peer review

The Dissemination Plan

After reviewing the logic model and change proposal and initiation plan the change plan would be evaluated through self-evaluation method for the physician. Surveys would be used to evaluate the patients on the performance of the self-care kiosk. The evaluation for the physicians would be based on their performance and the performance of the self-care kiosk. The evaluation would ask open ended questions about time management, effectiveness, and treatment and patient load. The physicians would then evaluate, the self-care kiosk on productivity various questions would be asked ranging from speed, time management, effectiveness and quality of care that the patient receives and ultimately if the kiosk is effective. Based off the feedback given and the proven statistical data such as the increase or decrease in the patients that where seen, how fast the patients were able to receive the treatment needed, and the surveys given from the patients that used the self-care kiosk and was satisfied from the patients that had negative feedback on the kiosk. Visual aid would consist of graphs, charts and line graphs to see if the increase or decrease in productivity to see if the kiosk is helpful and how to improve the patients experience and quality of care. Visual aide would also be used to show how much money was saved from the use of the self-care kiosk. The money retrieved from the self-care kiosk could be then used to upgrade the self-care kiosk. Physicians wouldn’t have to waste time on patients that are suffering none life threatening illnesses. Making more prescription grade medication over the counter would also help with the process through the self-care kiosk.

The evaluation process would consist of upper management, Directors, Human Resources, administrators, Physicians, and Nurse Practitioners. The qualitative research will be disseminated internally through power-point presentation charts, surveys the feedback would be used to make changes and start with the initiation process. The initiation process would trickle down from management, directors, human resources and administrators and be set in action on each unit focusing on emergency room entrees. Once the initiation process starts then, intake coordinators would take on the role of advising the patients of the self-care kiosk after being checked in and evaluated by a nurse. The self-care kiosk would be implemented to be used for patients that are suffering from minor healthcare issues to boost Physician productivity and response time to emergencies.

The expected outcome is an increase in productivity through separating real-time medical emergencies with non-life- threatening emergencies. This division would help physicians help those in need of emergency care to be seen quicker while given patients that are not in a medical crisis to speed up the treatment process without needing to wait to be seen physically by a physician. Telemedicine has started to make this process easier. Given physicians to treat patients over the computer through video technology. This technology gives the physician the ability to also rest and rotate between hands on treatment and telemedicine treatment which could aid in burnout as well. Externally the initiative process would be broadcasted on media platforms – such as the news and commercials. Social media would also be an asset in spreading the new and improved technology self-care kiosk and demonstration on how the kiosk is to be used it vital in the initiative process.

Implementation Plan: Physician Shortage

The healthcare system in the United States has many issues that needs to be addressed; one issue that hasn’t gotten much attention is the primary and specialty care physician shortage. The growth in the United States population is growing at a faster rate than estimated. Furthermore, since “The Affordable Care Act” also known as Obamacare was signed into law March 23,2010 healthcare has become more affordable for the American people. There are more insured Americans than ever before.

Obamacare was a great historical milestone in American healthcare history, nevertheless created future obstacles is essential within the American healthcare system. Obamacare boosted the demand of physicians and specialty physicians across the United States. (Emmanual Gudbranson ,2017) “In a study conducted for the Association of American Medical College documented that the demand for primary and specialty care physicians will exceed the supply by 46,100 to 90,400.” To combat the physician shortage patient self-care is becoming more popular giving people the ability to take control od their own healthcare. Giving people prescription grade medication over the counter is one example of how patient self -care works, now with the advancement in technology patient self -care will elevate to the next level. Implementing a virtual patient self-care center ran by nurse practitioners and physician assistants would be reduce cost, drastically increase access, boost productivity and increase the quality of care that the patient receives.

Resources

To implement a patient self-care center would require a bit of support from stakeholders such as Physicians, Nurses, Physician Assistants, Nurse Practitioners and Healthcare Administrators. The two important resources need for the implementation process is capital and technology. Donations, fundraisers, rallies and private funding would be a great benefit in starting the change process and generate funding for the virtual patient self-care center.

