Care Coordination Presentation Paper

Care Coordination Presentation Paper

Care Coordination Presentation Paper

Care coordination refers to the method used to aid patients in making informed decisions as they make their way through the complex healthcare system (Simpson et al., 2022). This creates the opportunity to guarantee that people are well-informed, compliant, and actively involved with their health care. To deliver secure, appropriate, and effective treatment, care coordination must ensure that individuals’ desires and needs are anticipated, conveyed to the appropriate parties, and acted upon. Care coordination’s primary objective is to facilitate the provision of high-quality, high-value medical care in accordance with individual patient’s preferences and requirements (Langberg et al., 2019). This presentation aims to provide education on the care coordination process.

Care that is ethical, acceptable, and effective is provided because the patient’s requirements and preferences have been assessed, expressed, and acted upon. It takes several moving parts to make up a comprehensive care coordination program. First, there is the issue of accessibility and the individual’s capacity to seek necessary care. The next step is to assess the individual to determine the best course of treatment (Eklund et al., 2019). After that, we do diagnostics and liaise to ensure everything is well. After the data is collated, a treatment strategy is developed. Patient education is an important part of any treatment plan, which fills them in on what is happening and what needs to be done to fix it (Gutberg et al., 2022). The final step is assessing the situation to determine what went well and what could be improved. Patients, family members, and their present healthcare professionals should all be active care coordination team members to obtain optimal results.

Elements of Coordinated Care

.           Care coordination consists of four main steps: assessment, diagnosis, planning, implementation, and evaluation. First, the patient must have quick and simple access to the necessary services and professionals. Next, there must be continuity of care through open lines of communication and well-executed changes to treatment plans. Finally, each individual’s specific requirements are considered as an individual healthcare strategy is developed. As a last step, patients should be given information that is both easy to comprehend and relevant to the importance of the plan. These components might seem elementary, but they continue to be challenging, with consistency and communication constraints among healthcare professionals (Simpson et al., 2022). Cooperation between multiple parties is required for effective care coordination. The key to a successful interdisciplinary team is realizing that it requires a certain amount of planning, material resources, leadership, and cultural support in order to be productive.

Principles of Care Coordination

Each individual’s integrated care plan should be centered on their needs and goals. This calls for a substantial commitment of time and energy from everyone involved.  It is essential to facilitate individualized treatment and encourage patients to become involved in their self-management and follow-up. For collaborative care to benefit patients, they must be included in the process. A joint effort should be started to make the individual the focal point of their care to help them feel more connected to their treatment (Gutberg et al., 2022). Primary care, laboratory findings, community services, a patient’s medical history, medications, and treatments must be integrated into a cohesive and comprehensive coordinated care plan.

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Steps for Care Coordination

The objectives of the care plan are taken into account with the individual’s preferences, beliefs, and problems during care coordination. A comprehensive evaluation of the patient’s medical history and current treatment requirements is required. Individuals with chronic conditions must adhere to a consistent regimen for the foreseeable future. Effective care coordination requires mutually beneficial information exchange (Eklund et al., 2019). Preventative measures and health checkups are a part of this procedure. Afterward, we will learn about the dangers to our health and how to avoid them. When those involved are on the same wavelength, a comprehensive intervention plan may be developed to best meet the patient’s needs (Bahr & Weiss, 2019). All parties concerned should be able to easily understand and follow the strategy as it is laid out in detail. The optimal course of treatment for a client’s health maintenance can only be determined after careful, step-by-step planning allows for adjustments and revisions.

Care Coordination Based on Evidenced-Based Practice

Care coordination for chronic illnesses is impacted by more than just models, steps, components, and concepts. Limitations in regular exercise, social impediments, and other health-related issues significantly impact the effectiveness of care coordination. The care coordination process begins with an individual’s transfer to a home or another long-term care setting. Maintaining touch with the patient’s former healthcare professionals while the discharge takes effect is crucial. For patient choices, care provider values, and long-term objectives to endure, all parties involved are necessary. The care coordination group and the client must collaborate to assess potential threats, notify the individual and other relevant parties of the situation and act accordingly (Eklund et al., 2019). Maintaining care and professional engagement from all team members, including family members, is crucial to ensuring continuity of care. In other words, this result establishes a bridge between high-quality medical treatment and care provided in the community. Care coordination treatments that are both accountable and practical have been shown to reduce readmissions and healthcare costs (Bahr & Weiss, 2019). Clinical research using objective measures found that an efficient care coordination strategy improved patients’ perceptions of their care and quality of life.

