NHS-FPX6004 Assessment 2: Policy Proposal Essay

 NHS-FPX6004 Assessment 2: Policy Proposal Essay

 Policy Proposal

Organizational assessments aim to promote continuous improvement, which requires organizations to develop new healthcare interventions, p[olices, and practice guidelines or update existing ones. Healthcare practices can become obsolete with time hence the need for continuous improvement. Change improvement events are also informed by data generated in the care delivery processes. Healthcare dashboards are vital data sources that help institutions determine shortfalls in their performance, hence the need for improved interventions. Dashboards p[resnet real-time data that allow organizations to measure their performance and evaluate it based on local, state, and national benchmarks used to inform improvement. This essay presents information on underperforming benchmarks from a healthcare dashboard and proposes an evidence-based intervention to manage the underperformance.

Proposed Organizational Policy and Practice Guidelines

The hbA1c test is the underperforming benchmark, with a  hospital turn-up rate of 24% compared to the nationally set benchmark of 79.5% by the Agency for Healthcare Research and Quality (AHRQ, 2021). The low benchmark means that only a few diabetes patients understand the importance and process of diabetes follow-up or only a few take follow-up interventions seriously, especially the HbA1c tests. The other benchmarks are also underperforming, meaning there is a genuine need for improvement in diabetes follow-up interventions. Low HbA1c test turn-up affects patient care provision. It denies the care providers a chance to monitor patient outcomes and the effectiveness of care interventions and represents missed opportunities in detecting care complications.

Failure to address the shortfall will lead to poor patient outcomes, with the development of complications in most patients. Klein and Buse (2020) state that HbA1c tests are reliable and primary predictors of diabetes complications; hence their absence leads to missed opportunities in early complication diagnosis and management. Diabetes causes high healthcare costs, and failure to address the issue will lead to more complications and increased healthcare costs. Andersson et al. (2020) note that diabetes complications impose high costs on organizations and patients, decrease productivity and increase morbidity and mortality. Organizations with poor patient outcomes also develop bad reputations hence the need to address the problem. Diabetes self-management education and support (DSMES) to replace routine diabetes education is the proposed policy and practice guideline change.

Potential Effects of Environmental Factors on Recommended Practice Guidelines

The DSME services at any facility must meet the prescribed standards by the 2022 National Standards for Diabetes Self-Managemnt Education and Support. The recommendations are a set of ten comprehensive standards that DSMES services must meet to be recognized or accredited by the responsible bodies (Davis et al., 2022). The components include a well defines internal structure, stakeholder support, population evaluation, quality coordination overseeing the services, a well-defined DSME team, curriculum, individualization, and ongoing support (Davis et a., 2022). DSMES should be systematic and organized, and these standards will meet and ensure the DSME system meets the demands. These regulatory requirements can impede the implementation of the intervention due to their complex demands for optimum healthcare services delivery. However, they will also facilitate the intervention to ensure it delivers quality and meets its intended purposes. Various environmental factors could affect the proposed change. The current nurse staffing shortage can negatively affect the institution’s ability to implement the interventions. Winter et al. (2020) note that staff shortage affects the quality of care and leads to poor patient outcomes, including poor patient satisfaction. Nurses are the primary implementers of the proposed changes; thus, their shortage can negatively affect change implementation.

Ethical, Evidence-Based Practice Guidelines to Improve Targetted Benchmarks

DSMES, the proposed policy and guidelines change, is an improved educational intervention that entails patient education in the various areas of diabetes care and integrates education and support, which includes patient follow-up. The intervention targets to improve patient self-efficacy and support them in achieving their desired outcomes (Davis et al., 2022). The components of DSMES include diabetes, types and differences, and preventing and detecting acute and chronic complications. The interventions include exercise, diet, and lifestyle modifications necessary to enhance diabetes control interventions. Other components include diabetes follow-up and increased access to management resources. Emawati et al. (2019) show that DSME imprOves patient clinical outcomes such as HbA1c tests, follow-up adherence, and patient quality of life and satisfaction scores, hence its significance

Another strategy is staff education. Staff education increases their vigilance in care delivery and helps them emphasize diabetes patient health monitoring and follow-up (Lawler et al., 2019). Educating staff increases their confidence in care delivery and directly affects their quality of care. Extensive staff education ensures they are competent to work with individuals from diverse cultures and helps them develop care interventions that meet the health needs of all populations. Staff education also helps implement complex strategies such as DSMES and healthcare technologies hence efficiency in care delivery. It also ensures equity through quality and safe care delivery to all patients, hence quality outcomes and patient satisfaction (Lawler et al., 2019).