Technology has advanced so much that healthcare is still trying to catch up with ways to utilize these advancements and incorporate them into the healthcare system to help boost productivity and increase quality by reducing cost and accelerating the healthcare process. Technology with the ability to stabilize the physician shortage and maintain the demand, healthcare has already started moving in the direction of virtual medicine referred to as Telemedicine technologies. Telemedicine involves a healthcare provider using telecommunications technology to provide healthcare and patients. According to (Thomas & S, Bodenheimer, 2013) Telemedicine innovations are home based to help with management of different diseases diabetes, hyperlipidemia, HIV and send medication refills physicians are able refill medication with little to no effort. The resources that the organization would need to implement that change plan

Output

The goal would be to design a patient self-care center kiosk that is equipped with the following features thermal body scan, voice recognition, touch screen, capable of taking blood pressure, temperature, check heart rate, listen to lungs, diagnose and prescribe medications. The kiosk would help a lot of primary care physicians manage time especially when 46 percent of the primary physician’s time is spent on acute care (Thomas S Bodenheimer, 2013). This patient care kiosk would be able to handle all acute cold cases under the supervision of a nurse practitioner and or physician assistant. This would save a huge amount of time money replacing clinicians with non- physician personnel. Non- clinical healthcare professionals will facilitate the kiosk. Manual automated instruction would make the patient self-care center simple and effective experience.

Stakeholders

The healthcare professionals that believe in and endorse the patient self-care center kiosk will invest into the plan. Stakeholders are investor of the plan implementation they give feedback in the best way to achieve the desired results. The key stakeholders would be clinical and non -clinical healthcare professionals, administrators, local, state, and federal legislators. Telemedicine would also become a stakeholder, telemedicine would be able to help in the technology that is needed to make this virtual patient self-care kiosk a real success.

Implementation Steps

The implementation process for the patient self-care kiosk should take one year to implement. Information will need to be gathered on the cost to build a proto type of the medicine. Then the capital will be raised to fund the proto type. The final step would be to demonstrate how effect the kiosk on time management, cost effectiveness and the quality of care received. Once it is proven that it works and accelerates the healthcare system then it would have to be approved through local, state and federal legislators enforce all state and federal laws such as the HIPAA, OSHA laws and the patient bill of rights laws. The final steps isare getting the public comfortable in seeing and utilizing the patient self-care center kiosk. Once people start to see how valuable the kiosk is and how user friendly they are they will be surprised at the accuracy and effectiveness.

Implementation Barriers and How to Overcome Them

The biggest implementation barrier for this plan is time and capital. Time is essential because of the state, local and federal laws that would have to be passed and pushed through the legislators and signed into law that could take a long time. How to overcome time can be overcome by is by prioritizing and utilizing the time in the best possible way. Bringing attention to the physician shortage and proposing a plan that has proven results in helping to combat the physician would really be all that it would take. Capital is another big factor in healthcare and with private, government and stakeholder investment and public donation will cover majority if not all the cost to implement this plan and build a functional proto-type that proves the effectiveness of diagnosing, and prescribing medication and treatment.

References

Thomas S. Bodenheimer, Mark D. Smith

Primary Care: Proposed Solutions to The Shortage Without Training More Physicians

http://doi.org/10.1377/hlthaff.2013.0234

Emanuel EJ, Gudbranson E. Shortage or Surplus of Physicians in the United States—Reply. JAMA. 2017;318(11):1070. doi:10.1001/jama.2017.11521

https://jamanetwork.com/journals/jama/article-abstract/2654380

https://jamanetwork.com/journals/jama/article-abstract/2613210

Kirch DG, Petelle K. Addressing the Physician ShortageThe Peril of Ignoring Demography. JAMA. 2017;317(19):1947–1948. doi:10.1001/jama.2017.2714

Steven C. Flood, MD

Fam Pract Manag. 1998 May;5(5):22-34. Using Qualitative Self-Evaluation in Rating Physician Performance