Innovations in Healthcare Discussion Assignment
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Innovations in Healthcare Discussion Assignment
Write a response for the following statements.
Innovations in Healthcare
One of the challenges of modern healthcare systems is how to scale, spread, and sustain innovations that deliver value to healthcare. Great ideas don’t always make it beyond local pilots and can fizzle out over time as the creators move on to other ideas or other organizations (Zelmer, 2015). There are times when change in healthcare is frustratingly slow, with promising innovations that are blocked by a variety of roadblocks or stuck as local gems that fail to benefit those in other areas (Zelmer, 2015). But it is not true that all innovations fail to grow and deliver value beyond the context in which they were first introduced. Studying these successful experiences can be at least as instructive as learning from the failures (Zelmer, 2015). This discussion will be a review of one innovation with an explanation of the innovation, the outcome, and how a similar innovation could be beneficial in my organization.
The innovation I selected was a pharmacy driven program to improve medication compliance and management. This innovation was located from Agency for Healthcare Research and Quality website as an innovation listed from 2016. The Managing Your Medications (MyRx) Medication Adherence Program offered culturally and linguistically tailored medication management and health education to seniors with hypertension and/or diabetes living in the community. The program consisted of pharmacists that made visits to the participants in their homes, to perform a medication assessment and reconciliation, offer personalized education, and develop a care plan. The plan also included two sessions hosted by health educators for a group session that focused on healthy eating and then a session on physical activity and stress management. The program resulted in increased participants’ knowledge about diabetes and hypertension, improved medication adherence, and observed significant reductions in blood pressure. The program’s impact on hemoglobin A1c levels and weight were inconclusive. The program ended when grant funding diminished. The total budget for the program was approximately $280,000, including payments to pharmacists and the student translator, the cost of materials, incentive payments to participants ($15 each), and research-related expenses.
Introducing Similar Innovation
When I read the above article on the innovation idea, my mind was swarming with ideas. From the hospital setting, lack of compliance and medication management is one of the primary reasons for readmissions. The Centers for Medicare and Medicaid Services (CMS) has penalties for preventable readmissions that could total $528 million (Walker, 2016). A study conducted by the Agency for Healthcare Research and Quality (AHRQ) on readmissions from 2011 identified congestive heart failure as the top cause of readmissions among Medicare patients, followed by septicemia, pneumonia, COPD and cardiac dysrhythmias (Walker, 2016). Several factors that increase the likelihood of readmission may be modifiable, especially those that relate to clinician or system level issues including adverse drug events and other medication related issues (Alper, O’Malley & Greenwald, 2020).
We implemented through the case management department, a transitional coach program. This program involves the transitional coach making a visit to certain high-risk patients prior to their discharge and then within the first week, a transitional coach call and a home visit. No care is provided during the home visit, but they do discuss the discharge instructions, discharge med list, and follow-up appts. Frequently, the home visit results in other needs being identified and resources discussed and/or initiated with the patient. Medication discrepancies and noncompliance seems to still be one of the primary findings. This program has resulted in improvement in follow-up visits being kept after discharge. With the innovation in mind that was reviewed, the transitional coach visits could be made with a pharmacist also. This could identify additional needs which could be lack of knowledge or misunderstandings about the medications ordered, and the education from the pharmacist could address those needs.
Part of the issue with the MyRx program was the costs. The criteria used to identify the high-risk patients are those with minimal or no pay source, new to the area, and do not qualify for other ongoing services such as home health services. The cost of the transitional coach addition has been far less than the benefits to the facility. The outcome has been beneficial to the facility in regards to a decrease in readmissions or at least an increased time period between admissions with some patients. Currently, the transitional coach consists of one full time position. The transitional coach program has been in place for over two years and still ongoing. Adding a pharmacist to the home visits may result in even more reductions. To implement, once the costs of the use of the already present hospital staff is approved for a trial, the criteria could be set to determine which patients are higher risk for medication mishaps that could determine which visits would be shared with the pharmacist. Keeping statistics on the readmission rates, the reasons for readmission, and the length of time between admissions, as well as interventions of the pharmacists and evaluation feedback from the patients can be monitored to assess the impact.
Healthcare leaders must often times think outside the box in order to solve issues in healthcare. Often time times, leaders don’t have to go to far outside the box if they look for innovations already in progress. Why re-create the wheel? Learning lessons from others can be useful by looking at the failures and successes. With the advantages of technology in our current time, sharing ideas is even easier than in the past. With a carefully planned, coordinated and implemented process, organizations can effectively spread their quality improvement interventions, sometimes employing and transferring the processes for identifying and implementing changes.
Agency for Healthcare Research and Quality (2016). Culturally Tailored Pharmacist Home Visits and Educator-Led Group Sessions Increase Medication Adherence and Reduce Blood Pressure for Seniors with Hypertension and Diabetes. Retrieved from https://www.innovations.ahrq.gov/profiles/cultural…
Alper, E., O’Malley, T. A. & Greenwald, J. (2020). Hospital discharge and readmission. Retreived from https://www.uptodate.com/contents/hospital-dischar…
Walker, B. (2016). The Top 5 Causes of Hospital Readmissions – and How to Prevent Them. Retrieved from https://insights.patientbond.com/blog/the-top-5-ca…
Zelmer, J. (2015). Beyond Pilots: Scaling and Spreading Innovation in Healthcare. Healthcare Policy, Vol 11(2), p. 8–9. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC47292…
Innovations in Healthcare Discussion Assignment
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper.
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