Research Critique

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Research Critique 6

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Running Head: RESEARCH CRITIQUE

Research Critique

Grand Canyon University

September 19, 2019

Research Critique

Qualitative Background Research

Healthcare organizations are regarded as one of the most crucial organizations in the world since they determine the health status of a population which translates to the level of productivity of any nation’s workforce. Therefore, healthcare organizations are tasked with ensuring that at all times the medical services offered by healthcare centers meet the standards as stipulated by the World Health Organization (WHO) (Aman, Stem, Schweitzer, Magnuson & Lidor, 2016). It has come to the realization of international medical regulators that due to compromise in the healthcare services provided by majority of the healthcare institutions, there has been a sharp increase in the number of patients been readmitted to treat the same conditions which they were admitted for the first time. In addition, coming up with strict medical procedures and penalties for any readmission case reported will help put almost all healthcare givers on their toes to ensure that at all times they provide quality healthcare that would reduce the number of patients been readmitted for additional complications which arose as a result of negligence from the side of the healthcare givers.

In addition, curbing the readmission cases will help the hospitals increase their efficiency and also save on the unnecessary budgetary allocations which the hospital has to set aside annually to deal with emergency cases of readmission of patients treated earlier. But for this to work as intended, hospitals individually have to audit their hospital medical services and identify loopholes which were making the cases of readmission be on the rise (Barnett, Hsu, & McWilliams, 2015). Consequently, the interventions which would follow thereafter should be geared towards reducing the number of readmission to zero percent if possible.

Some of the issues which are making the readmission cases be on the rise includes lack of proper education among both the patients and the medics so that healthcare practioner can know exactly what medical condition they are treating and what procedure is recommended for that specific health condition the patient is suffering from. Additionally, some patients lack the basic knowledge of some fundamental health principles which can help them know what medical or health conditions they are having and if either the doctor or a nurse is treating the right health complications. Another likely cause of readmission of already treated patients includes failure to put in place appropriate appointed schedules of outpatients and also poor follow up services of the already discharged patients to ensure that they are recuperating well.

This research is supposed to provide concrete solutions to the problem of readmission cases and in order to do this, questions well-structured should be designed to provide answers to the study question. The study questions are would increase in medical knowledge among both the patients and medical caregivers help in reducing the readmission cases?

The clinical problem highlighted above can be broken down in the PICOT interventions as indicated below.

P = Patients educated and those not educated on special education on heart disease and cancer.

I = Interventions for improving post discharge health improvement and care outcomes.

C = Communication between the nurse’s/healthcare professionals and the patients.

O = Increased support for post discharge preventive interventions by healthcare providers

T = Evaluating readmission rates within 30 days of discharge.

Methodology Adopted

Some of the methods or procedures which were put in place have proven to be helpful as through the collaborative and all inclusive process where patients can book early appointment with medical officers to discuss their health condition and possible medication that can be appropriate for such patients. The qualitative approaches proved very insightful in offering indications as to whether the fight to reduce the level of hospital readmission is being worn or not.

Moreover, the study was developed from the perspective that if all the stakeholders in the healthcare are brought together and communication between or among them streamlined with clear flow of information, everyone will be well informed on what to do and how best to do it as knowledge is power (Branowicki, et, all 2017). Previously what made cases of readmission be on the rise was lack of proper communication and engagement of all stakeholders in healthcare systems so that there could be exchange of knowledge and information which would enlightened all parties of their role in ensuring that cases of readmission are reduced to zero if possible. Methodology should really discuss the two qualitative articles and how they were developed. This would include the number of participants, how the qualitative research was conducted (interviews, focus group, etc) You need much more information and it seems that you have only addressed one article.

Result of the Study

The result of the study pointed out that hospital-initiated interventions such as home visits and follow up calls had a significant effect on hospital readmission rates. This impacts nursing because they can utilize the information to develop and implement the interventions identified to promote positive outcomes. The knowledge gained from the study contributes to nursing knowledge because utilizing the identified interventions improves the quality of healthcare services, thus promoting the desired positive outcomes for the health organizations and the healthcare industry. This means that the outcomes also affect all areas of nursing include practice, administration, and education, among others. Results should identify the themes that were discovered in the qualitative research

Ethical Considerations

The study involved the review of clinical trials for the past 25 years to 2014. As such, there were no ethical considerations for the study as opposed to other research types such as interviews. The study was approved by the Journal for Healthcare Quality, which resulted in the publication of the study.

Conclusion

The hospital initiated post-discharge interventions such as follow up call and visiting patients are effective in improving patient health and reducing the risk of readmission. Understanding how best to help patients to overcome potential health challenges is a crucial aspect of improving the performance and productivity of nurses in their duties and responsibilities. Healthcare organizations must create an enabling environment for nurses and healthcare professionals to have the capacity to engage with patient’s post-discharge to follow up on their compliance with the recommended interventions.

