Developing an Implementation Plan

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Implementation Plan

Elizabeth Foster

School of Nursing and Health Sciences, Capella University

NHS-FPX6008-Economics and Decision Making in Health Care

Dr. Nicole Aclin

Friday, July 23, 2021

 

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Introduction

The initiative of establishing a separate chronic disease preventive services department in

the clinic has been suggested due to the increased number of patients who present to the clinic with

chronic illnesses. This has made the clinic fail to provide high-quality healthcare services for their

community and provide holistic and comprehensive care that involves prevention services and

eliminating diseases. This is because the increase of patients with chronic diseases has made the

clinic experience congestion of patients, shortage, and burnout of clinicians making the clinic

employ more staff members. The increase of chronically ill patients has impacted the quality of

care provided by the clinic since it has led to an increased number of medical errors resulting from

negligence, making the clinic face lawsuits and penalties that have led to a low rate of patient

satisfaction. By establishing a separate chronic diseases preventive service department, the clinic

will specialize in providing preventive and treatment services for chronically ill patients. These

services will include screening for chronic disease, conducting tests, providing counseling and

health education, and providing immunization, among other services. This paper will cover the

implementation plan for the separate chronic disease preventive service department. The

implementation plan will include a budget for materials, staffing for the new initiative, and capital

cost over the first five years of the initiative, as well as the expected earnings. The implementation

plan will also include a timeline, the organizational impact analysis, and an explanation of the

impact of environmental changes on the initiative.

Budget for Materials

For this initiative to be implemented successfully, the expected materials that will be

needed include medical devices and sensors that care providers will use to assess, screen, and test

patients. These devices and sensors include respiratory rate sensors, glucometer, pulse oximeter,

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and sensors for measuring blood pressure, just to mention a few. The initiative will also have a

communication platform that will be integrated with the facility's Electronic Medical Record

(EMR) system, which functions as the facility's data analytic system. This system will enable the

physicians to keep a record of the patients on a daily basis. This is where patient analysis is

conducted, and support decisions are made based on the health condition of a patient. Since the

initiative will provide care services to both inpatients and outpatients, it will require setting up a

section that will cater to inpatients. This section will require beds and clothing to cater to the

inpatients. The initiative will be set up in one of the sections in the facility, and due to this, there

will be no construction or expansion costs. The cost of implementing these resources in the facility

is estimated to be around.

Item/Resources Cost ($)

Medical devices and sensors 300,000

Communication platform 13,000

Electronic Medical Record 120,000

beds 30,000

Bedding and Clothing 10,000

Training 25,000

TOTAL 498,000

Staffing

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Within the first five years of the initiative, the facility is planning to establish a total of 50

beds in the facility to cater to the inpatients whose chronic conditions have worsened. This is

because the facility does not receive a high number of chronically ill patients who require inpatient

services as compared to the number of outpatients. Due to this, the facility will require to have an

estimate of about 25 healthcare professionals who have specialized in providing care and

preventive services to patients with chronic illness. Each of the care professionals will provide care

services to two beds in the department to enable fair and smooth service provision in the

department. This professional will provide services such as conducting assessments and providing

diagnoses to the patient. They will receive assistance from registered nurses as well as licensed

practitioner nurses who will be hired to work together with specialized physicians. To save on the

cost of hiring new employees, the facility will conduct a training exercise on some of the available

nurses to enable them to acquire the required skills to work in the separate chronic disease

preventive services department. The nurses will provide care services such as administering

medicine, among other essential services.

Capital Cost Over the First Five Years of the Initiative and the Projected Earnings

Putting into consideration the first five years of the capital cost for this initiative, the cost

includes the cost for medical devices and sensors, communication platform, EMR, beds, beddings,

and clothing which are estimated to be around $ 513,000. In addition to this, there is an estimated

operating cost that includes salaries for the working staff and for the basic utilities such as the

internet, electricity, and gas, which is estimated to be $34,000 per year. Within the first year of

working, the staff members will receive an estimate of around $193,000 for physicians on full-time

duty and $150,000 for practitioner nurses, and $40,000 for those working as medical assistants per

annum. Since the clinic will just have to conduct training on their current staff members, which is

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estimated to cost $65,000, there is no need to hire new staff members (Agency for Healthcare

Quality and Research n.d.). This gives the initiative an estimated capital cost of $2,912,512.62,

which is to be experienced within the first five years of establishing the separate chronic illness

department. With this department, the projected earning is estimated to be $417,000 within the first

year since it receives around 600 patients every week who are charged a fee of $100 per patient.

Assuming that the revenue will grow by 2.5% every year for the five years, it is estimated that the

clinic will experience a total benefit of $2,478,842.46, and based on this total benefit, we can

conclude that the initiative will be economically beneficial for the clinic.

