Patient Family or Population Health Problem Solution
Overview of the Patient Problem and the Proposed Solution
In the quest to lessen the burden of chronic illnesses, preventative care has taken precedence over curative treatment. This emphasis on preventive treatment stems from the fact that the primary risk factors for most chronic illnesses are poor lifestyle choices and poor health behaviors.
The subsequent discussion is centered on a 66-year-old Black American patient with a three-year history of hypertension. He is a long-distance truck driver who has been unable to stick to his hypertension medication due to expense and has also neglected his three-monthly outpatient clinic follow-ups. He also failed to adhere to non-pharmacological therapies (diet, physical exercise).
A telemedicine solution with a multidisciplinary team, specific goals, and a crystal-clear strategy to fulfill the objectives was presented to assist him in managing his challenges. The intervention must be backed up by strong leadership, an effective communication strategy, and a steadfast collaborative team to achieve the desired results.
The purpose of this paper is to discuss the role of leadership and propose communication tactics for implementing the intervention. A review of telemedicine-related policies and nursing practice standards, as well as the intervention’s impact on quality, patient safety, and costs, are also covered.
Role of Leadership, Change Management, and Nursing Ethics in addressing the Problem
Leadership is critical in determining an organization’s performance and enhancing patient outcomes. Even though it is not a new technology, the fact that hospitals have just recently begun to embrace telemedicine adoption needs solid leadership behind its deployment.
Four essential leadership tactics, according to Laukka et al. (2020), are predictors of effective telemedicine implementation: training and education, identifying stakeholders and collaborative effort, physician leader role and coordination, and transparency, information sharing, and communication.
Patients must undergo a prodromal period of extensive training on how to utilize the different gadgets to promote acceptability and enthusiasm to engage in telemedicine intervention. This training is not only for patients but also for the project implementation team.
Identifying stakeholders, who in this context include physicians, nurses, pharmacists, the health informatics team, social workers, community health workers, nutritionists, exercise interactionists, and health prevention specialists, among others, provides a foundation for establishing a collaborative effort (Laukka et al., 2020). While overall leadership necessitates inter-professional and inter-sectoral collaboration, Laukka et al. (2021) argue that having physician leaders is preferable owing to their superior clinical, leadership, and research positions.
Another component that contributes to the success of telemedicine leadership is the broadcast of clear, accurate, and timely information, as well as the involvement of colleagues in decision-making.
Typically, transformation is a lengthy and painful process that needs individuals to acquire new skills, relearn old ones, or adjust existing ones. Change typically encounters tremendous opposition when individuals are not fully prepared. As a result, it is the leadership’s responsibility to identify change facilitators and change obstacles to assist the shift from traditional practice to telemedicine.
During the Covid-19 period, Kruse and Heinemann (2022) discovered that technical literacy, perceived usefulness, and organizational preparedness (finances, personnel) facilitated telemedicine adoption, while hatred for technology/technical illiteracy, patient preference for other alternatives, connectivity, and perceived cost were significant barriers.
Given that the intervention’s goal is to deliver care to patients, the devices that will be utilized must be beneficial (beneficence), not cause damage (nonmaleficence), not violate patients’ autonomy, and provide services independent of the patient’s socioeconomic characteristics (Keenan et al., 2021). Leadership, a seamless transformation, and the adoption of ethical standards provide successful intervention implementation and guarantees better patient outcomes.
Communication and Collaboration Strategies
Aside from leadership, communication and teamwork are important aspects of health project management. Mr. JM, the patient whose condition requires remedy, is a 66-year-old gentleman who falls within the elderly demographic. Elderly persons have declining strength and may have sensory deficits such as hearing and visual problems due to their age.
The initial communication method used when caring for the patient is to evaluate his level of knowledge, identify areas where he is lacking, and utilize this as a basis for establishing health education. Second, utilizing clear, precise, and unadorned prose improves patients’ comprehension of medical information (Oliveros et al., 2019). Furthermore, keeping eye contact and using affirmative gestures are unquestionably beneficial in increasing Mr. JM’s comprehension.
