Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations Paper

Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations Paper

Healthcare professionals are responsible for developing collaborative care plans to enhance care quality and improve care outcomes. Equally, healthcare organizations have an overarching obligation to align institutional infrastructure and culture to support the tenets of collaborative care approaches. According to Wei et al. (2018), embracing interprofessional collaboration among healthcare professionals is a profound aspect of creating care models that enhance care efficiency, effectiveness, safety, and quality. Elements that enshrine interprofessional collaborative practice (IPCP) are proper leadership, effective communication, and policy considerations. This paper defines a patient, family, or population health problem, analyzes evidence from peer-reviewed literature that guides nursing interventions for the identified problem and explains how state board of nursing practice or organizational/government policies could affect the problem. Finally, it proposes leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the clinical problem.

Defining a Patient, Family, or Population Problem Relevant to Personal and Professional Practice

JJ (patient initials), a 52-year-old African American, reported to the hospital’s emergency department with chief complaints of irregular heartbeat, confusion, vomiting, nausea, anxiety, chest pain, and muscle tremors. The patient had a 20-year history of cigarette smoking and accepted inappropriate measures for managing stress. For instance, he admitted engaging in alcoholism and food as ways of coping with stress and anxiety. Due to unhealthy habits, the patient was 28 lbs past the recommended body mass index (BMI), rendering him obese. Based on the patient’s reported symptoms, healthcare professionals conducted a series of tests to ascertain the underlying conditions. These tests included blood and urine tests to check cholesterol and blood sugar levels and electrocardiograms to measure the heart’s electrical activity. Further, healthcare professionals conducted an echocardiogram, a non-invasive exam that leverages soundwaves to create comprehensive images of the heart’s rhythm, as well as blood circulation through the heart and heart valves (Mayo Clinic, 2022). After conducting these examinations, physicians confirmed that the patient suffered from hypertension and increased susceptibility to stroke.

Hypertension is a significant health concern due to its association with adverse health outcomes and consequences. According to the Centers for Disease Control and Prevention [CDC] (2022), high blood pressure can damage the heart and is the primary risk factor for heart disease and stroke. In the current healthcare systems, heart disease and stroke are the leading causes of mortalities, increased care costs, disability-adjusted life years (DALYs), prolonged hospitalization, and compromising quality of care. In the United States, hypertension-related complications and conditions result in premature deaths and a massive economic burden. The Centers for Disease Control and Prevention [CDC] (2022) contends that approximately 670000 people died in 2020 due to hypertension-related complications like heart disease and stroke. In the same vein, the country endures a burden of about $131 billion annually that emanates from high blood pressure prevention, treatment, and management.

Although hypertension is a public health concern, its prevalence, incidences, and burden are disproportionate and dependent on social determinants of health (SDOH). Muntner et al. (2017) contend that African Americans are more susceptible to hypertension due to their propensity to various risk factors and poor social determinants of health. In this sense, this population section encounters low socioeconomic status, discrimination, stress, and lime access to healthy foods. In comparison to other ethnic groups, hypertension is more common among African Americans (56%) than white adults (48%) and Asian adults (46%) (Centers for Disease Control and Prevention, 2022). It is essential to note that non-Hispanic black adults are more likely to engage in poor stress management practices, such as cigarette smoking and alcoholism. These considerations increase the population’s vulnerability to high blood pressure, stroke, and heart disease.

Significance of the patient’s problem

JJ’s case scenario confirms how people’s poor lifestyle choices can increase their susceptibility to chronic conditions, including high blood pressure, stroke, and heart disease. From the patient’s case study, it is possible to ascertain the role of alcoholism, cigarette smoking, and poor stress management practices can increase the risk of high blood pressure. Finally, the scenario underscored the rationale for developing a collaborative care plan for restoring patient health and wellness.

