NURS FPX 6612 Assessment 3 Patient Discharge Care Planning

NURS FPX 6612 Assessment 3 Patient Discharge Care Planning
  • NURS FPX 6612 Assessment 3 Patient Discharge Care Planning.

Patient Discharge Care Planning

In response to the Institute of Medicine’s (IOM) seminal report, “To Err Is Human: Reducing Health Care Disparities: An Imperative to Act,” hospitals and other healthcare institutions have been advised to adopt Health Information Technology (HIT) as a means to improve patient safety and quality of patient care. This shift of emphasis further highlights the importance of using HIT in discharge care planning, such as eliminating gaps in the process and reducing adverse events after discharge.

  • Leveraging HIT for Marta’s Discharge Planning and Care

In Marta’s case, one of the most critical roles is that of a senior care coordinator responsible for her transition from the hospital to a home environment. In this regard, it is vital to discuss how HIT technology can facilitate the development of a comprehensive and patient-centered discharge care plan.

The following paper investigates the efficiency of HIT elements, data reporting, and Electron Health Record (EHR) data to coordinate Marta’s care better and potentially improve the outcomes. Such an analysis of the key considerations can educate the interdisciplinary team on MARTA’s communication strategies about the patient’s discharge, emphasizing how IT significantly impacts proper discharge planning and patient safety.

Longitudinal, Patient-Centered Care Plan

Health Information Technology (HIT) is a key element of the integrated process for delivering a patient-centered care plan that provides providers with a longitudinal view of an individual’s care across the continuum of care. It is possible to integrate HIT into the care planning process to provide continuity of care, engage patients in the processes of care, and support planning individualized treatment depending on the patient’s needs (Hersh, 2019).

  • EHRs and Patient Portals: Enhancing Marta’s Care Journey

As a form of HIT, EHRs also significantly impact longitudinal care planning. EHRs, essentially electronic databases in the form of patient files, contain medical history information and diagnostic tests, medications, and treatment plans (HIMSS 2020). By collecting these data and putting all of them into one place, healthcare providers can know how Marta’s condition is progressing and plan future interventions accordingly. This longitudinal view allows providers to adjust their interventions to Marta’s changing health status and desires throughout the healthcare process, often called more continuous and consistent.

NURS FPX 6612 Assessment 3 Patient Discharge Care Planning

HIT helps to ensure patient-centered care by increasing the patient’s involvement in the care process, as in the case of Marta, the patient we are talking about. Patient portals and mobile health applications provide access to health information and support communication between patients and the care team, providing learning opportunities for self-management (Zhou et al., 2021). Through these platforms, the patient can see her treatment plan, see her progress, or even give feedback to her providers). This enables Marta to have a sense of ownership of her care regime and helps clinicians stick to the individual’s care plan according to their values, goals, and culture.

Ways in Which Data Reporting Specific to Client Behaviors Can Shape Care Coordination

Client-focused data reporting can contribute to different components of care, like care coordination, management, efficiency of care in health workers’ clinical work, and innovation development between professionals. Using KPIs and other metrics and understanding trends in client behavior allows healthcare providers to target interventions better, allocate staffing and funding appropriately (as well as identify opportunities for improvement in care).

For instance, in NURS FPX 6612 Assessment 3 Patient Discharge Care Planning, data reporting can highlight existing gaps or inefficiencies in the care process. For example, reporting on patient data can measure adherence to medication schedules to identify patients needing extra educational, motivational, or informational support. Similarly, keeping track of appointment attendance and follow-up care can enable healthcare professionals to approach patients who stop engaging with healthcare systems and educate them about available care alternatives (Sullivan et al., 2020).

Regarding care management, the use of data can help prepare interventions for treatment and care planning depending on the behaviors developed by clients. For instance, using statistics to identify changes in a patient’s vital signs, the seriousness of the symptoms, and the patient’s self-assessment can help determine how to modify the drugs being administered or the type of treatment or lifestyle suggestions. Furthermore, by incorporating data from wearable devices or telemedicine-connected devices, healthcare organizations can get client data on their actions outside of the hospital and thus provide them with a better-tailored and proactive approach.

