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Opening North Alabama Medical Center Hospice Unit


The health care system plays a significant role in people’s lives. It provides an environment for treating various health conditions and illnesses and allows for the education of healthcare professionals and conducting of clinical research. Most medical centers usually provide their patients with inpatient and outpatient services depending on the severity of the illness and the available facilities. However, hospitals require resources and facilities to improve the quality of services. This paper focuses on opening an inpatient Hospice Unit at North Alabama Medical Center situated in Florence, Alabama.

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The inpatient hospice care project aims to provide an eight-bed unit for caregivers and patients experiencing life-limiting, advanced illnesses in North Alabama Medical Center. The project aims to improve hospice care quality provided to patients of all ages, including the young and the old. Furthermore, the initiative will serve all people regardless of their gender, race, or ethnicity. Research has shown that low-income people usually receive poor quality health care and lack access to hospice care. However, the project will enable the opening of an affordable unit that will be available to patients of diverse socioeconomic statuses. In addition to serving people from urban areas, the team will help people from the rural parts of Alabama.

Health Epidemiology

The people of Florence, Alabama, are affected by various health conditions and diseases. The city is mostly facing challenges in dealing with chronic health diseases (Cain, 2019). The solution to this problem is complex because the city has the most significant number of people with stroke and among the highest diabetes and kidney disease rates. According to US CDC, many people in Florence also have significantly increased levels of obesity and heart disease (Haverhals et al., 2019). This situation has mainly been attributed to the low levels of physical activity and fruit and vegetable intake in the area.

The percentage of adults with hypertension in Florence, Alabama, exceeds 42.5 %, while those with diabetes are about 14%. The children who have obesity in the area are 16%, while adults are more than 36% (Haverhals et al., 2019). Moreover, deaths related to drugs, alcohol, or suicide are on the rise in Florence. In addition, the current level of health in Alabama State has placed it 48th in the United States health ranking (Noh et al., 2018). The leading cause of death is heart disease, with a rate of 223.2. Cancer, stroke, and chronic lower respiratory infections have a rate of 170.0, 50.0, and 57.8, respectively (Haverhals et al., 2019). Diabetes and kidney disease have also caused many deaths, with 19.8 and 16.5, respectively.

The rise in health issues in Florence has led to an increase in healthcare costs despite options that make it affordable. Almost half the city’s population receives health insurance coverage from their workplaces, and 35% acquire it through Medicare (Haverhals et al., 2019). However, there are about half a million residents who do not have any health insurance coverage. Nonetheless, those whose income is low are provided subsidies to reduce costs and make plans more affordable.

Determinants of Health

There are various determinants of health for hospice patients, including the political, social, and behavioral components. The political determinants of health consist of factors present due to competing power groups, interests, and ideologies within various administrative systems. For instance, the health policies in Florence have contributed to the current status of hospice units in the city (Noh et al., 2018). The policy on subsidies of health care costs has improved the quality of care provided to patients in hospice units (Cain, 2019).

Moreover, social determinants such as economic stability and education access have reduced the number of sick people considering hospice units in Florence. The amount of income most people receive is below the national average (Haverhals et al., 2019). Therefore, many of them are forced to lead unhealthy lives and have reduced access to medical services. Additionally, a positive change in a person’s behavior can significantly cause a reduction in the rate of chronic diseases (Noh et al., 2018). For example, behavioral determinants of health, including diet, physical activity, and drug use, substantially define the health of hospice patients.

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System Participants

The inpatient hospice unit will work with various healthcare systems to ensure patients are fully supported. The micro-system will perform the day-to-day practice of patient care, and the members will include the primary physician and hospice nurses. Conversely, the mesosystem will link the microsystems to ensure the provision of quality patient care. The participants of the mesosystem will consist of the medical director, clinical director, and medical records coordinator. At the same time, the macro system will deal with regulations, economic barriers, and job availability. The membership will include the executive directors and managers of the hospital.

The executive director will play the role of strategically directing the medical center toward the unit’s growth. On the other hand, the primary physician will be responsible for caring for the patient and attending to their needs individually. Advanced practice registered nurses is also an essential part of the hospice care project. They will be responsible for assessing, diagnosing, and managing the patient’s problems, prescribing medications, and ordering tests.

Moreover, the medical director will be responsible for the overall management of the patients by the unit disciplinary team. He or she will also provide consultation on palliative care to the physicians and other team members. Likewise, the hospice nurse will have the responsibility for every patient. He or she will ensure patient care is followed through the development and management of the nursing care plan.

Furthermore, the medical records coordinator will have the role of faxing orders and ensuring that suitable patients utilize the equipment and medications. The individual will also ensure hospital records are well stored. Another project participant is the clinical director, who will ensure the staff accomplishes their daily workload of offering direct patient care. Still, there is a need for a spiritual care coordinator who will provide spiritual assistance to patients who desire it.

Finally, there is the community relations coordinator, who will link the hospital and the community. He or she will ensure the community is educated on matters involving hospice care. There are various stakeholders in the eight-bed inpatient hospice unit. The internal stakeholders who operate within the organization include the staff and other hospital employees, while the external stakeholders are the Florence, Alabama community, suppliers, and government.


Hospice care is essential for every community since it provides quality care and ensures comfort for patients in the last stages of incurable diseases. The eight-bed inpatient hospice unit at North Alabama Medical Center will ensure all community members have the opportunity to receive care regardless of age, race, or gender. The professional healthcare team and other hospital employees will work together to ensure the achievement of the project goals.


Cain, C. L. (2019). Agency and change in healthcare organizations: Workers’ attempts to navigate multiple logics in hospice care. Journal of Health and Social Behavior, 60(1), 3-17. Web.

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Haverhals, L. M., Manheim, C. E., Mor, V., Ersek, M., Kinosian, B., Lorenz, K. A., Faricy-Anderson, K. E., Gidwani-Marszowski, R. A., & Levy, C. (2019). The experience of providing hospice care concurrent with cancer treatment in the VA. Supportive Care in Cancer, 27(4), 1263-1270. Web.

Noh, H., Kim, J., Sims, O. T., Ji, S., & Sawyer, P. (2018). Racial differences in associations of perceived health and social and physical activities with advance care planning, end-of-life concerns, and hospice knowledge. American Journal of Hospice and Palliative Medicine®, 35(1), 34-40. Web.

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