800 Words   |  4 Pagesemotional exposure, and sadness. Marina Abramovic work is about self abuse, self discipline, and unreasonable punishment and great courage. Through the conditions she puts herself and her audience in her performance. 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The Plays of Tennessee Williams - 1740 Words

Tennessee Williams was known as one of the greatest and most controversial playwrights in American history. He once said â€Å"I believe that writing or any form of creative work was never meant by nature to be a man’s way of making a living, that when it becomes one it almost certainly loses a measure of purity† (Lewis 54). This statement shows that Williams was a genuine writer who used his plays and poems to express his own thoughts. Williams was known for his Southern Gothic writing style. This is â€Å"a style of writing practiced by many writers of the American South whose stories set in that region are characterized by grotesque, macabre, or fantastic incidents† (â€Å"Southern gothic†). Some critics believe that Williams had sacrificed his†¦show more content†¦It is shown throughout the play that lying is something people do daily in order to conform to society’s wants. Big Daddy has made his life, rose up from beneath and became a rich and social man. His son, Brick, knows what his family expects of him and refuses to let them down by even contemplating the fact that he may be homosexual. He has not been true to himself or the world in the aspect of love. He knows that neither the world nor his family would accept him if it turned out that he was homosexual, so he buries that thought deep inside him. The denial of his friend Skippers’ love for him tore Brick down little by little on the inside until he began to hate the world, and felt disgusted for being a part of it. This play is just one more reason that Williams was known as a controversial playwright. At this point in time, in 1955, homosexuality was not discussed publicly. When Cat on a Hot Tin Roof was being made into a movie all hints of homosexuality were taken out of the script because it was considered to be a form of perversion. 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Familial Conflict in the Short Stories The Yellow...

Many different conflicts arise in one household but it is also common in the short stories, The Yellow Wallpaper written by Charlotte Perkins Gilman and in Responsibility written by Russell Smith. In both short stories there are challenges that characters need to face due to the fact that family relationships are the cause. In the Yellow Wallpaper, the narrator is the protagonist she is a woman that is apparently suffering from nervous depression. In the short story responsibility, the son James is the protagonist, there are many differences between him and his mother they share a usual relationship where the child rebels against the parents’ wishes. In The yellow wallpaper the narrator is also the protagonist and her husband share a†¦show more content†¦The Narrator states that, â€Å"he is very careful and loving, and hardly lets me stir without special direction.† (Gilman, 56) meaning that he does not let her do many things, without permission it appears that the relationship is more of a doctor to patient not a husband to wife relationship. In responsibilities, James is the son and he and his mother both have different needs and wants in life, there are conflicts in this relationship because the mother is more of a traditional woman, and James has more of a modern outlook. Thus this creates conflicts within their relationship as mother and son. James has big dreams and wanted to achieve each and every single one of them but mostly want to get a book written about his music column he states that â€Å"it could be the kind of book that would sell outside this little... anyways. Yes, it’s a bigger risk y es, but actually it could pay off very well, if you do something successful. So I am being more ambitious than you and dad were.† (Smith 36) meaning that he wanted more than having to be nobody he wanted to be somebody and what he had was not enough. He was drawn to the fact that it could pay off very well. But the reality of it all was that his mom was pressuring him to having the normal life where he would get married and have a steady job and have kids, But James wanted to have his life his way. This is where the lifestylesShow MoreRelatedpreschool Essay46149 Words   |  185 Pagessays, â€Å"This is my platano.†* †¢ Using a large paintbrush, first paints some areas green and then uses a smaller paintbrush to make orange dots scattered among the green areas. Says, â€Å"This is a pumpkin patch.† †¢ Paints the sun as a round yellow circle. †¢ Draws what was seen at a Mardi Gras parade and shows the colorful drawings to the teacher. †¢ Uses finger paint and, on own initiative, adds a moon and a tree to the finished work. †¢ Draws a dragon and asks the teacher, â€Å"Do we

Case Analysis of Sutton Health Free Essays