Analyzing Evidence from Peer-reviewed Literature and Professional Sources that Describe and Guide Nursing Actions Related to the Problem

The current scholarly literature confirms all factors identified when caring for JJ. According to the World Health Organization [WHO] (2021), unhealthy diets, physical inactivity, being overweight and obese, alcoholism, and tobacco use are the primary risk factors for hypertension. Equally, age, race, and a family medical history are non-modifiable factors for high blood pressure (Modey Amoah et al., 2020). The modified risk factors for hypertension provide opportunities for preventing, treating, and managing hypertension. According to Modey Amoah et al. (2020), initiation and adherence to pharmacological interventions emerge as profound strategies for treating and managing high blood pressure. Examples of proven medications for alleviating the symptoms of hypertension are angiotensin II receptor blockers (ARBs), calcium channel blockers, and angiotensin-converting enzyme inhibitors. Further, Mayo Clinic (2022) recommends alternative medications, including fiber and mineral supplements, Omega-3 fatty acids, and folic acid. Healthcare professionals should assist patients to comply with medication schedules to manage hypertension symptoms effectively.

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Although pharmacological interventions can alleviate hypertension symptoms, non-pharmacologic strategies are more effective in preventing, treating, and managing the condition because they focus on modifying the modifiable risk factors. According to the World Health Organization [WHO] (2021), preventive interventions for hypertension include improving people’s access to healthy foods, reducing alcohol consumption, providing opportunities for physical exercise, and early screening. Equally, it is possible to manage high blood pressure by embracing effective interventions for stress management, regular checks for blood pressure, creating public awareness of self-management approaches, and managing other associated medical conditions like diabetes, kidney disease, and stroke (World Health Organization, 2021). Preventative and management actions require healthcare professionals to develop collaborative and team-based action plans. According to Santschi et al. (2021), team-based care (TBC) entails collaborative relationships and partnerships between healthcare stakeholders to ensure coordinated activities and optimize patient-centered care. Healthcare professionals should involve patients in care plans through effective communication, care coordination, and regular follow-ups to ensure adherence to pharmacological and non-pharmacologic interventions.

How State Board of Nursing Practice Standards and Organizational/Government Policies Could Affect Hypertension

Provision 6 of the American Nurses Association (ANA) Code of ethics requires healthcare professionals to participate in individual and collective efforts and establish, maintain, and improve the ethical environment of the work setting to provide safe and quality care. Also, provision 8 proposes interdisciplinary collaboration to protect human rights, reduce healthcare disparities, and promote healthy diplomacy (Haddad & Geiger, 2022). These ethical obligations align governmental and organizational policies for preventing, treating, and managing chronic conditions, including hypertension. According to Chait & Glied (2018), the Affordable Care Act (ACA) of 2010 is a landmark federal policy that influences preventive interventions and access to care. The researchers contend that ACA increases clinical coverage through Medicaid expansion, incentivizes performance and wellness programs, and expands public health capacity. In the context of preventing and managing chronic conditions like hypertension, the Affordable Care Act established the Medicaid Incentives for Prevention of Chronic Diseases (MIPCD) in 2011.

The MIPCD provides incentives for behavioral modification programs and is profound in promoting preventative care. Witman et al. (2018) argue that the Medicaid Incentives for Prevention of Chronic Disease supports targeted initiatives like smoking cessation counseling, quit attempts, and smoking cessation. These approaches are consistent with the overarching objective of addressing modifiable risk factors for hypertension and are effective in improving population health and wellness.

Proposed Leadership Strategies to Improve Outcomes, Patient-Centered Care, and Patient Experience Related to Hypertension

Organizational leadership is a profound determinant of patient-centered care and the culture of excellence in nursing. According to Sfantou et al. (2017), leadership entails the relationships between leaders and followers that determine institutional behaviors, activities, and shared norms. When providing patient-centered care to clients with hypertension, it is essential to consider elements of transformative leadership that enhance interprofessional collaboration, employee empowerment, participative care interventions, and ideal organizational culture. These aspects include the ability to inspire confidence, staff respect, effective communication, motivational inspiration, and intellectual stimulation (Sfantou et al., 2017). Further, leaders should encourage creativity, establish feedback loops, and cultivate an institutional culture that supports quality improvement initiatives.

