The issue that is of concern, in this case, is the fact that hospital readmission rates for the same diagnosis within 60 days have been high. The issue has been narrowed down to the hospital discharge system, and the proposed changes are thus targeted towards ensuring an efficient patient discharge approach (Hall, Chang, & O’Grady, 2016). The current hospital system of letting patients out is the traditional approach in which they are given instructions sheets, and general advice on how to manage their conditions at home. However, the weakness with this model is that the patients, in this case, the children with respiratory illnesses, find it hard to adhere, and interpret the instructions given to them (Felix, Seaberg, Bursac, Thostenson, & Stewart, 2016). For this specific scenario, it is the parents that are at a loss on how to implement the instructions given. Some of them do not take the time to completely read them, while others lose them since they see the medication as more important than the procedures for caring for the sick at home. The proposed change is to use the case assigned discharge model for helping the parents manage their children’s conditions at home (Hall, Chang, & O’Grady, 2016). In this model, during discharge, a physician is assigned to the patient, and required to aid them through the recovery process at home. This change would call for elaborate plans that help in educating the patients, and create a rapport between these patients, and assigned physicians.
Change Model Overview
The change model, in this case, is aimed at reducing the readmission rates of children to the facility for the same diagnosis within the specified period of sixty days with regards to respiratory illnesses. This change is necessary because it would help reduce the cost of medication for the parents, clear the doctor’s schedules so that they can attend to more patients, and spare the children the pain of having a delayed recovery. To implement the proposed design would require utilization of an evidence-based procedure, in this case, it is the ACE Star model. In this approach, there are five steps that are adhered to to ensure a streamlined process of knowledge discovery, and integration (Kumar, 2015). The stages, or tenets of the model are; the discovery of knowledge, summary of evidence, recommendations for implementation, the actual implementation, and finally, the evaluation (Kumar, 2015). This is a participatory process that would include several stakeholders such as donors, the hospital management, patents (parents with affected children), experts in the field, and the staff of the hospital (Vincent, Renz, Dopson, & Parand, 2014). This is important as it would ensure that the decision, and process arrived at in consisted with the mission of the hospital, and agreeable with the recipients (Lumbasi, K’Aol, & Ouma, 2016). Nurses should use this model as a guide to facilitate change through underrating the necessary education of the patients, and availing themselves in case a discharged individual requires an assigned physician
Photo: The ACE Star model: source http://www.aahs.org/aamcnursing/wp-content/uploads/ACE-Star-Model-of-Knowledge-Transformation.jpg. Retrieved 26th January 2018.
The evidence that supports the need for this change in design of the hospital discharge system stems from the fact that within the last 60days, over 60% of the patients have returned for the same diagnosis with the same conditions. This is an issue that must be addressed since it is the hospital’s ethical responsibility to society to ensure that a patient is helped to fully recover after having sought services from the facility. The evidence-based solutions that are highlighted in the evidence summary sheet would be sufficient in addressing this issue. The prominent ones are the education of the patients before they leave the facility, and the assigning each patient a physician who would help them handle the home care aspects of the condition. Since it is clear that the mothers with children who have respiratory illnesses are not doctors, or nurses, it would be inappropriate to leave them to deal with their health issue at home. It is, therefore, necessary to allow for a follow-up program that would save the facility potential negative reputation arising from the fact that it is deemed unable to effectively treat respiratory illnesses in children.
The activities that are necessary to effect the suggested options are outlined in this section. The primary consideration, in this case, is the fact that manpower, and finances must be put in place to facilitate the program. Since it is a new program that is being introduced, training for the nurses, and practitioners is necessary. This is due to the fact that treating a patient physically, and remotely are different things, thus, a nurse must be able to tell when to advice, and when not to do so remotely. A brief training workshop is necessary, it does not have to take staff from their duties, since this is something in line with their profession, they can learn on the job as well (Lagace, 2009). The second aspect of this program is to provide the patients with education on how to manage the communication with the hospital. There must be clear schedules, and communication channels. In this case, phoning the patients, and doctors would be the primary means of communication since it often gets the recipients attention quickly. The hospital must invest in new devices for purposes of this communication such as cellphones customized for the hospital. In addition, during the admission period, the mothers of the children would be educated on how to take care of the children. This is a duty that would be undertaken by the nurses. The funding for this initiative would be obtained from donors, and well-wishers. Since it would be a recurring expense on the hospitals budget, it must be allocated a certain quota that would be guaranteed every year, or semiannually. Finally, to effectively translate this plan into action, the hospital policy must be amended in a manner that explicitly includes the terms, and conditions of the said service. This helps align it with organization goals. In fact, the information gathered is transformed into actionable plans via the aforementioned activities, and entrenching it into the policy manual of the institution. These changes would take approximately 6 months to be fully actualized, and funded. However, this may vary with the organization’s budget, and funding schedules. The expected outcome is the significant decline in the number of patients returning for the same diagnosis. The projected decline is over 90% of the original figures over the 60-day period that the study was conducted in. The effective way of communicating the plan to staff members is through a participatory forum such as group discussion. In fact, the entire solution proposed is based on participatory planning, and action.
