NURS 4050 – Assessment 3: Care Coordination Presentation to Colleagues Paper

NURS 4050 – Assessment 3: Care Coordination Presentation to Colleagues Paper

Care Coordination Presentation Narrative Script

Hello, and welcome to my video presentation on care coordination. My name is ….and I am a … nurse. Care coordination is a deliberate process. This process is systematic, organized, and involves collecting patient information and sharing this information with stakeholders that would positively impact patient care. Therefore, care coordination involves communication and collaboration with various professionals and personnel with an interest in the care of the patient. Usually, we conduct care coordination at various points of change of patient care, such as admission, shift reporting, referrals, and follow-ups. During these periods, the responsibility of patient care changes from the outgoing care provider to the oncoming care provider. Other processes that can run concurrently with care coordination are care planning, assessment, change management, and patient collaboration. In this video, I will discuss one strategy for patient collaboration, the relevant change management aspect, the importance of basing clinical decisions on ethics, and the implications of relevant policy provisions in care coordination

Engaging patients and their families in the care enhances the achievement of desired health outcomes. Their engagement in patient care increases adherence to health interventions and promotes patient-centered care. When a patient and their families are involved in the care, the barriers that exist between care providers and these stakeholders can be breached. Patients and their families can be involved in their care through various strategies that include but are not limited to creating mutual trust, shared decision-making, and family support. Creating mutual trust between the patient or their families and the care providers increases their confidence in the care and chances of engaging in care activities. This mutual trust can be created through various strategies such as personalized care planning, patient navigation, and shared decision-making. Personalized care planning, for example, incorporates the patient’s sociocultural and economic needs that make the care appropriate to the specific patient’s situation. Shared decision-making includes the patient in making the decision as the patient, or their families are consulted in clinical decisions. A systematic review by Menear et al. in 2020 assessed various patient collaboration strategies in mental health settings. Shared decision-making was identified as a direct patient care strategy that incorporates clinical judgment, evidence-based practice, patient preferences, and patient values. Therefore, the final care decision is shared between the clinician’s input and the patient’s health determinants and wellbeing.

Family support strategies incorporate family consultation, communication with family, and partnership with family members to make shared decisions and ensure family-centered care. An example is when a patient with a chronic health condition is under home care, but according to the nurse’s judgment, the patient will require the utilization of community resources to reduce the risk of readmission and improve quality of life. Therefore, the nurse can collaborate with the family to identify affordable, accessible, and sustainable community resources to aid the patient in coping with the disease. In so doing, the nurse would have provided family support through third-party involvement. This strategy will require care coordination through family collaboration and communication.

Change is inevitable. To improve is to change, and to be perfect is to change often. Change in care coordination is an expectable process, and a care coordinator needs to plan and preempt a change in patient care during this process. One of the critical aspects of change management that is relevant to care coordination is change communication. Communicating change to the patients and their families can make them feel valued in the care process. Clear communication of change is an essential aspect of change that will improve patient experience because the patient will think about what matters to them, and these issues are addressed in the care according to an online article published by Zielinski & Rodriguez in 2018 on the Healthcare Financial Management Association website. Change communication requires effective nurse knowledge, skills, and attitudes that enhance successful outcomes. Effective change communication must be timely so that patients and their families have adequate time to process the impact of the change. This consideration can improve patient satisfaction. Patient satisfaction scores are sometimes an objective method to assess patient care quality.

Ethics-based decision-making has been an integral part of nursing practice, both in clinical and administrative situations. At the basic level, decisions during care coordination should observe respect for patient autonomy, intend to do no harm to the patient, aim in the patient’s best interest, and be fair and just. The assumption is that these basic ethical principles can be applied differently without conflicts. The reality is that ethical dilemmas and ethical conflicts arise when these principles are used in decision-making. In such situations, the code of ethics by the American nurse association in 2015 can apply to give directions. Utilization of the nine provisions in the code of ethics for nurses ensures that a nurse, during care coordination, adheres to policy and regulations of care. Ethical-based care plans are thus compliant with organizational and professional cultures and commitment to serving the patient’s interest.

Health policies regulate care coordination at the individual, organizational, and national levels. These policies are specific to certain settings, while other policies are general in care coordination. Some of the influential policies that regulate care coordination are the affordable care act, popularly known as Obamacare or ACA, the Health Insurance Portability and Accountability Act (HIPAA) which was enacted in 1996, and the Health Information Technology for Economic and Clinical Health Act also known as HITECH act of 2009. HITECH policy has five key objectives that include increasing coordination of care, improving healthcare quality, efficiency, and safety, improving patient engagement, encouraging patient information security and privacy, and improving population health. This policy determines how healthcare professionals, especially coordinators of care, exchange information. According to the HIPAA Journal website, this policy strengthened the HIPAA privacy and security rules to improve care coordination. The HIPAA policy of 1996 aims at keeping safe personal patient health information which is also known as protected health information or PHI. The affordable care act influences care coordination by encouraging patient access to information about the care-providing institutions. This is a strategy to improve patient engagement in their care by having prior knowledge of the institutions to choose where to receive care. Most institutions are therefore required to share any shareable information about their care and policies to the public for patient consumption. This can improve the patient experience.

