Principles of Patient-Centered Care
Write a report on the application of population health improvement initiative outcomes to patient-centered care, based on information presented in an interactive multimedia scenario.
In this assessment, you have an opportunity to apply the tenets of evidence-based practice in both patient-centered care and population health improvement contexts. You will be challenged to think critically, evaluate what the evidence suggests is an appropriate approach to personalizing patient care, and determine what aspects of the approach could be applied to similar situations and patients.Principles of Patient-Centered Care
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By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Apply evidence-based practice to plan patient-centered care.
Evaluate the outcomes of a population health improvement initiative.
Develop an approach to personalizing patient care that incorporates lessons learned from a population health improvement initiative.
Competency 2: Apply evidence-based practice to design interventions to improve population health.
Propose a strategy for improving the outcomes of a population health improvement initiative, or for ensuring that all outcomes are being addressed, based on the best available evidence.
Competency 3: Evaluate outcomes of evidence-based interventions.
Propose a framework for evaluating the outcomes of an approach to personalizing patient care and determining what aspects of the approach could be applied to similar situations and patients.
Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision.
Justify the value and relevance of evidence used to support an approach to personalizing patient care.
Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions.
Write clearly and logically, with correct grammar and mechanics.
Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.
There have been many changes in healthcare settings regarding treatment and intervention plans. The aging population is growing tremendously, which indicates the efficiency of healthcare. However, this presents stiff challenges for healthcare professionals because the aging population is prone to chronic illnesses following their severely deficient immune systems. According to Watts et al. (2016), the aging population is highly susceptible to mental illnesses such as Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD). Healthcare institutions have adopted Population Health Improvement Initiatives (PHIIs) to reduce medical costs and escalate health stability among diverse populations such as the aging population and women.
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This report considers Mr. Nowak’s medical condition. Mr. Nowak suffered from TBI following a fall from a tree; he also mentioned having trouble with his balance. Evidence-based Safe Headspace was proposed as the most cost-friendly health improvement initiative that improves health outcomes in elderly individuals diagnosed with PTSD and TBI. This report aims to provide an evaluation, which establishes knowledge gaps of PHIIs, develop strategies to minimize the gaps, and initiate newer intervention approaches into Nowak’s care plan. Further, the evaluation’s obtained evidence will be employed in proposing an assessment framework for patient care.Principles of Patient-Centered Care
Evaluation of Outcomes of the PHII
Safe Headspace is one of the leading PHIIs because of its reputable health improvements among the aging population suffering from PTSD and TBI. This initiative incorporates integrated health interventions such as exercises, therapy, and medication to treat mental illnesses. Based on its collected health information, the adoption of memory exercises such as Sudoku and crossword puzzles among the aging population had no positive impact. Significant improvement was registered through regular physical exercises such as strength training and aerobic exercise as a health intervention measure. The adopted exercises need to be tailored to factor in the vulnerability demonstrated in the aging population. However, the exercises must meet the desired health standards for the patients. Other than improving physical flexibility, regular exercises are essential toward achieving enhanced memory and improved mood. Intense negative moods and low self-esteem commonly characterize mental illnesses. Therefore, regular exercises initiate a therapeutic approach, improving a patient’s mood and memory, and induces positive attitudes.
Although there exist values that govern PHIIs, the knowledge does not provide a comprehensive description of outcomes. The health interventions adopted were meant for patients suffering from both PTSD and TBI. The intervention outcome was investigated in a combination of both illnesses without grouping the population to achieve reliable findings and application for each. Mr. Nowak, in this study, only suffered from TBI and had no history of PTSD. This scenario presents uncertainty in the study; hence further assessment was necessary. Further, the outcomes by Safe Headspace did not reveal the cause of motivation loss among the patients. The majority of the patients lost motivation during self-management interventions, although outcomes do not reveal whether this is attributed to care cost or unfulfilling care. Evaluating such an outcome would help generate reliable evidence for effective healthcare interventions.