According to Oliveros et al. (2019), a clinician should be empathetic and act in the best interests of the patient while still maintaining honesty during communication. Because communication is a two-way process, including speaking and listening, the patient must be allowed to express himself and ask questions, and the views must be respected and used to make choices.
Besides communicating with the patient and considering his views, including his family members, is critical for achieving both patient-centered care (PCC) and family-centered care (FCC). Because of the many cultural and societal factors that may distort the family’s perception of health, the first step is to identify and debunk their misconceptions about health, followed by teaching them facts to develop a better understanding (Oliveros et al., 2019).
It is conceivably straightforward to develop a solid collaboration amongst numerous healthcare experts, patients, and families amid effective communication. However, to fortify collaboration, negotiation and respect must be considered crucial qualities.
While negotiation necessitates that care professionals develop an amicable timetable with patients and families on when to undertake activities such as health education and family visits, respect entails valuing both sides’ perspectives and integrating them into decision-making processes (Goodridge et al., 2018). The efforts of the care staff, patients, and families are all important in establishing an effective therapeutic environment.
How Nursing Practice Standards and Policies guided the Development of the Proposed Intervention
Nurses play a critical role in the deployment of telemedicine methods to patient care. Nurses are trained in clinical areas, leadership, healthcare technology, and research, which allows them to be more versatile in patient care management.
The American Nurses Association (ANA) nursing practice guidelines, which have been established to coincide with the nursing process, guide the professional practice of nurses. Nurses have a role in patient assessment by taking medical histories and doing physical examinations.
Patients with hypertension, for example, may go to the emergency room with nonspecific symptoms and, more often than not, will have nurses as their initial point of contact. Besides the assessment, nurses have a diagnostic role, which may involve blood pressure measurements and assessing if the values fall within the hypertensive range (Spies et al., 2018).
In addition, nurses determine the expected outcomes of whatever intervention is being used, plan the treatment, implement it, and evaluate the results. This compliance with the nursing process, coupled with adequate baccalaureate training, provides nurses with the ability and confidence to engage in the execution of any intervention aimed at improving patients’ outcomes and alleviating their plight.
Telemedicine is a tightly regulated intervention that provides treatment to patients, provides a platform for health education, collects data on patient vital parameters, and transmits it to care providers. Due to their usage in patient care, telemedicine tools must be designed, verified, and approved by regulatory bodies.
The Food and Drug Administration is the regulatory body in the United States that defines the standards of a telemedicine tool, and it states that telemedicine software meets the regulatory standards only if it is intended for the diagnosis, curing, or prevention of a disease, does not interfere with the function of the body and exhibits its actions in chemical-free methods (Omboni et al., 2020).
Furthermore, the American Telemedicine Association maintains a telemedicine certification program that guarantees that doctors or anybody who provides treatment through telemedicine meets the essential standards of practice, assuring patient safety and operational transparency (Omboni et al., 2020).
Moreover, compliance with HIPAA security safeguards ensures that patient health information is secured and, in addition to other regulatory organizations, offers standard guidelines to follow in the deployment of telemedicine.
How does the Proposed Intervention improve the Quality of Care, Patient Safety and Reduce Costs?
Multiple studies have linked telemedicine to several benefits, including improved patient care quality, safety, and cost-cutting. According to Omboni et al. (2020), telemedicine promotes a long-term and enduring interaction between the patient and the care provider. This connection encourages regular health education, which takes place around an amicably devised timetable between patients and care providers.
Multiple pre- and post-intervention studies on telemedicine use in the management of hypertension, as summarized in a systematic review by Hoffer-Hawlik et al. (2021), highlight the three relevant clinical blood pressure outcomes of the intervention as systolic blood pressure change, diastolic blood pressure change, and a change in the proportion of individuals who achieve the target blood pressure.
Eleven of the fourteen studies found a significant reduction in systolic or diastolic blood pressure in the telemedicine group, and eight studies found a difference-in-difference change in systolic blood pressure between the intervention and control groups, with a range as large as 13.2 mm Hg and 12.45 mm Hg to as small as 0.37 mm Hg, all statistically significant (Hoffer-Hawlik et al., 2021).
