FOR THE DISCUSSION IT ASKED:
Make sure to address all parts of this discussion:
1. Describe a local or domestic healthcare problem associated with your organization that creates a quality improvement opportunity. If you are not currently working for a healthcare organization, use one that you have worked for in the past or one that you hope to work for in the future.
2. Suggest an evidence-based intervention that can be implemented to affect change for the problem.
FOR THIS DISCUSSION I SAID:
Quality Improvement Opportunities and Interventions
Local Or Government Healthcare Problem Associated With Wellstar
I am working for Wellstar, and one key opportunity for improving healthcare quality that I identified lies in management of chronic diseases. This challenge has become increasingly significant given the context of population health and our organization’s patient demographics – an increasing number suffer from chronic conditions such as heart disease, respiratory disorders, diabetes and cancer. Addressing these issues requires ongoing coordination to effectively manage symptoms and prevent complications, promoting patients’ overall well-being. Most of which there is an increased rate of readmissions on patients with chronic illness, therefore leading to an increase in healthcare cost. Studies indicate that a proactive and integrated approach to managing chronic diseases can lead to improved health outcomes and reduced healthcare costs. The Centers for Disease Control and Prevention (CDC) have reported chronic conditions to be responsible for 90% of the country’s medical expenses, with efficient management substantially easing its economic impact (CDC, 2019). Additionally, Hu, Wang, & Li, (2020) found that coordinated care for patients with multiple chronic conditions led to improved clinical outcomes, including reduced hospitalizations (Hu, Wang, & Li, 2020).
Evidence-Based Intervention
An evidence-based intervention that Wellstar could implement to address the management of chronic diseases is the adoption of a Patient-Centered Medical Home (PCMH) model. The PCMH model is a comprehensive and team-based approach to primary care that emphasizes patient-centred, coordinated, and accessible care. This intervention aligns with Wellstar’s commitment to providing high-quality, patient-centered healthcare services. Research has demonstrated the effectiveness of the PCMH model in improving outcomes for patients with chronic diseases. A study by Goldberg, Gimm, Burla, and Nichols (2020) found that practices using the PCMH model were associated with better patient experiences, improved chronic disease management, and reduced hospitalizations. Additionally, a systematic review and meta-analysis concluded that the PCMH model was associated with improved self-management outcomes and hospital admissions and improvements in health-related quality of life (John, Jani, Peters, Agho, & Tannous, 2020).
In the PCMH model, a dedicated care team, including primary care providers, nurses, care coordinators, pharmacists, and other healthcare professionals, collaboratively manage patients with chronic conditions. This team approach allows for more comprehensive and proactive care, ensuring that patients receive the necessary interventions, education, and support to manage their needs effectively. Additionally, the PCMH model often incorporates advanced health information technology, including electronic health records and secure patient portals, which facilitate better communication and information sharing among members of the care team. This technology also gives patients more accessible access to their health information, empowering them to take a more active role in managing their chronic conditions (John, Jani, Peters, Agho, & Tannous, 2020).
At Wellstar, introducing this model will enable us to adopt a patient-focused strategy for managing chronic illnesses that can result in better outcomes, increased levels of satisfaction among patients and more effective healthcare resource utilization.
References
CDC. (2019). Health and Economic Costs of Chronic Disease. Retrieved from cdc.gov website: https://www.cdc.gov/chronicdisease/about/costs/index.htm
Goldberg, D. G., Gimm, G., Burla, S. R., & Nichols, L. M. (2020). Care Experiences of Patients with Multiple Chronic Conditions in a Payer-Based Patient-Centered Medical Home. Population Health Management, 23(4), 305–312. https://doi.org/10.1089/pop.2019.0189
Hu, J., Wang, Y., & Li, X. (2020). Continuity of Care in Chronic Diseases: A Concept Analysis by Literature Review. Journal of Korean Academy of Nursing, 50(4), 513. https://doi.org/10.4040/jkan.20079
John, J. R., Jani, H., Peters, K., Agho, K., & Tannous, W. K. (2020). The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials. International Journal of Environmental Research and Public Health, 17(18), 6886. https://doi.org/10.3390/ijerph17186886
BUT NOW I HAVE TO:
In response to your peers, suggest an evidence-based intervention that has not already been suggested within the thread and explain the reasoning behind your recommendation.
THE PEER SAID:
In my present organization, pressure ulcers are at the forefront of conversation. Prevention and reduction within pressure ulcers is an important topic as a pressure ulcer can develop into a serious medical issue. In October 2008, the Centers for Medicare & Medicaid Services (CMS) listed pressure ulcers as a preventable adverse event targeted for reimbursement reduction (Sendelbach et al., 2021). Pressure ulcers can range from stage 1 all the way to unstageable. When a stage three or higher-pressure ulcer is acquired within the hospital, it must be reported to the Health Department. This is one way how national and local data is collected and managed.
An evidence-based intervention that can be implemented to affect the change for this problem could be accurate assessment at admission and effective treatment. This can prevent the pressure ulcer from worsening into a bigger and worse ulcer. This can lead to other issues with the patient’s condition and compromise their healing. Another intervention is the pressure distribution mattress that is effective in redistributing pressure in those areas that are prominent for developing pressure ulcers (Anthony et al., 2023). In the current organization that I work for, if at any time a patient has a Stage 1 or Stage 2 pressure ulcer, we have standard orders that have been passed down from the wound nurse and approved by the physician, that we can initiate. If the pt has a stage three or higher, adequate documentation is needed, such as the measurements and accurate description. A consultation with the wound nurse is also ordered, and the physician is notified for orders until the patient is seen by the wound nurse. We can also place patients on pressure distribution beds as well based on their needs.
Antony, L., Thelly, A. S., & Mathew, J. M. (2023). Evidence-based Clinical Practice Guidelines for Caregivers of Palliative Care Patients on the Prevention of Pressure Ulcer. Indian journal of palliative care, 29(1), 75–81. https://doi.org/10.25259/IJPC_99_2022
Sendelbach, Sue PhD, RN, CCNS; Zink, Mary BSN, RN, CWOCN; Peterson, Jane MS, RN. Decreasing Pressure Ulcers Across a Healthcare System: Moving Beneath the Tip of the Iceberg. JONA: The Journal of Nursing Administration 41(2):p 84-89, February 2011. | DOI: 10.1097/NNA.0b013e3182059479
Posts and responses must be evidence-based and include sources in the most recent APA form.
Use scholarly writing to support your initial post, as well as all of your responses.
Cite references using proper APA.
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