The last strategy from the literature is patient follow-up programs. Patient follow-up programs are designed to enhance patient healthcare delivery through calls and other reminders such as emails and automated call systems. The patient’s details are fed into the hospital database, and healthcare providers access data and call patients to remind them of their medications, dosages, frequencies, and appointments and monitor their progress (AHRQ, n.d.). In addition, the follow-up programs incorporate ready patients and use communication channels that the patient consents to. The programs consider patient preferences and ensure patients receive the services they need most. Follow-up programs ensure patients feel valued and reduce room for missed follow-up appointments and other care interventions (AHRQ, n.d.).

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Importance of Stakeholders and Stakeholder Groups

The nurse manager, charge nurse diabetes unit, nurses, executive leadership, and patient groups will be integral stakeholders in this project. The nurse manager is the nurse responsible for all nursing activities in the facility hence her involvement. Her participation will help improve and advocate for the program as an executive leadership team member by presenting and supporting the idea in executive meetings. The nurses are the implementors of the intervention, and they provide vital perspectives, including their perception of the program vital to its improvement and implementation. Concannon et al. (2019) note that stakeholder involvement will minimize change resistance and promote quality outcomes. Patients are vital stakeholders in the project as the recipients of care. Their participation in activities like pilot tests will enhance care outcomes assessment and program improvement. The charge nurse in the diabetes outpatient unit will be vital for the leader of the implementation team. She has a vast knowledge of diabetes management and DSME and will thus provide critical information on the design and other interventions hence her inclusion. These stakeholders and stakeholder groups are vital to the success of the proposed intervention. Thus, their participation will lead to a stronger policy and facilitate successful change implementation.

Strategies For Collaborating with Stakeholder Groups

The stakeholder group will play a vital role in implementing the proposal. Their proposal and feedback will help improve the proposal to ensure it meets the holistic needs of patients and does not negatively impact the environment and the healthcare facility. Their collaboration also ensures they present less change resistance to the intervention, promoting their success. It prevents unnecessary delays, and participation will also ensure harmony and unity of direction, which improves decision-making processes and directs efforts toward goal achievement (Santoro et al., 2020). Developing and communicating clear goals, objectives, and directional strategies is the first step in enhancing stakeholder collaboration. The strategy ensures stakeholders understand them fully and thus helps them identify with the change interventions.

Building social relationships through social platforms also enhance collaboration. Holding meetings and social interaction platforms such as social media groups can enhance formal and informal interactions, which helps build relationships that facilitate collaboration. Lumpkin and Bacq (2019) note that social interactions bring together stakeholders with shared interests and themes and stimulate idea generation, promoting success in developing and implementing innovations. Agreeing and communicating with stakeholders’ clear and straightforward roles and communicating with them helps promote their collaboration. Thizy et a. (2019) note that stakeholders must understand their roles, allowing them to collaborate with other individuals, hence the success of collaborative efforts.

Conclusion

Healthcare improvement depends on extensive consideration of current performance and national and local guidelines. The underperformance in HbA1c tests provoked this quality improvement initiative focusing on policy and practice guideline changes. The focus of the policy proposal is a change from routine diabetes patient care to DSMES, a program that focuses on diabetes patient self-efficacy and access to resources. The current legislation regulating the quality of DSMES programs by the american diabetes Association will inform the project’s implementation and form the framework for the legal and ethical justification of the program. The stakeholder groups’ involvement will enhance the development and improvement of the policy proposal and influence its implementation.

