Assessment 1: Planning and Presenting Care Coordination Plan
Name
Capella University
FPX 6618
Dr. Name
July 2024
Planning and Presenting a Care Coordination Project
Slide 1: Hello everyone! I’m __________. Today, I will discuss a patient care management initiative for individuals with chronic conditions, emphasizing presentation and planning. I will outline a detailed strategy for effectively organizing and managing patient care in my role as a patient care management project manager.
Objective of Care Coordination Plan
Slide 2: Outlining a care coordination strategy for chronic care patients aims to optimize and streamline patient care procedures and associated tasks. This approach facilitates the sharing of critical medical information among healthcare professionals, preventing misunderstandings or negative outcomes. By efficiently organizing patient care practices, the plan ensures that all aspects of patient management are addressed comprehensively and effectively (Mahumud et al., 2022).
An effective care coordination plan aims to improve the standard of care delivered to patients. It includes measures to monitor patient health status, manage their conditions, and assist them in creating effective information systems. This coordinated effort helps improve patient outcomes and ensures that patients receive consistent and well-organized care throughout their treatment journey.
Goal for Cross-Agency Collaboration
Slide 3:Effectively organizing and managing care for patients with chronic conditions is crucial for aiding them in managing their illnesses and enhancing their overall experience, satisfaction, and health outcomes. Implementing a coordinated care approach is the most effective strategy for creating a unified care plan (Welkin, 2022). This patient-centered and integrated method involves collaboration with patients and their families, ensuring interventions are tailored to meet individual patient requirements (Welkin, 2022). The strategy focuses on accountability, proactive care planning, connecting community resources, and assisting patients in achieving their self-management objectives. Leadership roles within this plan foster teamwork, reduce inefficiencies, and facilitate better information exchange regarding patient stays, medications, symptom reporting, and equipment arrangements (Welkin, 2022).
Interagency Collaboration
Slide 4:Managing chronic care patients often involves addressing unsolvable health issues that require collaborating with various professionals, including psychologists, nurses, chronic care specialists, psychiatrists, and the patients themselves. Engaging psychologists and psychiatrists is vital, as patients may experience trauma and distress due to ongoing treatment processes. The foundational assumptions of this vision include the high costs of chronic care treatments, leading to significant patient distress, and recognizing that individuals of all ages and backgrounds may face chronic health issues (Khatri et al., 2023). Uncertainty areas encompass the necessary skills nursing staff must develop to enhance collaboration and communication, ensuring the interagency approach’s success.
Essential Organizations and Groups for Caring for Chronic Patients
Slide 5:Identifying the organizations and groups essential for caring for chronic patients involves recognizing the diverse range of stakeholders required to provide comprehensive care. Key participants include healthcare providers such as hospitals, primary care clinics, specialty care providers, mental health professionals, and rehabilitation centers(Hacker, 2024). Additionally, community organizations, social services, and patient advocacy groups are crucial in supporting patients beyond medical treatment (Samal et al., 2021). These entities work together to address chronic patients’ holistic needs, ensuring that care’s medical, psychological, and social aspects are integrated and coordinated effectively.
Comprehensive Analysis of Environment and Provider Capabilities
Slide 6:A comprehensive and insightful evaluation of the setting and healthcare provider capacities is necessary to optimize this collaborative care approach for chronic patients (Foo et al., 2023). This involves evaluating the strengths and limitations of each participating organization, identifying gaps in services, and understanding the community’s specific health needs. By assessing the capabilities of healthcare providers and community resources, it becomes possible to develop targeted interventions that leverage existing strengths and address areas needing improvement. This comprehensive analysis ensures that care for chronic patients is delivered efficiently, resources are utilized effectively, and patients receive the highest quality of care tailored to their unique circumstances.
Determining Resource Needs for Chronic Care Patients
Slide 7: To effectively manage chronic care, it is crucial to identify and allocate appropriate resources. A comprehensive understanding of the economic burden of chronic illnesses is essential for this process. Recent data from 2024 indicates that approximately ninety percent of the United States’ annual healthcare spending, amounting to $4.1 trillion, is allocated to chronic diseases. Specific conditions contribute significantly to these costs, with heart disease accounting for approximately $216 billion spent on cardiovascular disease, $240 billion on cancer, and $327 billion on diabetes. Implementing preventive measures can significantly reduce these costs.
Utilization of Financial and Support Resources
Slide 8: Numerous essential funding programs and organizations significantly support chronic care patients. The CDC’s national center provides funding to reduce unhealthy behaviors and prevent chronic illnesses within communities nationwide. The American Chronic Pain Association offers resources for pain relief, and ACO incentivizes improved care outcomes through financial rewards, promoting affordable and quality care. Utilizing these resources within care coordination plans ensures patients receive comprehensive support, both financially and medically.