Communicating Care Coordination

It is unrealistic to expect positive results from the healthcare system if patients and their caregivers are not actively involved in their treatment. All patients must believe that they had a hand in developing their treatment plan and that their opinions and ideas were taken seriously. Healthcare professionals should include patients and family members in all aspects of the care team. Care plan comprehension is enhanced when all parties involved are well informed and involved in its development (Dudley et al., 2019). Follow-up and monitoring ensure that any problems are addressed as soon as possible. The success of the treatment is everyone’s responsibility. The ability to make decisions and work together effectively during times of change is boosted. If there is a gap between care sites, research suggests that health and well-being deteriorate. In order to enhance the individual’s overall experience, enhance health outcomes, and decrease healthcare costs, it is crucial to pay attention to health risks and anticipated preventive difficulties (Simpson et al., 2022).

Patient-Centered Care Coordination

One goal of patient-centered care is to ensure that each individual’s specific needs are addressed via the collaborative efforts of a multidisciplinary care team. It is based on the individual needs of the patient and how the condition has impacted their life. In addition to setting objectives and assigning interim management, a personalized strategy provides flexibility for ongoing progress (Eklund et al., 2019). Race and ethics are considered in patient-centered care because of their direct impact on teamwork. Patient-centered care that spans the whole continuum requires a community-based network of services.

The quality of life for both the patient and their loved ones may be improved with a well-coordinated care plan that focuses on the needs of the individual. Involvement from the individual and their loved ones is essential for the effectiveness of any treatment plan, so it is important to listen carefully, use language that is easily understood, employ techniques that give patients a sense of control, welcome questions, and keep encouraging patients to take an active role in their care. Patient-centered care plans often emphasize using outreach programs and support services (Langberg et al., 2019). To better coordinate care at every stage and assist in minimizing inadequacies in the plan of care, constant contact between all disciplines is vital and may be readily accomplished via electronic technologies.

Affordable Healthcare Policies

Providers’ awareness of their obligations in patient care is crucial to the success of healthcare policy. Organizations must have a unified vision of the healthcare results they want (Simpson et al., 2022). Establishing transparent norms is crucial for providing adequate care. The available data suggests that the existing policies affect healthcare by raising the bar for the quality of treatment provided, setting reasonable improvement timelines, and keeping costs low for people of varying financial means. As our team’s capacity for collaborative, patient-centered care grows, we can better promote positive health outcomes for the patients. It has also been a problem that there are more obstacles to connections to specialists and other help. The rules and principles of the Affordable Care Act (ACA) have increased the quality and quantity of treatment by making these resources more accessible to all patients (Michener, 2020).

Nurses’ role

When patient-centered, team-based, coordinated care becomes the norm, nurses’ responsibilities naturally broaden to meet the needs of their patients. Nurses contribute to healthcare reform by delivering coordinated, patient-centered services throughout a continuum of care. They can effectively advocate for their client’s health and welfare if they have a deeper understanding of and ability to implement the improvements in treatment. The nursing profession must significantly lower healthcare costs without compromising patient outcomes, quality, or satisfaction. Nurses can achieve this goal by delivering competent, risk-free care (Bahr & Weiss, 2019). Developing a learning environment focused on the needs of individual patients to provide high-quality, accessible, and timely medical treatment in an open and fair setting.

Conclusion

Coordinated care across providers is crucial to maintaining a high quality of life for patients. The quality of life for both the patient and their loved ones may be improved with a well-coordinated care plan that focuses on the needs of the individual. Healthcare professionals should include patients and family members in all aspects of the care team. Cooperation between multiple parties is required for effective care coordination. Good communication is essential to ensure effective coordination of care. Nurses contribute to healthcare reform by delivering coordinated, patient-centered services throughout a continuum of care.

References

Bahr, S. J., & Weiss, M. E. (2019). Clarifying model for continuity of care: A concept analysis. International Journal of Nursing Practice, 25(2), e12704. https://doi.org/10.1111/ijn.12704

Dudley, N., Ritchie, C. S., Rehm, R. S., Chapman, S. A., & Wallhagen, M. I. (2019). Facilitators and barriers to interdisciplinary communication between providers in primary care and palliative care. Journal of Palliative Medicine, 22(3), 243-249. https://doi.org/10.1089/jpm.2018.0231

Eklund, J., Holmström, I. K., Kumlin, T., Kaminsky, E., Skoglund, K., Höglander, J., & Summer Merenius, M. (2019). Same or different? A review of reviews of person-centered and patient-centered care. Patient Education and Counseling, (1), 3-11. https://doi.org/10.1016/j.pec.2018.08.029

Gutberg, J., Evans, J. M., Khan, S., Abdelhalim, R., Wodchis, W. P., & Grudniewicz, A. (2022). Implementing coordinated care networks: The interplay of individual and distributed leadership practices. Medical Care Research and Review, 79(5), 650-662. https://doi.org/10.1177/10775587211064671