References

Agency for Healthcare Research and Quality (n.d.). Health Literacy Universal Precautions Toolkit, 2nd Edition: Follow Up With Patients Tool #6. Retrieved 31^st January 2023, from https://www.ahrq.gov/health-literacy/improve/precautions/tool6.html

Andersson, E., Persson, S., Hallén, N., Ericsson, Å., Thielke, D., Lindgren, P., Carlsson, K. S., & Jendle, J. (2020). Costs of diabetes complications: hospital-based care and absence from work for 392,200 people with type 2 diabetes and matched control participants in Sweden. Diabetologia, 63, 2582-2594. https://doi.org/10.1007/s00125-020-05277-3

Concannon, T. W., Grant, S., Welch, V., Petkovic, J., Selby, J., Crowe, S., Synnot, A., Greer-Smith, R., Phil, E. M. D., Tambor, E., & Multi-Stakeholder Engagement (MuSE) Consortium. (2019). Practical guidance for involving stakeholders in health research. Journal of General Internal Medicine, 34, 458-463. https://doi.org/10.1007/s11606-018-4738-6

Davis, J., Fischl, A. H., Beck, J., Browning, L., Carter, A., Condon, J. E., Dennison, M., Francis, T., Hughes, P. J ., Jaime, S., Lau, K. H. K., McArthur, T., McAvoy, K., Magee, M., Newby, O., Ponder, S. W., Quraishi, U., Rawlings, K., Socke, J., Stancil, M., and & Villalobos, S. (2022). 2022 National standards for diabetes self-management education and support. The Science Of Diabetes Self-Management And Care, 48(1), 44-59. https://doi.org/10.1177/26350106211072203

Ernawati, U., Wihastuti, T. A., & Utami, Y. W. (2021). Effectiveness of diabetes self-management education (DSME) in type 2 diabetes mellitus (T2DM) patients: Systematic literature review. Journal Of Public Health Research, 10(2), Jahr-2021. https://doi.org/10.4081/jphr.2021.2240

Klein, K. R., & Buse, J. B. (2020). The trials and tribulations of determining HbA1c targets for diabetes mellitus. Nature reviews Endocrinology, 16(12), 717-730. https://doi.org/10.1038/s41574-020-00425-6

Lawler, J., Trevatt, P., Elliot, C., & Leary, A. (2019). Does the Diabetes Specialist Nursing workforce impact the experiences and outcomes of people with diabetes? A hermeneutic review of the evidence. Human Resources For Health, 17, 1-9. https://doi.org/10.1186/s12960-019-0401-5

Lumpkin, G. T., & Bacq, S. (2019). Civic wealth creation: A new view of stakeholder engagement and societal impact. Academy of Management Perspectives, 33(4), 383-404. https://doi.org/10.5465/amp.2017.0060

Maiorino, M. I., Signoriello, S., Maio, A., Chiodini, P., Bellastella, G., Scappaticcio, L., … & Esposito, K. (2020). Effects of continuous glucose monitoring on metrics of glycemic control in diabetes: a systematic review with meta-analysis of randomized controlled trials. Diabetes Care, 43(5), 1146-1156.

Santoro, G., Bertoldi, B., Giachino, C., & Candelo, E. (2020). Exploring the relationship between entrepreneurial resilience and success: The moderating role of stakeholders’ engagement. Journal of Business Research, 119, 142-150. https://doi.org/10.1016/j.jbusres.2018.11.052

Thizy, D., Emerson, C., Gibbs, J., Hartley, S., Kapiriri, L., Lavery, J., Lunshof, J., Ramsey, J., Shapiro, J., Singh, J. A., Toe, L. P., Coche, I., & Robinson, B. (2019). Guidance on stakeholder engagement practices to inform the development of area-wide vector control methods. PLoS Neglected Tropical Diseases, 13(4), e0007286. https://doi.org/10.1371/journal.pntd.0007286

Winter, V., Schreyögg, J., & Thiel, A. (2020). Hospital staff shortages: Environmental and organizational determinants and implications for patient satisfaction. Health Policy, 124(4), 380-388. https://doi.org/10.1016/j.healthpol.2020.01.001

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Assessment 2 Instructions: Policy Proposal

Write a 4-6 page policy proposal and practice guidelines for improving quality and performance associated with the benchmark metric underperformance you advocated for improving in Assessment 1.