Current Discharge System
And participatory planning and action
In conclusion, it is important to actively minimize the rate of readmissions for the same diagnosis in the hospital. This helps in building a positive reputation, and avoids cases of dissatisfied clients. The change plan, in this case, aims to eradicate the readmission instances on the same diagnosis of children with respiratory illnesses. The five stages of the ACE Star change model are invaluable for translating the planned knowledge into actions. First, the knowledge was acquired through research and situation analysis at the hospital. Then the evidence is gathered regarding readmission rates and solutions sought to mitigate the problems. Guidelines are formulated to actualize the solutions and the actual translation into the institution is undertaken. Afterwards, an evaluation is performed to determine effectiveness and applicability of solutions. The basis for the plan is participatory action, and implementation. The staff, and patients have to be educated on how the program would run, and the management must be in league with these activities so that they can effectively support the program. Such support may be in the form of funds allocation, and research, and development. In fact, the participatory approach goes a long way in ensuring the sustenance of the program, and its improvement. If patients can communicate with the staff effectively, and management listens to recommendations, and implements them, then the program would be self-evolving, and can be highly customized to an institution. For financial sustainability, patients can be asked to chip in voluntarily, or as part of the home care programs associated with the specific illness that they suffer from.
Felix, H. C., Seaberg, B., Bursac, Z., Thostenson, J., & Stewart, M. K. (2016, January 29). Why do patients keep coming back? Results of a Readmitted Patient Survey. Soc Work Health Care, 54(1), 1–15. doi:10.1080/00981389.2014.966881
Hall, K. K., Chang, A. B., & O’Grady, K.F. (2016). Discharge plans to prevent hospital
readmission for acute exacerbations in children with chronic respiratory illness (Protocol). Cochrane Database of Systematic Reviews, Issue 8. Art. No.: CD012315. DOI: 10.1002/14651858.CD012315
Kumar, Y. (2015, July 13). Evidence-Based Quality Improvement: A Knowledge Transformation in Nursing Care. International Journal of Health Sciences and Research, 5(8), 522-524. Retrieved from http://www.ijhsr.org/IJHSR_Vol.5_Issue.8_Aug2015/7…
Lagace, M. (2009, November 23). Management’s Role in Reforming Health Care. Retrieved from Harvard Business School: https://hbswk.hbs.edu/item/managements-role-in-ref…
Lumbasi, G. W., K’Aol, G. O., & Ouma, C. A. (2016, July). The Effect Of Participative Leadership Style On The Performance Of COYA Senior Managers In Kenya. Researchjournali’s Journal of Management, 4(5), 1-12.
Vincent, C., Renz, A., Dopson, S., & Parand, A. (2014, September). The role of hospital managers in quality and patient safety: a systematic review. BMJ Open. doi:http://dx.doi.org/10.1136/bmjopen-2014-005055
Week 6: Capstone Project: Milestone 3: Educating Staff (graded)
- Due Sunday by 11:59pm
- Points 200
- Submitting a file upload
CAPSTONE PROJECT MILESTONE 3: EDUCATING STAFF: IMPLEMENTING CHANGE GUIDELINES
The purpose of this assignment is to create the Educating Staff: Implementing Change Project PowerPoint presentation. Your plan is to educate the staff that will be involved in the pilot program. You will need to educate them on the problem, show the supporting evidence, and how your pilot plan will be implemented.
This assignment enables the student to meet the following Course Outcomes.
- CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO2)
- CO3: Communicates effectively with patient populations and other healthcare providers in managing the healthcare of individuals, families, aggregates, and communities. (PO3)
- CO7: Integrates the professional role of leader, teacher, communicator, and manager of care to plan cost-effective, quality healthcare to consumers in structured and unstructured settings. (PO7)
Milestone 3 consists of the PowerPoint presentation Educating Staff: Implementing Change Project. Submit the PowerPoint file by Sunday, 11:59 p.m. MT by the end of Week 6.
