Original Major Proposal

Eva Knee, 2020

Susan Huehn 

Working Title: 

Public Health Policy & Administration: Study of Local and Global Healthcare Systems

This includes the integrative study of health care, business, and management. I plan to use these courses to acquire business fundamentals and how to coordinate technology, people, and resources efficiently in healthcare facilities. Additionally, to be prepared to oversee the finances, resources, services, and business operations at hospitals, nursing homes and other medical facilities.

I have special interest in end-of-life care and the ethics around palliative care and America’s current approach to it versus other cultural approaches to death and dying. I am also very interested in the use of slow medicine and how we can incorporate those practices into the acute care setting. My idea of slow medicine is dealing with the environment of a patient such as their basic needs, support system, economic status, etc and removing any obstacles in the environment that is inhibiting poor health to allow the body to naturally maintain itself with time. Although I have two main interests as of right now, I would not like to specific my undergraduate studies because I want as wide an education and perspective as possible. 

 

Questions:

What is the sustainability of acute care hospitalization versus long term care, both financially and personally?

I am a proponent of slow medicine, and as of right now, I see no place in which that fits in the American Healthcare System – is there anywhere or any way that it could? 

How does the allocation of money and time best work to promote Healthcare? Should we be focusing on progressions in technology (expensive and inaccessible to lots) or on maintaining steady but sturdy healthcare (more accessible, but less flashy)? 

Is healthcare equally accessible to all population demographics? 

What role does America’s “suing” culture play in healthcare economics? 

How does alternative medicine interact with acute care? What role does alternative medicine play in global health and distributing medical resources? 

How much value is placed on ethics while prescribing patients their medications? Do doctors look at the financial burdens? Why can medications cost an exorbitant amount for patients compared to their cost for hospitals? 

Do specialty clinics work better than general clinics? 

Why are places like the Mayo spending Millions of dollars on creating obscure and exclusive treatments rather than using money to bring all of the US to the same base line of healthcare? Or global base line to the same level? 

 

Courses: 

Administrative setting

This cluster of classes prepares me for a very practical perspective of healthcare administration, or any administration for that matter. I will be introduced to topics such as inflation rates, bookkeeping, management skills, etc. The set of skills that this cluster prepares me for will give me a good insight to a workplace environment and how to navigate various roles in the workplace. 

 

Statistics for Science (STATS 212) Spring 2017

  • This statistics course opened my eyes to the idea of research and how to pursue any research. I was able to learn simple coding, using “R” and the basis of sample groups, control groups, variables, etc. If I want to study any portion of healthcare, whether it be patients or staff, I have the ability to implement research proposals and studies. 

Management (MGMT 251) Fall 2019

  • Working in a team of healthcare professionals, having basic leadership and management skills will be a great asset to my career. Learning how to work efficiently and effectively with others, and learning how to be appropriately professional when personal differences arise, is a priceless skill. This class will undoubtedly help me gain understanding of a business structure and where health care administration fits into that. 

Organizational and Industrial Psychology (PSYCH 250) Spring 2019

  • Gaining knowledge about the systemic psychology of an institution is vital for a career in an administrative role. Studying the dynamics of the ladder of demand, work relationships, and other various organizational elements will give me a basis of understanding and knowledge about how to create a productive and efficient work environment. Working in Healthcare it is important to foster a good work environment, because when there is toxicity, people act poorly and make mistakes. Making mistakes is normally rather understandable, but in the healthcare setting it could mean life or death. 

 

Theory of healthcare 

The classes presented in this group of academia are beneficial to me in the sense that they help me evaluate and assess healthcare. I will be learning critical skills to study, recognize problems, and think of strategies to manipulate healthcare systems for the better. Having a “big picture” look at healthcare and all the fields it directly and indirectly affects will allow me to be a productive member of the healthcare community. 

