Final Project Submission

1

Implementation Plan Design

Name

Capella University

Professor

September, 2022

Implementation Plan Design

The purpose of intervention plans is to utilize an evidence-based approach to achieve practice change and improve patient health outcomes and satisfaction. A successful implementation plan design requires a sound and reasonable approach to translating evidence-based research into clinical practice. This intervention addresses the clinical question of the high 30-day readmission rate for head and neck oncology surgical patients at the University of Miami Hospital. This paper presents an intervention plan design that outlines the management, leadership, delivery technology, stakeholders, policy regulations, and timeline considerations.

Management and Leadership

This intervention requires the collaboration of a multidisciplinary team involved in the management of head and neck oncology patients. Research has established that when compared to fragmented health care, multidisciplinary surgical care results in better health outcomes, reduced healthcare outcomes, and better patient-reported outcomes (Davis et al., 2021). The multidisciplinary team involved is the surgical oncology unit's nursing and medical staff. These include nurses, nurse managers, physicians, surgeons, oncologists, and clinical assistants. Other clinicians involved in ancillary support include nutritionists, clinical psychologists, and physiotherapists. Some of the leadership and management strategies required to promote multidisciplinary collaboration include:

· Collaborative communication: Effective communication channels are required to ensure the success of this intervention plan (Kumar et al., 2019). The project will create communication channels that foster teamwork, morale, and team trust. Some skills that will be encouraged include empathy, active listening, and positive reinforcement through rewards.

· Collaborative practice: All interdisciplinary care team members will have an opportunity to contribute their skills, expertise, and experience to the implementation plan. This ensures that all aspects of the intervention are holistic and patient-centered.

· Shared and collectivistic leadership: This ensures that all resources within the organization are maximized, and individuals with diverse backgrounds are given an opportunity to lead and apply professional judgement (Aufegger et al., 2020). Decisions will be made in an open, honest, and democratic manner, where the common goal is to improve patient outcomes.

Collaboration of a multidisciplinary surgical care team is required to promote the delivery of individualized and high-quality patient care to head and neck cancer patients. Through shared leadership, collaboration, and collectivistic leadership and management strategies, the patients will benefit from the experience and education of different providers (Reid et al., 2021). For instance, the nursing and nutrition team may collaborate to design a treatment plan that promotes wound care and recovery. There will also be decreased medical errors and workflow redundancies, and potential health complications will be identified before they worsen.

Delivery and Technology

This project's organization uses a clinic-based head and neck discharge and follow-up plan. This intervention plan proposes an evidence-based discharge and follow-up bundle with two major components: comprehensive patient education and post-discharge phone-based care and follow-up. To increase project effectiveness, this project will be delivered in four phases. Phase 1 will involve a needs assessment to identify the staff and patient population attitudes and health literacy levels. Phase 2 involves testing and tailoring the proposed head and neck discharge and a follow-up plan to the identified staff and patient needs. Phase 3 involves staff education and training to ensure they understand how to implement the intervention. Phase 4 involves the actual project implementation at the Head and Neck oncology unit. One of the key assumptions of this intervention plan is that the hospital will provide all the resources required to implement the four project phases. These resources include dedicated staff, time, equipment, and resources. Another assumption of the intervention plan is that the needs assessment will demonstrate willingness among the staff to implement a practice change project.

Phases 2 and 3 of this implementation plan require using the internet and internet-based devices. This is because the needs assessment will be conducted using online surveys, while the staff training will be on an online web-based platform. Phase 4 (implementation) entails using a phone-based follow-up call and videoconferencing (optional). Current telemedicine technologies (telephone and video consultations) will be crucial in enhancing the delivery of the intervention plan. During the phone-based follow-up call, the nursing staff uses a post-discharge survey to inquire about the patient's health, schedule post-operative appointments, and request videoconference consultation if needed. One of the emerging healthcare and digital technologies that may support this proposed intervention plan is artificial intelligence (AI). Several studies have established the role of image-based artificial intelligence (AI) algorithms in optimizing wound assessment, care, and healing (Anisuzzaman et al., 2021).

Stakeholders, Policy, and Regulations

The implementation of this intervention plan requires the collaboration of various stakeholders. The internal stakeholders, such as the nurses, surgeons, oncologists, nutritionists, and clinical psychologists, will be responsible for implementing the intervention in the target population and setting. The external stakeholders, such as the patients and healthcare insurers, will be crucial in facilitating the intervention implementation plan design. The patients are core stakeholders of this intervention as they are the target population. Therefore, patient needs must be considered in the intervention plan design. For instance, the patient needs assessment will determine whether the phone-based follow-up will be carried out via phone calls or SMS.

This intervention utilizes post-discharge phone-based care and follow-up intervention, with the option of requesting a videoconference consultation. Because the intervention plan requires telemedicine technology, it must be implemented based on two policy regulations: The Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009 and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). These two federal regulations ensure that patient health information is protected and kept confidential (Moore & Frye, 2019). Additionally, the project will seek approval from the University of Miami Hospital IRB by demonstrating adherence to ethical principles and standards. These existing policies will ensure that the intervention plan protects the rights and privacy of the patients. 

Timeline

This intervention plan will be implemented for a period of four months (16 weeks) at the Head and Neck oncology unit at the University of Miami Hospital. The first four (4) weeks will be dedicated to conducting a departmental needs assessment, staff education, and troubleshooting the proposed bundle care. The next eight (8) weeks will be allocated for the project execution and implementation. This involves identifying project participants, implementing the oncology unit's discharge and follow-up bundle care, and collecting patient outcomes. Some of the project's primary patient outcomes include the 30-day readmission rate and compliance to wound care protocols. The next four (4) weeks will be allocated for analyzing the collected patient health outcomes to determine the impact of the intervention. During this period, the results of this project will be presented and disseminated to various stakeholders within and outside the organization. Some factors that may negatively impact my projected timeline include institutional bottlenecks, staff resistance, high project attrition rate, lack of required resources, and poor compliance with the project protocol.  

References

Anisuzzaman, D. M., Wang, C., Rostami, B., Gopalakrishnan, S., Niezgoda, J., & Yu, Z. (2021). Image-Based Artificial Intelligence in Wound Assessment: A Systematic Review. Advances in Wound Care. https://doi.org/10.1089/wound.2021.0091

Aufegger, L., Alabi, M., Darzi, A., & Bicknell, C. (2020). Sharing leadership: Current attitudes, barriers and needs of clinical and non-clinical managers in UK’s integrated care system. BMJ Leader, 4(3), 128–134. https://doi.org/10.1136/leader-2020-000228

Davis, M. J., Luu, B. C., Raj, S., Abu-Ghname, A., & Buchanan, E. P. (2021). Multidisciplinary care in surgery: Are team-based interventions cost-effective? The Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland, 19(1), 49–60. https://doi.org/10.1016/j.surge.2020.02.005

Kumar, H., Morad, R., & Sonsati, M. (2019). Surgical team: Improving teamwork, a review. Postgraduate Medical Journal, 95(1124), 334–339. https://doi.org/10.1136/postgradmedj-2018-135943

Moore, W., & Frye, S. (2019). Review of HIPAA, Part 1: History, Protected Health Information, and Privacy and Security Rules. Journal of Nuclear Medicine Technology, 47(4), 269–272. https://doi.org/10.2967/jnmt.119.227819

Reid, M., Lee, A., Urbach, D. R., Kuziemsky, C., Hameed, M., Moloo, H., & Balaa, F. (2021). Shared care in surgery: Practical considerations for surgical leaders. Healthcare Management Forum, 34(2), 77–80. https://doi.org/10.1177/0840470420952485