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BHA FPX 4020 Assessment 4 Interdisciplinary Presentation of Evidence-Based Recommendations

BHA FPX 4020 Assessment 4

BHA FPX 4020 Assessment 4

Interdisciplinary Presentation of Evidence-Based Recommendations

The solution to this problem is most important for several reasons. First of all, it affects the patient’s outcome and level of satisfaction in healthcare. It is a firm part of healthcare delivery to strive to offer the patient the best care they can get and helping to tackle this issue is meeting that commitment.

(Smith and Jones.,2019) support this view stating that decreasing the number of patients who need to be brought back into the hospital increases positive effects on the patients’ care quality and experiences. Secondly, the determination of this issue can enhance resource optimization in that there will be decreased costs of patient readmission that are preventable and optimization of workflow (Brown et al., 2020).

Lastly, as healthcare providers, we should update ourselves on best practices that goes in our area of specialization about regulation and ethical provisions.

Data-Driven Action Plan

Our action plan aims at the minimal hospital readmissions for elderly patients within the next one year, hoping to achieve that the rate drops by 20%. This plan was developed based on the standards and best practices which exist in the industry and the best practices of organizations that have a similar goal as depicted above.

The first procedure in our implementation plan is to perform detailed risk assessments on all elderly patients upon admission with the help of the LACE Index which will help predict future readmissions (van Walraven et al. , 2010).

After the formation of the risk assessment plan, a care coordination team shall be formed by the physician, nurses, social workers, and pharmacists. Mr. Jeffrey C Jack et al have asserted that effective care coordination leads to the sequel of readmissions in hospitals.

Discharge planning for high-risk patients will be written based on every individual’s plan aimed at providing vigor discharge education to patients as well as caregivers. This study further shows that, discharge planning interventions must result in the reduction of readmission rates, and enhancement of patient experiences.

After being discharged, patients’ follow-up visits should be scheduled for not more than 7 days and incorporation of telehealth check-ups to be done. It is established that early clinic visits reduce the probability of readmission (Shanbhag et al. , 2019). This action plan is also developed with a timetable, which is crucial to take it chronologically. During the initial two months, the primary strategy will be risk assessments to be carried out by the nursing staff and the IT department.

The next two months will be used to form a care coordination team that entails leaders from different departments. Clinical staff will formulate and carry out discharge planning in the fifth and sixth months of the study respectively. The outpatient services team will implement Rehabilitation health care measures in the seventh and eighth months.

For months nine and ten of the study, the patient education team will implement patient engagement tools among the participants. Ending in the last two months, all departments will observe the status and perhaps change strategies.

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The short-term anticipated change at the end of this plan is the increased level of patient satisfaction and minimization of readmission rates to 10% within six months. I consider short-term goals as the first one that is connected with decreasing readmissions number, The second one is to improve the quality of the organization’s services and decrease the expenditures ultimately.

The recommendations we are proposing based on the available literature to support vulnerable elders’ post-discharge requires sharing our proposed plans with the leadership of our organization to ensure they embrace our mission, vision, values, and strategic directions and goals.

Let’s analyze these recommendations in the context of each aspect:Let’s analyze these recommendations in the context of each aspect:

  • Organizational Mission

Our aim is to deliver quality care to our patients and client. Directly addressing the issue of hospital readmission is in line with this mission since it helps in enhancing patients’ wellbeing and furnishing continuous care. Therefore, by intensifying carrying out risk assessments, developing complex personalized discharge plans, as well as accompluring timely follow-up, we are promoting the quality of the offered patient care.

It also helps treat primary health problems while assisting with the overall well-being of a person, proving that patient care is our priority and goal (Smith & Jones, 2019).

  • Organizational Vision

The mission is to work towards the formulation of a healthcare organization that creates positive impact through innovative and effective Implementation of care interventions. The proposed recommendations incorporate contemporary strategies into best practices of the future such as telehealth and mobile health.

In this way, we aim to be ahead of time by implementing the progressive approaches that define the advanced vision for health care to enhance the quality of patient’s health and meaningful satisfaction (Brown et al., 2020).

BHA FPX 4020 Assessment 4

Evidence-Based Recommendations

To address the issue of high hospital readmissions among elderly patients, we propose three key evidence-based recommendations: nursing care needs assessment, interdisciplinary team collaboration and patient-specific discharge planning. Here is the rationale for each:

  • Comprehensive Risk Assessments

Systematic evaluations that consider all the aspects of a patient’s condition are crucial for recognizing patients who are at a higher risk of being readmitted. It is possible to know which patients are at higher risks of readmission, with tools like LACE Index, thus plan suitable interventions appropriately.

The study has shown that the LACE Index is useful in predicting readmissions and early deaths and saves healthcare providers’ time to manage high-risk patients more efficiently. LACE Index takes into account factors such as the length of stay, admission severity, presence of comorbidities, and the subsequent emergency department visits, so it takes into account pretty much all aspects of a patient’s health condition.

The integration of extensive risk assessment tools is beneficial since it leads to the reduction of readmission and enhanced patient outcomes as pointed out by Waring and Marshall (2020).

  • Multidisciplinary Care Coordination

Such other team members would include pharmacists, dieticians, physiotherapists and occupational therapists because coordination of care right from admission, through the treatment process, till the patient is discharged and even at the next visit would have been assured.