Year Cost ($) Current Year 1,012,000.00 First Year 408,823.53 Second Year 400,807.38 Third Year 392,948.41 Fourth Year 385,243.54 Fifth Year 377,689.75 Total 2,977,512.62

Timeline

This initiative is projected to be fully established within the first four months. The first

month will involve presenting the idea to the management of the clinic to see if they will be

interested in as well as convincing them to understand the benefits of implementing the initiative

not only for the clinicians but also for the clinic. Presenting the initiative to these stakeholders is

essential since it enables them to understand the benefits presented by the initiative. Within the first

month, I will have to convince the management in the clinic to provide the required resources for

the initiative as well as convinced the staff members of the clinic of the benefits presented by the

initiative. The second month involves gathering all the required resources for the initiative, such as

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sensors and devices, computers, beds, beddings, and inpatient clothing. The third month will

involve implementing the separate department and introducing the healthcare staff members of the

clinic to the department. The fourth month will involve conducting training not only on the staff

members who will be working in this department but also on the entire clinic staff members to

enable them to know the best way to prevent or treat chronic diseases.

Time Process First Month Presenting Idea Second Month Gathering Resources Third Month Implementation Process Fourth Month Training

To ensure that the initiative is implemented ethically and culturally, the implementation

process will be divided into various steps. With the various steps, it will be easy to manage the

implementation process. For instance, during the hiring process of new employees, it will be easy

to change the hiring and promotion process in the facility. This will be through ensuring that there

is no cloud judgment during the hiring and promotion processes. The establishment of the initiative

in the clinic will be advertised on the facility website and the social media platforms where a huge

number of patients can access the information regarding the care services provided in this

initiative. There will also be a poster installed at the entrance of the facility to enable those without

access to the website to read about the initiative. This will enable a large number of individuals

from the community to access the information. After the initiative has been implemented, there

will be a performance evaluation to determine the performance of the initiative and if it is

presenting the expected benefits to the clinic. This assists in determining if the initiative has

achieved its expected goals and objectives.

Organizational Impact Analysis

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By establishing a separate chronic disease preventive service department, the clinic will

focus on providing high-quality healthcare services for the patient with chronic illness and the

patients who present with other diseases. This is because establishing the department will enable

the clinic to provide increased access to the healthcare services they provide. The department will

enable the clinic to provide services such as screening for diseases, conducting tests, providing

counseling and immunization, and offering health education for the chronic illness and the isolated

and deprived population that may not have any means of accessing the services. The initiative will

enable the clinic to assist patients in comprehending their health condition and particular health

problems they may be experiencing since the department will have healthcare professionals who

have specialized in treating and dealing with different illnesses. This will enable the clinic to focus

on preventing chronic illnesses using different methods such as educating patients on how to stay

physically fit and active, eat healthy diets, avoid the use of alcohol and smoking, just to mention a

few. The chronic disease preventive service department initiative will enable the clinic to detect

early not only chronic illnesses but also other health conditions, which will make it easy to

implement successful treatment processes for the patients (Reynolds et al. 2018). This is because,

through the initiative, the clinic will have clinicians who can conduct the recommended screening

activities that would enable early detection of particular diseases such as heart diseases, blood

pressure, diabetes, and cancer, among others. The initiative will enable the various departments in

the clinic will be able to operate effectively since they will operate on a patient with different

diseases rather than focusing on those with chronic illnesses. This will enable the various

department in the clinic to operate more effectively, thus reducing the shortage of staff members

and eliminating burnout of the staff members, making the clinic eliminate the need to hire or

employ new staff members. With the initiative within the five years, the clinic will be able to

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establish patient-centered care that offers healthcare services based on the preference and

requirements of the patient, which will lead to a reduction of errors and wastage of resources in the

clinic.

Effects of Environmental Changes on the Initiative

Changes in the environment can cause patients with chronic diseases to be exposed to air

pollution, organic pollutants, water pollution, radiation, and chemicals that affect the severity of

chronic diseases, making them more challenging to treat or prevent. These changes in the

environment will increase the number of chronically ill patients in the clinic since the patient will

be more exposed to pollutants that affect their health (Climate change and health, 2018). This

means that the initiative has to teach patients how to deal with pollutants and live healthy lifestyles.

This data can be analyzed by determining if there is an excessive increase of chronically ill patients

in the clinic. With this initiative, the chronically ill patient will learn different ways of managing

their condition in different environmental conditions. Through the initiative, the facility can

conduct campaigns where they announce environmental changes to the community to enable the

individuals to know when there are changes in the environment. This would assist the facility in

improving its preventive measure against chronic disease.

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Reference

Agency for Healthcare Quality and Research. (n.d.). Improving patient flow and reducing

emergency department crowding: A guide for hospitals – Appendix C: Example

implementation plan. https://www.ahrq.gov/research/findings/final-reports/ptflow/

appendix-c.html

Climate change and health. (2018, February 1). WHO | World Health Organization.

https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health

Pritchard, G. (n.d.). How to develop an operating budget for a nursing

unit. Chron. http://smallbusiness.chron.com/develop-operating-budget-nursing-unit-

79824.html

Reynolds, R., Dennis, S., Hasan, I., Sliwa, J., Chen, W., Tian, D., ... & Zwar, N. (2018). A

systematic review of chronic disease management interventions in primary care. BMC

family practice, 19(1), 1-13.