 

Medical Anthropology (SOAN 267) Spring 2019

  • This course will assess the dynamics of healthcare across many cultures and subpopulations. We will be looking at the access to healthcare, the values placed on healthcare and various types of healthcare (acute care, long term, holistic, etc). Studying the way in which people view medicine can help to gain perspective on global health. 

Healthcare Econ (ECON 245) Fall 2019

  • After obtaining a basis of economics, it would be infinitely beneficial to study economics in the healthcare setting. Being able to assess the politics of money, time, equipment, and resources will give a very helpful insight. Additionally, I will be able to use these skills to assess cross-cultural healthcare economies. Obviously American healthcare is exponentially more expensive than any other country, and I want to study why that is. 

Biomedical Ethics (PHIL 250) Interim 2018

  • This class studies the ethics of various medical practices around the world. We assess specific cases and the philosophical thought behind the case, some arguments in favor and some against the ethics of the situation. This created a new perspective of thought for students, and it encouraged a deeper level of thinking in correspondence to medical scenarios. The ethics of dealing with a human body differ dramatically across cultures, religions, etc and having the capacity to recognize and ponder that is an asset to working in the healthcare field.

Frontiers of Aging (ID 271) Spring 2019

  • The study of aging and how we, as a society, deal with aging is a fascinating and relevant topic. We will be diving into questions about end-of-life care and how our perception of it has changed over time. What are the familial responsibilities with the elderly? What do our facilities look like and their regulations? Studying the inevitable end-of-life stage will broaden my realm of healthcare administration professionalism, especially because Long Term Care is astonishingly prominent in America. 

 

Healthcare Practice 

These classes have exposed me to real healthcare settings and situations from which I have learned the feasibility and reality of changes in healthcare, or lack thereof. I have observed and collaborated with nurses to assess patients, participated in interdisciplinary meetings, and studied the impact of Medicare/Medicaid on healthcare accessibility. These classes have also opened my eyes to the acute care of American health through pathopharmacology and nursing diagnoses. 

 

Fundamentals in Professional Nursing (NURS 311) Fall 2018

  • Having a basis of knowledge in the nursing profession will help me to gain perspective in a healthcare setting. I have learned the foundation of care plans, nursing objectives, scope of practice and much more. Being able to understand the job of a nurse, a backbone of any hospital, will give me a more detailed and accurate insight to the needs of healthcare settings.

Pathopharmacology (ID 210) Spring 2018

  • This course studied over 100 of the most common medications used in healthcare today. We learned the drug name (generic and trade), method of action, side effects, and contraindications. Obviously medication is a large part of the acute care health system that we partake in, and I believe that having a firm understanding of those drugs will help me to develop as a professional in a Healthcare setting. 

Exploration in Healthcare Vocation (ID 110) Interim 2017

  • I was able to explore a plethora of healthcare vocations, thus widening my perspective and understanding of healthcare and the roles that each job play. I was able to study the intertwining and relationships between healthcare professions, including the administrative side. I gained a systemic view of healthcare from this course. 

Gerontological Nursing (NURS 311) Fall 2018

  • We study the process of aging within the context of holistic health. Obviously there is a large demand for end-of-life care as the “baby boomer” population ages. Grasping the initial ideas of caring for the elderly includes pathopharmacology, ADLs, family involvement, etc. This class acts as an introduction for healthcare professionals to better understand their role within the end-of-life care dynamic. We also talk a lot about the ethics of palliative care/ life supporting care, and we discuss cultural differences in caring for the elderly. 

Holistic Health (NURS 211) Spring 2018

  • Evaluating the patient as a whole person was the focus of this class. We were taught to see not only a disease or singular problem with a patient, but to study their environment, support system, etc. This class helped me to see the ways in which slow medicine is slightly included in acute care settings, and allowed me to see where it could be more integrated, as well. 

 

Supporting Courses and Experiences

Principles of Accounting (MGMT 225) Spring 2019

  •  I will need to know simple accounting skills because that is a part of the administrative side of healthcare. This class will give me an understanding of the income statement, statement of retained earnings, balance sheet, and statement of cash flows. How business events are recorded and represented on the financial statements and how to use the information to make sound economic judgments.

