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Question description<\/strong><\/p>\n

Design Proposal<\/p>\n

Student\u2019s name<\/p>\n

Professor\u2019s Name<\/p>\n

Course<\/p>\n

Date<\/p>\n

Design Proposal<\/p>\n

Introduction<\/strong><\/p>\n

The issue that is of concern, in this case, is the fact that hospital readmission rates for the same diagnosis within 60 days have been high. The issue has been narrowed down to the hospital discharge system, and the proposed changes are thus targeted towards ensuring an efficient patient discharge approach (Hall, Chang, & O’Grady, 2016). The current hospital system of letting patients out is the traditional approach in which they are given instructions sheets, and general advice on how to manage their conditions at home. However, the weakness with this model is that the patients, in this case, the children with respiratory illnesses, find it hard to adhere, and interpret the instructions given to them (Felix, Seaberg, Bursac, Thostenson, & Stewart, 2016). For this specific scenario, it is the parents that are at a loss on how to implement the instructions given. Some of them do not take the time to completely read them, while others lose them since they see the medication as more important than the procedures for caring for the sick at home. The proposed change is to use the case assigned discharge model for helping the parents manage their children\u2019s conditions at home (Hall, Chang, & O’Grady, 2016). In this model, during discharge, a physician is assigned to the patient, and required to aid them through the recovery process at home. This change would call for elaborate plans that help in educating the patients, and create a rapport between these patients, and assigned physicians.<\/p>\n

Change Model Overview<\/strong><\/p>\n

The change model, in this case, is aimed at reducing the readmission rates of children to the facility for the same diagnosis within the specified period of sixty days with regards to respiratory illnesses. This change is necessary because it would help reduce the cost of medication for the parents, clear the doctor\u2019s schedules so that they can attend to more patients, and spare the children the pain of having a delayed recovery. To implement the proposed design would require utilization of an evidence-based procedure, in this case, it is the ACE Star model. In this approach, there are five steps that are adhered to to ensure a streamlined process of knowledge discovery, and integration (Kumar, 2015). The stages, or tenets of the model are; the discovery of knowledge, summary of evidence, recommendations for implementation, the actual implementation, and finally, the evaluation (Kumar, 2015). This is a participatory process that would include several stakeholders such as donors, the hospital management, patents (parents with affected children), experts in the field, and the staff of the hospital (Vincent, Renz, Dopson, & Parand, 2014). This is important as it would ensure that the decision, and process arrived at in consisted with the mission of the hospital, and agreeable with the recipients (Lumbasi, K\u2019Aol, & Ouma, 2016). Nurses should use this model as a guide to facilitate change through underrating the necessary education of the patients, and availing themselves in case a discharged individual requires an assigned physician<\/p>\n

Photo:\u00a0The ACE Star model<\/i>: source\u00a0http:\/\/www.aahs.org\/aamcnursing\/wp-content\/uploads\/ACE-Star-Model-of-Knowledge-Transformation.jpg<\/a>. Retrieved 26th<\/sup>\u00a0January 2018.<\/p>\n

Evidence<\/strong><\/p>\n

The evidence that supports the need for this change in design of the hospital discharge system stems from the fact that within the last 60days, over 60% of the patients have returned for the same diagnosis with the same conditions. This is an issue that must be addressed since it is the hospital\u2019s ethical responsibility to society to ensure that a patient is helped to fully recover after having sought services from the facility. The evidence-based solutions that are highlighted in the evidence summary sheet would be sufficient in addressing this issue. The prominent ones are the education of the patients before they leave the facility, and the assigning each patient a physician who would help them handle the home care aspects of the condition. Since it is clear that the mothers with children who have respiratory illnesses are not doctors, or nurses, it would be inappropriate to leave them to deal with their health issue at home. It is, therefore, necessary to allow for a follow-up program that would save the facility potential negative reputation arising from the fact that it is deemed unable to effectively treat respiratory illnesses in children.<\/p>\n