In advocating for institutional policy changes related to local, state, or federal health care laws or policies, health leaders must be able to develop and present clear and well-written policy and practice guideline proposals that will enable a team, a unit, or an organization as a whole to resolve relevant performance issues and bring about improvements in the quality and safety of health care. This assessment offers you an opportunity to take the lead in proposing such changes.
As a master’s-level health care practitioner, you have a valuable viewpoint and voice on policy development, both inside and outside your care setting. Developing policy for internal purposes can be a valuable process toward quality and safety improvement, as well as ensuring compliance with various health care regulatory pressures. This assessment offers you an opportunity to take the lead in proposing such changes.

Propose an organizational policy and practice guidelines that you believe will lead to an improvement in quality and performance associated with the benchmark underperformance you advocated for improving in Assessment 1. Be precise, professional, and persuasive in demonstrating the merit of your proposed actions.

The policy proposal 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, be sure to note the requirements for document format and length and for supporting evidence.
Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
What is the current benchmark for the organization and the numeric score for the underperformance?
How is the benchmark underperformance potentially affecting the provision of quality care or the operations of the organization?
What are the potential repercussions of not making any changes?
What evidence supports your conclusions?
Summarize your proposed organizational policy and practice guidelines.
Identify applicable local, state, or federal health care policy or law that prescribes relevant performance benchmarks that your policy proposal addresses.
Keep your audience in mind when creating this summary.
Analyze the potential effects of environmental factors on your recommended practice guidelines.

What regulatory considerations could affect your recommended guidelines?
What resources could affect your recommended guidelines (staffing, financial, and logistical considerations, or support services)?
Explain ethical, evidence-based practice guidelines to improve targeted benchmark performance and the impact the proposed changes will have on the targeted group.
What does the evidence-based literature suggest are potential strategies to improve performance for
your targeted benchmark?
How would these strategies ensure performance improvement or compliance with applicable local, state, or federal health care policy or law?
How can you ensure that these strategies are ethical and culturally inclusive in their application?
What is the direct impact of these changes on the stakeholders’ work setting and job requirements?
Explain why particular stakeholders and groups must be involved in further development and implementation of your proposed policy and practice guidelines.
Why is it important to engage these stakeholders and groups?
How can their participation produce a stronger policy and facilitate its implementation?
Present strategies for collaborating with the stakeholder group to implement your proposed policy and practice guidelines.
What role will the stakeholder group play in implementing your proposal?
Why is the stakeholder group and their collaboration important for successful implementation?
Organize content so ideas flow logically with smooth transitions.
Proofread your proposal, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.
Use paraphrasing and summarization to represent ideas from external sources.
Be sure to apply correct APA formatting to source citations and references.

Policy Proposal Format and Length
It may be helpful to use a template or format for your proposal that is used in your current organization. The risk management or quality department could be a good resource for finding an appropriate template or format. If you are not currently in practice, or your organization does not have these resources, many appropriate templates are freely available on the Internet.
Your policy should be succinct (about one paragraph). Overall, your proposal should be 4–6 pages in length.

Supporting Evidence
Cite 3–5 references to relevant research, case studies, or best practices to support your analysis and recommendations.
Portfolio Prompt: You may choose to save your policy proposal to your ePortfolio.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Analyze relevant health care laws, policies, and regulations; their application; and their effects on organizations, interprofessional teams, and professional practice.
Explain and interpret for stakeholders the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
Competency 2: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.

Summarize a proposed organizational policy or practice change guideline and analyze the potential effects of environmental factors on recommended practice guidelines.
Competency 3: Evaluate relevant indicators of performance, such as benchmarks, research, and best
practices, to inform health care laws and policies for patients, organizations, and populations.
Explain how ethical, evidence-based practice guidelines to improve targeted benchmark performance will impact a stakeholder group needed for successful implementation of the policy or practice change.
Competency 4: Develop strategies to work collaboratively with policy makers, stakeholders, and colleagues to address environmental (governmental and regulatory) forces.
Explain why particular stakeholders and groups must be involved in further development and
implementation of a proposed policy or practice change to improve quality and outcomes. Present strategies for collaborating with a stakeholder group to implement a proposed policy and practice guidelines.
Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella’s writing standards.
Organize content so ideas flow logically with smooth transitions.
Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.

SCORING GUIDE
Use the scoring guide to understand how your assessment will be evaluated.

VIEW SCORING GUIDE