Introduction to Sociology (SOAN 121) Fall 2016

  • Answering questions about the basis of human nature such as “What is human nature?” or “Do societies have a culture?” and others help to create a foundational examination of peoples. Additionally, I learned research methods related to sociological research, which can help ensure a good work environment, work dynamics, patient-doctor care, etc. Being able to recognize and assess the unspoken questions of society is a useful skill in all disciplines. 

Developmental Psychology (PSYCH 241) Spring 2017

  • In this course, we attempted to understand human development from the moment of conception and across the life span. The course focuses on biological and environmental factors that shape human development. This information is pertinent because it helps one to understand the health problems that may arise over a lifespan, as well as the ability to deal with problem. Additionally, it is relevant to have a deeper understand of humans while working with them in any capacity, hospital administration included. 

Leadership

  • Student Government Association: I am executive assistant of the budgeting branch of SGA. My branch specifically deals with recognizing and funding student organizations on campus. 
  • Residence Life: I have been and continue to be an RA for 40-60 residents. I maintain and safe and welcoming environment for them to live in, as well as planning events for my residents regularly. 

Administration 

  • Building supervisor: I was in charge of two recreational buildings for which I had to schedule clubs to use the space (volleyball, swimming, etc) and organize the memberships into computer and paper files. 
  • Poster room renovation: I was given $1800 and 3 months to redo a room used by students to create posters and other publicity materials. I had to budget time and money, and work with the director of the space to create a productive space. 

Work Experience 

    • Nursing Assistant: Spending the summer as a NAR gave me very relevant insight to the practices of nursing aides and allowed me to observe the work of nurses in the long term care setting. 

 

  • Potential Internships: I have applied for multiple very relevant internships for this summer. The list includes Bioethics at the Mayo Clinic, Center for Innovation at the Mayo Clinic, Marketing and Fundraising at Doctors Without Borders, etc. 

 

 

Senior Project 

  • (NUMBER ONE CHOICE) Work in collaboration with Northfield Hospital to shadow and interview an administrator. While shadowing an administrator, I will learn about the facility and their gaps in information – which populations they are reaching, which they aren’t. Various insurances and how the affect care. I would assess why specific population needs are not being met and try to theorize and figure out a logistical way to implement programs to reach those populations/communities. The plan may include healthcare education about ethics, regulations, hygiene, safety, etc. This will allow me to gather on-floor knowledge about healthcare administration, as well as putting to practice the skills needed to be an effective healthcare administrator. 
    • Setting up appointment with Tammy (at Northfield Hospital) 
    • Population and gap in care – hispanic women delivering babies or mental health needs in children 
    • Work on proposal research question 
    • Population will become evident while interviewing 
    • Do interviewing this semester!!!! 
    • Political route — who creates policy 
    • Ask Susan about presentation 
    • MINOVA healthcare summit – october minneapolis 

Rationale

Healthcare is an exponentially booming industry and is often a source of great controversy. Many people believe healthcare lies primarily in politics and legislation, however, I see there is a great need for change within established healthcare infrastructures. No matter what changes on the political side of healthcare, it is meaningless if the practitioners fail to change their practices. Therefore, I am deeply interested in diving into the healthcare system and gaining insight to the change that needs to occur on individual institutional levels. Although I plan to go through an administrative perspective of healthcare, there is a great deal of connection with nursing, physicians, lab techs, etc. Creating specific programs or incentives to practice medicine a certain way is what we need to slowly change healthcare into a more accessible and affordable system, however, we need collaboration with nurses, physicians, techs, nursing aides, etc to make that happen. Administration is just one small part in the bigger picture. 

Creating this major at St. Olaf is ideal because St. Olaf allows me to gain a wide perspective. I am able to study philosophy, religion, economics, accounting, and countless other topics and relate them all back to my prospective career. Additionally, as I have been involved with the nursing program here, I have been able to go into facilities (Northfield Hospital, Three Links, and HealthFinders) in order to more closely study the inner workings of healthcare systems close to home. St. Olaf also offers a vast network of alumni that I can contact in order to make connections within healthcare administration and to potentially interview for a senior research project. 

