Skip to content 
NURS FPX 6030 Assessment 4
Implementation Plan Design
In the health sector, an implementation plan designer is required to come up with a detailed procedure on how new health care tools, program or methods will be introduced and integrated into the health care system. Some of the tasks that are involved are identifying client needs, goal setting, assigning resources and tasks and coming up with deadlines.
Therefore, to come up with a detailed plan that will guarantee a successful implementation, compliance with the law, as well as improved patients’ experiences and better health care delivery, the planner of the change ought to consider the hurdles, risks, and issues of change management. Here is the PICOT question:
What is the impact of health care payment models that focuses on value (I) as opposed to traditional fee-for-service payment models (C) on the health of people with chronic conditions or treated at community health centers (P) within six months (T)? What are the consequences on factors such as, fewer hospitalizations, control measures, completed screening activities, and improved compliance (O)?
Strategies for Leading, Managing, and Implementing Professional Nursing Practices
Two leadership concepts through which you can implement action plans stemming from the PICOT question are the transformational leadership and shared leadership (Galli, 2019). This is because transformational leadership entails helping people in a team to feel that they own a certain goal and therefore they will strive to achieve it (Lorinkova & Perry, 2019).
In shared leadership, members of the team take turns in being the leaders of the team. This makes them more likely to collaborate and decide (Ali et al. , 2020). It is possible to ensure that health care professionals of various disciplines can cooperate with each other by creating conditions under which people can share their experiences, discuss issues, and respect each other.
Of all the management models, PDSA model and the Lean management model are the most effective way to develop management plans. According to the PDSA model, quality, therefore, should be improving in the planning, implementing, observing, and refining process (Øyri et al. , 2020).
Thus, teams can modify and enhance their action plans based on the feedback they get from other people and the outcomes of the planning process. According to Prado-Prado et al. (2020), lean management is simply the elimination of waste, improvement of processes, and provision of value to people.
These strategies will help mixed teams to be effective in their working relationship, improve on their ways of doing things, and efficiently utilize their resources. This will enable the value based payment models to fly.
Such professional practices as the use of research, patient care that is centered on the patient and clear communication are all useful for an intervention plan. We depend on the most reliable patient data, our expertise, and the patients’ preferences to guide our actions and ensure they receive quality care (Engle et al. , 2021).
Patient-focused model of care entails the consideration of the patient’s demands, views, and preferences. This increases their chances of being actively engaged in the treatment process and therefore, adhere to the prescribed regime.
According to Schober et al. (2021), for shared teamwork, it is necessary for all the members to be able to articulate about their jobs and the tasks that they are supposed to perform as well as the goals that they are supposed to achieve. The following guidelines can be useful for nurses and other healthcare personnel to collaborate in value-based payment systems: In the end, this may lead to an enhancement of health and happiness of the patients respectively.
-
Conflicting Data and Other Perspectives
The proposed plans and actions are to enhance health outcomes and enhance collaboration among professionals; nevertheless, there is some evidence which does not support these statements.
As noted by Milad and his colleagues in 2022, there is evidence that indicates value-based payment models do not always have to result in significant changes in patients’ health outcomes or cost savings in comparison to the conventional fee-for-service models. Healthcare workers who are more comfortable with the existing approaches may also resist the new ways of payment and leadership. This proves that change is a crucial factor and must be well managed and staff ought to be incorporated (Boustani et al., 2019).
Analysis of Implication of Change Associated with Proposed Strategies
New ways of leading include shared leadership and transformational leadership that will revolutionize the care setting by enabling people to collaborate, innovate and improve. The quality of care shall rise since all healthcare personnel will have to collaborate in identifying and applying the most appropriate interventions. This will assist in getting improved care. Similarly, El-Haddad et al.
(2020) also noted that patients will have a better experience with care if it is more coordinated and revolves around them and their needs, with the care teams collaborating to address the patient’s needs and desires. All these ways of leadership will also assist in cutting down on costs as people will be encouraged to be economical in the use of resources and ensure that they do not perform unnecessary tasks.