Information Collected from Client Records

Engaging in HIT enables the use of client information in the system to impact health outcomes via several channels positively. Through data mining existing datasets from EHRs, clinical notes, lab results, and PROMs, healthcare providers can gain actionable knowledge about patients’ health, treatment choices, or outcomes. This information also forms the basis on which evidence-based decisions are made, creating care plans customized to patients and patient populations and the implementation of intervention strategies in a proactive manner to attain health outcomes (Ahmadian et al., 2019).

  • Early Detection and Risk Assessment Through Data Analysis

Including such information for health outcomes may involve the early discovery of health conditions through client records. Data analysis will also help evaluate the risk factors, disease conditions, and health deterioration. For instance, abnormal laboratory findings, changes in vital signs, or variations of the treatments prescribed in the client’s chart can be considered leading indicators of emerging difficulties or the necessity to switch care focus. It becomes evident that failing to act quickly is inappropriate and may lead to worsening health conditions or adverse events and a negative impact on the treatment process.

Conclusion

According to the discussion, it is clear that effective patient discharge care relies on using Health Information Technology (HIT) to coordinate transitions, deliver personalized care, and meet the care goals and objectives.

HIT enables healthcare practitioners to establish cohesive care plans through EHRs, patient portals, and predictive modeling software to integrate care that meets patients’ needs around individual preferences and circumstances. The inter-professional team may easily work with the help of HIT to decrease the number of adverse events after discharge and better coordinate various treatment stages.

Equally important is the data, which directly focuses on client data behavior to determine health status, treatment response, and preference in care. As part of the NURS FPX 6612 Assessment 3 Patient Discharge Care Planning, client drivers could be helpful to healthcare providers in the development of strategic interventions that can improve the healthcare delivery system in various ways, from identifying necessary changes in client behaviors to devising client-specific approaches to achieve quality improvements in healthcare. Explore our sample NURS FPX 6612 Assessment 2 Cost Savings Analysis for complete information about this class.

References

Ådnanes, M., Cresswell-Smith, J., Melby, L., Westerlund, H., Šprah, L., Sfetcu, R., Straßmayr, C., & Donisi, V. (2019). Discharge planning, self-management, and community support: Strategies to avoid psychiatric rehospitalization from a service user perspective. Patient Education and Counseling103(5).

https://doi.org/10.1016/j.pec.2019.12.002

Considine, J., Berry, D., Sprogis, S. K., Newnham, E., Fox, K., Darzins, P., Rawson, H., & Street, M. (2020). Understanding the patient experience of early unplanned hospital readmission following acute care discharge: A qualitative descriptive study. BMJ Open10(5), e034728.

https://doi.org/10.1136/bmjopen-2019-034728

Emes, M., Smith, S., Ward, S., & Smith, A. (2019). Improving the patient discharge process: Implementing actions derived from a soft systems methodology study. Health Systems8(2), 117–133.

https://doi.org/10.1080/20476965.2018.1524405

Haselden, M., Corbeil, T., Tang, F., Olfson, M., Dixon, L. B., Essock, S. M., Wall, M. M., Radigan, M., Frimpong, E., Wang, R., Lamberti, S., Schneider, M., & Smith, T. E. (2019). Family involvement in psychiatric hospitalizations: Associations with discharge planning and prompt follow-up care. Psychiatric Services70(10), 860–866.

https://doi.org/10.1176/appi.ps.201900028

Hayajneh, A. A., Hweidi, I. M., & Abu Dieh, M. W. (2020). Nurses’ knowledge, perception and practice toward discharge planning in acute care settings: A systematic review. Nursing Open7(5), 1313–1320.

https://doi.org/10.1002/nop2.547

Loerinc, L. B., Scheel, A. M., Evans, S. T., Shabto, J. M., O’Keefe, G. A., & O’Keefe, J. B. (2021). Discharge characteristics and care transitions of hospitalized patients with COVID-19. Healthcare9(1), 100512.

https://doi.org/10.1016/j.hjdsi.2020.100512

Luther, B., Wilson, R. D., Kranz, C., & Krahulec, M. (2019). Discharge processes: What evidence tells us is most effective. Orthopaedic Nursing38(5), 328–333.

https://doi.org/10.1097/nor.0000000000000601

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