Quantitative Study

Background of the Study

The Quantitative study selected is titled “Risk factors for 30-day hospital readmission among general surgery patients” by Krumholz et al. (2017). Examining readmission among patients who have been admitted multiple times provides an opportunity to identify the common trends or healthcare challenges that need to be overcome to reduce readmission rates and improve patient health and quality care outcomes. The goal of the study is to examine readmission outcomes among patients who have been admitted multiple times for similar diagnosis at one or more hospitals within a given year. The research questions of the study are focused on finding out whether patients who have multiple readmissions have better outcomes compared to those with minimum or no readmission. Also, the purpose of the research question related to the problem since readmissions occur following health complications on the patients.

Methods of Study

The author does not identify the specific benefits or risk that was associated with participating in the study. Consent was obtained from the healthcare organizations for providing data on Medicare and Medicaid Services. It would be appropriate to point out that the hospitals seemed to have participated voluntarily in the study (Barnett, Hsu, & McWilliams, 2015). The authors did not identify and define the significant variables for the study. Data for the study was collected by reviewing hospital readmission for the hospitals on July 2014 to June 2015 by diving them into two random samples. The author believes that that data collection method is effective for finding patterns and insights on the readmission rates. Sample performance quartile was utilized to describe the characteristics of the identified hospitals. To minimize the research bias, the researchers focused on a large group of patients within the identified hospitals to increase the scope of the study. Again, how many participated, from where, etc. You need more description and it needs to be in two articles.

Result of Study

The results of the study pointed out that there is a significant difference in the rate of readmission when patients from a worse performing quartile seek care services from the best performing quartiles. The findings are valid and accurate in reality, and I support it because utilizing effective post-discharge interventions could be the result of the positive outcomes. Various limitations were identified by the author, which include using hospital-wide readmission, which did not focus on individual patients. Also, the study did not detect the difference between principal diagnosis and admission characteristics. The results can be used in nursing to signal the importance of readmission rates in evaluating the effectiveness of healthcare processes (Reed, Pearlman, & Buchner, 1991). Therefore, nurses will work to ensure that they continually improve these processes to promote the desired outcomes. Future studies can be undertaken to evaluate a particular hospital rather than a group of hospitals to determine their individual performance and readmission rates. Results of quantitative research should be displayed in numbers. The % difference in two groups, etc.

Ethical Considerations

The study was approved by the United States National Library of Medicine National Institute of Health resulting in its publication. Patient privacy was protected as the information utilized by the study did not focus on private health information but rather the trends in the readmission rates. Also, the author does not identify any ethical considerations that were considered for the treatment of the target population or audience.

Conclusion

Utilizing risk-standardized readmission rates provide an opportunity to evaluate reliable hospital readmission rates that can be used to improve the quality of healthcare outcomes and the success of the healthcare industry. Standardizing risks help healthcare organizations and nurses to determine the specific areas of care that needs to be improved to realize the desired positive outcomes. Improving hospital quality is crucial for reducing hospital readmission rates by improving the health of the patients.

You need a section that discusses the PICOT statement along with the nursing practice problem and how the articles supported the process.

You also need a section on an actual practice change that you could implement.

References

Aman, M. W., Stem, M., Schweitzer, M. A., Magnuson, T. H., & Lidor, A. O. (2016). Early

Hospital readmission after bariatric surgery. Surgical endoscopy, 30(6), 2231-2238. Sourced from: https://link.springer.com/article/10.1007%2Fs00464-015-4483-4

Barnett, M. L., Hsu, J., & McWilliams, J. M. (2015). Patient characteristics and differences in

Hospital readmission rates. JAMA internal medicine, 175(11), 1803-1812. Sourced from: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2434813

Reed, R. L., Pearlman, R. A., & Buchner, D. M. (1991). Risk factors for early unplanned hospital readmission in the elderly. Journal of general internal medicine, 6(3), 223-228.

Branowicki, P. M., Vessey, J. A., Graham, D. A., McCabe, M. A., Clapp, A. L., Blaine, K., ... & Chiang, V. W. (2017). Meta-analysis of clinical trials that evaluate the effectiveness of hospital-initiated postdischarge interventions on hospital readmission. The Journal for Healthcare Quality (JHQ), 39(6), 354-366. Sourced from: https://insights.ovid.com/pubmed?pmid=27631713

Krumholz, H. M., Wang, K., Lin, Z., Dharmarajan, K., Horwitz, L. I., Ross, J. S., ... & Normand, S. L. T. (2017). Hospital-readmission risk—isolating hospital effects from patient effects. New England Journal of Medicine, 377(11), 1055-1064. Soured from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671772