Finally, in my presentation, I would like to discuss the vital role that nurses have in care coordination and the continuum of care. According to the American Nurses Association website, the current paradigm shifts in care coordination highlight the relief that nurses have had after the government and healthcare system have stressed care coordination. Hospitals, healthcare systems, and health insurance organizations rely on care coordination to improve patient health quality, patient experience, and satisfaction. Other players can benefit from well-coordinated care and providers of auxiliary services such as pharmacies, external laboratories, and community resources. The nurses have a vital role in ensuring well-coordinated care because they understand the patient and spend the most time with the patient in the clinical setting. As the first clinical contact with the patient, nurses have an opportunity to understand the patient’s needs and preferences. Therefore, they get to understand what services and care professional the patient need and thus can appropriately coordinate this care.

According to the American Nurses Association website, nurses develop care plans that are guided by the needs and preferences of the patient, provide education to the patient and their families at discharge that include post-discharge coordination to community resources, and thereof ensuring that the care continues across the different settings. These roles are essential in care coordination and the care continuum.

In sum, care coordination should be systemic, planned, and deliberate. Care coordination is guided by ethics and policies and should be directed by patient needs and preferences to improve care quality by ensuring patient-centered care. Key policies that must be adhered to in most settings are HIPAA, HITECH, and ACA. The influential policies regulate patient information exchange and health information access to patients and third parties. Nurses have to understand the ethical and policy underpinnings of care coordination because they have a vital role in well-coordinated care. Through patient education, care planning, and patient communication, nurses archive care coordination.

Thank you for following my presentation.

References

ANA. (2017, October 14). Care Coordination and the Essential Role of Nurses. ANA. https://www.nursingworld.org/practice-policy/health-policy/care-coordination/

HIPAA Journal. (2022, April 7). What is the HITECH Act? HIPAA Journal. https://www.hipaajournal.com/what-is-the-hitech-act/

Menear, M., Dugas, M., Careau, E., Chouinard, M.-C., Dogba, M. J., Gagnon, M.-P., Gervais, M., Gilbert, M., Houle, J., Kates, N., Knowles, S., Martin, N., Nease, D. E., Jr, Zomahoun, H. T. V., & Légaré, F. (2020). Strategies for engaging patients and families in collaborative care programs for depression and anxiety disorders: A systematic review. Journal of Affective Disorders, 263, 528–539. https://doi.org/10.1016/j.jad.2019.11.008

Zielinski, L., & Rodriguez, M. (2018, September 25). Change Management in Health Care: Navigating the Human Side of Successful Transitions. Hfma. https://www.hfma.org/topics/article/61970.html

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Develop a 20-minute presentation for nursing colleagues highlighting the fundamental principles of care coordination. Create a detailed narrative script for your presentation, approximately 4-5 pages in length, and record a video of your presentation.

Introduction
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 assessment provides an opportunity for you to educate your peers on the care coordination process. The assessment also requires you to address change management issues. You are encouraged to complete the Managing Change activity.

Completing course activities before submitting your first attempt has been shown to make the difference between basic and proficient assessment.

Preparation
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.

To prepare for this assessment, identify key factors nurses must consider to effectively participate in the care coordination process.

You may also wish to:

Review the assessment instructions and scoring guide to ensure you understand the work you will be asked to complete.
Allow plenty of time to rehearse your presentation.
Recording Equipment Setup and Testing
Check that your recording equipment and software are working properly and that you know how to record and upload your presentation. You may use Kaltura (recommended) or similar software for your audio recording. A reference page is required. However, no PowerPoint presentation is required for this assessment.

If using Kaltura, refer to the Using Kaltura tutorial for directions on recording and uploading your video in the courseroom.
Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@capella.edu to request accommodations.

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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.
Note: You are not required to deliver your presentation.

Presentation Format and Length
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 video. Include your source citations on a references page appended to your narrative script. Explore the resources about effective presentations as you prepare your assessment.

Grading 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.
Provide, for example, drug-specific educational interventions, cultural competence strategies.
Include evidence that 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
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 assessment only once, so be sure that both assessment deliverables are included.

Portfolio Prompt: Save your presentation to your ePortfolio. Submissions to the ePortfolio will be part of your final Capstone course.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide 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.