Aside from blood pressure, other cardiometabolic variables such as hemoglobin A1C and LDL cholesterol were considerably impacted. As the patient’s blood pressure and other cardiometabolic variables improve, their quality of life improves, and their safety improves since they are at a lower risk of complications and mortality.
Aside from increasing patient safety and quality of life, the intervention is also cost-effective. Dehmer et al. (2018), in an economic analysis of home blood pressure telemedicine combined with pharmacist case management of hypertension, discovered that the intervention group spent $281 less per person than the control group.
In a separate study on the cost-effectiveness of blood pressure telemonitoring, Padwal et al. (2019) discovered that telemonitoring resulted in a $1929 cost reduction and guaranteed an additional 0.83 quality-adjusted life year (QALY). Following the influence on the quality of care, patient safety, and cost reduction, healthcare practitioners feel confident in using telemedicine to manage hypertension and other chronic conditions.
Role of Technology, Care Coordination, and Community Resources in Addressing the Patient’s Problem
The recommended intervention-telemedicine indicates that technology was used to address Mr. JM’s problems. The intervention incorporates several technologies, including data collecting tools (sensor-equipped blood pressure cuffs), data transmission tools and services (Bluetooth, WI-FI), patient-provider engagement platforms such as online portals, and live audio-visual teleconferencing. An effective care coordination strategy and appropriate utilization of community resources are required to ensure a seamless implementation process and that the expected outcomes are achieved. Care coordination demands a multidisciplinary team that is aware of their duties and responsibilities, as well as their objectives, and is dedicated to meeting them while aligning the goals with the patient’s needs and preferences.
The fact that a diverse team delivers treatment, each of whom is trained in a different profession and has distinct clinical expertise, benefits both the quality of care and the safety of the patients.
Community resources may help improve patient recovery or increase engagement in health promotion activities. Community recreation facilities, such as football fields, cycling resources and grounds, the gym, and traditional food preparation events, serve as the basis upon which health preventive activities are carried out.
According to a comprehensive review by Pescatello et al. (2019), physical exercise as a non-pharmacological intervention for hypertension reduces systolic blood pressure by 5 to 17 mm Hg and diastolic blood pressure by 2 to 10 mm Hg.
Furthermore, traditional food preparation activities promote the eating of healthy, non-junk food, which has advantages in lowering blood pressure. The research-proven credible results on the importance of community resources provide sufficient incentive to extend chronic disease management beyond the hospital’s precincts to the broader society.
The prevalence of chronic diseases has risen exponentially due to an aging population and an unparalleled wave of poor lifestyle choices. As the prevalence rises, current healthcare resources are stretched beyond capacity to keep up with the tide. This has resulted in a depletion of healthcare resources, prompting innovative ways to treat and strategies that utilize technology such as telemedicine.
Telemedicine has been demonstrated to be effective, particularly during Covid-19, when its use was at its highest. While studies indicate its usefulness and care providers applaud it, its execution requires a well-planned strategy carried out by a multidisciplinary team. It is, therefore, a proposal to future healthcare planners and policymakers to progressively account for and push for telemedicine-directed treatment approaches in the drive to minimize the burden of chronic illnesses.