Conclusion

Hypertension is a primary risk factor for heart disease and stroke, which remain the leading causes of death globally. Equally, hypertension-related complications inflict massive economic burdens on healthcare systems and perpetuate other adverse effects, including increasing care costs and leading to disability-adjusted life years (DALYs). Healthcare professionals play a forefront role in promoting early screening and spearheading other preventive and management actions for hypertension. However, their roles and responsibilities in preventing, treating, and managing high blood pressure rely massively upon organizational and governmental policies, including scopes of practice and federal health regulations, including the Affordable Care Act (ACA) of 2010.

References

Centers for Disease Control and Prevention. (2022). Facts about hypertension. https://www.cdc.gov/bloodpressure/facts.htm#

Chait, N., & Glied, S. (2018). Promoting prevention under the Affordable Care Act. Annual Review of Public Health, 39(1), 507–524. https://doi.org/10.1146/annurev-publhealth-040617-013534

Haddad, L. M., & Geiger, R. A. (2022, August 22). Nursing ethical considerations. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK526054/

Mayo Clinic. (2022). High blood pressure (hypertension) – Diagnosis and treatment. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/diagnosis-treatment/drc-20373417

Modey Amoah, E., Esinam Okai, D., Manu, A., Laar, A., Akamah, J., & Torpey, K. (2020). The role of lifestyle factors in controlling blood pressure among hypertensive patients in two health facilities in urban Ghana: A cross-sectional study. International Journal of Hypertension, 2020, 1–8. https://doi.org/10.1155/2020/9379128

Muntner, P., Abdalla, M., Correa, A., Griswold, M., Hall, J. E., Jones, D. W., Mensah, G. A., Sims, M., Shimbo, D., Spruill, T. M., Tucker, K. L., & Appel, L. J. (2017). Hypertension in blacks. Hypertension, 69(5), 761–769. https://doi.org/10.1161/hypertensionaha.117.09061

Santschi, V., Wuerzner, G., Pais, B., Chiolero, A., Schaller, P., Cloutier, L., Paradis, G., & Burnier, M. (2021). Team-Based care for improving hypertension management: A pragmatic randomized controlled trial. Frontiers in Cardiovascular Medicine, 8. https://doi.org/10.3389/fcvm.2021.760662

Sfantou, D., Laliotis, A., Patelarou, A., Sifaki- Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of leadership style towards the quality of care measures in healthcare settings: A systematic review. Healthcare, 5(4), 73. NCBI. https://doi.org/10.3390/healthcare5040073

Wei, H., Corbett, R. W., Ray, J., & Wei, T. L. (2019). A culture of caring: The essence of healthcare interprofessional collaboration. Journal of Interprofessional Care, 34(3), 1–8. https://doi.org/10.1080/13561820.2019.1641476

Witman, A., Acquah, J., Alva, M., Hoerger, T., & Romaire, M. (2018). Medicaid incentives for preventing chronic disease: Effects of financial incentives for smoking cessation. Health Services Research, 53(6), 5016–5034. https://doi.org/10.1111/1475-6773.12994

World Health Organization. (2021). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension#

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In a 5-7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective. Plan to spend approximately 2 direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Introduction

Nurses in all professional roles work to effect positive patient outcomes and improve organizational processes. Professional nurses are leaders in problem identification, planning, and strategy implementation—skills that directly affect patient care or organizational effectiveness.

Too often, change agents jump to a conclusion that an intervention will promote the envisioned improvement. Instead, the ideal approach is to determine which interventions are appropriate, based on an assessment and review of credible evidence. Interventions could be patient-facing or involve a change in policy and process. In this assessment, you’ll identify and make the case for your practicum focus area, then explore it in depth from a leadership, collaboration, communication, change management, and policy perspective.