Milestone 3 is worth 200 points.
- A tutorial with tips on completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=8912a4b3268463312e115abf9e73efd6 (Links to an external site.)
- Create an educational presentation for staff before the launch of your change project. This should inform the staff of the problem, your potential solution, and their role in change project.
- The format for this proposal will be a PowerPoint presentation.
- Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx (Links to an external site.) The Chamberlain Student Success Strategies (SSPRNBSN) offers a module on Computer Literacy that contains a section on PowerPoint. You can access SSPRNBSN from your Canvas course list.
- The length of the PowerPoint presentation should be 15-20 slides; excluding the title and reference slides.
- Below are the main topics or bullet points for your slides:
- Title slide
- Description of the Ace Star change model that you have used for this project.
- Practice Issue
- Scope of the problem—use basic statistics from what you know of the problem in your work area.
- Your team/stakeholders
- Evidence to support your need for change—from your Evidence Summary
- Action Plan
- Timeline for the plan
- The nurse’s role and responsibility in the pilot program
- Procedure (what steps are to be taken to complete this change process, from start to finish?)
- Forms that will be used (if applicable)
- Resources available to the staff—including yourself
- Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. Citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, “How do I know this?” and then cite the source. Scholarly sources are expected, which means choose peer-reviewed journals and credible websites.
- Application: Use Microsoft PowerPoint 2010 or later.
- Length: The PowerPoint slide show is expected to be between 15-20 slidesin length (not including the title slide and reference list slides).
- Submission: Submit your by 11:59 p.m. Sunday by the end of Week 6.
- Late Submission: See the Policies on late submissions.
- Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx (Links to an external site.) The Chamberlain Student Success Strategies (CCSSS) offers a module on Computer Literacy that contains a section on PowerPoint. The link to SSP CCSSS may be found under your course list in the student portal.
Best Practices in Preparing a PowerPoint Presentation
The following are best practices in preparing this presentation.
- Be creative.
- Incorporate graphics, clip art, or photographs to increase interest.
- Make easy to read with short bullet points and large font.
- Use speaker notes (found under the section View and “Notes” in the PowerPoint template you choose. These are for your personal use to use as a reference if you are giving your presentation to an audience and they help faculty identify what you will speak to your audience about.
- Review directions thoroughly.
- Cite all sources within the slides with (author, year) as well as on the Reference slide.
- Proofread prior to final submission.
- Spell check for spelling and grammar errors prior to final submission.
**Academic Integrity Reminder**
Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.
By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.
Please see the grading criteria and rubrics on this page.
|This criterion is linked to a Learning OutcomeThe ProblemSummary of change model discussed. Practice Issue is stated. Scope of the problem includes statistics as it relates to your work area and scope of problem to healthcare as a whole discussed. Team and stakeholders and their role/reason chosen is discussed as is logical.||
|This criterion is linked to a Learning OutcomeThe EvidenceDiscussion of the evidence is done in terms of themes of the multiple views given in the Systematic Review. Pertinent information is summarized. Sources are not listed individually but as an Evidence Summary synthesized into concepts discovered.||
|This criterion is linked to a Learning OutcomeThe PlanPlan of action described. Important elements are discussed and logical. Timeline is thorough and contains all elements. Timeline is logical and appropriate.||
|This criterion is linked to a Learning OutcomeThe Nurse’s RoleThe nurse’s role in the pilot plan is described and clear. Procedures for the pilot plan are clear and concise.||
|This criterion is linked to a Learning OutcomeResourcesForm for tracking the outcomes during pilot plan is included. Resources the nurses will need to help implement the plan are included. At least three resources are included. The nurse investigator, the team, internet resources, or other resources the staff needs is included.||
|This criterion is linked to a Learning OutcomeSummarySummary slide reiterates the problem and purpose of the plan along with the measurable goals in terms of success.||
|This criterion is linked to a Learning OutcomeOverall PresentationPresentation is presented in a clear and logical manner. PowerPoint is appealing to the eye and includes creativity. Font is easy to read. Speaker notes are present.||
|This criterion is linked to a Learning OutcomeMechanicsIncludes title slide. Grammar, punctuation, and sentence structure are correct. References are properly cited within the paper. Reference page includes all citations. Evidence of spell and grammar check.||