Evaluation of outcomes of the PHII by Safe Headspace reveals improved health outcomes among elderly patients who had PTSD due to TBI. Patients at Safe Headspace were subjected to essential health interventions, including therapy, exercise, and meditation. Regular exercise was the most successful intervention in the program’s initiatives. Four hundred patients participated in the study, most being men aged 45-80. Seventy-five patients in the study successfully indulged in regular exercises for four months; their muscle control improved by 15%, their mood improved by 22%, and their short-to-medium term memory improved by 61%. Medication therapy was also incorporated as a health intervention in the group. 40% of the elderly patients were provided with antidepressant medication, and 9% started taking antipsychotic medication. Through such medication, the elderly patients recorded increased mood and enhanced short-to-medium term memory. Patients who were provided with medication were also matched with therapists to offer emotional support. Out of the entire population, 23 participants were taken through meditation. Medication therapy was also a successful health intervention; the patients demonstrated elevated mood and memory levels.Principles of Patient-Centered Care
Strategy for Improving Outcomes of the PHII
The evaluation of outcomes of Safe Headspace’s PHII demonstrates a lack of integrated Triple Aim goals. The Triple Aim is a framework that was introduced to achieve quality healthcare in the United States. The Triple Aim objectives include improving the patient experience of care, improving health populations, and reducing the individual cost of healthcare. PHIIs that embrace the Triple aim have the most effective strategy as they typically maximize performance within the healthcare system.
Uptown Wellness Clinic’s (UWC) care plan is primarily based on evidence gathered from Safe Headspace’s PHII outcomes only. As a result, the novel healthcare setting could inherit unreliable outcomes. A proper strategy for improving outcomes of the PHII entails incorporating the Triple Aim; this prevents the transfer of weak, limited, and biased evidence into UWC’s patient care plans. Aligning the plan with Triple Aim helps set reasonable health goals, thereby improving patient care quality in the facility. Through the bridging of existing knowledge gaps in the Safe Headspace’s health interventions, the PHII can be employed during Mr. Nowak’s treatment. Despite Triple Aim demonstrating outstanding achievements, challenges that impact efficiency are prone. Therefore, it is crucial to analyze the values and challenges of a quality improvement effort in any given healthcare setting. UWC’s healthcare professionals need to critically analyze the benefits and limitations associated with Triple Aim if incorporated in Mr. Nowak’s care plan. The care plan should also consider lessons learned from the PHII outcomes and initiate relevant changes to address any inadequacies in the plan.
Individualized Personal Care Plan Approach
An individualized personal care plan adopts two parts: short-term and long-term objectives. The short-time objective entails diagnosing and treating Mr. Nowak’s primary health concerns. The long-term objective would be progressive, measurable, and adaptable as Mr. Nowak’s needs change, and his health improves. Although the care plan is individualized to suit Mr. Nowak, it can be adopted by patients with similar health needs. Any alterations should consider the provisions of Triple Aim and follow evidence-based knowledge. Care providers need to consider their patients’ social, economic, and cultural values as this demonstrates acknowledgment of diversity in healthcare. Besides, the care plan should provide objectives that are manageable to the patient in the home setting. Ultimately, the objectives must be tailored to encourage independence and autonomy for Mr. Nowak.
Patient-Centered Medical Home (PCMH) provides a reliable approach for a personal care plan. PCMH aligns with the Triple Aim’s goals and advocates for patient independence and autonomy. PCMH allows patients to receive adequate care while at home. It eliminates hospitalization because of minor health problems, thereby reducing medical costs (Franz et al., 2017). It also encourages cultural sensitivity while providing medical care to patients. Evidence-based practice (EBP) is beneficial as it enhances positive health outcomes (Huber, 2017). The patient’s care providers need to embrace EBP. Implementing PCMH alongside EBP entails educating and training care providers on properly offering care to the patient. Mr. Nowak’s family members would be educated and trained on proper medical instruments in the home setting. Generally, the adoption of PCMH, EBP, and telehealth can significantly improve Mr. Nowak’s outcomes. Besides, care providers need to motivate the patient to practice self-care within the home setting. Such practices typically demonstrate value and relevance by improving the patient’s healthcare and can be adopted in both the home and hospital settings.Principles of Patient-Centered Care
Value and Relevance of Evidence Used for Personalizing Patient Care
Research upholds embracing the self-management, EBP, and PCMH practices in population health improvement efforts. Evidence-related practice is a crucial guideline for all levels, programs, and departments in health care, not just population health enhancement. However, the PCMH is a relatively new idea in medical care, together with the application of telehealth, and needs evaluation of its evidence-base. Evidence-based practice is broadly supported in health improvement efforts since it is recommended in all phases of patient care. Because of the increasing need for quality, accessible, and affordable care, the embracing of home-based and EBP assists in bringing awareness and advising health professionals on the excellent encouragement and intervention to apply for each patient group (Kieber-Emmons et al., 2017). Studies have revealed that the PCMH has been fruitful in improving the relationship between health care providers, patients, and family members. The PCMH is broadly used in chronic disease control; hence it lacks the capability to control acute diseases or any other disease that may emerge.