The care setting will be different because PDSA and Lean management will emphasize decision-making based on data and improvement of processes. These changes will enhance care since healthcare teams will be able to experiment with different ways of working and search for better approaches that are grounded in evidence (Rizan et al. , 2020).
There will be improved patient satisfaction with the care since it will be more organized, thus offered in quick succession. It will also be easier to get services and with less waiting time. The above ways of managing will also assist in the reduction of costs through elimination of waste, minimisation of variations and optimal utilisation of resources. Garay et al. (2021) claim that the different wait times decrease by 26% initially and by 17% at the end when a sequence of plan–do–study–act cycles is applied.
The care setting will be different due to the existence of evidence-based practice, patient centered care, and proper communication. This is because they will encourage the idea of lifelong learning in work places, empower patients and integrate the professionals from various disciplines.
These changes will also guarantee that the nurse treatments provided are research-based, are specific to the patient, and are administered systematically (Kwame & Petrucka, 2021). Therefore, this paper concludes that if the patient is more involved, knowledgeable and assisted in the process, he or she will receive better care. It will also reduce costs because such nurse practices will prevent adverse events, reduce hospital readmissions and enhance patient adherence to the recommended treatment plans (Kwame & Petrucka, 2021). Thus, it will result in improved and enhanced ways of delivering care to the patients.
Delivery Methods for the Implementation of Intervention
A value-based payment model option that works well for CHC vulnerable patient population with chronic disease is offered as a delivery method that has more than a single element. The first thing that healthcare workers and staff should do is three know the difference between value-based model and fee-for-service model (Pittman et al. , 2021).
There are reasons for it, its functions and its mechanism would also be included. After them, writing materials, pictures, and other forms of printed and artificial materials for marketing or training the patients should be created. This will assist them to gain knowledge on the new model and engage in the management of their own health care (Ayman & Kaya, 2020).
Are you Looking for guidance for NURS FPX 6030 Assessment 4? Our experts are here to assist you. Reach out to us for support today.
Incorporating a sound data tracking system in the intervention should be part of the general area to keep the battle of tracking things like treatment, compliance to screening and other condition controlling measures (WHO, 2020). It calls for the high risk patients to have care workers who will assist with follow up care and commitment.
Finally, reward systems that are aligned with performance evaluations to reflect value-based quality measures should be implemented with an aim of changing the providers’ behavior as desired (Lee et al. , 2019). Additional, Mortality, morbidity and functional decrements are more likely to be well catered for in the value based model than in the fee for service model. This is because MDPM takes more of full participation of the patient, instructions, data system, care management, and even the change in benefits.
Current and Emerging Technological Options
Here is a look at some new and current technology choices that are linked to the ways that a value-based payment model assistance is suggested to be delivered at community health centers:Here is a look at some new and current technology choices that are linked to the ways that a value-based payment model assistance is suggested to be delivered at community health centers:
Mobile applications for patients, EHR with analytical tools, as well as the recent self-developed video conference in telehealth are some of the most relevant technologies available at the moment. With the help of these modern tools the suggested transport methods can be much more efficient. In this way, EHR allows to simultaneously watch quality measures, coordinate the care, and provide the performance results to the providers that comply with the value oriented goals (Rudin et al. , 2020).
NURS FPX 6030 Assessment 4 Implementation Plan Design
Other common social media platforms include Patient websites and apps that enhance the sharing of training materials and increase people’s engagement (Dendere et al. , 2019). Telehealth enhances access to health because clients with chronic diseases can be monitored remotely (Bitar & Alismail, 2021). EHRs and analytics tools that operate with patient platforms can probably have the most significant impact on noticeable improvement by the simplicity of data tracking, teaching and tutoring.
Thus, the healthcare industry has integrated new technologies in its working model, client health support systems empowered by the AI facilities in clinical decision aids, smart home diagnostic devices that can observe the patient from a distance, and natural language interactive AI assistants. Some of these new tools could make delivery even more effective.
In order to obtain measurable value-based solutions, AI clinical decision assistance can enhance given care sequences by means of evidence-based medicine (Giordano et al . , 2021). According to El-Rashidy et al. , (2021) the tracking devices used when managing chronic diseases means that data involving real time patient information can be gotten.