This assessment lays the foundation for the work that will carry you through your capstone experience and guide the practicum hours needed to complete the work in this course. In addition, it will enable you to do the following:

Develop a problem statement for a patient, family, or population that’s relevant to your practice.
Begin building a body of evidence that will inform your approach to your practicum.
Focus on the influence of leadership, collaboration, communication, change management, and policy on the problem.
Preparation

In this assessment, you’ll assess the patient, family, or population health problem that will be the focus of your capstone project. Plan to spend approximately 2 hours working with a patient, family, or group of your choice to explore the problem from a leadership, collaboration, communication, change management, and policy perspective. During this time, you may also choose to consult with subject matter and industry experts about the problem (for example, directors of quality or patient safety, nurse managers/directors, physicians, and epidemiologists).

To prepare for the assessment, complete the following:

Identify the patient, family, or group you want to work with during your practicum The patient you select can be a friend or a family member. You’ll work with this patient, family, or group throughout your capstone project, focusing on a specific health care problem.
Begin surveying the scholarly and professional literature to establish your evidence and research base, inform your assessment, and meet scholarly expectations for supporting evidence.
In addition, you may wish to complete the following:

Review the assessment instructions and scoring guide to ensure that you understand the work you’ll be asked to complete and how it will be assessed.
Review the Practicum Focus Sheet: Assessment 1 [PDF], which provides guidance for conducting this portion of your practicum.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

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Instructions

Complete this assessment in two parts.

Part 1
Define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective and establish your evidence and research base to plan, implement, and share findings related to your project.

Part 2
Connect with the patient, family, or group you’ll work with during your practicum. During this portion of your practicum, plan to spend at least 2 hours meeting with the patient, family, or group and, if desired, consulting with subject matter and industry experts of your choice. The hours you spend meeting with them should take place outside of regular work hours. Use the Practicum Focus Sheet [PDF] provided for this assessment to guide your work and interpersonal interactions. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Capella Academic Portal

Complete the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal. Include a description of your relationship to the patient, family, or group in the Volunteer Experience comments field.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

Define a patient, family, or population health problem that’s relevant to your practice.
Summarize the problem you’ll explore.
Identify the patient, family, or group you intend to work with during your practicum.
Provide context, data, or information that substantiates the presence of the problem and its significance and relevance to the patient, family, or population.
Explain why this problem is relevant to your practice as a baccalaureate-prepared nurse.
Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to the patient, family, or population problem you’ve defined.
Note whether the authors provide supporting evidence from the literature that’s consistent with what you see in your nursing practice.
Explain how you would know if the data are unreliable.
Describe what the literature says about barriers to the implementation of evidence-based practice in addressing the problem you’ve defined.
Describe research that has tested the effectiveness of nursing standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe what the literature says about a nursing theory or conceptual framework that might frame and guide your actions during your practicum.
Explain how state board nursing practice standards and/or organizational or governmental policies could affect the patient, family, or population problem you’ve defined.
Describe research that has tested the effectiveness of these standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of this problem.
Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the patient, family, or population problem you’ve defined.
Discuss research on the effectiveness of leadership strategies.
Define the role that you anticipate leadership must play in addressing the problem.
Describe collaboration and communication strategies that you anticipate will be needed to address the problem.
Describe the change management strategies that you anticipate will be required to address the problem.
Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Organize content so ideas flow logically with smooth transitions.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
Define a patient, family, or population health problem that’s relevant to personal and professional practice.
Competency 2: Make clinical and operational decisions based upon the best available evidence.
Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to a defined patient, family, or population problem.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how state board nursing practice standards and/or organizational or governmental policies could affect a defined patient, family, or population problem.
Competency 7: Implement patient-centered care to improve quality of care and the patient experience.
Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to a defined patient, family, or population problem and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Competency 8: Integrate professional standards and values into practice.
Organize content so ideas flow logically with smooth transitions.
Apply APA style and formatting to scholarly writing.