Post 1
A medication wallet card is a card that indicates a patient's medication names, doses and it’s easily kept in a patient’s wallet for easy retrieval and referral. A wallet card is very beneficial to a patient particularly in regards to creating awareness of the current patient's ailments, which will help improve the patient’s quality of life considerably and also lead to revenue generation by the clinic.
Depression is an infringement to the normal way of life of an individual and does disrupt it in a major way. An amount in excess of $210 Billion has been spent annually in treating depression (Greenberg, 2015). In the first half of 2016 alone, around 70 patients either terminated or were terminated from treatment from the clinic and this has led to an estimated loss of $46,620 to the clinic. Based on the termination of patients due to lack of improvements in their symptoms, a medication wallet card would have come in handy. The card would be able to show the different medications and doses that the patient is on and therefore give the doctors an opportunity to try a new medication or approach to the same.
The generation of the wallet card will require no increase in manpower since it will be given together with the after-care instructions. The prevailing Clinic practice requires that all patients must fill the PHQ-9 before consulting with the provider and therefore the plan calls for no overtime. The patient’s past and current PHQ-9 must be evaluated before consultation which only proves the importance of the wallet card in providing these important details. The medication wallet card template is freely available and therefore shows its cost effectiveness and the efficiency with which this card provides to operations. The printer for generating the cards is already in place (the same that prints the aftercare instructions) and the cost of the paper and toner (black cartridge) summed up to $191.98 and given the total clinic benefit of $46,620, the clinic has a net benefit of $46,428.02.
Post 2
Heart failure has become a predominant disaster in recent times. The disease has become the main reason for hospitalisation mainly to the elderly people over 65 years of age. This has presented an economic and clinical strain to both the individual patients and the state. CMS, the centre for Medicare and Medicaid services has placed an important emphasis on reducing the rates of hospital readmission mostly for heart attack patients who are predicted to improve both the patients’ safety and make the care effective in attaining its objective.
An advanced nurse practitioner is very beneficial to this reduction in readmission plan. The advanced nurse practitioner will help reduce medical complications that are associated with heart failure. The practitioner will also be able to provide better patient and caregiver comprehension on heart failure which will help reduce the chances of readmission drastically. This will improve the patient’s quality life and also provide a base for management of the condition.
Rates of readmission are currently very high on the elderly to within three and six months after discharge. Heart failure costs amounts in excess of $31 Billion in the United States and inpatient, and outpatient costs that are associated with this disease have made it one of the costliest diseases. Poor prognosis of the disease has led to huge costs and a 1-year mortality of 33%-35% (Azad & Lemay, 2014). A reduction in the rates of readmission will also help in redressing all these issues that are presented by the disease and will provide relief both materially and emotionally to the patients. The inference on the outcome will also be beneficial for the generation of other better, efficient and cost effective means of dealing with this disease and how to counter its effects on the elderly in the society. Almost half of all the readmissions for heart failure are related to co-morbidities, polypharmacy and defects related to the cost of heart failure which shows that they are manageable defects with the appropriate care and skill in place. This shows that there’s need for the implementation of the advanced nurse practitioners who will help remedy the shortfalls. The project will be very detrimental in identifying all these flaws and emphasis points and given its cost efficiency, should help redress the condition’s readmission issue.
Post 3
There’s apparent disparity in both advanced wound care, and the traditional standard would care based on a cost-benefit-effectiveness approach. Both methods will give a relatively similar end result, but the process, cost and the related technicalities with each approach varies which call for an analysis of the two. In chronic wounds, advanced wound care is the best approach. Wound care leads one to incur various costs, the nursing cost being the most important and prevalent cost. As the Swede economic survey shows, dressing change alone can take a sufficient amount of time and resources. In as much as nursing time takes the greatest cost, there are other significant costs associated with wounds and the analysis of the various approaches to adopt (Lind Holm et al., 1999)
The cost of dressings vary, and one must, therefore, weigh the cost and benefits of each and every dressing before making the choice. Of importance to note is that each dressing has a certain speciality and therefore choice has to be relative to the use and application. Specialised medical staff also adds to the cost of wound care. They are however important in providing guidance on the correct and ideal therapies when the wounds fail to heal as expected.