Some of the patient education that can be given to a large number of patients can be explained in a personalized manner automatically by conversational AI (Barrett et al. , 2019). Clinical decision supporting system might have the biggest impact by embedding best practices into more or less standardized and yet very individualistic care plans correspond to the idea of value-based model.
What has not been given adequate attention is how the tools that have been mentioned can integrate to complement the various health IT systems and platforms applied in CHCs. Barrett et al. (2019) state that nobody understands how much it truly costs to establish and maintain these applications. Also, it has not been determined if doctors and patients will like and adopt tools such as AI CDSS. Moreover, better and more research and evidence are required to understand better how all the varieties of technology perform at achieving goals relevant to L&D.
Stakeholder, Regulatory Implications, and Potential Support
When designing a value-based payment model for the community health centers to provide care for patients with LTI, it is crucial to consider people, healthcare rules, and factors that could alter the mentioned plan. Some of the most significant stakeholders are; healthcare workers, professional staff, patients, payers insurances, and government bodies (Natafgi et al. , 2022).
However, the list does not end here. Several things that define an intervention will depend on the desires of the people involved such as professional services, ways through which patients can be engaged, financial remunerations that are linked with quality services, and legal considerations.
This is due to the requirements of HIPPA rules that protect and ensure the data for tools such as EHRs and telemedicine (Shah & Khan, 2020). Also incorporated into these guidelines are state laws and the guidelines established by The Centers for Medicare & Medicaid Services (CMS) for VBC. If you do not want to get fined and pay the money back in installments, be sure that the action obeys these rules.
For further assistance, it is necessary to employ individuals to coordinate care, establish the technology for the linked data platforms, manage the transition to alter the fee for service approach that dominates the healthcare system and seek for the grants that can help to cover the costs of the mentioned changes (Kissam et al. , 2019).
Forethought in terms of plans, resources, and good leadership is something that has to be put in place if the answer is to work and be sustainable in the long run. Ensuring that the value-based payment plan is used to enhance patient outcomes requires the consideration of the stakeholders’ perception, adherence to the rules provided by the regulators, and assistance from experts and other personnel.
Existing or New Policy Considerations Supporting the Intervention Plan
Such rules that enable the use of value-based payment are already underway in the case of community health centers. MACRA and MIPS are two examples of the former, where MACRA repealed the Sustainable Growth Rate (SGR) and implemented MIPS.
These rules help in providing quality care to patients and at the same time it also determines the remuneration that is made to providers based on quality of care given. There are also the Advanced Primary Care Practice Demonstrations at Federally Qualified Health Centers (FQHCs) enabled by the Affordable Care Act where one can also try value-based models (Izguttinov et al. , 2020).
There are new policy ideas for instance expanding the models tests conducted by the centers for medicare and medicaid innovation to directly encourage the management of the long term issues (Berwick & Gilfillan, 2021). Two possibilities for such a system include condition-based packed payouts (also known as shared savings) that encourage people to seek and maintain preventive care.
Tobey et al. (2022) also noted that it would also save money if FQHC paid more for such value-based services as care planning and management. It is recommended that health plans and doctors should be mandated to have an interface that can work with other systems.
This way it will be easy to see the scores of the quality of all the types of care. Changes that occur across the country and which affect all users would be the best for the community health centers to embrace as their value-based payment strategy.
-
Policy Considerations That Might Impair Implementation
As Ndayishimiye et al. (2023) have noted, policies such as MACRA and MIPS hinder physicians’ reporting, which in turn affects resources that could be used in other areas, such as patient education and coordination. Maybe, high standards and measures are not the most suitable approach to coping with a chronic disease. This can be the case even if the payment rates and cash rewards are higher. The costs of execution could be only partially covered.
Some of the opponents of new policies that pertain to packaged payments or making data sharing an important component may include some of the health plans and doctors as they believe it will only create more work and make things more complex (Freeman & Coyne, 2020).
The small community health centers may not be in a position to make changes that are anticipated to occur rapidly with the onset of value-based policies for all doctors. Such policies need to be planned and backed by facts so that the implementation of interventions should not pose a problem.