string(24) " that this is achieved\." CASE ANALYSIS OF SUTTER HEALTH 1 Case Analysis of Sutter Health CASE ANALYSIS OF SUTTER HEALTH 2 Sutter Health is a non-profit network that is made up by community-based health care providers based in Northern California. This network introduced an interface that was aimed at enhancing revenue collection of the facilities from the self-pay patient. This network identified that traditional payment processing system had limitations that hindered the effective collecting of revenue. We will write a custom essay sample on Case Analysis of Sutton Health or any similar topic only for you Order Now What with the recession, healthcare organizations have seen an increase in the inability to collect debt from the self-pay, the uninsured and underinsured patients. This has caused a lot of struggle when it comes to the organizations to meet the operational margins and the profits. I find there are a number of reasons for the new increase in patient’s debts, the most common are, poor accounting practices, lack of patient information and correct demographics. There is new governance that is designed to provide more coordinated care to said patients (Gleeson,2010). There are five geographic regions that reflects the health care access to the customers of Northern California. Each of the five regions will have governance structure and it will oversee many of the Sutter affiliated medical facilities and also the hospitals. In its effort to increase point of service collections and improve the overall revenue cycle Sutter health took steps to measure performance using a handful of specific primary benchmarks, empowering PFS staff to assume responsibility for every individual account they handle, ensure each registration is analyzed using a rules engine to identify problems before patients leave the registration desk and ensure PFS staff receive appropriate co mprehensive training to excel under the new system† (Souza, McCarty, 2007). Obtaining the correct patient information plays a large part on non-collectable debt because patients are not able to be reached. These limitations were associated with limited access to accurate information by the account representatives, ineffective performance measures and fragmented centers of the service provision. The Sutter Health program developed a system that was comprised of solutions that were geared towards overcoming these limitations. I will be CASE ANALYSIS OF SUTTER HEALTH 3 discussing the new system that was created by Sutter Health. The key problems and issues, is that the United States healthcare system is characterized by huge upkeep from collecting revenue from patients. This situation is brought about by a health care insurance system which entails high deductible pay health plans and as well as higher co-payments plan. (Souza, McCarty, 2007). This situation has been made worse through the large proportion of the population not having healthcare coverage. The traditional health care system has had a hard time meeting their target revenue collection. This is due to several problems that attached along with the traditional payment system. Unlike when dealing with the payments through insurance claims but also dealing with the up-front payments that are required by the hospital for payment of services before the patient could even receive the service (Souza, Mccarty, 2007). So this means that the patient services staff (PFS) has to have complete and accurate information about above said client. This presented a problem for the traditional payment system where much of the customer payment system was processed in the back end. This system also required that the PFS staff ask for money from self-pay patients, but the PFS were not accustomed to this under the traditional system. The PFS staff found it hard to wait for the back end section to process customer information and to provide a breakdown of the patients payment details. So this became a tedious task for hospital accounting departments as well as for patients that had to wait a longer period before receiving services. The inefficiency of the traditional system not only resulted in low quality services, but also in low revenue collections. The system provides such a broad range of health care services, which include acute, sub- acute, home health, long term, outpatient care as well as physician delivery systems. These services are provided through an integrated health care delivery approach that gives the system the ability to deliver a full range of healthcare products and services. CASE ANALYSIS OF SUTTER HEALTH 4 Sutter also identified that PFS staff could not get ahold of real time information in operational and financial indicators such as cash collections and A/R (Souza, McCarty, 2007). So in the long run this meant that the managers and staff had to wait until the end of the month in order to identify the benchmarks. Sutter also recognized that the traditional system did not provide a means for analyzing selected data nor did it generate required detailed report on demand. This led to more cost as the hospital had to rely on programmers to generate such reports. The front desk staff also lacked real time information which hindered their ability to serve the client without consulting the back end staff. It also meant that the front desk staff could not monitor the patients progress (Souza, McCarty, 2007). Another challenge was that the PFS members were not empowered enough to be held accountable for each patients accounts they dealt with and it reduced the amount of accountability among the staff. These are some of the key challenges that the Sutter system were meant to address. The solutions that were employed by Sutter Health was an attempt to overcome the challenges stated above. Sutter Health implemented certain changes in the fore mentioned system that would make their operation more efficient. The strategies identified by the Sutter program entailed transferring most of the back end tasking to the front desk; providing accurate and complete information to managers and upfront staff; providing more effective performance evaluation and integrating all data elements within the system (Souza, McCarty, 2007). Allowing front desk staff to handle much of the payment process was deemed to have an