Final Project Submission

Evaluation of Plan

a. The Goal of the Intervention Plan

This intervention is focused on achieving two major outcomes concerning lowering the admission rates for head and neck cancer patients at the University of Miami Hospital. The first major outcome expected of this project is to reduce wound infections and complications in head and neck cancer patients through patient, family, and/or caregiver education on wound care and proper management of the surgical site. According to Jabbour et al. (2017), head and neck oncology patients present with unique postoperative needs relating to wounds, gastrostomy, and tracheostomy care. By the end of the project, therefore, patient, family, and/or caregiver education having the required skills, knowledge, and attitude, should facilitate faster postoperative healing, thus lowering readmission rates .

Another expected outcome includes an increase in head and neck cancer patient survival rate. According to Chilkuri et al. (2021), compliance with pre-treatment, treatment, and post-treatment can help in increasing the cancer patient's survival rate. The survival rate can be increased by reduced postoperative signs and symptoms such as pain fever nausea and vomiting among other symptoms upon the implementation of the post-discharge care component of the project. This outcome can be attained by the use of telemedicine where the multidisciplinary team at the oncology surgical unit inquires via telephone about the patient's health and address any emerging patient concerns (Jabbour et al., 2017). Video conferencing between the patient or caregiver and the oncologist surgical unit is expected to minimize the 30-day readmission rate for head and neck cancer patients at the facility.

a. Evaluation Plan

Discussion

Advocacy

The nurse plays several critical roles in leading change and driving improvements in the quality and experience of care. Among the roles related to leadership roles in primary healthcare include episodic illness management reconciliation of medication, proper management of hospital transition, patient health assessments, and documentation (Thomas et al., 2016). The nurse can also improve the quality and experience of care as “the boundary spanner” where they connect patients with community-based resources. In the case of head and neck cancer patients, for instance, a nurse can link elderly patients to better-performing nursing homes to minimize 30-day readmission cases. Care coordination and facilitation of interprofessional collaboration is also a nurse’s role where nurses can facilitate change and quality improvement (Thomas et al., 2016). In the oncology unit, for instance, the nurse can collaborate and coordinate with the family, physician, surgeon, and specialist nurses on wound care to promote quick treatment and healing. Nurses must therefore take the leading role towards continued quality improvement in the clinical and community setting.

The intervention plan above impacts nursing and interprofessional collaboration significantly and also contribute to the field of health care. First, the plan will focus on the patient, caregiver, and/or family education on wound management and also be enrolled in phone-based follow-ups and these roles require interprofessional collaboration (Jabbour et al., 2017). This will include the surgical unit, the oncology unit, and the UHealth Virtual Clinics that operate within the laws of Florida State. While some providers are trained in videoconferencing, others can provide teleconsultation and thus recommend either readmission or home-based care for patients (Malouff et al., 2021). A multidisciplinary approach is thus necessary for the success of the implementation. Regarding the project’s impact on the field of healthcare, it presents innovation toward improving head and neck cancer patient survival rate and quality of life. Reports on the outcomes of the project can inform future research on expanding the approach to ameliorating other risks associated with chronic conditions (Jabbour et al., 2017). The project is thus highly beneficial to the field of health care based on its contribution to cancer care and professional improvement.

Future Steps

The current project can be improved in different ways towards creating a bigger impact on the target population and also take advantage of emerging technology and care modes to improve both outcomes and safety. The first approach includes training more physicians and nurses on telemedicine and the use of related technology to diagnose and recommend treatment for post-operative complications in head and neck cancer patients (Jabbour et al., 2017). The oncology unit thus must be equipped with more telemedicine technology in abundance to address the numerous numbers of patients with unique needs. Secondly, the University of Miami Hospital should consider expanding its workforce, especially in the oncology unit to avoid nurse burnout in the quest to address both in-patient care and post-operative follow-ups (Thomas et al., 2016). With more physicians and nurses trained on telemedicine applications and a large multidisciplinary team, the facility can cut down the 30-day hospital readmission rates through the recommended patient-centered care for head & neck cancer patients.

Reflection on Leading Change and Improvement

The project has significantly impacted my ability to lead change, especially in personal practice as well as in future leadership positions. First, through the development of the project, I have developed a sense of innovativeness and reliance on evidence-based studies to create practical interventions in healthcare (Thomas et al., 2016). Earlier research on cancer care and review reports on the Florida state and national policies on cancer management provided a critical background to developing the project. To lead change in personal practice in my practice thus, I will greatly rely on evidence-based decisions. Secondly, the project has brought out the need for collaboration in nursing practice. I have thus learned to embrace collaboration through a multidisciplinary approach as a means to implement and sustain change (Jabbour et al., 2017). In my future leadership position, therefore, I will promote interprofessional collaboration to provide optimum care to patients with both chronic and non-chronic conditions.

The intervention, implementation, and evaluation plans above can be transferred into nursing practice and steer quality improvements in other contexts. Usually, quality improvement measures focus on standardizing processes and structure to reduce unnecessary variation, attain predictable results, and trigger improved outcomes for patients, the healthcare systems, and the organization (Backhouse & Ogunlayi, 2020). The intervention, implementation, and evaluation plans can thus be adopted by the University of Miami Hospital as well as any other facility to bolster patient-centered care, especially for chronic conditions. Based on research recommendations, the project can be adopted in cancer care settings and thus minimize readmissions while maximizing survival rates as critical measures of quality improvement. The plans also emphasize the need for collaboration among stakeholders which when adopted in any other context can still promote quality improvement in healthcare (Backhouse & Ogunlayi, 2020). The project’s applicability thus allows for its replication in other units beyond the oncology unit at the University of Miami Hospital. Other facilities may consider adopting the approach envisaged in the project and hence boost patient outcomes such as survival rate and lowered mortality.

References

Backhouse, A., & Ogunlayi, F. (2020). Quality improvement into practice.  BMJ (Clinical research ed.),  368, m865. https://doi.org/10.1136/bmj.m865

Chilkuri, M., Vangaveti, V., & Smith, J. (2021). Head and neck cancers: Monitoring quality and reporting outcomes. Journal of Medical Imaging and Radiation Oncology, 66(3), 455–465. https://doi.org/10.1111/1754-9485.13359

Jabbour, J., Milross, C., Sundaresan, P., Ebrahimi, A., Shepherd, H. L., Dhillon, H. M., Morgan, G., Ashford, B., Abdul-Razak, M., Wong, E., Veness, M., Palme, C. E., Froggatt, C., Cohen, R., Ekmejian, R., Tay, J., Roshan, D., & Clark, J. R. (2017). Education and support needs in patients with head and neck cancer: A multi-institutional survey. Cancer, 123(11), 1949–1957. https://doi.org/10.1002/cncr.30535

Malouff, T. D., TerKonda, S. P., Knight, D., Abu Dabrh, A. M., Perlman, A. I., Munipalli, B., Dudenkov, D. V., Heckman, M. G., White, L. J., Wert, K. M., Pascual, J. M., Rivera, F. A., Shoaei, M. M., Leak, M. A., Harrell, A. C., Trifiletti, D. M., & Buskirk, S. J. (2021). Physician Satisfaction with Telemedicine During the COVID-19 Pandemic: The Mayo Clinic Florida Experience. Mayo Clinic Proceedings. Innovations, Quality & Outcomes, 5(4), 771–782. https://doi.org/10.1016/j.mayocpiqo.2021.06.006

Thomas, T.W., Seifert, P.C., Joyner, J.C., (2016). Registered nurses leading innovative changes. OJIN: The Online Journal of Issues in Nursing Vol. 21, No. 3, Manuscript 3.