I need this by Tuesday

Running head: PATIENT-CENTERED CARE REPORT 1

Patient-Centered Care Report

Oluwadamilare Ojuile-Edokpayi

Capella University

Evidence-Based Practice for Patient-Centered Care and Population Health

September 27, 2019

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PATIENT-CENTERED CARE REPORT 2

Patient-centered Care Report

Population Health Initiatives (PHI) has become an essential aspect of the health care

world today. It ranges from all types of providers irrespective of size or specialty. Attributed to

this is the new trend of risk-based contracts and pay-for-performance arrangements aimed at

financial incentives for improved patient outcomes (Hatef et al., 2018). It is also through this that

patients are receiving preventive attention with proper tracking across the care continuum.

Health care organizations have taken the challenge and invested heavily to develop strategies and

technologies for proactive patient management. Evidence-based practice (EBP) is a significant

resource for this approach (Hatef et al., 2018). On the same path, this assignment seeks to apply

EBP in solving a patient's health issue and using the same approach, determine the success of the

same program for other patients in a similar situation.

Alice Balewa, the director of Safe Headspace, a non-profit making institution for TBI

patients, is working with Mr. Nowak. The patient presents with difficulties in balance in his last

cholesterol check. It is thought to be from his hypertensive problem or the trauma he experienced

some years ago after falling from a tree. He is a candidate for the Institution. It is through this

charitable venture for older adults that Mr. Nowak is referred to the facility to get support having

suffered through his middle and senior years. Headspace offers support for these older patients

who have many years past their traumatic events and seek strategies to see them through the

ordeal. In the same approach, there is a need to evaluate Mr. Nowak's current treatment regime

and identify inconsistencies and gaps that would best aid in achieving a patient-centered plan of

care enough for incorporation into his current care plan.

Evaluation of the Outcomes of Population Health Improvement Initiative

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PATIENT-CENTERED CARE REPORT 3

There are some achievements of Safe Headspace for their patients. They focus on

exercise, medication, and meditation for the patients (Capella University). In a population of 400

people of 45-80 years, the facility reports success in about 200 people in the exercise program.

Boosting of the program, the facility says that all participants improved in memory, mood, and

muscle control over four weeks. However, after this report, most of the patients dropped out of

the program. Only 75% remained with continued improvements in muscle control by 15%, mood

by 22%, and memory by 61% (Capella University). The report also makes it clear that there was

no weekly recording of the type of exercises for the patients. It is a significant shortfall in an

exercise strategy.

Researchers state that successful exercise regimes are guided by keeping them simple,

meaningful and functional, and teaching patients on the need for the exercises (Lox et al., 2016).

A primary reason for patients dropping out would have been a lack of clear guidelines on the

exercise program. Another would be an effect of the daily activities of the patients by making

them find them unnecessary. Additionally, exercise is planned based on a patient's health issues.

Some patients suffer from chronic conditions like COPD and diabetes that may require a patient-

centered exercise plan for best outcomes and to avoid complications. Safe Headspace

generalized the plan of care.

In medication therapy, it was important for the facility to provide psychotherapy based on

the fact that most patients never received the necessary aid after their traumatic events. Through

the assessment, patients started antidepressants (40%) and antipsychotics (9%). To promote

efficiency, the patients have regular contact with a therapist at home (Capella University). Some

patients still failed to follow the treatment plans. However, there was a record of 26%

improvement in mood and 6% in memory for over six months (Capella University). Despite the

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PATIENT-CENTERED CARE REPORT 4

history of patients dropping out, the hospital makes no effort to make follow-ups to learn of the

sudden disinterest in the program. Some of the factors may be a lack of understanding of the

diagnosis, importance of treatment, inabilities in getting the medicines, or time. By

understanding the reasons for the dropout, it is easy to find a solution. However, the hospital is

only keen on the achievements of the programs and fails to seal the available loopholes.

In meditation, despite much disinterest from the patients, the facility encouraged 10-15

minutes of daily sessions for 23 patients. The group would also attend a weekly one-hour long

meeting under guidance. Dramatically, these sessions resulted in improved mood (70%) and

muscle control (32%) despite two patients showing disinterest after two weeks of engagement

(Capella University). In this scenario, there was no record of follow-up to learn of the reason for

disinterest in the program. Such a strategy would go a long way into understanding the

motivations and need for further interventions to retain them in the group.

Overall, there is a problem in patient-centered care in the hospital. Despite the clear

guidelines in helping the patients, there is a problem in follow-up in patients who decide to

discontinue a program. It may be for reasons of not achieving the necessary results or inadequate

knowledge in the necessity of the program for better health outcomes. Therefore, there is a need

to come up with a strategy aimed at improving outcomes for these people.

Strategies to Improve Outcomes of a Population Health Improvement Plan

The Institute of Medicine (IOM) makes significant contributions in developing strategies

for population Health Improvement plans. The first aim in improvement is 'Safe' (AHRQ, 2018).

This plan intends to benefit the patient while avoiding any harm from any intended care. Such is

a strategy in a Texas children hospital where they aim at reducing surgical site infections,

respiratory viral diseases, among others (Story, 2016). Another approach is 'Effective.' IOM

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PATIENT-CENTERED CARE REPORT 5

insists that there is a need for services build on scientific knowledge (EBP) and refrain from any

services that are not beneficial for the patients (AHRQ, 2018). There should be an avoidance of

underuse and misuse of interventions. It helps avoid patient dropouts in the program.

