NURS FPX 4050 Assessment 3 Care Coordination Presentation to Colleagues

NURS FPX 4050 Assessment 3 Care Coordination Presentation to Colleagues

Care Coordination Presentation to Colleagues

Hi, I will discuss the care coordination process. Care coordination is an important aspect of healthcare that involves carefully organizing patient care activities and sharing information to ensure safer and more effective care. In the US healthcare system, the Institute of Medicine has identified care coordination as a key strategy to improve the healthcare system’s effectiveness, safety, and efficiency. For instance, care coordination can be achieved through broad approaches such as teamwork, care management, medication management, health information technology, and patient-centered medical homes (AHRQ, 2018). These approaches aim to meet patients’ needs and desires by providing high-quality, valuable health care. 

NURS FPX 4050 Assessment 3 Care Coordination Presentation to Colleagues

Medication management is a treatment coordination approach that can improve patient outcomes regarding medication-specific education for chronic obstructive pulmonary disease (COPD). NURS FPX 4050 Assessment 3 Care Coordination Presentation to Colleagues. Care coordination teams can help reduce readmissions, morbidity, and mortality by supporting patients with appropriate medication education and self-management goals.

Evidence-Based Collaborative Strategies

Nurses are vital in delivering healthcare services as they are often the first point of contact for patients and their families. Nurses can increase patient and family satisfaction by building trust and helping patients and their families understand treatment options and outcomes. Collaboration between nurses and other healthcare professionals has been shown to increase the efficiency and effectiveness of patient care and create a more supportive environment for team members to develop their practice. The American Association of Critical Care Nursing formulated a standard definition for true nursing cooperation and collected organizations and the main element of organizations and individuals to promote cooperation (AACN, n.d.). These elements include support throughout vocational education and coaches, determining the duties of cooperation, and the structure of the decision-making force of the nurse (McLaney et al., 2022).

NURS FPX 4050 Assessment 3 Care Coordination Presentation to Colleagues

The Agency for Healthcare Research and Quality also outlined some transformative strategies for engaging patients and families in evidence-based care and quality improvement. These strategies include engaging patients and families in translating evidence into practice, connecting patients and families to community resources to help them implement evidence-based care plans, and supporting patients and families to participate in their own evidence-based care (AHRQ, 2020).

Several evidence-based strategies for engaging patients and their families in collaborative care exist. For example, a systematic review of collaborative projects in depression and anxiety disorders found that patient education and self-management support were the most common patient and family engagement strategies. NURS FPX 4050 Assessment 3 Care Coordination Presentation to Colleagues. Other strategies include personalized care planning, shared decision-making, and family or peer support (Menear et al., 2020).

Personalized Care Planning

Personalized care planning for COPD involves working with patients to develop individualized care plans that consider their unique needs, preferences, and goals. This approach ensures that patients receive care tailored to their specific circumstances and can improve patient engagement and outcomes (Menear et al., 2020).

Shared Decision Making

Shared decision-making is a collaborative process in which the person with COPD and the healthcare provider collaborate to make patient care decisions. This approach involves discussing available treatment options, the potential benefits and risks, and the patient’s values and preferences. Shared decision-making can improve patient satisfaction and outcomes by actively involving patients in the decision-making process (Menear et al., 2020).

Family or Peer Support

Family or peer support involves enlisting the help of the patient’s family members or peers to provide emotional, informational, or practical support. This approach can help COPD patients feel more supported and empowered to manage their health and improve patient engagement and outcomes (Menear et al., 2020).

Aspects of Change Management

Change management is the process of planning and implementing changes in an organization to improve performance. Change management can directly impact patient experience elements critical to delivering high-quality patient-centered care in healthcare. Accessibility to care, interaction with healthcare professionals, and participation in decision-making are a few patient-valued components of care that can be impacted by change management (Harvard School of Public Health, 2021).

Access to Care

Patients with COPD require regular access to health care services, including doctor visits, medication management, and pulmonary rehabilitation. Change management focused on improving access to care can improve the patient experience by reducing wait times, improving access to care, and increasing patient satisfaction. For example, healthcare organizations that implement telehealth programs can improve access to care for COPD patients who have difficulty making appointments (Barbosa et al., 2022).

Communication with Healthcare Providers

Effective communication between patients and healthcare providers is critical to providing high-quality, patient-centered care to patients with COPD. People with COPD often have complex medical needs and may need frequent contact with their healthcare provider to manage their symptoms. Change management that facilitates communication can improve the patient experience by increasing patient engagement, reducing errors, and increasing patient satisfaction.

