Benchmark - Evidence-Based Practice
Ellamae17
DisseminationofEvidenceFFINAL.pptxDissemination of Evidence
Care Management Proposal
Kimberly Boynton
Introduction
Care management is a term that refers to the activities carried out to improve patient care and reduce the need for medical services
Care management consists of several healthcare professionals, such as nurses, social workers, and patent educators (Wideman, 2012).
Care management services include patient education, medication management, managing symptoms, and preventative testing
The problem that is aimed to be solved in care management is high rehospitalization rates due to poor care management among adults.
One of the ways to improve the quality of geriatric care management is through the use of pay for performance incentives
Care management is a term that refers to the activities carried out to improve patient care and reduce the need for medical services by enhancing care coordination and helping patients and caregivers to manage their healthcare conditions effectively. Care management utilizes several integrated programs which extend beyond current clinical care. Care management consists of several healthcare professionals, such as nurses, social workers, and patent educators. These healthcare management professionals work collaboratively to create a health care plan that will help meet the specific needs (Wideman, 2012). Care management services include patient education, medication management, managing symptoms, and preventative testing.
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The PICOT Question
In older patients (P), what is the effect of pay for performance incentives for nurses (I) on improving care management and reducing rehospitalization rates (O) compared with the use of social support (C) within six months?
P-Elderly patients
I-Effect of pay performance incentives for nurses
O-Improving care management and reducing rehospitalization rates
C-Compared with the use of social support
T-Within six months
One of the ways to improve the quality of geriatric care management is through the use of pay for performance incentives. Pay for performance incentives are offered to healthcare providers if they meet specific performance results instead of their work. This incentive will motivate the healthcare team responsible for geriatric care management to improve the quality of care, efficiency, and the overall care they will be providing for the older adults, resulting in reduced hospitalization rates.
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The benefits of care management
Health care providers and social caregivers would improve the quality of performance of the elders by providing both physical and social support
Pay for performance is expected to improve the level of competency among the health caregivers since they would improve their services and attract more patients to their health care environment
Pay for performance will reduce the hospitalization rates of the elders by ensuring that they get all the medical attention that they would need
Numerous benefits would be expected from the project. First, health care providers and social caregivers would improve the quality of performance of the elders by providing both physical and social support. This would increase their lifespan (Antoñanzas, Rodríguez-Ibeas and Juárez-Castelló, 2018). The second goal lies in the intervention programs. The solution is expected to improve the level of competency among the health caregivers since they would improve their services and attract more patients to their health care environment. Another objective is to reduce the hospitalization rates of the elders by ensuring that they get all the medical attention that they would need (Brunn, 2017).
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How the benefits will be achieved
The older adults would be given more attention that would improve their current situations.
The pay for performance initiative would improve the morale of the health care providers, which would help them improve on their intervention programs.
Consistent checkups on older adults would ensure that they follow all the medical guidelines (Peckham & Wallace, 2018)
Re-hospitalization rates will reduce if adults do not suffer from serious health-threatening diseases that would require urgent medical attention
These changes would have an immediate impact on the quality care improvement of the patients.
The older adults would be given more attention that would improve their current situations. However, it is assumed that this would be possible if the nurses and social caregivers maintain consistency in their work.
The pay for performance initiative would improve the morale of the health care providers, which would help them improve on their intervention programs. However, this may only be possible if the initiative is free and fair to all the employees.
Consistent checkups on older adults would ensure that they follow all the medical guidelines. Re-hospitalization rates will reduce if they do not suffer from serious health-threatening diseases that would require urgent medical attention.
These changes would have an immediate impact on the quality care improvement of the patients (Peckham & Wallace, 2018). This is because the standards of medical services will improve, and the elders will also receive constant social care that would improve their conditions.
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Implementation model for the initiative:
Roger's diffusion of innovation theory
Diffusion of Innovation (DOI) model is used to explain how an idea gains momentum and spreads through a particular population over time.
The use of the DOI model to implement this initiative implies that after a short while, nurses and physicians who are the main stakeholders in the implementation of this initiative would start performing their roles differently than how they have been doing it previously (García‐Avilés, 2020).
The model asserts that people who adopt an idea earlier have distinct features than those who embrace an idea later. There are five adopter categories proposed in DOI.
They include innovators, early adopters, early majority, late majority, and laggards
Implementing pay for performance for nurses on improving care management and reducing re-hospitalization rates among the aging population can be done using Roger's diffusion of innovation theory. Diffusion of Innovation (DOI) is used to explain how an idea gains momentum and spreads through a particular population over time. According to DOI theory, the spread's result is that people adopt innovative ideas or behavior. Adoption means that there will be a meaningful change in the way people do things. In my organization, the implementation of pay for performance initiative will motivate nurses. It is also associated with low re-hospitalization rates among people with acute conditions, ensuring proper care management. The use of the DOI model to implement this initiative implies that after a short while, nurses and physicians who are the main stakeholders in the implementation of this initiative would start performing their roles differently than how they have been doing it previously. The adoption of an idea and innovation does not happen simultaneously in a healthcare organization. Instead, it is a process where some nurses and physicians are more apt to adopt the innovation than others. The model asserts that people who adopt an idea earlier have distinct features than those who embrace an idea later. There are five adopter categories proposed in DOI. They include innovators, early adopters, early majority, late majority, and laggards. These adopter categories are used to appeal to the target population when promoting an innovation.
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Rodger’s diffusion of innovation theory
Innovators: Innovators are a set of customers that use new products as soon as they are launched, that is are the first set of customers of any new technology or new products it count for 2.5% and product example of Innovation model is Foldable Phones, Foldable phones are very few in few in numbers and is a very new product, one will hardly find people using it. There is extraordinarily little that needs to be done to the initiative to appeal to these people (García‐Avilés, 2020).
