Defining a Viable Health Care Future
Defining a Viable Health Care Future
Topic 1: Defining a Viable Health Care Future
What are critical considerations you will need to incorporate for a presentation to administrative leadership to showcase the strengths of your project recommendations within the context of internal and external stakeholder engagement, economics and/or profitability, health care policy, and information technology? Then, summarize why this project is important for the future viability of this organization.
Improving Discharge Procedures to Reduce Unnecessary Emergency Department Return Visits Name: DNP Project Proposal Purdue University Global Introduction ➢ Unnecessary return visits to the emergency department are a problem for most healthcare facilities face across Florida and other states. ➢ Unnecessary return visits are indicators of poor care quality. ➢ Numerous studies have demonstrated emergency departments discharge procedures are a significant contributor to unnecessary return visits (Taylor, 2000). ➢ This issue creates gabs in continuity of care for patients resulting in an inadequate or incomplete emergency department discharge. ➢ The healthcare providers must realize that inadequate discharge negatively impacts patient compliance with care, treatments and follow-ups. Purdue University Global | This is Where the Title of the Presentation Will Go 2 Introduction Project Purpose ➢ The purpose of this project is to implement a discharge tool that will help healthcare providers to better communicate with patients and better achieve patient understanding. ➢ The proposed intervention is to implement a discharge checklist tool that enables patients to document their understanding of discharge instructions by marking and answering questions about the discharge instructions packet. ➢ The patient and the provider will document the exchange by both signing the discharge tool. Defining a Viable Health Care Future
The tool will remain in the patient’s medical records. Cite your slides here 3 Introduction Problem Background and Significance to Healthcare ➢ Florida Hospitals have been working to reduce costs and increase health care quality. ➢ Despite hospital efforts, reducing emergency department unnecessary return visits has not been completely addressed. ➢ In Florida, 28% of acute care visits and 50% of hospital admissions originate from the Emergency Department (ED). ➢ Variables contributing to excess ED patient readmission rates include older age, non-ambulatory status, and absence of family support. ➢ The unnecessary return visits are important care quality indicators. Purdue University Global | This is Where the Title of the Presentation Will Go 4 Introduction Project Relationship to Advanced Nursing Practice and DNP Essentials ➢ Offers nurses the opportunity to more effectively perform their patient care and discharge duties ➢ Doctors and APRN can analyze itemized patient and disease data ➢ Project will increase ED patient care trainings, including discharge skills that reduce return visits ➢ Project’s intensive training will target nurses’ and doctors’ roles that maximize patient engagement. Purdue University Global | This is Where the Title of the Presentation Will Go 5 Introduction Practice Setting and Target Population/ Community ➢ The project will be done in the Florida Celebration community. ➢ The project practice site is a private emergency department in Polk County. ➢ The project target population includes adults with an average age of 35 years. Diverse population: ➢ African Americans, Hispanics, Asians, Native Americans, and multi-racial persons. ➢ Gender distribution (49.1% male; 50.9% female). ➢ Average family size of 3.14 persons. Purdue University Global | This is Where the Title of the Presentation Will Go 6 Introduction Project Alignment with Practice site Mission and Goals ➢ Project objectives align with practice site mission and goals ➢ Project site goal is to eliminate poor-quality patient care indicators and enhance high-quality patient care provision ➢ Project increases patient care quality and reduces unnecessary ED return visits ➢ Increases care transition safety, which is essential to improving patient experiences, reducing costs, and enhancing patient outcomes. Purdue University Global | This is Where the Title of the Presentation Will Go 7 Introduction Key Stakeholders ➢ ➢ ➢ ➢ ➢ ➢ ED Patients, Families, and Caregivers ED Providers – Nurses and Physicians Managers Insurance companies Pre-hospital care personnel Home care providers Purdue University Global | This is Where the Title of the Presentation Will Go 8 Introduction Project Benefit to Practice Setting ❑Project will have multiple practice setting impacts, including: ➢ Defining a Viable Health Care Future