Dehmer, S. P., Maciosek, M. V., Trower, N. K., Asche, S. E., Bergdall, A. R., Nyboer, R. A., O’Connor, P. J., Pawloski, P. A., Sperl-Hillen, J. M., Green, B. B., & Margolis, K. L. (2018). Economic evaluation of the home Blood Pressure Telemonitoring and pharmacist case management to control hypertension (Hyperlink) trial. Journal of the American College of Clinical Pharmacy : JAACP, 1(1), 21–30. https://doi.org/10.1002/jac5.1001
Goodridge, D., Henry, C., Watson, E., McDonald, M., New, L., Harrison, E. L., Scharf, M., Penz, E., Campbell, S., & Rotter, T. (2018). Structured approaches to promote patient and family engagement in treatment in acute care hospital settings: protocol for a systematic scoping review. Systematic Reviews, 7(1), 35. https://doi.org/10.1186/s13643-018-0694-9
Hoffer-Hawlik, M., Moran, A., Zerihun, L., Usseglio, J., Cohn, J., & Gupta, R. (2021). Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review. PloS One, 16(7), e0254222. https://doi.org/10.1371/journal.pone.0254222
Keenan, A. J., Tsourtos, G., & Tieman, J. (2021). The value of applying ethical principles in telehealth practices: Systematic review. Journal of Medical Internet Research, 23(3), e25698. https://doi.org/10.2196/25698
Kruse, C., & Heinemann, K. (2022). Facilitators and barriers to the adoption of telemedicine during the first year of COVID-19: Systematic review. Journal of Medical Internet Research, 24(1), e31752. https://doi.org/10.2196/31752
Laukka, E., Huhtakangas, M., Heponiemi, T., & Kanste, O. (2020). Identifying the roles of healthcare leaders in HIT implementation: A scoping review of the quantitative and qualitative evidence. International Journal of Environmental Research and Public Health, 17(8), 2865. https://doi.org/10.3390/ijerph17082865
Laukka, E., Pölkki, T., Heponiemi, T., Kaihlanen, A.-M., & Kanste, O. (2021). Leadership in digital health services: Protocol for a concept analysis. JMIR Research Protocols, 10(2), e25495. https://doi.org/10.2196/25495
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Omboni, S., McManus, R. J., Bosworth, H. B., Chappell, L. C., Green, B. B., Kario, K., Logan, A. G., Magid, D. J., Mckinstry, B., Margolis, K. L., Parati, G., & Wakefield, B. J. (2020). Evidence and recommendations on the use of telemedicine for the management of arterial hypertension: An international expert position paper: An international expert position paper. Hypertension, 76(5), 1368–1383. https://doi.org/10.1161/HYPERTENSIONAHA.120.15873
Padwal, R. S., So, H., Wood, P. W., Mcalister, F. A., Siddiqui, M., Norris, C. M., Jeerakathil, T., Stone, J., Valaire, S., Mann, B., Boulanger, P., & Klarenbach, S. W. (2019). Cost-effectiveness of home blood pressure telemonitoring and case management in the secondary prevention of cerebrovascular disease in Canada. Journal of Clinical Hypertension (Greenwich, Conn.), 21(2), 159–168. https://doi.org/10.1111/jch.13459
Pescatello, L. S., Buchner, D. M., Jakicic, J. M., Powell, K. E., Kraus, W. E., Bloodgood, B., Campbell, W. W., Dietz, S., Dipietro, L., George, S. M., Macko, R. F., McTiernan, A., Pate, R. R., Piercy, K. L., & 2018 PHYSICAL ACTIVITY GUIDELINES ADVISORY COMMITTEE*. (2019). Physical activity to prevent and treat hypertension: A systematic review: A systematic review. Medicine and Science in Sports and Exercise, 51(6), 1314–1323. https://doi.org/10.1249/MSS.0000000000001943
Spies, L. A., Bader, S. G., Opollo, J. G., & Gray, J. (2018). Nurse-led interventions for hypertension: A scoping review with implications for evidence-based practice. Worldviews on Evidence-Based Nursing, 15(4), 247–256. https://doi.org/10.1111/wvn.12297
Assignment Description: Patient Family or Population Health Problem Solution
Develop an intervention (your capstone project), as a solution to the patient, family, or population problem you’ve defined. Submit the proposed intervention to the faculty for review and approval. This solution needs to be implemented (shared) with your patient, family, or group. You are not to share your intervention with your patient, family, or group or move on to Assessment 5 before your faculty reviews/approves the solution you submit in Assessment 4. In a separate written deliverable, write a 5–7 page analysis of your intervention.
Please submit both your solution/intervention and the 5–7 page analysis to complete Assessment 4.