Telehealth and mhealth have significantly boosted results for the individuals who reside in remote areas, with limited reach or no access to transportation to well-equipped medical facilities. Telehealth entails contact via phone, text messaging, or emails to get in touch with patients. Telehealth decreases the amount of travel needed by the patient for health care services. It also increases independence among patients and health care providers and is also brings peace of mind since health care services have been simplified and made easily accessible through phone and other communication media (Thornicroft et al., 2019). Some challenges related to telehealth include; some patients still require face to face interaction with the healthcare providers. Even though telehealth can be accomplished through person-to-person messaging, not all consumers can easily access it due to technology barriers. Some consumers need to be trained further to use such modern technology for healthcare reasons.
Evaluation Framework
Evaluation is essential for EBP since its absence improvements cannot be accomplished. The evaluation platform should, however, follow Shared Decision Making (SDM). Evaluation framework incorporated with Shared Decision Making enables the recognition of the required resources and the need for any transformations. The scheme marshals the healthcare goals of fostering wellness by alleviating suffering among the ailing community (Paudel et al., 2018).
In shared decision-making, medical practitioners and patients cooperate to access health resources and relevant data that are evidence-based and patient-centered. Many patients show a desire for more information and fondness for active participation in their well-being decisions. This desire differs based on the patient and their ailment’s seriousness (Hessinger et al., 2018). Approaches to foster shared decision-making are communication training for patients and clinicians and decision-makers to convey targeted information and values elaboration. Studies in numerous areas of health care services reveal that active patient participation outcomes in a variety of benefits, ranging from increased contentment of patients to decreased symptom trouble. Several modern mental health interventions support client-centered care, self-directed care, and client option, yet research on shared decision-making in mental health for patients with acute and steady mental illness is just commencing (Paudel et al., 2018). The techniques will be compared with the framework while integrating the pinpointed results to improve physically and mentally suffering elderly persons such as Mr. Nowak.
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Incorporating a new framework can address operational challenges at UWC. Successful application of this framework at UWC needs an assessment of the challenges and barriers to a different patient population. Additionally, the clinic may require the requisite training to learn new process implementation and assessments.
The barriers, by themselves, are not as challenging as there are particular strategies available that can convey the issues. Nor do they dilute the significance of the operations. An evaluation is the only way UWC can put together useful information concerning the quality and safety of its program and notice the Triple Aim.Principles of Patient-Centered Care
Conclusion
Executing a PHII effectively is a challenging and complex situation that encompasses the adherence of several intervention approaches. In these cases, faults are likely to occur if the EBP techniques are not adequately evaluated. When PTSD and TBI exist together, it is usually hard to sort out what is happening.
However, regardless of the challenges, the intervention helps generate an effective and inclusive care plan of action for patients across various health groups. Besides, the approaches assist in improving the ability to embrace changes and serve as a pillar for future remedies.
References
Franz, B. A., & Murphy, J. W. (2017). The patient-centered medical home as a community-based strategy. The Permanente Journal, 21.
Hessinger, J. D., London, M. J., & Baer, S. M. (2018). Evaluation of a shared decision-making intervention on the utilization of evidence-based psychotherapy in a VA outpatient PTSD clinic. Psychological Services, 15(4), 437. https://psycnet.apa.org/record/2020-78676-001
Huber, D. (2017). Leadership and nursing care management-e-book. Elsevier Health Sciences.
Kieber-Emmons, A. M., & Miller, W. L. (2017). The patient-centered medical home (PCMH) framing typology for understanding the structure, function, and outcomes of PCMHs. The Journal of the American Board of Family Medicine, 30(4), 472-479. https://www.jabfm.org/content/30/4/472.short
Paudel, S., Sharma, N., Joshi, A., & Randall, M. (2018). Development of a Shared Decision-Making Model in a Community Mental Health Center. Community Mental Health Journal, 54(1), 1-6. https://link.springer.com/article/10.1007/s10597-017-0134-7
Thornicroft, G., Ahuja, S., Barber, S., Chisholm, D., Collins, P. Y., Docrat, S., … & Patel, V. (2019). Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries. The Lancet Psychiatry, 6(2), 174-186. https://www.sciencedirect.com/science/article/pii/S2215036618302980
Watts, B. V., Zayed, M. H., Llewellyn-Thomas, H., & Schnurr, P. P. (2016). Understanding and meeting information needs for patients with posttraumatic stress disorder. BMC psychiatry, 16(1), 21. Principles of Patient-Centered Care