Address the stages that transgender youth experience when supported or not supported by family.

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Read the provided case(Wanda J) and answer the following 10 questions in the form of Term Paper with your ideas and support your ideas, possible barriers and solutions with references. The paper should be 3 pages, 8-12 font size, 1-1.5 spacing. You have full creative license in describing the family, interventions, resources and solutions.
this is a timely matter paper!
The Case of Wanda J.
Wanda J. is a 14-year-old African American girl, born to an intact middle class African American family. She is an only child. Her father is a manager of a trucking company and her mother is a court stenographer. As of late, Wanda’s grades have started dropping in school. When questioned by her parents, she states that she is very unhappy because she has realized in the past few years that she was born into the wrong body and is really a male. In fact she states that in the future, she would like to change her name to William, undergo hormonal treatments and eventually have her breasts surgically removed and have a penis surgically constructed. Her parents are “incredulous” to the situation and think their daughter is “insane.” They have taken her to a psychologist who happens to be white/European, and who has diagnosed Wanda with “gender dysphoria.” The psychologist has also deemed her to be “competent” with no signs of psychosis. Her parents who are also conservative Catholics, are enraged with the doctor’s diagnosis stating that “because the psychologist is white and liberal, she is excusing behavior incompatible to God’s will.” The parent’s believe that their daughter is misguided or even “mentally ill” concerning her preferred gender identity. Out of frustration, they yell at and berate Wanda every time she discusses her desire to become a boy. As of late they have even put together a religious support group to “pray away” her desire to be a boy.
Wanda, who can no longer stand her parent’s hostile and conservative religious attitudes, takes an overdose of her mom’s sleeping pills and is brought to the emergency room where she is medically stabilized. Wanda states to the ER physician, that unless her parents support her gender identity transition, she will continue to hurt herself. She is therefore hospitalized for depression and continued suicidal ideations.
Her parents are angry with her continued insistence on sexually transitioning as well as her threat to hurt herself, but because they do love her, also feel guilty that their actions may have resulted in their daughter’s suicide attempt and hospitalization.
The parents insist that Wanda not be released from the hospital until the medical team (which you lead) “cures” her gender identity issue/obsession.
Formulate a culturally responsive treatment plan for Wanda and her parents, incorporating the following points:
Address the stages that transgender youth experience when supported or not supported by family.
How are transgender individuals viewed in society in general and African American society in particular?
How can you help Wanda’s parents work through their rigid social, racial and religious belief system so they can constructively address her gender dysphoria?
What might happen to Wanda, physically and or emotionally if she is denied the wish to transition?
How can you address Wanda’s depression and gender dysphoria using established medical and psychiatric treatments?
In what ways would you educate the parents about transgender issues?
How can you help her parents deal with their guilt, anger, and frustration with this situation?
If you gain the parent’s permission, what services and or recommendations would you offer Wanda regarding her transition?
What would her parents need to know regarding supportive and constructive behavior towards Wanda if she goes through the transition?
Discuss other Cultural Sensitivity and Competence issues that may impact and even ameliorate this case?

Identify a real-world example of a healthcare error that impacted patient safety

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Identify a real-world example of a healthcare error that impacted patient safety. Use the readings and your knowledge of risk management and quality/performance improvement to write a report to the chief executive and board of governors of this organization stating your assessment and recommendations for improvement. Your report should describe this situation and the impact on patient safety:
-Who was affected and how did it influence quality service delivery at this facility?
-How was this event handled by the healthcare leaders and internal stakeholders? By external stakeholders?
-What recommendations do you have for performance improvement to prevent this situation or event from reoccurring?
Your report should meet the following requirements:
-Be formatted according to APA Requirements.
-Provide support for your statements with in-text citations from a minimum of four (4) scholarly articles— sources must be within 10 years.
-Utilize headings to organize the content in your work.

What are the best ways to mitigate risk in health care settings?