Involvement in Decision Making

Involving patients in decisions about their care improves the patient experience and facilitates patient-centered care. NURS FPX 4050 Assessment 3 Care Coordination Presentation to Colleagues. COPD patients often have unique preferences and goals for their care and involving them in decision-making can improve their overall satisfaction with care. Change management promoting participative decision-making can improve the patient experience by increasing patient engagement, patient outcomes, and patient satisfaction (Tobiano et al., 2021).

These aspects of change management can significantly impact the patient experience in COPD treatment. Healthcare organizations focusing on improving these aspects of care can increase patient engagement, reduce errors, and improve patient outcomes and satisfaction.

Difference between Patient Satisfaction and Patient Experience

It is important to note that there is a difference between patient experience and patient satisfaction. Patient experience refers to the sum of all patient interactions with healthcare, while patient satisfaction refers to patient satisfaction with their care. Change management can improve patient experience and satisfaction by focusing on aspects of care that patients value (Larson et al., 2019).

The Rationale for Coordinated Care Plans

The rationale for a coordinated COPD care plan based on ethical decision-making is rooted in patient autonomy. Patient autonomy is the ethical principle that patients have the right to make decisions about their own care and ensure that their healthcare providers respect those decisions (Houska & Loučka, 2019). A coordinated care plan developed using a patient-centered approach respects patients’ autonomy and incorporates their values, wishes, and goals into the care plan. 

In developing coordinated care plans for patients with chronic conditions like chronic obstructive pulmonary disease (COPD), the American Nurses Association (ANA) is aware of nurses’ critical role in care coordination and the significance of ethical decision-making (Buhagiar et al., 2020). The ANA claims that registered nurses’ contributions to care coordination have long been a fundamental professional requirement and skill for Registered Nurses (RNs). RNs enable continuity of care for patients across settings and among providers, whether by developing care plans based on patient’s needs and preferences, educating patients and their families at discharge, or any other task.

Logical Implications and Consequences

In COPD patients, a coordinated care plan developed with an ethical approach can improve outcomes by involving patients in developing their care plan and considering their values and preferences. This ensures better adherence to the plan and improves health. A coordinated care plan tailored to the COPD patient’s needs and preferences can also reduce healthcare costs by reducing the likelihood of unnecessary treatments, tests, and procedures. Moreover, when patients feel that their healthcare provider has considered their values and preferences while developing their care plan, they are more likely to be satisfied with their care and have a better overall experience (Buhagiar et al., 2020).

Assumptions

Regarding coordinated care plans, it’s important to remember that patients have the right to decide about their care. When developing a care plan, their unique values, preferences, and goals should be considered. Healthcare providers are responsible for providing care that is in the patient’s best interest.

For instance, a patient with COPD wants to focus on improving their quality of life rather than undergoing aggressive treatment. In this case, an ethical approach to care would involve creating a coordinated care plan that prioritizes symptom management and enhancing the patient’s quality of life. This plan would be developed in collaboration with the patient, considering their values, preferences, and goals.

Impact of Healthcare Policy Provisions 

Specific healthcare policy provisions can significantly impact outcomes and patient experiences for individuals with chronic obstructive pulmonary disease (COPD). For example, policies that promote access to care, improve the quality of care, and support the development of coordinated care plans can improve patient outcomes and enhance the patient experience. The COPD Foundation supports national policies that improve COPD prevention, diagnosis, management, and research and ensure that all people with COPD have access to appropriate, high-quality care (COPD Foundation, 2021).

 The COPD Foundation is actively involved in promoting access to health care, improving the payment and provision of health care, improving the quality of care, and regulating medicines and medical devices. One such policy is the COPD National Action Plan, the first blueprint for a unified, multifaceted fight against COPD. This action plan, developed at the request of Congress and the broader COPD community, describes how we can work together to increase awareness of COPD and reduce its impact (National Heart, Lung, and Blood Institute, 2021).

Raising Awareness of the Nurses’ Role in Continuum of Care

Nurses are often the primary point of contact for inpatient and outpatient COPD patients. As such, they are responsible for educating, counseling, and supporting patients and their families across the continuum of care. Nurses also work with other healthcare providers, including doctors, respiratory therapists, and social workers, to ensure that people with COPD receive comprehensive and coordinated care.

The nurse’s role in the coordination and continuity of care for a COPD patient includes the following.

Patient Education

Nurses play a key role in educating COPD patients and their families about the disease, its management, and its impact on daily life. This training may include information on medication management, breathing techniques, diet, and exercise.

Medication Administration

Nurses are responsible for administering medications to COPD patients, monitoring their response to treatment, and ensuring they understand their proper use and dosage.