effect on the efficiency of the process. Various solutions were employed to ensure that this is achieved. You read "Case Analysis of Sutton Health" in category "Essay examples" One of these solutions entailed using benchmarks to measure performance by the Patient Service Staff (PFS). Sutter identified a handful of primary benchmarks which included; Unbilled A/R days, Gross A/R days, Major A/R days, Cash Collection, Billed A/R days, and CASE ANALYSIS OF SUTTER HEALTH 5 percentage of A/R over 90, 180, 360 days (Souza, McCarty, 2007). This benchmark introduced shorter periods with which staff performances could be evaluated. This move was timely especially when onsidering that the industry has changed and things happen in terms of hours and days but not months. Another solution involved empowering the PFS members to have full responsibility over the accounts they are dealing with. This move was meant to increase a sense of responsibility and accountability as each individual members will be responsible for his or her own account (Souza, McCarty, 2007). This also gave the PFS members more autonomy to act as they saw fit and this improved the speed and efficient of service delivery by these staff members. The program also provided the PFS members with tools, that enabled them to automate their accounts, sort out their accounting using various means and seen their performances based on the achievement of the target. PFS and other accountant representatives were presented with individual dashboards that helped in the tracking of their progress in meeting targets. This also helped in enforcing the benchmarks set by this program. Sutter’s health program also introduced a front end collecting system as means of overcoming the mentioned problems. The pint of access collecting system introduced an opportunity for the health care facilities to reduce claims and denials. Though this system the patient records are analyzed before the patient leaves the registration desk. This enables the front desk staff to identify problems such as bad debt, patient or invalid patient type early enough and take the necessary corrective action. The Sutter health program also embarked on a comprehensive training program that was designed to support the existing PFS members and the registration staff. This gave staff the necessary competence to deal with the tools provided by this system. The training program also eliminated the need to hire formally educated staff to operate the system that would CASE ANALSIS OF SUTTER HEALTH 6 demand more than the $10-$20 an hour paid to current registration and PFS staff. For example, registration staff who were not used to asking patients for money were trained in effective communication skills. The training was also designed to introduce autonomy and effectiveness which acted as a motivator to the employee. The Sutter system allows staff to act with more independence which has made them active in owning the system. Autonomy is a critical element that enables workers to work effectively and deliver the best when it comes to their ability. The efficiency of the system has also made the work of the staff easier, acting as a further motivating factor for the staff. Another solution involved getting patients on board with this program. The POS collection system is not only beneficial to hospitals but also to the health care customers as well. (Souza, McCarty, 2007). This system provides a patient friendly billings which ensures transparency in the way customers are asked to pay for health care services. The payment system that is in force in other parts, bills the patient after he or she has already received the services and has already left the hospital. However, the Sutter program introduced transparency as the patient then gets to know what the services will cost him or her before they receive the services. It has become evident that patients would love to know how much the care they receive will cost them and this is what the Sutter program has provided. This system also offers a simplified system of settling hospital bills thereby making things easier for customers using said hospital system, customers are usually compelled to produce a lot of records and documentations in order to have their payment processed which introduces a lot of inconveniences. There is more accounting practices that are used by Sutter in identifying and solving problems, such as Sutter was discontented with the amount of revenue being collected from the self-pay patients (Souza, McCarty, 2007). The management team understood that the self-pay CASE ANALYSIS OF SUTTER HEALTH 7 patients were capable of meeting their medical expenses and therefore the problem was in their system. Sutter then resorted to evaluate the accountability and transparency in the process involved in the collection of revenue. It is through this evaluation that most of the traditional system did encourage responsibility and accountability to the people handling the revenue collection. Another accounting practice that was adopted was cost reduction. Accounting principles dictate that there are two major ways for increasing the margin; increasing profits or reducing costs. After exhausting all the avenues they could use in increasing revenue, Sutter embarked on a campaign that would reduce the cost of operation. This saw the collection process being integrated into a unified system. The methods used were also cost conscious, is why they opted for comprehensive training of their existing PFS and registration staff rather than hiring specially trained professionals, who would have demanded higher pay. Another alternative would be that