Langberg, E. M., Dyhr, L., & Davidsen, A. S. (2019). Development of the concept of patient-centeredness–A systematic review. Patient Education and Counseling, 102(7), 1228-1236. https://doi.org/10.1016/j.pec.2019.02.023

Michener, J. (2020). Race, politics, and the affordable care act. Journal of Health Politics, Policy and Law, 45(4), 547-566. https://doi.org/10.1215/03616878-8255481

Simpson, K., Nham, W., Thariath, J., Schafer, H., Greenwood-Eriksen, M., Fetters, M. D., & Abir, M. (2022). How health systems facilitate patient-centered care and care coordination: A case series analysis to identify best practices. BMC Health Services Research, 22(1), 1-17. https://doi.org/10.1186/s12913-022-08623-w

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Care Coordination Presentation to Colleagues

Professional Context

Nurses have a powerful role in the coordination and continuum of care. All nurses must be cognizant of the care coordination process and how safety, ethics, policy, physiological, and cultural needs affect care and patient outcomes. As a nurse, care coordination is something that should always be considered. Nurses must be aware of factors that impact care coordination and of a continuum of care that utilizes community resources effectively and is part of an ethical framework that represents the professionalism of nurses. Understanding policy elements helps nurses coordinate care effectively.

This assignment provides an opportunity for you to educate your peers on the care coordination process.

By successfully completing this assignment, you will demonstrate your proficiency in the following course competencies and assignment criteria:

Competency 2: Collaborate with patients and family to achieve desired outcomes.

Outline effective strategies for collaborating with patients and their families to achieve desired health outcomes.

Competency 3: Create a satisfying patient experience.

Identify the aspects of change management that directly affect elements of the patient experience essential to the provision of high-quality, patient-centered care.

Competency 4: Defend decisions based on the code of ethics for nursing.

Explain the rationale for coordinated care plans based on ethical decision making.

Competency 5: Explain how health care policies affect patient-centered care.

Identify the potential impact of specific health care policy provisions on outcomes and patient experiences.

Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.

Raise awareness of the nurse’s vital role in the coordination and continuum of care in a video-recorded presentation.

Scenario

Your nurse manager has been observing your effectiveness as a care coordinator and recognizes the importance of educating other staff nurses in care coordination. Consequently, she has asked you to develop a presentation for your colleagues on care coordination basics. By providing them with basic information about the care coordination process, you will assist them in taking on an expanded role in helping to manage the care coordination process and improve patient outcomes in your community care center.

Instructions

Complete the following:

Develop a video presentation for nursing colleagues highlighting the fundamental principles of care coordination. Include community resources, ethical issues, and policy issues that affect the coordination of care. To prepare, develop a detailed narrative script. The script will be submitted along with the video. THIS IS WHAT I NEED YOU TO WRITE. THE SCRIPT

Note: You are not required to deliver your presentation live to your employer or organization. You do need to create a presentation for this assignment.

Presentation Format and Length

The video-based presentation should be no more than 20-minutes in length. You can record your presentation using Kaltura (recommended) or similar software.

Create a detailed narrative script for your video presentation, approximately 4–5 pages in length. Include a reference list at the end of the script.

Supporting Evidence

Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your presentation. Include your source citations on a references page appended to your narrative script. Explore the resources about effective presentations as you prepare this assignment.

Presentation Requirements

The requirements outlined below correspond to the grading criteria in the Care Coordination Presentation to Colleagues Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

Outline effective strategies for collaborating with patients and their families to achieve desired health outcomes.

For example, drug-specific educational interventions and cultural competence strategies.

What evidence do you have to support your selected strategies?

Identify the aspects of change management that directly affect elements of the patient experience essential to the provision of high-quality, patient-centered care.

Explain the rationale for coordinated care plans based on ethical decision making.

Consider the reasonable implications and consequences of an ethical approach to care and any underlying assumptions that may influence decision making.

Identify the potential impact of specific health care policy provisions on outcomes and patient experiences.

What are the logical implications and consequences of relevant policy provisions?

What evidence do you have to support your conclusions?

Raise awareness of the nurse’s vital role in the coordination and continuum of care in a video-recorded presentation.

Fine-tune the presentation to your audience.

Stay focused on key issues of import with respect to the effects of resources, ethics, and policy on the provision of high-quality, patient-centered care.

Adhere to presentation best practices.

Additional Requirements

Before submitting your assignment, proofread your script to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your video presentation.

Submit both your presentation video and script. The script should include a reference page. See Using Kaltura for more information about uploading multimedia files. You may submit the assignment only once, so be sure that both assignment deliverables are included.