Hospital bed costs also take up a significant portion of the total cost and these costs weigh up directly on the patient's mental form. They may lead to pressure related diseases like ulcers. The wound also provides an external cost in the economic status of the patient and may trickle down to the family. The patient is unable to work and therefore can’t provide for himself and his/ her family at large. This also impacts negatively on the economy leading to a reduction in the GDP though the effect is minimal based on the number and level of the wound conditions. An evaluation of all these factors is therefore very important to help in the identification of the different levels of patients and their classification. This will help redress other pertinent issues that may arise related to the condition and other related issues like affordability showing the importance of the cost benefit analysis between the chronic wound care and the traditional standard wound care.
Post 4
Schizophrenia is a mental disorder that is characterised by abnormal social behaviour and lack of basic understanding by the patients of what’s real. The provision of shelter to individuals with this condition is an additional boost in their healing process. The patients receive the necessary treatment at the comfort of their home, and the availability of their friends and family will mostly provide a serene environment for active engagement and better uptake of the medication (Barrowclough & Tarrier 1992).
The condition is the most expensive disorder among all the existing psychiatric conditions with an annual estimated burden of 3.5 million according to a Japanese study. Re-hospitalization is a costly phenomenon and therefore any measures and strategies put in place to reduce or counter this is very important.
The implementation of the proposal will lead to the expenditure of additional costs in terms of an increase in the manpower to handle and tend to the patient. A cost-benefit analysis is, therefore, important to evaluate the costs associated with the shelter approach and the benefits that accrue to the same. The total cost of all the equipment is $135.50 and with a total facility benefit of $152,842, there’s a net benefit of $39.292 to the facility. This mechanism has a total economic benefit in excess of $3.5 million. The strategy is perfect since it leads to the benefit of the patient through improvement of their condition and the clinic while making an economic contribution.
The strategy calls for an increase in the number of nurses tending to the patients and a possibility of overtime due to lack of home health nurses, but the benefits are worth the strain and do pay off. All patients, whether insured or not are also taken care of, and no additional job is necessary with the project since current questionnaires are highly useful.
Post 5
Quality management is the foundation of any success story, and this has to be the case in the health care facility. The leadership of the clinical facility has to be beyond reproach to ensure that the principles, objectives, mission and the vision are all achieved. The leadership of the facility will provide the requisite feedback mechanisms and all the other necessary mechanisms that should be put in place to ensure that sound decisions and criteria are used.
The leadership has to, therefore, make sure that they are on the same page, working towards the same goals and have the same interests of those they serve. Good leadership is able to identify loopholes and help them improve the level of quality and assurance they provide to the clients.
When making new implementations in the facility, the quality of leadership is at such a time put to the test and the quality of what they implement in terms of the acceptance, the time period and relevance really matters (Grove, Burns & Gray, 2011). The facility has to, therefore, make certain that the management selection process is flawless.
The quality and diversity of the management are very important in the development of a fall prevention program, and this will ultimately ensure that both the staff members and the patients have harmony in the conduct of their duties and responsibilities. Feedback and variables evaluation is a perfect way to conduct corrections and make improvements through the evaluation of the existing weaknesses and looking at the possible methods of developing solutions to them.
Quality leadership also ensures that they are able to approach the barriers that may be on the way both professionally and with conviction. This will ensure that all people are on the same page and that all people are actively engaged in addressing the same issue at hand. It will also be able to translate hard evidence and results from research into actual medical practice.
Post 6
Clinicians in any health care institution should be able to realise that the patient is the focal point, and all resources are utilised in addressing his/ her problems. The management should, therefore, create the awareness to staff on who they are all really trying to address and quality management principles should, therefore, be analysed, evaluated and implemented to ensure that they lead to continual development.