Sutter’s strategies focused on improving accountability and autonomy of the staff in order to enhance revenue collection. Sutter health relied on solutions such as setting benchmarks and the empowering of staff. What they found to work was a full cycle of the amount payable. Amount payable refers to money owed to the institution by other parties while the full cycle refers to the amount of time it takes for the patients to settle their debt. (Rauscher, Wheeler, 2008). Reducing the full cycle may help to reduce the number of bad debts that a health institution suffers from. Traditionally a patient cycle followed procedures such as organizing schedule, registration, treatment, billing and collection (Solomon, 2011). The collection part is why the health institution is able to recover the debt owed to it by the patients. This section comes along after the treatment process is concluded and therefore increases the chances for bad debt. This paper proposes a system where bills are settled on a pre-service basis. The pre-service CASE ANALYSIS OF SUTTER HEALTH 8 system will be enabled by developing a system that standardized serves to make billing before the client receives services easier (Trans Union, 2007). A per item standardized billing is advised. This is why a standard is set for each and every hospital procedure and the patient is billed by summing up the cost of all service items he or she has utilized. In my informed opinion the approach used by Sutter Health was effective. This is because their approach was able to address the concerns raised by the network. Sutter health was concerned with the growing number of self-pay payments and the diminishing of the amount of revenue. The need to increase the amount of collecting from this section of market was the primary objective of developing this strategy. The success of every strategy is able to deliver the set goals. When it comes to Sutter Health it is estimated that revenue collection from the self-pay patients increased by an additional $78 million after the implementation of the strategy (Souza, McCarty, 2007). This is a clear indicator of the program’s success. One of the benefits is improved quality of care for the patient. One of the solutions identified by Sutter was bringing the health customer onboard. This system did this by factoring the customer’s needs into the system, making it customer friendly. The customer’s now spend less time processing payment while at the same time, the patient’s get to know of the cost they will incur before receiving the services. The system has also reduced the number of patients being denied treatment as a result of a streamlined inventory system. In conclusion Sutter Health is a non-profit network based in California and is made up of community based health care providers. This case discussed how Sutter developed a system that was able to improve revenue collection from the self-pay patients. Sutter recognized that the number of bad debts was rising along with the rising number of self-pay patients, This network conducted an evaluation on its facilities and identified that the problem of low revenue collection was linked to a disintegrated system of collection, in adequate accurate information CASE ANALYSIS OF SUTTER HEALTH 9 and poor performance indicators. Sutter Health employed solutions that entailed setting new benchmarks, empowering employees, factoring the customer’s interest and compressive training. References Rauscher, S. Wheeler, J. (2008). Effective Hospital Revenue Cycle Management. Journal of Healthcare Management Robertson, K. (Oct, 16, 1995). Sacramento Business Journal 12, 30: 3 Solomon, P. (2011). State of Healthcare Reform Revenue Cycle Retrieved from http://philcsolomon. om/2011/04/the-state-of-healthcare-revenue-cycle-an-insi ders- perspective-part-2/ Souza, M. McCarty, B. (2007). From bottom to top: How one provider retooled collection. Healthcare Financial Management 61 (9). 67-73 Trans Union (2007). Healthcare Collections: How Full Cycle Improvements Reduce Bad Debt. http://www. tranunion. com/docs/healthcare/businessneeds/healthcarecollectionsWP. pdf How to cite Case Analysis of Sutton Health, Essay examples

Employee Benefits (1803 words) Essay Example For Students

Employee Benefits (1803 words) Essay Employee BenefitsRob BarrBenefits that will come with a job might not make you take the job just because of that. But It could have major influence over your decision. Flexible scheduling, paid time off, and child care were singled out as key programs that impress job candidates. (http://www.amcity. com/)3 Employee benefits are becoming a major part of what employees are looking for from their companies. And in return companies are looking at their benefit packages trying to trim benefits that are not benefiting anyone. Or basically trying to get the most for their buck without upsetting their employees. Benefits also can be a way to motivate employees into better enjoying their jobs. By employers surveying their employees to see what kind of needs they have, they can better suit the benefits for their employees. Surveying is a primary tool for better understanding employees desires, and the migration of those desires.1(http://www.amcity. com/) And it is a good way of getting rid of unwanted benefits without upsetting the employees as much, because this is what they wanted. This paper will cover the topic of employee benefits, How they have evolved through time?, What types of benefits are being offered now?, and What benefits are required by law and which are not? EVOLUTION OF BENEFITSEmployee benefits, once known as fringe benefits, use to be only given to a