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What are the best ways to mitigate risk in health care settings? Consider a focus on patient safety/satisfaction, data, and culture (i.e just culture) of the institution. Analyze at least three methods to mitigate risk, providing examples and supporting evidence.

discuss what you would do to re-launch a population health management program after this episode of chaos in the clinic

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Dr. Lynn is a DBH and a relatively new member of the Patient-Centered Medical Home team in a busy, but small urban primary care clinic. Dr. Lynn has been working in the clinic for 9 months as the first and only Behavioral Health Consultant. She took great care to establish herself with the team. From the office administrator to the four PCP’s, four nurses and the nutritionist. Dr Lynn educated the team about the importance of integrated behavioral health and demonstrated the value of the hallway hand-off. Over the past few months the team gained increased understanding, confidence and interest in referring patients with appropriate problems – poor medication adherence, difficulty making and maintaining changes in nutrition and physical activity, depression and anxiety co-morbid with medical disease.
Dr. Lynn wanted to take it to the next level. She wanted to put into practice the lessons learned in her DBH program and implement a population health management program. She decided to implement a combined depression and substance use disorder screening program using the PHQ-9 and the AUDIT. Further, she would use the new reimbursement codes for both SBIRT screening and for patients at high risk, the new chronic disease care management codes. Dr. Lynn decided that she would start a new stress management group for depressed patients. Patients who met criteria for “sub-threshold” depression as well as DSM-V depression would meet criteria for assessment and treatment. She would also start an education and behavior change group for substance use disorder for patients with mild to moderate severity substance abuse based on the AUDIT. Consistent with the SBIRT model she would refer patients with severe substance abuse to a local specialty substance abuse clinic. After patients were stabilized she planned to conduct telephonic follow-up and educate patients on the use of internet and smart phone APP behavior change resources.
Dr. Lynn spent several months planning this new population health management program. She was excited about the opportunity to achieve the triple aim. By identifying and treating patients she would improve the patient experience of care. By using a population health management program she would improve the population of the entire clinic population of at-risk depressed and substance abuse patients in the clinic. She knew that these patients had higher utilization and associated costs and was confident that with appropriate treatment clinical outcomes would improve, hospital and ED utilization would decrease and she would achieve the goal of Return on Investment. Dr. Lynn made a series of great presentations to the clinic leadership, clinical team and administrative staff. She sold the package and sealed the deal.
The new program was launched on a Monday. By Wednesday, there was chaos in the clinic! The screens were administered and automatically scored on the clinic ipad at patient check-in with the help of the office assistant. The PCP’s and nurses reviewed the results of the screen and made the hallway hand-off to Dr. Lynn. So far, so good, things were going swimmingly. However…it turns out that about 25% of all patients each day were screening positive based on the cut-off scores. Between the 4 PCP’s who saw an average of 25 patients per day, a total of 25 patients were being referred to Dr. Lynn. By luck of the draw, many of the patients were identified around the same time, so Dr. Lynn was faced with each of the PCP’s approaching her for a warm hand-off only to find that she already had 1 patient in her office and 1-2 more in the waiting room.
Dr. Lynn was overwhelmed. She had planned to use the 5 A’s model to engage and develop treatment plans with patients using a brief intervention model that required 30 minutes. She did not plan on a backlog of patients in the waiting room and not enough time in the day to see all of them. The office administrator started to notice grumpy faces on patients waiting and was soon fielding questions and complaints from waiting patients. The PCP’s were getting annoyed that the hallway hand-off model that worked so well up to this point suddenly seemed broken and led to frustration. The nurses were empathic and wanted to help but really had not significant training or experience in brief interventions for depression or substance abuse.
Exasperated, Dr. Lynn pulled the plug on the program by Friday morning. The team was relieved and felt bad that the program didn’t work, and they still had confidence in Dr. Lynn for doing the same type of work she had been doing before the new program. Dr. Lynn was disappointed, frustrated…and tired! But she was trained in quality improvement and Lean, and she was determined to both evaluate what went wrong AND how to re-launch the program but with modifications based on the lessons learned.
For your discussion board, discuss what you would do to re-launch a population health management program after this episode of chaos in the clinic. What would you do differently? How would the population health management program be changed to avoid the chaos? How would you re-engage the team and get them to give you a second chance? What quality improvement or Lean strategies and techniques might you utilize in order to better plan the program?