Timeline for Implementation of Intervention Plan
As part of the action plan there will be separate stages in the next six months. The first month will be used to explain and get concurrence of staff and patients in the community health center on the value-based payment plan. Next, the staff will be trained on the new method of payment and the structures that will be put in place to facilitate this over the next one month.
It will be possible to transform electric health records and look for new approaches to managing patient’s treatment, for example. The transition of payment model from the fee-for-service model to the value-based model will take some time up to two months. This will allow for improvements and changes to be made as and when necessary.
Last, the last two months will be for following and evaluating how the approach affected the health indicators such as the number of hospitalizations, control measures, the number of completed screenings among the patients, and the attendance. This time frame is appropriate because the change process is so long and tedious and a great deal of time for experimenting and preparation is needed.
Several things could imply that the time needs to be changed for instance; When engaging in the community, issues such as resistance or misunderstanding may occur at any time. It will take longer to train people and achieve consensus.
According to Nirgude et al. (2019), it will take time to get the tools or set up the system for new payment models if there are problems with this or if there are delays. Also, if challenges such as wrong code or billing issues emerged without warning during the transition from fee for service to value-based payment systems, it implies that the following modifications might be necessary to facilitate a smooth transition (Mueller, 2019).
Last but not the least, it is possible that while monitoring the activities in the course of the plan, it would be realized that certain alterations need to be made in the middle of the plan to address certain events that might have been overlooked or to make the action more helpful. This may suggest that the schedule has to be changed.
Conclusion
To come up with a strategy on how to shift the community health centers into the value-based payment model, one has to take into consideration the kind of leadership, management and nursing practices that will be adopted. Leaders who share and transform can assist people to collaborate and come up with new strategies. The PDSA and Lean management styles can assist in the improvement of the existing situation.
Having to work with facts and methods that prioritize the patient is something that is incorporated in nursing as a profession. It is not always easy to integrate tools, however, and polices may affect the matter and thus adjustments must be made frequently.
So that the job will be completed on time, everybody must be included, rules should be observed and good planning is essential. Although, the schedule may be flexible depending on what is unexpected to happen.
If you need complete information about class 6030, click below to view a related sample:
NURS FPX 6030 Assessment 1 Conference Call Scheduling and Notes
References
Ali, A., Wang, H., & Johnson, R. E. (2020). Empirical analysis of shared leadership promotion and team creativity: An adaptive leadership perspective. Journal of Organizational Behavior, 41(5), 405–423.
https://onlinelibrary.wiley.com/doi/abs/10.1002/job.2437
Apathy, N. C., & Everson, J. (2020). High rates of partial participation in the first year of the merit-based incentive payment system. Health Affairs, 39(9), 1513–1521.
https://doi.org/10.1377/hlthaff.2019.01648
Ayman, U., & Kaya, A. K. (2020). Promotion and marketing communications. In Google Books. BoD – Books on Demand.
Barrett, M., Boyne, J., Brandts, J., Brunner-La Rocca, H.-P., De Maesschalck, L., De Wit, K., Dixon, L., Eurlings, C., Fitzsimons, D., Golubnitschaja, O., Hageman, A., Heemskerk, F., Hintzen, A., Helms, T. M., Hill, L., Hoedemakers, T., Marx, N., McDonald, K., Mertens, M., & Müller-Wieland, D. (2019). Artificial intelligence supported patient self-care in chronic heart failure: A paradigm shift from reactive to predictive, preventive and personalised care. The EPMA Journal, 10(4), 445–464.
https://doi.org/10.1007/s13167-019-00188-9
Berwick, D. M., & Gilfillan, R. (2021). Reinventing the Center for Medicare and Medicaid Innovation. JAMA, 325(13), 1247.
https://doi.org/10.1001/jama.2021.3203
Bitar, H., & Alismail, S. (2021). The role of eHealth, telehealth, and telemedicine for chronic disease patients during COVID-19 pandemic: A rapid systematic review. DIGITAL HEALTH, 7(2), 205520762110093.
https://doi.org/10.1177/20552076211009396
Boustani, M., Alder, C. A., Solid, C. A., & Reuben, D. (2019). An alternative payment model to support widespread use of collaborative dementia care models. Health Affairs, 38(1), 54–59.
https://doi.org/10.1377/hlthaff.2018.05154
Dendere, R., Slade, C., Burton-Jones, A., Sullivan, C., Staib, A., & Janda, M. (2019). Patient portals facilitating engagement with inpatient electronic medical records: A systematic review. Journal of Medical Internet Research, 21(4).