select few employees. During World War II, there was a pay freeze in effect. Employers wanting to pay more to attract employees couldnt, so the stepped up the benefits offered to the employees. It was at this time that employee benefits started to grow and bring us to where we are today with all kinds of benefits. DIFFERENT TYPES OF BENEFITSOver time there has been a large increase in the different types of benefits introduced into the workplace. With benefits initially introduced to attract potential employees, there have been some very good ideas and some very bad ones. To start out lets first list the benefits that are out there. Retirement and Savings Plans Life Insurance and Death Benefits Medical Coverage Paid Vacations and Holidays Sick Leave Personnel Time/Flex Time Parental Leave Discounts Child care Employee Assistance ProgramsMost companies have some type of retirement plan set up. It could be in the form of a savings plan, 401k, pension plan or whatever they call it. There are two category types of pension plans. They are 1) contributions from the employer and 2) amount of pension benefits to be paid. Under these different types there are four different types of plans. They are: Contributory Plan- A pension plan where contributions are made jointly by employees and employers Noncontributory Plan- A pension plan where contributions are made solely by the employer Defined-Benefit Plan- A pension plan in which the amount on employee is to receive upon retirement is specifically set forth Defined-Contribution Plan- A pension plan that establishes the basis on which an employer will contribute to the pension fund2A spinoff of the pension plan is the 401k plan, which is named after the section in the Internal Revenue Code. This plan is becoming more popular since its introduction because it is tax deferred and it is taken out by payroll deductions. Since the 1992 Presidential election, health care has been on the hot seat for a lot of companies. There are usually two different types of health care available for employees. Health maintenance organizations(HMOs) which are organizations of physicians and health care professionals that provide a wide range of services to subscribers and dependents on a prepaid basis. And Preferred provider organization (PPO) which is a hospital or group of physicians who establish an organization that guarantees lower health care costs the employer.2 And since health care costs are on the rise companies are finding ways to combat this. Bob Smith Essay These programs are designed to help employees with school and tuition reimbursement. Usually you take the classes and after the semester and you receive passing grades, they give you back a prorated amount of your tuition. BENEFITS REQUIRED BY LAWThere are several benefits required by law. Workers Compensation Insurance covers workers injured in the line of duty. The injury has to keep the worker out of work for an extended period of time. The worker usually receives a prorated amount of their pay. The next is social security insurance. Both the employee and employer contribute to the fund. The employer matches what is put into it by the employee. When the employee reaches 65 years of age is when they can start to draw on their social security and receives a prorated amount. And the last is unemployment insurance. This is when an employee is fired from a job or laid off and have to be covered by the social security act, will receive up to twenty six weeks of unemployment insurance through their unemployment. EMPLOYEE FEELINGS ABOUT BENEFITSHow employees feel about their benefit packages is just coming into play. Most companies are asking their employees what they would want in their benefit packages. But employers be ware Surveying employees when no action is likely to be taken, which can engender distrust.(http://www. amcity.com/)1 Surveying employees of what they want is a great way to communicate and motivate their employees. By employees seeing management listening and communicating will help bust moral in the company. Surveyed more than 800 employers nationwide representing 7 million workers, and nearly two-thirds of these organizations said the programs have a positive effect on morale, while half say the programs improve attendance and productivity. (http://www.amcity.com/)3 Along with this survey, nearly three-fourths (74 percent) of Midwest employers said that flexible work scheduling is the most important issue they have to address.(http://www. amcity.com/)3 Employers are getting more information than they thought they would from these surveys. This information can better help them improving conditions with employees in a number of different areas, like morale, communication and motivation. CONCLUSIONBenefits can be used for many different motives. To boost morale, communicate with their employees on their concerns and needs, and to motivate their employees about their job. There are a lot of different of benefits a employer can offer its employees from health care to dental to child care. And even before a potential employee accepts a job, benefits might weigh heavily in the decision of which job to take. Bibliography. Companies see a benefit in seeking employee feedback, Business Times, Douglas Robson. http://www.Amcity.com/sanfrancisco/stories/032497/focus2 2. Managing Human Resources, 1996, Arthur Sherman, Scott Bohlander, Scott Sneel. South-Western College Publishing 3. Programs to balance work, family lift workers morale, March 31, 1997. Http://www. amcity.com 4. Wellness programs are worth every dollar you spend, March 31, 1997. Miriam Sims http://www.amcity.com Business Reports