Importance of Skilled Staffing and Assumptions
Adequate staffing is another critical resource for chronic care management. It is the number of staff that matters, as well as their training and expertise. Ensuring that healthcare providers are well-trained and continuously updated on best practices is essential for effective patient care (Bierman et al., 2021).
The presumption is that the designed, coordinated care plan will be eligible for patient financial assistance programs and that these provisions will be adequate to meet patient needs. However, there remains uncertainty about how these funding programs will impact patient outcomes.
Project Milestones
Slide 9:Establishing project benchmarks and outcome measures necessitates thoroughly understanding the project’s scope and expected results. A successful care strategy should aim to improve the well-being of patients with chronic conditions. Collaboration among specialists from different fields is essential to address the diverse issues associated with chronic illnesses (Bendowska & Baum, 2023). The care coordination team, comprising chronic specialists, nurses, patients, doctors, and hospital management, will work together to enhance health literacy, promote better self-management, and assess patient progress for continuous improvement. Patient satisfaction will be measured through surveys or questionnaires to evaluate the plan’s success (Schwarz et al., 2022). The care coordination plan aims to establish the care strategy, assemble the team, develop the coordination process, and evaluate outcomes to ensure success. Expected results include improved patient knowledge and boosted self-management confidence, reduced patient distress through improved collaboration and communication, and optimized resource utilization (Taberna et al., 2020).
Project Plan Presentation for Administrative Decision Makers
Slide 10:Improving communication and collaboration among all stakeholders is essential to implementing an effective healthcare coordination strategy for chronic care patients (Vos et al., 2020). Identifying and efficiently utilizing the most suitable resources is key to achieving each milestone, ultimately increasing patient satisfaction. A thorough plan, including detailed steps for each phase, ensures the project’s goals are met (Alderwick et al., 2021).
Securing funding from various organizations will alleviate patients’ financial burdens, further supporting the plan’s success. The project plan presents a coherent argument for its feasibility and benefits by outlining these components clearly and accurately.
Evaluation and Anticipation of Responses
The implementation of the care coordination plan will be continuously evaluated through periodic surveys designed to assess the program’s quality and effectiveness (Alshehri et al., 2023). This ongoing assessment allows for adjustments and improvements, ensuring that the plan remains responsive to patient needs and organizational goals. Preparing for potential questions and alternative viewpoints from administrative decision-makers is crucial. Anticipating these responses and providing well-thought-out answers demonstrates a comprehensive understanding of the project’s scope and reinforces the plan’s credibility. This proactive approach helps build confidence in the project’s potential for success and its positive impact on chronic care patients.
NURS FPX 6618 Assessment 1 Planning and Presenting Care Coordination Plan Conclusion
Slide 11:The proposed healthcare coordination strategy for chronic care patients provides a comprehensive framework emphasizing improved communication, collaboration among diverse healthcare providers, and efficient resource utilization. By establishing a care coordination team and leveraging funding from various organizations, the plan aims to alleviate financial distress and enhance patient satisfaction. The project includes clear milestones and outcome measures, ensuring continuous evaluation and effective adjustments to meet patient needs. Anticipating and addressing potential questions and alternative viewpoints strengthen the plan’s credibility. Ultimately, this strategy aims to enhance the well-being of individuals with chronic conditions through a holistic, patient-centered approach, fostering better health literacy, self-management, and reduced distress.
NURS FPX 6618 Assessment 1 Planning and Presenting Care Coordination Plan References
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Alshehri, A., Balkhi, B., Gleeson, G., & Atassi, E. (2023). Efficiency and resource allocation in government hospitals in Saudi Arabia: A casemix index approach. Healthcare (Basel, Switzerland), 11(18), 2513. https://doi.org/10.3390/healthcare11182513
Bendowska, A., & Baum, E. (2023). The significance of cooperation in interdisciplinary health care teams as perceived by Polish medical students. International Journal of Environmental Research and Public Health, 20(2), 954. https://doi.org/10.3390/ijerph20020954
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Foo, C., Yan, Y., Chan, L., & Yap, H. (2023). Identifying key themes of care coordination for patients with chronic conditions in Singapore: A scoping review. Healthcare (Basel, Switzerland), 11(11), 1546. https://doi.org/10.3390/healthcare11111546
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Welkin. (2022). Managing chronic conditions through care coordination. Welkin Health. https://welkinhealth.com/managing-chronic-conditions-through-care-coordination/