Additionally, patient-centered care is vital for effective patient strategies. It is built on

respect, preferences, needs, and values of the patient. Timely care is also crucial. It helps reduce

the waiting time that may be harmful to the patient. Patients may also show dissatisfaction in

instances where they had to wait for long to receive care. The last strategy is 'Efficient.' It builds

on avoiding waste in energy, ideas, equipment and supplies in rendering health care services

(AHRQ, 2018). All this go hand in hand in improving outcomes for a health improvement plan.

Personalized Patient Care Plan

By taking the IOM approach to health improvement, there is a need to come up with a safe,

effective, patient-centered, timely, efficient, and equitable care plan for Mr. Nowak. One of these

is through a monthly interactive educative workshop for hypertension (Lu et al., 2015). Through

this, there will be improved knowledge of the disease, adherence to medications, proper salt

intake, and regular physical activity. Long-term results will be a reduction in body mass index

and LDL cholesterol levels. Lu et al., 2015 reports on the efficiency of these strategies in the

management of hypertensive patients. It is of utmost importance since it utilizes the beneficial

aspect of exercise that is important for reduced stress levels for the traumatic experience by Mr.

Nowak. Subsequently, the benefits of hypertension control help in reducing complications for the

traumatic injury for the patient.

The recommended salt intake is 6g in a day with the moderate exercise of not less than

thirty minutes three times a week (Lu et al., 2015). Mr. Nowak is a stay-at-home patient and has

a lot of time for the exercise regime in the program. Any difficulties in the exercise program may

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PATIENT-CENTERED CARE REPORT 6

be changed to suit needs in subsequent clinic follow-ups from the health fitness instructor at the

hospital. Mr. Nowak is not a cigarette smoker, and, therefore, bears no risk from it, but there is a

need for information on the harmful effect of second-hand smoke. There is also a need for him to

see a psychotherapist for the traumatic events in his past for assessment and treatment

(Rothbaum, 2017). Through bi-weekly phone follow-up, there will be a success in retaining him

in the program and a sense of responsibility in health team involved in his recovery (NCSL,

2016). By applying this multi-collaboration, patient-centered care, there is a chance of improved

patient outcomes with the hope of a reduced chance of dropout.

Value and Relevance of Evidence

Lu et al., 2015 is valuable and relevant for this study. It makes significant contributions to

hypertension management through monthly educative workshops. Through the research, there is

a proof of evidence in taking up the strategy for Mr. Nowak. It is even beneficial with the

exercise part that brings about a diverse solution towards his posttraumatic event and reduces the

body mass index and LDL cholesterol levels. It provides a multi-faceted solution to my patient.

The same applies to the article by Rothbaum, 2017. He insists on the crucial role of

psychotherapy after a traumatic event. It is also essential for the patient, and it opens the idea of a

multidisciplinary approach to care. Both articles are valuable and relevant for my study.

Evaluation of Proposed Strategy

As already indicated, there is an improvement in the patient’s outcome through the

proposed strategy. However, to gain this, there is a need for evaluation. One of these is through

the biannual screening for cholesterol levels to determine success. It will show the efficiency in

the daily exercise regimens.

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PATIENT-CENTERED CARE REPORT 7

Additionally, there will be a monthly assessment of the daily recording of blood pressure

recordings in a booklet to be carried in every monthly learning session. The psychotherapist will

monitor progress every two-months and report on any improvements. There will also be a bi-

weekly follow-up through the phone to ensure that the patient is consistent in exercise, blood

pressure monitoring, and a report of general well-being. The strategy has proved effective in

patient health improvement strategies (NCSL, 2016). These strategies would be sufficient for

evaluation.

There are various situations where the same proposed strategy would be utilized for

another patient. One of these is when the patients are hypertensive and have undergone a

traumatic experience. The approach goes a long way into improving health outcomes for the

entire community faced with hypertensive patients. The psychotherapy part is not only beneficial

for traumatic events but is also crucial for patients having problems in coping with hypertension.

It is, therefore, a broad solution to a community problem.

In conclusion, evidence shows that there is a need for health initiatives to solve some of

the problems faced by people in society. Through well planned, patient-specific interventions,

there is a chance for better outcomes. However, it is crucial to base the responses in EBP to

reduce redundant services that would otherwise be harmful to a patient. Additionally, a

generalization of care would have the same effect. Through well-thought ethical approaches,

there is a chance for victory in designing health interventions for patients.

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PATIENT-CENTERED CARE REPORT 8

References

Agency for Health care Research and Quality. (2018). Six Domains of Health Care Quality.

Retrieved from https://www.ahrq.gov/talkingquality/measures/six-domains.html

Hatef, E., Lasser, E. C., Kharrazi, H. H., Perman, C., Montgomery, R., & Weiner, J. P. (2018). A

population health measurement framework: evidence-based metrics for assessing

community-level population health in the global budget context. Population health

management, 21(4), 261-270.

Lox, C. L., Ginis, K. A. M., & Petruzzello, S. J. (2016). The psychology of exercise: Integrating

theory and practice. Taylor & Francis.

Lu, C. H., Tang, S. T., Lei, Y. X., Zhang, M. Q., Lin, W. Q., Ding, S. H., & Wang, P. X. (2015).

Community-based interventions in hypertensive patients: a comparison of three health

education strategies. BMC public health, 15(1), 33.

National Conference of State Legislatures (2016). State Coverage for Telehealth services.

Retrieved fromhttp://www.ncsl.org/research/health/state-coverage-for-telehealth-

services.aspx.

Rothbaum, B. O. (2017). Psychotherapy for posttraumatic stress disorder in adults. UpToDate

[Internet]. Waltham (MA): UpToDate.

Story, S. (2016). How to Reduce Preventable Healthcare-Associated Conditions in Children

Using Best Practice Bundles and Analytics.

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