The management should, therefore, involve all the stakeholders in the facility in decision making and also respect their preferences to ensure there is a certain degree of autonomy and harmony. Clear, concise and perfect information should also be disseminated to all parties to enhance and improve the support to the main client, the patient. The management should also not be devoid of emotional support, empathy and respect for the wishes and desires of others and should provide fast and reliable health care advice to the desiring party to enable informed decisions.
The management should ensure that the firm is providing effective treatment that also provides the necessary attention to the environmental and the physical needs of all related parties. Quality management must ensure that they support and involve family members and caregivers in all decisions involving their sick relatives and provide care and transitions efficient enough to create desirable effects on the recipients. Quality management should also ensure that the values and principles of the patients are maintained and that their preferences and expressed needs are met in a timely and efficient manner. The management should also be in a position to translate research knowledge and do innovative practices out of the inferences to help avoid poor decision making.
Post 7
The world is changing, trends in the healthcare industry are changing, and the expectations and demands of the consumers are growing by the day. With the increase in the health care costs, the medical consumer is, therefore, demanding value for his money. This means that the healthcare facility has to create a niche in the market and make sure that they address the needs and requirements of the niche that it serves. Each facility should, therefore, strive to provide the best service there is and work to awe the consumer. They, therefore, have to provide state of the art medical services through quality and efficiency.
Many consumers, however, judge the quality of service provided by the outcome and on this note the principle of the better the outcome, the better the service applies (Melnyk et al.., 2015). The facilities should try to come up with quality measurement strategies to determine the quality of service that they offer to their consumers, the satisfaction level derived and then come up with methods of improving the same.
The evidence-based principle which is an integration of the clinical expertise or the provision of an expert opinion, the external scientific evidence and the client perspective of the same issue at hand helps to provide high-quality services. The principle also helps in the reflection of interests, values, needs and choices of the individuals that the institution is striving to serve.
A better quality evaluation strategy may be through the institutionalisation of the same. This is through the establishment of an independent body or department that is solely tasked with the responsibility. This will also enable proactive action on any research data and findings and enable corrective strategies within the shortest time possible. The department will also be able to observe how others are doing the same kind of things and how their peers provide their own services and conduct affirmative action based on the same. This will enable the firm to be market compliant and ensure that they provide the best services to their consumers.
Post 8
Evidence-based practice has been proved to be the best form of clinical decision making. The practice makes the use of translated evidence that’s applied to clinical decision making. The practice utilises the best available evidence in the generation of decisions on the best course of action for the patient based on alternatives (Steelman 2006). The AHRQ model also represents three stages that ensure that the very best decision and the alternative are arrived at.
Through knowledge creation and information distillation, enables packaging of information into products that can be put into use and includes recommendations while diffusion and recommendation provides an opportunity to liaise with the opinion leaders and other health care facilities with an aim of understanding how they do operate and finally the teams, facilities and the specific individuals adopt and use the evidence and research findings in practice to solve actual problems.
For EBP to be successful, the practitioner has to cultivate a spirit of enquiry to make certain that all questions are answered. The aim is attaining the best evidence for appraisal which is then integrated with clinical expertise that’s possessed by the practitioner. They then have to consider the patient preferences and their values in the deliberation of a medical decision, then evaluate the decision or change and finally share the results with the patient.
A segmented process like this gives the medical practitioner and the patient an opportunity to both come to a decision that incorporates all their wishes and preferences without compromising their values and responsibilities. The process also ensures that no important detail is overlooked and that all important factors are taken into consideration before making a final decision.
References
Barrowclough, C. & Tarrier, N. (1992). Families of schizophrenic patients. London: Chapman & Hall.
Steelman, V. (2006). Evidence based practice. Philadelphia: Saunders.
Burns, N., Grove, S., & Gray, J. (2011). Understanding nursing research. Maryland Heights, MO: Elsevier/Saunders.
