Health Self Management and Practice Change Order Instructions: The writer will have to read each of these articles and react to them by commenting, analyzing and supporting with relevant articles. The writer will have to read carefully before giving constructive comments on the article.
The writer should write one paragraph of at least 150 words. APA and in-text citation must be used as each respond to the two articles must have in-text citations. The writer will have to use an article to supports his comments in each of the articles. Address the content of each article below in one paragraph each, analysis and evaluation of the topic, as well as the integration of relevant resources to support the facts.
The writer will have to read each of these articles and react to them by commenting, analyzing and supporting with relevant articles. The writer will have to read carefully before giving constructive comments on the article. The writer should write one paragraph of at least 150 words. APA and in-text citation must be used as each respond to the two articles must have in-text citations. The writer will have to use an article to supports his comments in each of the articles. Address the content of each article below in one paragraph each, analysis and evaluation of the topic, as well as the integration of relevant resources.
Article 1
What is the feasibility of implementing the practice change in your clinical setting?
I personally believe that the feasibility of implementing the practice change within my clinical setting would be highly likely. There are great teamwork and accountability among the practitioners and other primary care providers that I have met. There is already great documenting concerning chronic conditions and mental illness. So, this is exciting.
What are the potential barriers to making the change?
Potential barriers to initiating the change within my clinical setting would have to be communicating the implementation of my proposal among other specialists that are involved in the patient’s care. If it is not being assessed and/or documented that the patient is beginning to show or is showing signs and symptoms of depression…the other parties will not be abreast on how effective the treatment plan is. The key to this proposal is ignition on a very strong, solidly built foundation that pertains to education, proper treatment, and proper communications. You will have to communicate effectively with specialists and/or psychiatrist to have the most effective outcome. Another barrier that I have noted is that we are in a rural area, this is a benefit because the community is small and everybody knows everybody. Additionally, located in 2 mental health facilities, but none that focus specifically on depression and chronic conditions. There is also a limited amount of research that is strictly aimed at depression and chronic conditions.
Sawyer, Gale, and Lambert (2006) lists the same barriers that I mentioned above and also mentioned insurance coverage as being a barrier. It is simply unrealistic within a rural area to expect every individual to have insurance coverage. Those that do are on a fix or limited income. It is true that we strive to meet the basic needs within life, however, when you don’t have money to buy food…..you are sure not going to spend it on medications. This is driven to review the general age of these suffers. This will help me focus in on the cost of providing care and address and education how the caregivers feel about the diagnosis and implementation.
What risks are involved in making the practice change?
Risks that are involved in making the practice change is that the change will not be received well, therefore, will not initiate well, and then we are back to square one. We have to take out on a strong note to get stronger as we grow in our knowledge of the risks and benefit related to my proposal discussion. An additional risk is lack of support, follow-up, and follow through.
What are the benefits of making the practice change?
The benefits of making the practice change would be that more individuals are getting their needs met and more providers are working together in a productive manner. I am praying that this proposal will show the benefits of further research into the matter and bring further awareness of the importance of addressing this matter. This could potentially save us millions of dollars that are currently associated with treating depression. We must note that along with the physical chronic conditions that depression is a chronic mental condition.
Do time and cost justify change toward improving clinical outcomes?
Yes, time and cost justify change toward improving clinical outcomes, however, there should be emphasis placed on the ethical considerations associated with fair and effective treatment for all. Though there is a potential to save a lot of money, it is more important to ensure that we as consumers and as primary providers continue to advocate and strive for growth. If not, all the efforts would be in vain and the implementation of the proposed changes would cease before we could even get started.
Which governing entities will need to grant permission for you to make a practice change? Will your work needs to be approved by an Institutional Review Board (IRB)?
Governing entities that would need to grant permission for approved to try my proposal would be the health care administration, practicing physicians, the ethics committee, and affiliated mental health specialists. Additionally, the patients must be willing to comply and report as they are instructed by their primary care provider. Yes, I may work would need to be approved by an IRB. I would love for it to be approved so that it would have some validation and be accepted among other health care professional and entities. Stanford Medicine (2016) supports my argument about having governing entities on board and also touch base on a previous argument concerning the effective use of nurse practitioners to their full scope of practice. Another barrier is that there is a lack of primary care providers within rural areas to provide the care that the patient needs.
The United States Department of Health and Human Services (2016) explains that IRBs must approve proposed non-exempt research before the involvement of human subjects may begin, therefore, we must respect the ethical considerations involved while at the same time providing holistic care.
I look forward to your responses. I am eager to have your input. I have continued to build upon my resource materials for my proposal. I think that I will more than enough information to make my argument. We will see how it turns out.
Health Self Management and Practice Change Reference
Sawyer, D., Gale, J., Lambert, D. (2009). Rural and frontier mental and behavioral health care: Barriers, effective policy strategies, best practices. Retrieved from: http://www.narmh.org/publications/archives/rural_frontier.pdf.
Stafford Medicine. (2016). Healthcare disparities and barriers to healthcare. Retrieved from: http://ruralhealth.stanford.edu/health-pros/factsheets/disparities-barriers.html.
Unites States Department of Health and Human Services. (2016). Institution review boards. Retrieved from: http://www.hhs.gov/ohrp/assurances/irb/index.html.
Include the one paragraph comments hear using a peer review article to support your comments. Also, include in-text citations in APA.
Article two
- What is the feasibility of implementing the practice change in your clinical setting?