In your first three assessments, you applied new knowledge and insight gleaned from the literature, from organizational data, and from direct consultation with the patient, family, or group (and perhaps with subject matter and industry experts) to your assessment of the problem. You’ve examined the problem from the perspectives of leadership, collaboration, communication, change management, policy, quality of care, patient safety, costs to the system and individual, technology, care coordination, and community resources. Now it’s time to turn your attention to proposing an intervention (your capstone project), as a solution to the problem.
In this assessment, you’ll develop an intervention as a solution to the health problem you’ve defined. To prepare for the assessment, think about an appropriate intervention, based on your work in the preceding assessments, that will produce tangible, measurable results for the patient, family, or group. In addition, you might consider using a root cause analysis to explore the underlying reasons for a problem and as the basis for developing and implementing an action plan to address the problem. Some appropriate interventions include the following:
- Creating an educational brochure.
- Producing an educational voice-over PowerPoint presentation or video focusing on your topic.
- Creating a teaching plan for your patient, family, or group.
- Recommending work process or workflow changes addressing your topic.
Plan to spend at least 3 direct practicum hours working with the same patient, family, or group.
In addition, you may wish to complete the following:
- Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
- Conduct sufficient research of the scholarly and professional literature to inform your work and meet scholarly expectations for supporting evidence.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.
Complete this assessment in two parts: (a) develop an intervention as a solution to the problem and (b) submit your proposed intervention, with a written analysis, to your faculty for review and approval.
Develop an intervention, as a solution to the problem, based on your assessment and supported by data and scholarly, evidence-based sources.
Incorporate relevant aspects of the following considerations that shaped your understanding of the problem:
- Change management.
- Quality of care.
- Patient safety.
- Costs to the system and individual.
- Care coordination.
- Community resources.
Submit your proposed intervention to your faculty for review and approval.
In a separate written deliverable, write a 5–7 page analysis of your intervention.
- Summarize the patient, family, or population problem.
- Explain why you selected this problem as the focus of your project.
- Explain why the problem is relevant to your professional practice and to the patient, family, or group.
In addition, address the requirements outlined below. These requirements correspond to the scoring guide criteria for this assessment, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.
- Define the role of leadership and change management in addressing the problem.
- Explain how leadership and change management strategies influenced the development of your proposed intervention.
- Explain how nursing ethics informed the development of your proposed intervention.
- Include a copy of the intervention/solution/professional product.
- Propose strategies for communicating and collaborating with the patient, family, or group to improve outcomes associated with the problem.
- Identify the patient, family, or group.
- Discuss the benefits of gathering their input to improve care associated with the problem.
- Identify best-practice strategies from the literature for effective communication and collaboration to improve outcomes.
- Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of your proposed intervention.
- Cite the standards and/or policies that guided your work.
- Describe research that has tested the effectiveness of these standards and/or policies in improving outcomes for this problem.
- Explain how your proposed intervention will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
- Cite evidence from the literature that supports your conclusions.
- Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
- Explain how technology, care coordination, and the utilization of community resources can be applied in addressing the problem.
- Cite evidence from the literature that supports your conclusions.
- Write concisely and directly, using active voice.
- Apply APA formatting to in-text citations and references.
- Format: Format the written analysis of your intervention using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
- A title page and reference page. An abstract is not required.
- Appropriate section headings.
- Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
- Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
- Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Portfolio Prompt: Save your intervention to your ePortfolio. After you complete your program, you may want to consider leveraging your portfolio as part of a job search or other demonstration of your academic and professional competencies.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
- Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
- Define the role of leadership and change management in addressing a patient, family, or population health problem and includes a copy of intervention/solution/professional product.
- Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
- Explain how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
- Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
- Explain how technology, care coordination, and the utilization of community resources can be applied in addressing a patient, family, or population health problem.
- Competency 5: Analyze the impact of health policy on quality and cost of care.
- Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of a proposed intervention.
- Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
- Propose strategies for communicating and collaborating with a patient, family, or group to improve outcomes associated with a patient, family, or population health problem.
- Competency 8: Integrate professional standards and values into practice.
- Write concisely and directly, using active voice.
- Apply APA formatting to in-text citations and references.
Use the scoring guide to understand how your assessment will be evaluated.