Healthcare Administration, especially on the global level, is extremely multi-dimensional. Religion, culture, spirituality, gender, and so much more plays into the way in which patients receive healthcare and how professionals give healthcare. Studying this topic at the undergraduate level demands an integrative education. One must be familiar with the concepts of philosophy, religion, maths, economics, etc and one must also be an active and independent thinker. Using critical thinking skills developed through a liberal arts education will be pertinent to assessing and progressing healthcare. 

Our Mission. St. Olaf College challenges students to excel in the liberal arts, examine faith and values, and explore meaningful vocation in an inclusive, globally engaged community nourished by Lutheran tradition.

The mission statement at St. Olaf deeply correlates with my intended major. When thinking about the direction I want my studies to pursue, I am consistently drawn towards the global level of healthcare dynamics. Attempting to understand and work within the global relationships of healthcare through different types of medicine and practices is a critical part within my academic goals. Assessing my own values and beliefs throughout my education and onward will be an ever-changing foundation of which to base my career on. Not only will I need to be constantly assessing my own values and beliefs, but those of the people around me. Although healthcare is generally universal in some sense, it is extremely intimate in it’s delivery and methodology to different groups of people. Educating myself about faith and values, both locally and globally, will be fundamental in my undergraduate education and in life. 

Self Description 

Accepting my position at St. Olaf, I never thought about creating an individual major. In fact, by the time I started my junior year, I had not thought seriously about creating my own major. I did not have a pin-point topic that I knew I was passionate about, instead I thought I would fit into a pre-existing major and after college I would specify my studies at graduate school. Throughout my first two years I changed my major twice. I came into St. Olaf thinking seriously about Music Therapy, and then after shadowing a music therapist, I realized I yearned for more patient interaction. Nursing appealed to me specifically because of the relationship with the patients. A nurse not only acts as an advocate and support for the patient, but also as a liaison between a wide array of healthcare professionals. Thus, I declared a Nursing major. I spent 2 years in the nursing degree, and thought I would graduate with a nursing degree and later go into nursing administration. However, throughout the progression of my studies, as clinicals started getting more serious and we created patient care plans, etc, I realized nursing is not where I want to be. I learned a lot about systemic healthcare and about the hierarchy of professionals, but I ached to study the theories behind healthcare practices, rather than the practices themselves. 

I was intrigued by the practice of slow medicine, and so I took that idea and ran with it. I read a lot about holistic therapies, old European and Chinese medicine practices, almshouses, and about the introduction, and takeover, of acute care medicine. I was much more interested and passionate about my outside readings and studies than the skills I was learning in class. Eventually, I realized I wanted to make my career in continuing those studies of slow and holistic medicines, I just needed to figure out how to make that a reality. After speaking with professors about potentially going into healthcare administration after college, or going into public health, I decided I wanted to use my time at St. Olaf, and all the opportunities St. Olaf presents, to kickstart my career in healthcare administration. Bizarrely, there is a gap within the preparation into healthcare at St. Olaf and there are no classes or majors for healthcare administration, specifically. Therefore, I am using the great classes St. Olaf does have to offer, as well as external opportunities such as internships, to best prepare myself for healthcare administration. Because of the large amount of independent study I have done in the last few years on the topic, I believe I am very capable of pursuing a more structured study of the topic with the help of professors and mentors. 