I think this practice change is highly feasible. The research and groundwork has been done with the project and there would be minimal work for the other providers to do. Data collection can be gathered on the current EHR. There wouldn’t be a need for extra personnel or overtime work. Space is available to do group sessions at the current clinic.2. What are potential barriers to making the change? I think potential barriers include attendance and lack of provider referral. Currently, with a lack of a regular educator, we don’t refer many people because it is very difficult to get the educator to come and more than one patient to show up all at the same time. There is also the barrier of getting patients to attend because of the rural location of most patients and sometimes a lack of transportation. Potential solutions to this are to have our patients do the education at the time of their office visit and let them know their office visit will be expanded; also by recommending it as part of their treatment and pushing a little harder to have them do it will make them more likely to do it.3. Risks
Potential risks include implementing the program and unable to get attention for the program.4. Benefits are twofold. The benefit to the office includes increased income from billing. Medicare reimbursement for the first hour is 48.46-68.11 per 30 minutes; then the reimbursement rate goes to 12.05-18.43 per 30 minutes for a maximum of 9 more hours. (DNCC, 2013). If 10 patient is enrolled in the program, this averages to 3128.20-4679.60 of reimbursement for the office.
Its known that DSME can help reduce patient expenses on medications, acute complications, and chronic complications. A 1% reduction in mean A1C levels is associated with a risk reduction of 21% for death related to diabetes; 14% for MI; and 37$ for microvascular complications (Center for Health Law & Policy Information, 2015). With the evidence showing that DSME will help improve patient education and decrease A1C levels, this is a great benefit for our patients.
5. Do the time and cost justify change toward improving clinical outcomes?
One study showed an average savings of $135/month among beneficiaries that did DSME (DNCC, 2013). There will be a cost of $800.00 for AADE certification and an hourly wage of an educator although this would not be overtime for anybody that did this because of the number of hours regularly worked. In 2012, diabetes cost $245 billion with $176 billion in direct medical cost and $69 billion in indirect costs related to unemployment. Medical expenditures for diabetics is also 2.3 times higher than nondiabetics; $13,741 versus $5,853 (Center for Health Law and Policy Information, 2015). With the potential to achieve better outcomes for patients and increased revenue for the clinic, the cost and time are justified towards improving clinical outcomes.
6. Which governing entities?
There are no particular entities at this clinic. This paper and the evidence presented would be submitted to the administrator who would present it to the providers at the clinic. If they would be interested in pursuing the project, I would be able to present the project to the providers in the clinic.
References
Center for Health Law and Policy Information. (2015). Reconsidering cost-sharing for diabetes self-management education: recommendation for policy reform. Retrieved from www.diabeteseducator.org/docs/default-source/advocacy/reconsidering-cost-sharing-for-dsme-chlpi-paths-6-11-2015-(final-draf.pdf?sfvrsn=2
DNCC (2013). Diabetes Self Management Education/Training Reimbursement Toolkit. Retrieved from www.cmspulse.org/resource+center/health-topics/diabetes/documents/DSME-Toolkit.pdf
Include the one paragraph comments hear using a peer review article to support your comments. Also, include in-text citations in APA.
Health Self Management and Practice Change Sample Answer
Article 1
The writer describes the feasibility of the study and believes with the excellent teamwork at the place of work, the practical implementation process will be excellent. The writer needs to expound on the study feasibility; why is the study important, or what would happen if the practice. The potential barrier identified in the study is communication; which calls for intense research to ensure that there is a strong foundation that can help fight alleviate doubts among the stakeholders involved (Stafford Medicine, 2016). The issue of confidentiality is also highlighted. The main risk identified changes resistance among the staff and patient pulling out of the study prematurely. The benefits highlighted are mainly patient satisfaction as it will improve patient outcome. This justifies the time and costs that will be used to implement the practice. The study will need to be approved by IRB as it involves human being in order to ensure that they are not harmed (United States Department of Health and Human Services, 2016).
Health Self Management and Practice Change References
Stafford Medicine. (2016). Healthcare disparities and barriers to healthcare. Retrieved from: http://ruralhealth.stanford.edu/health-pros/factsheets/disparities-barriers.html.
Unites States Department of Health and Human Services. (2016). Institution review boards. Retrieved from: http://www.hhs.gov/ohrp/assurances/irb/index.htmlArticle 2
The article argues that the practice change is feasible, but the writer states that there has been the ground of the work that has been done already; which makes me question the relevancy of re-doing the work. The data that will be used is from Electronic Health Record; again, how will the researcher ensure that there is patient confidentiality (Centre for Health Law and Policy Information, 2015)? The main challenge highlighted by the article is lack of adequate resources (regular educator) and transportation of the patient, making it difficult to implement the practice effectively. The main limitation of risk is failing to get adequate attendance for the program. The strengths/benefit identified includes increases income. According to the writer’s argument, the time and costs justify the project as they promise improvement of the clinical outcomes by increasing the clinic revenue and simultaneously reducing the cost of care, especially among the primary acute care (DNCC, 2013).
Health Self Management and Practice Change References
Centre for Health Law and Policy Information. (2015). Reconsidering cost-sharing for diabetes self-management education: recommendation for policy reform. Retrieved from www.diabeteseducator.org/docs/default-source/advocacy/reconsidering-cost-sharing-for-dsme-chlpi-paths-6-11-2015-(final-draf.pdf?sfvrsn=2
DNCC (2013). Diabetes Self Management Education/Training Reimbursement Toolkit. Retrieved from www.cmspulse.org/resource+center/health-topics/diabetes/documents/DSME-Toolkit.pdf