Increase the quality of patient care, discharge processes and follow-up care. ➢ Reduce the overall cost of patient care ➢ Reduce ED over-crowding ➢ Improve clinical practice of nurses, physicians and other healthcare practitioners. Purdue University Global | This is Where the Title of the Presentation Will Go 9 Needs Assessment ➢ Range of 72- 98 daily ED patient admissions. ➢ Excess non-emergent ED visits – 35% of patients return due to unclear follow up instructions, inadequate diagnosis explanation, or missing test results. ➢ Potentially avoidable hospital admissions – 12% of return ED patients are admitted. ➢ Return visit reasons – failure to complete treatment, relevant to insufficient discharge instructions. ➢ More than a third of the revisits happen due to information gaps Cite your slides here 10 Literature Review ❑Databases ➢ Cochrane library ➢ MEDLINE ➢ CINAHL ❑Key words ➢ ➢ ➢ ➢ ➢ Return visits Emergency department Overcrowding Discharge process Quality of care Purdue University Global | This is Where the Title of the Presentation Will Go 11 Literature Review Title Return visits to the emergency department: The patient perspective Minimizing ED waiting times and improving patient flow and experience of care Revisiting the behavioral model and access to medical care: Does it matter? National health surveys and the behavioral model of health services use. Med Care Societal and individual determinants of medical care utilization in the United States Author(s) Year Article Type Grade Summary Rising, L. k, Padrez, A, B’Brien, M, Hollander. E. J Carr, G. B & Shea, A. J. Sayah, A, Rogers, L, Devarajan, K, Rocker, K. L & Lobon, F, L. yah et al. Andersen, R. 2014 Original Research 2 The paper summarizes the perspectives of patients on the reasons for return visits to emergency departments 2014 Original Research 1 The paper examines the ways of minimizing waiting time in emergency departments and to improve experience of care 1995 Original Research 2 Andersen RM 2008 Original Research 2 Andersen, R., & Newman, J. F. 2005 Original Research 2 The paper looks at the behavioral models applied in healthcare and the extent to which it influences the quality of care The paper also looks at various health behavioral models and the extent to which they impact access to health services The paper discusses the societal and individual factors that determine the utilization of care services in the country Literature Review Title Emergency department visits Author(s) Centers for Disease Control and Prevention Trends in emergency department Ericksen, G, M & use by rural and urban populations Kocher, K. in the United State Environmental health Healthy People 2020 Examining health literacy Rikard et al. disparities in the United State: A Rikard, V. R, third look at the National Thompson, S. M, Assessment of Adult Literacy McKinney, J & (NAAL) Beauchamp, A. Year Article Type Grade Summary 2017 Short report 1 Discusses a wide range of emergency issues in many health facilities 2019 Original 1 Research 2019 Short 1 Report Original 1 Research The paper takes a look at the trends in America’s emergency departments with a keen interest in quality indicators The paper looks at the environmental factors that influence the health of individuals The paper summarizes health literacy in the United States. It is concerned with the manner in which health literacy impacts health choices 2016 Project Theoretical Framework ➢ The Andersen health utilization framework will guide study execution ➢ Andersen framework used to analyze and explain the factors that influence people’s ability to access healthcare services ❑ ➢ Defining a Viable Health Care Future
Alignment with Project The framework may be used to improve the quality of care in emergency departments Cite your slides here 14 Project Description Project summary and expected outcomes ❑ The project aims to implement of a clinical tool to reduce unnecessary return ED visits. ❑ Anticipated outcomes include: ➢ ➢ ➢ ➢ ➢ ➢ ➢ Cite your slides here Reduced unnecessary ED returns. Reduced avoidable hospital admissions. Increased ED patient care quality. Increased patient treatment compliance. Increased patient satisfaction. Improved ED provider competence. Reduced patient care costs, and unreimbursed care form medical insurances. 15 Project Description • Project Timeline June 2020: Impact analysis and change introduction March – April 2020: Existing Employee Training April-May 2020: Review existing policies • Project Budget and Justification ITEM COST ($) Employee training and materials, e.g., printing costs $127.89 Discharge checklist tool copies $152.59 Discharge policy changes, printed papers of evidence-based data collection and editing services $175.00 TOTAL $455.48 Project Implementation Plan ➢ Implementation will follow discharge checklist tool development. ➢ Patients will mark checklist boxes to document understanding of discharge instruction packet. ➢ Patients will sign if satisfied with the discharge instructions received from the physicians and nurses. ➢ Provider will also sign tool, documenting delivery of complete discharge instructions. ➢ Upon project proposal approval, an application will be submitted for IRB approval. Cite your slides here 17 EMERGENCY DEPARTMENT PATIENT DISCHARGE CHECKLIST Discharge Checklist Tool Hospital Logo DISCHARGE CHECKLIST ANSWERS COMMENTS Language of preference Spanish Certified interpreter present Yes Education given: Verbal, Written, Video Verbal and Written Diagnosis Hypertension Prescriptions given Yes Beta Blockers Prescriptions instructions explained Yes Side effects Test results given: verbal, copies copies Explained Follow up care with specialists or PCP given Yes Dr. John Doe Cardiologist Care notes given and discussed Yes Monitor B/P, HTN diets Hospital property returned Yes Gown, blankets Presense of next of kin No No companion Discharge instructions understood Yes Addional instructions material provided No PATIENT SIGNATURE DISCHAGE NURSE SIGNATURE DISCHARGE DOCTOR SIGNATURE Cite your slides here Patient Label C.P #1234 Joe Doe CPales MSN ARNP John Doe MD 18 Project Implementation Plan ➢ Defining a Viable Health Care Future