After having started this process, I have had ample time to think about how I got here, and I realize there was no exact moment in time or event that happened, it was an accumulation of experiences. I lived in England until I was 10, where there is national health insurance (National Health Service), and after moving to America I was able to easily identify the differences in the systems – time allocation, resources and services offered, priority patients, etc. Additionally, my father quit his job during our time in America and my family was left without health insurance for 2 years. Eventually, after months of paperwork and waiting, my brothers and I got Medicaid Insurance, but my father was not granted help from the Government because he was not a US citizen. Through that process I caught a glimpse of how difficult it is to get government healthcare for citizens, and how inaccessible it is for non-citizens. Finally, my family is very internationally spread, we have aunts/uncles/cousins on 6 of the 7 continents. Through conversations with those family members, I have gained a small insight to some of the universal issues around the world, one of the most prominent being healthcare. There is a huge gap in healthcare services across nations, partly dependent on practices and customs, but largely due to resources – finances, equipment, professionals, etc. That gap is an issue most people are aware of, but not enough people are doing anything about. I hope to try to understand that gap and make decisions/programs to create some sort of change in the right direction.

Consultations

Peer review

Our peer review session took place on Tuesday, November 27th. I had two other junior class students read my proposal draft, while I read theirs and we gave each other constructive criticism. My peers made great comments and were very reassuring in my progress. I took all of their comments to heart, but a few that really stuck out to me included their suggestions to think more about my initial questions. I had a lot of specific questions that I verbalized in conversation, and they told me to write them all down – rather have too many than too few. Additionally they suggested I add more in my rationale about my journey from music therapy to nursing. My career goals always involved healthcare, but changed from frustration of lack of patient interaction, to wanting big picture theories, and my peers wanted a more in depth look at how that happened. 

Librarian session

I met with librarian, Jason Paul, for the first time on Tuesday, December 11th. Firstly, I spoke with him a bit about what brought me to this point of my academic career in which I am creating my own major. That conversation included me talking about my rationale, my ideas and questions, and my journey with the nursing program. Right away Jason noticed that I have a lot of questions and that they are very wide spread, which is understandable with a topic as large as healthcare. Jason suggested that I work to specific my questions and ideas, especially as we approach the senior capstone project. I elaborated a bit on my ideas for a senior project – potentially working with Northfield Hospital, VA, and Allina to observe and conduct some sort of research with the facility to compare different styles of healthcare. Possible research opportunities are studying the archives to look for changes/progressions in practices, interview staff about their experience with administration and protocols of the hospital, or interview patients about their view on the healthcare they are receiving. I need to look more into the IRB and HIPAA to see what possible research is feasible, but all ideas are very exciting to me. Jason also helped me pinpoint some databases to use to find articles and studies for comparative knowledge and general information about healthcare administration. He also helped me emphasize classes that will be incredibly beneficial such as healthcare economics, statistics for science, and getting in touch with professors such as Jason Marsh and Ashley Hodgson. After I have a more specific and planned idea for a senior capstone, I will definitely be going back to Jason for help with research and data collection. 

Faculty

Susan Huehn: Susan has been an immense help. Holy cow! Susan has been my advisor as I navigated the nursing major, but when I told her about my interest in administration she was so wonderfully supportive and excited! Not only did she give me advice about which classes to take, but she emailed professors on my behalf, put me in contact with leadership at Northfield Hospital and suggested readings that would assist my interests. Susan has sat and brainstormed with me about my overarching questions, about resources I can use at school to obtain the education I am looking for and she has given guidance about potential senior projects. I look forward to continue working with Susan through this process. Hopefully I can act as a sort of guinea pig so that this pathway may be open to other nursing majors interested in the same field as myself. 

Ketty Holt: Ketty has been one of my professors in the Nursing Department for two semesters. She was the first faculty member who had suggested that she did not necessarily see my future in “on the floor” nursing. She suggested that I may look into research, academia or education as a future career in the nursing world. I was shocked, and slightly upset, but I realized that the source of my frustration with the comment was that I agreed with her, but had been trying to convince myself otherwise. Once I had processed and thought about the information more, I went to Ketty’s office and told her about my plan to go into administration. She was very supportive and gave me advice on what to tell other professors in the nursing department. She also has helped push me in class to think not only of clinical nursing when we are studying various topics, but to think of the logistics behind it that excite me.