El-Haddad, C., Hegazi, I., & Hu, W. (2020). Understanding patient expectations of health care: A qualitative study. Journal of Patient Experience, 7(6), 237437352092169.
https://doi.org/10.1177/2374373520921692
El-Rashidy, N., El-Sappagh, S., Islam, S. M. R., M. El-Bakry, H., & Abdelrazek, S. (2021). Mobile health in remote patient monitoring for chronic diseases: Principles, trends, and challenges. Diagnostics, 11(4).
https://doi.org/10.3390/diagnostics11040607
Engle, R. L., Mohr, D. C., Holmes, S. K., Seibert, M. N., Afable, M., Leyson, J., & Meterko, M. (2021). Evidence-based practice and patient-centered care: Doing both well. Health Care Management Review, 46(3), 174–184.
https://doi.org/10.1097/HMR.0000000000000254
Freeman, R., & Coyne, J. (2020, October). Successes and failures with bundled payments in the commercial market. AJMC.
https://www.ajmc.com/view/successes-and-failures-with-bundled-payments-in-the-commercial-market
Galli, B. J. (2019). A shared leadership approach to transformational leadership theory: Analysis of research methods and philosophies. Scholarly Ethics and Publishing: Breakthroughs in Research and Practice.
Garay, B., Erlanson, D., Binstadt, B. A., Correll, C. K., Fitzsimmons, N., Hobday, P. M., Hudson, A., Mahmud, S., Riskalla, M. M., Kramer, S., Xiong, S., Vehe, R. K., & Bullock, D. R. (2021). Using quality improvement methodology and tools to reduce patient wait time in a paediatric subspecialty rheumatology clinic. BMJ Open Quality, 10(4), e001550.
https://doi.org/10.1136/bmjoq-2021-001550
Giordano, C., Brennan, M., Mohamed, B., Rashidi, P., Modave, F., & Tighe, P. (2021). Accessing artificial intelligence for clinical decision-making. Frontiers in Digital Health, 3, 645232.
https://doi.org/10.3389/fdgth.2021.645232
Izguttinov, A., Conrad, D., Wood, S. J., & Andris, L. (2020). From volume- to value-based payment system in Washington state federally qualified health centers: Innovation for vulnerable populations. The Journal of Ambulatory Care Management, 43(1), 19–29.
https://doi.org/10.1097/JAC.0000000000000311
Kissam, S. M., Beil, H., Cousart, C., Greenwald, L. M., & Lloyd, J. T. (2019). States encouraging value‐based payment: Lessons from CMS’s state innovation models initiative. The Milbank Quarterly, 97(2), 506–542.
https://doi.org/10.1111/1468-0009.12380
Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(158)..
https://doi.org/10.1186/s12912-021-00684-2
Lee, S. J., Venkataraman, S., Heim, G. R., Roth, A. V., & Chilingerian, J. (2019). Impact of the value‐based purchasing program on hospital operations outcomes: An econometric analysis. Journal of Operations Management, 66(1-2), 151–175.
https://doi.org/10.1002/joom.1057
Lorinkova, N. M., & Perry, S. J. (2019). The importance of group-focused transformational leadership and felt obligation for helping and group performance. Journal of Organizational Behavior, 40(3), 231–247.
https://doi.org/10.1002/job.2322
Milad, M. A., Murray, R. C., Navathe, A. S., & Ryan, A. M. (2022). Value-based payment models in the commercial insurance sector: A systematic review. Health Affairs, 41(4), 540–548.
https://doi.org/10.1377/hlthaff.2021.01020
Mueller, J. T. (2019). Meeting the challenges of future payment systems. ASA Monitor, 83(7), 6–7.