The players in this team include physicians, nurses, social specialists, pharmacists, and others as appropriate whose role is to develop and offer necessary individualized healthcare plans for the client. Or: Coordinated care has been associated with decreased hospitalization, and enhanced patients’ satisfaction and health status. In a study by (Kangovi et al.,2020), it was discovered that a community health worker populace attached to different hospitals had a positive impact on reducing the number of hospitalisations.

Several social factors that may lead to readmissions can be combatted by a multidisciplinary team comprising of physicians, nurses, pharmacists, occupational therapists, and social workers.

  • Individualized Discharge Planning

Targeted discharge planning centers on the writing of discharge plans for each individual patient in relation to his or her needs and condition. This involves patient/caregiver education on the disease, treatment, drugs and other relevant topics for better compliance and follow-up.

Discharge planning is one of the practices that have been revealed as beneficial for patients to have better health outcomes, decrease the number of readmissions, and increase their level of satisfaction. Based on the literature, patients whose plans of care are individualized are likely to follow their discharge instructions and experience reduced readmissions (Sanger et al. , 2020).

Discharge planning, particularly for arrangements of follow-up treatment, has also been explained to decrease hospital readmissions (Rodgers et al., 2019).

BHA FPX 4020 Assessment 4 Interdisciplinary Presentation of Evidence-Based Recommendations

With regards to the three evidence-based recommendations: comprehensive risk assessment, coordinated multidisciplinary care, and individualized discharge planning, rehospitalization of elderly patients shall be reduced tremendously.

These strategies are backed by clickable evidence and they fit within our organization’s strategic plan to deliver quality, patient-centred care. Thus, utilizing the mentioned approaches will be beneficial for the improvement of patient’s condition, satisfaction, and utilization of resources with a positive impact on the function of our healthcare organization.

Conclusion

In conclusion, old patients have elevated chances of pre-hospitalization pose a major problem to healthcare services, and require immediate and efficient solutions. Collected findings – risk assessments, multidisciplinary care, and individualized discharge planning – are aimed at meeting the needs of this patient group.

Strengthening implementation of initial whole-person assessments results in the effective identification of high-risk patients; thus, guiding interventions that empower medical professionals to avoid readmissions. In this way, we facilitate efficient communication and coordination between healthcare providers of different fields, to guarantee the proper management of all aspects of the patient’s care.

It is important to say that the more individualized the discharge planning is, the more competent and ready to face challenges the patient as well as his or her family will be.

If you need complete information about class 4020, click below to view a related sample:
BHA FPX 4020 Assessment 3 Data Collection and Analysis

References

Birken, S. A., Haines, E. R., Hwang, S., Chambers, D. A., Bunger, A. C., & Nilsen, P. (2020). Advancing understanding and identifying strategies for sustaining evidence-based practices: A review of reviews. Implementation Science, 15(1).

https://doi.org/10.1186/s13012-020-01040-9

Corp, N., Mansell, G., Stynes, S., Wynne‐Jones, G., Morsø, L., Hill, J. C., & van der Windt, D. A. (2020). Evidence‐based treatment recommendations for neck and low back pain across europe: A systematic review of guidelines. European Journal of Pain, 25(2), 275–295.

https://doi.org/10.1002/ejp.1679

Eng, J. J., Bird, M.-L., Godecke, E., Hoffmann, T. C., Laurin, C., Olaoye, O. A., Solomon, J., Teasell, R., Watkins, C. L., & Walker, M. F. (2019). Moving stroke rehabilitation research evidence into clinical practice: Consensus-Based core recommendations from the stroke recovery and rehabilitation roundtable. Neurorehabilitation and Neural Repair, 33(11), 935–942.

https://doi.org/10.1177/1545968319886485

Heiligenhaus, A., Minden, K., Tappeiner, C., Baus, H., Bertram, B., Deuter, C., Foeldvari, I., Föll, D., Frosch, M., Ganser, G., Gaubitz, M., Günther, A., Heinz, C., Horneff, G., Huemer, C., Kopp, I., Lommatzsch, C., Lutz, T., Michels, H., & Neß, T. (2019). Update of the evidence based, interdisciplinary guideline for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis. Seminars in Arthritis and Rheumatism, 49(1), 43–55.

https://doi.org/10.1016/j.semarthrit.2018.11.004

Law, M., & MacDermid, J. (2024). Evidence-Based rehabilitation: A guide to practice. In Google Books. Taylor & Francis.

https://books.google.com.pk/books?hl=en&lr=&id=Z6cLEQAAQBAJ&oi=fnd&pg=PP1&dq=Interdisciplinary+Presentation+of+Evidence Based+Recommendations+&ots=FLCAzUawwf&sig=EhhTzkhDefLCraaPsDN6DzFSWds&redir_esc=y#v=onepage&q=Interdisciplinary%20Presentation%20of%20Evidence-Based%20Recommendations&f=false

O’Hare, T. (2020). Evidence-Based practices for social workers: An interdisciplinary approach. In Google Books. Oxford University Press.

https://books.google.com.pk/books?hl=en&lr=&id=sLTRDwAAQBAJ&oi=fnd&pg=PP1&dq=Interdisciplinary+Presentation+of+EvidenceBased+Recommendations+&ots=5rip3GgTO4&sig=vf5NTzY97MQNcdKbyT3zI3UATrA&redir_esc=y#v=onepage&q=Interdisciplinary%20Presentation%20of%20Evidence-Based%20Recommendations&f=false

Wade, D. T. (2020). What is rehabilitation? An empirical investigation leading to an evidence-based description. Clinical Rehabilitation, 34(5), 571–583.

https://doi.org/10.1177/0269215520905112

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