Symptom Management

Nurses are trained to assess and manage symptoms associated with COPD, such as shortness of breath, coughing, and wheezing. They work with patients to develop strategies to manage these symptoms and improve their quality of life. 

Care Coordination

Nurses work with other healthcare providers to coordinate care for people with COPD in various settings, including hospitals, clinics, and home care. This coordination ensures that patients receive consistent and comprehensive care throughout their illness.

Palliative and End-of-Life Care

Nurses often provide palliative and end-of-life care for people with COPD. They work with patients and their families to manage symptoms, provide emotional support, and ensure that the patient’s wishes are followed.

Conclusion

Care coordination is essential for managing chronic diseases such as chronic obstructive pulmonary disease in the US healthcare system. Healthcare providers can improve patient outcomes and enhance the patient experience by developing coordinated care plans that inform ethical decisions and involve patients in decision-making. Nurses play a critical role in the coordination and continuity of care, and their contribution to the coordination of care is essential to achieving desired health outcomes. Specific policies and regulations, such as National COPD Action Plan, can also significantly impact treatment outcomes and the patient experience for people with COPD. 

References

AACN. (n.d.). True Collaboration. Aacn.org. Retrieved May 8, 2023, from 

https://www.aacn.org/nursing-excellence/healthy-work-environments/true-collaboration 

AHRQ. (2018, August 1). Care coordination. Ahrq.gov. 

https://www.ahrq.gov/ncepcr/care/coordination.html 

AHRQ. (2020, October 1). EvidenceNow key drivers and change strategies. Ahrq.gov. 

https://www.ahrq.gov/evidencenow/tools/keydrivers/description.html 

Barbosa, M. T., Sousa, C. S., & Morais-Almeida, M. (2022). Telemedicine in the management of chronic obstructive respiratory diseases: An overview. In Digital Health (pp. 131–144). Exon Publications. 

https://doi.org/10.36255/exon-publications-digital-health-respiratory-diseases 

Buhagiar, T. M., Schoenlein, M. H., & Smith, D. S. (2020). Ethical decision making in critical care: Communication, coordination of care, and the practice of the clinical nurse specialist. Clinical Nurse Specialist CNS34(3), 93–95. 

https://doi.org/10.1097/NUR.0000000000000520 

COPD Foundation. (2021). COPD public policy issues. Copdfoundation.org. 

https://www.copdfoundation.org/Take-Action/COPD-Policy-Issues/Learn-More.aspx 

Harvard School of Public Health. (2021, September 20). Change management: Why it’s so important and challenging in health care environments. Executive and Continuing Professional Education

https://www.hsph.harvard.edu/ecpe/change-management-why-its-so-important-and-so-challenging-in-health-care-environments/ 

Houska, A., & Loučka, M. (2019). Patients’ autonomy at the end of life: A critical review. Journal of Pain and Symptom Management57(4), 835–845. 

https://doi.org/10.1016/j.jpainsymman.2018.12.339 

Larson, E., Sharma, J., Bohren, M. A., & Tunçalp, Ö. (2019). When the patient is the expert: Measuring patient experience and satisfaction with care. Bulletin of the World Health Organization97(8), 563–569. 

https://doi.org/10.2471/BLT.18.225201 

McLaney, E., Morassaei, S., Hughes, L., Davies, R., Campbell, M., & Di Prospero, L. (2022). A framework for interprofessional team collaboration in a hospital setting: Advancing team competencies and behaviours. Forum Gestion Des Soins de Sante [Healthcare Management Forum]35(2), 112–117. 

https://doi.org/10.1177/08404704211063584 

Menear, M., Dugas, M., Careau, E., Chouinard, M.-C., Dogba, M. J., Gagnon, M.-P., Gervais, M., Gilbert, M., Houle, J., Kates, N., Knowles, S., Martin, N., Nease, D. E., Jr, Zomahoun, H. T. V., & Légaré, F. (2020). Strategies for engaging patients and families in collaborative care programs for depression and anxiety disorders: A systematic review. Journal of Affective Disorders263, 528–539. 

https://doi.org/10.1016/j.jad.2019.11.008 

National Heart, Lung, and Blood Institute. (2021, February 9). COPD national action plan. NHLBI, NIH. 

https://www.nhlbi.nih.gov/health-topics/education-and-awareness/COPD-national-action-plan 

Tobiano, G., Jerofke-Owen, T., & Marshall, A. P. (2021). Promoting patient engagement: A scoping review of actions that align with the interactive care model. Scandinavian Journal of Caring Sciences35(3), 722–741. 

https://doi.org/10.1111/scs.12914 

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