https://pubs.asahq.org/monitor/article-abstract/83/7/6/3588
Natafgi, N., Ladeji, O., Blackwell, S., Hong, Y. D., Graham, G., Cort, M., & Mullins, C. D. (2022). Similar values, different expectations: How do patients and providers view “health” and perceive the healthcare experience?. Health Expectations, 25(4).
https://doi.org/10.1111/hex.13493
Ndayishimiye, C., Tambor, M., & Jakóbczyk, K. D. (2023). Barriers and facilitators to health-care provider payment reform – A scoping literature review. Risk Management and Healthcare Policy, Volume 16, 1755–1779.
https://doi.org/10.2147/rmhp.s420529
Nirgude, A. S., Kumar, A. M. V., Collins, T., Naik, P. R., Parmar, M., Tao, L., Akshaya, K. M., Raghuveer, P., Yatnatti, S. K., Nagendra, N., Nagaraja, S. B., Habeena, S., MN, B., Rao, R., & Shastri, S. (2019). “I am on treatment since 5 months but I have not received any money”: Coverage, delays and implementation challenges of “Direct Benefit Transfer” for tuberculosis patients – A mixed-methods study from South India. Global Health Action, 12(1).
https://doi.org/10.1080/16549716.2019.1633725
Øyri, S. F., Braut, G. S., Macrae, C., & Wiig, S. (2020). Hospital managers’ perspectives with implementing quality improvement measures and a new regulatory framework: A qualitative case study. BMJ Open, 10(12), e042847.
https://doi.org/10.1136/bmjopen-2020-042847
Pittman, P., Rambur, B., Birch, S., Chan, G. K., Cooke, C., Cummins, M., Leners, C., Low, L. K., Meadows-Oliver, M., Shattell, M., Taylor, C., & Trautman, D. (2021). Value-based payment: What does it mean for nurses? Nursing Administration Quarterly, 45(3), 179–186.
https://doi.org/10.1097/naq.0000000000000482
Prado-Prado, J. C., García-Arca, J., Fernández-González, A. J., & Mosteiro-Añón, M. (2020). Increasing competitiveness through the implementation of lean management in healthcare. International Journal of Environmental Research and Public Health, 17(14).
https://doi.org/10.3390/ijerph17144981
Rizan, C., Low, R., Harden, S., Groves, N., Flaherty, B., Welland, T., Das, P., & Bhutta, M. F. (2020). A blueprint for streamlining patient pathways using a hybrid lean management approach. Quality Management in Health Care, 29(4), 201–209.
https://doi.org/10.1097/qmh.0000000000000267
Rudin, R. S., Fischer, S. H., Damberg, C. L., Shi, Y., Shekelle, P. G., Xenakis, L., Khodyakov, D., & Ridgely, M. S. (2020). Optimizing health IT to improve health system performance: A work in progress. Healthcare, 8(4), 100483.
https://doi.org/10.1016/j.hjdsi.2020.100483
Scherer, L. D., Matlock, D. D., Allen, L. A., Knoepke, C. E., McIlvennan, C. K., Fitzgerald, M. D., Kini, V., Tate, C. E., Lin, G., & Lum, H. D. (2021). Patient roadmaps for chronic illness: Introducing a new approach for fostering patient-centered care. MDM Policy & Practice, 6(1), 238146832110199.
https://doi.org/10.1177/23814683211019947
Shah, S. M., & Khan, R. A. (2020). Secondary use of electronic health record: Opportunities and challenges. IEEE Access, 8, 136947–136965.
https://doi.org/10.1109/access.2020.3011099
Tobey, R., Maxwell, J., Turer, E., Singer, E., Lindenfeld, Z., Nocon, R. S., Coleman, A., Bolton, J., Hoang, H., Sripipatana, A., & Huang, E. S. (2022). Health centers and value‐based payment: a framework for health center payment reform and early experiences in Medicaid value‐based payment in seven states. The Milbank Quarterly, 100(3), 879–917.
https://doi.org/10.1111/1468-0009.12580
WHO. (2020). Screening programmes: A short guide. Increase effectiveness, maximize benefits and minimize harm. World Health Organization. Regional Office for Europe.