Early adopters: These are people who represent opinion leaders. These are people who embrace change opportunities in an organization and enjoy leadership roles. These people are aware that an organization needs change, and therefore they are comfortable adopting innovative ideas, and they do not need the information to convince them to change.
Early Majority: These are the set of customers those who widely adopt an innovative new product and are accepted by the society as a products and people smart using it. Such products become constant for group of people and majority of people start using it. These counts for 34% example of such products are Debit cards and credit cards. Many customers nowadays use these cards for payments. These people need to see evidence to be convinced that the initiative works.
Late majority: The late majority comprises a population of people who are skeptical about changing. These people will only adopt an idea after the majority has tried it. These people require information to be convinced of the effectiveness of the initiative.
Laggards: Laggards consist of people who are bound with tradition, and they are also conservative. are the set of customers those who avoid using technology and stick to old technology and they use new products when they become old. These count for 16%. Product example is 2G internet service.
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Timeline for the project implementation
The implementation process of the proposed initiative will start on 1 January 2022 and is expected to end on 30 December 2022. The following steps will be followed: assessing the project plan, executing the plan, making changes as needed, analyzing project data, and gathering feedback, and providing a final report.
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The potential barriers to be eliminated during implementation process
The potential barrier that will need to be assessed and eliminated during the initiative's implementation is resistance to change
The pay for performance initiative is characterized by many disadvantages like affecting teamwork and leaving the possibility of subjectivity
Nurses and doctors who are the major stakeholders in this initiative may resist the implementation of the initiative
However, by informing the employees about the benefits of the initiative early and communicating how I plan to manage the problems, the problem will be eliminated
The potential barrier that will need to be assessed and eliminated during the initiative's implementation is resistance to change. The pay for performance initiative is characterized by many disadvantages like affecting teamwork and leaving the possibility of subjectivity (Leite, Bateman & Radnor, 2020). Nurses and doctors who are the major stakeholders in this initiative may resist the implementation of the initiative. However, by informing the employees about the benefits of the initiative early and communicating how I plan to manage the problems, the problem will be eliminated.
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Implementation plan
The implementation process of pay for performance would require an increase in human capital as health professionals would be rewarded based on the quality of their work.
The implementation of the initiative will require a pay increase
The cost of purchasing computers for the implementation process is estimated at the cost of $200,000.
The organization will hire five professionals to facilitate the implementation of the initiative.
The potential barrier that will need to be assessed and eliminated during the initiative's implementation is resistance to change
The implementation process of the proposed initiative will start on 1 January 2022 and is expected to end on 30 December 2022
The implementation of any change requires a lot of finance used to buy equipment and tools for achieving the needs of the new initiative. The implementation process of pay for performance would require an increase in human capital as health professionals would be rewarded based on the quality of their work. The implementation of this reward system requires motivation from all health professionals (Peckham & Wallace, 2018). This would mean that all the nurses and physicians would require training and education to compete and achieve the needs of the new initiative. The implementation of the initiative will require a pay increase. This will need the organization to reduce supplies to concentrate on service delivery to obtain more funds for implementing the initiative.
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Project evaluation
Methods of project evaluation
Return on investment
Payback method
Present Net value
Internal rate return
These are potential evaluation strategies that can be used to evaluate pay for performance initiative
ROI is used as a criterion in an evaluation process (Witter et al., 2018). The higher the ROI, the higher is its acceptability. The concepts about the amount of investment in a project include the number of assets, capital investment, or equity capital. Return on asset is the ratio between net profit and the assets.
The payback period is when the time between project implementation to the time when the profit becomes equal to the total costs of the project
To understand how NPV works, we can assume that an initiative expects to obtain a revenue R1 in the initial year of project implementation and R2 in the second year, and R3 in the third year. Also, we can assume that the project's initial cost is C1, and in addition, an organization will spend Q amount in the first year, C2 in the second year, C3, C4…Cn. From this illustration, we deduct the present value of the flow of costs of the project from the current value of the flow of revenue. The result from our calculations will be the NPV.
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The appropriate evaluation method
Net Present Value (NPV)
NPV has all the properties of project evaluation
It uses the rate of the opportunity cost of capital as the discount rate to find the present value of all the standard cots and profits.
It also considers all the expected lows of losses and earnings of an initiative. Finally, it evaluates projects independently
The evaluation method that would be appropriate for my initiative is Present Net Value (NPV) (Witter et al., 2018). This is because NPV has all the properties of project evaluation. It uses the rate of the opportunity cost of capital as the discount rate to find the present value of all the standard cots and profits. It also considers all the expected lows of losses and earnings of an initiative. Finally, it evaluates projects independently.
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References
Wideman, M. (2012). Geriatric care management: role, need, and benefits. Home Healthcare Now, 30(9), 553-559.
Peckham, S., & Wallace, A. (2018). Pay-for-performance schemes in primary care:
what have we learned? In The Quality and Outcomes Framework (pp. 137-146). CRC Press.
Peckham, S., & Wallace, A. (2018). Pay-for-performance schemes in primary care:
what have we learned? In The Quality and Outcomes Framework (pp. 137-146). CRC Press.
García‐Avilés, J. A. (2020). Diffusion of innovation. The International Encyclopedia of Media Psychology, 1-8.
Witter, S., Brikci, N., Harris, T., Williams, R., Keen, S., Mujica, A., ... & Renner, A. (2018). The free healthcare initiative in Sierra Leone: evaluating a health system reform, 2010‐2015. The International journal of health planning and management, 33(2), 434-448.