Translation<\/strong><\/p>\n

The activities that are necessary to effect the suggested options are outlined in this section. The primary consideration, in this case, is the fact that manpower, and finances must be put in place to facilitate the program. Since it is a new program that is being introduced, training for the nurses, and practitioners is necessary. This is due to the fact that treating a patient physically, and remotely are different things, thus, a nurse must be able to tell when to advice, and when not to do so remotely. A brief training workshop is necessary, it does not have to take staff from their duties, since this is something in line with their profession, they can learn on the job as well (Lagace, 2009). The second aspect of this program is to provide the patients with education on how to manage the communication with the hospital. There must be clear schedules, and communication channels. In this case, phoning the patients, and doctors would be the primary means of communication since it often gets the recipients attention quickly. The hospital must invest in new devices for purposes of this communication such as cellphones customized for the hospital. In addition, during the admission period, the mothers of the children would be educated on how to take care of the children. This is a duty that would be undertaken by the nurses. The funding for this initiative would be obtained from donors, and well-wishers. Since it would be a recurring expense on the hospitals budget, it must be allocated a certain quota that would be guaranteed every year, or semiannually. Finally, to effectively translate this plan into action, the hospital policy must be amended in a manner that explicitly includes the terms, and conditions of the said service. This helps align it with organization goals. In fact, the information gathered is transformed into actionable plans via the aforementioned activities, and entrenching it into the policy manual of the institution. These changes would take approximately 6 months to be fully actualized, and funded. However, this may vary with the organization\u2019s budget, and funding schedules. The expected outcome is the significant decline in the number of patients returning for the same diagnosis. The projected decline is over 90% of the original figures over the 60-day period that the study was conducted in. The effective way of communicating the plan to staff members is through a participatory forum such as group discussion. In fact, the entire solution proposed is based on participatory planning, and action.<\/p>\n

Current Discharge System<\/p>\n\n\n\n\n
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Proposed Model<\/p>\n

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Translation<\/p>\n\n\n\n\n
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Process evolution<\/p>\n

And participatory planning and action<\/p>\n

Conclusion<\/strong><\/p>\n

In conclusion, it is important to actively minimize the rate of readmissions for the same diagnosis in the hospital. This helps in building a positive reputation, and avoids cases of dissatisfied clients. The change plan, in this case, aims to eradicate the readmission instances on the same diagnosis of children with respiratory illnesses. The five stages of the ACE Star change model are invaluable for translating the planned knowledge into actions. First, the knowledge was acquired through research and situation analysis at the hospital. Then the evidence is gathered regarding readmission rates and solutions sought to mitigate the problems. Guidelines are formulated to actualize the solutions and the actual translation into the institution is undertaken. Afterwards, an evaluation is performed to determine effectiveness and applicability of solutions. The basis for the plan is participatory action, and implementation. The staff, and patients have to be educated on how the program would run, and the management must be in league with these activities so that they can effectively support the program. Such support may be in the form of funds allocation, and research, and development. In fact, the participatory approach goes a long way in ensuring the sustenance of the program, and its improvement. If patients can communicate with the staff effectively, and management listens to recommendations, and implements them, then the program would be self-evolving, and can be highly customized to an institution. For financial sustainability, patients can be asked to chip in voluntarily, or as part of the home care programs associated with the specific illness that they suffer from.<\/p>\n

References<\/strong><\/h1>\n

Felix, H. C., Seaberg, B., Bursac, Z., Thostenson, J., & Stewart, M. K. (2016, January 29). Why do patients keep coming back? Results of a Readmitted Patient Survey.\u00a0Soc Work Health Care, 54<\/i>(1), 1\u201315. doi:10.1080\/00981389.2014.966881<\/p>\n

Hall, K. K., Chang, A. B., & O’Grady, K.F. (2016). Discharge plans to prevent hospital<\/p>\n

readmission for acute exacerbations in children with chronic respiratory illness (Protocol).\u00a0Cochrane Database of Systematic Reviews<\/i>, Issue 8. Art. No.: CD012315. DOI: 10.1002\/14651858.CD012315<\/p>\n

Kumar, Y. (2015, July 13). Evidence-Based Quality Improvement: A Knowledge Transformation in Nursing Care.\u00a0International Journal of Health Sciences and Research, 5<\/i>(8), 522-524. Retrieved from\u00a0http:\/\/www.ijhsr.org\/IJHSR_Vol.5_Issue.8_Aug2015\/7…<\/a><\/p>\n

Lagace, M. (2009, November 23).\u00a0Management\u2019s Role in Reforming Health Care<\/i>. Retrieved from Harvard Business School:\u00a0https:\/\/hbswk.hbs.edu\/item\/managements-role-in-ref…<\/a><\/p>\n

Lumbasi, G. W., K\u2019Aol, G. O., & Ouma, C. A. (2016, July). The Effect Of Participative Leadership Style On The Performance Of COYA Senior Managers In Kenya.\u00a0Researchjournali\u2019s Journal of Management, 4<\/i>(5), 1-12.<\/p>\n

Vincent, C., Renz, A., Dopson, S., & Parand, A. (2014, September). The role of hospital managers in quality and patient safety: a systematic review.\u00a0BMJ Open<\/i>. doi:http:\/\/dx.doi.org\/10.1136\/bmjopen-2014-005055<\/p>\n

Week 6: Capstone Project: Milestone 3: Educating Staff (graded)<\/h1>\n

Submit Assignment<\/a><\/p>\n