NURS FPX 4050 Assessment 3 Care Coordination Presentation to Colleagues

Name

Capella university

NURS-FPX 4050 Coord Patient-Centered Care

Prof. Name

Date

Care Coordination Presentation to Colleagues

Hello everyone! I am _______, the care coordinator. In this presentation, I will share key insights on Care Coordination (CC) strategies for engaging with patients and communities. I will discuss approaches to manage change and highlight the role of ethical decision-making in the process. CC is a critical component of care management. Collaboration among all parties, the exchange of information, goal setting, and the transformation of care practices are essential for providing quality care. CC customizes care for each patient by taking a complete, integrated approach with a focus on addressing their unique needs (Kern et al., 2020).

Strategies for Care Coordination

Nursing staff, patients, and their families must work together to achieve successful medical outcomes. Nurses play a key role in enhancing CC and improving patient outcomes by utilizing Evidence-Based Practices (EBP). One essential strategy is implementing educational interventions focused on medication counseling. This method involves informing patients and their families about medications, including their benefits, proper dosages, and potential side effects (Kinnaer et al., 2020). Research by Cusanno et al. (2021), supports this approach, showing that informed patients tend to adhere to their medication regimens more consistently, leading to better outcomes.

Nurses engage with patients and their families through discussions, social gatherings, and educational workshops. They foster a cooperative environment by involving patients and families in these activities and addressing questions and concerns to ensure a clear understanding of the treatment plan. This teamwork enhances medication adherence and enables patients to manage their conditions effectively (Ho et al., 2023). A collaborative approach to patient education is crucial for achieving optimal health outcomes and improving patient quality of life.

Effective communication that respects cultural differences is an important strategy centered on cultural competence. Nurses familiar with cultural awareness employ methods that admire patients’ cultural values and practices. This involves adapting communication styles, using translation services, and collaborating with community members to ensure that treatment plans are clearly understood, accepted, and tailored to patients’ unique needs. Culturally sensitive care fosters trust and enhances the interaction between patients and nurses (Stubbe, 2020).

According to Lambert et al. (2021), culturally competent healthcare experts can better serve marginalized patients by recognizing their cultural beliefs. They employ inclusive strategies to bridge cultural gaps, ensuring equitable care that improves patient outcomes. Nurses can offer personalized care by acknowledging cultural diversity, fostering engagement, and enhancing outcomes for patients from Culturally and Linguistically Diverse (CALD) backgrounds.

Effective and collaborative teamwork is essential for comprehensive CC. This approach involves a diverse group of specialists, including clinicians, nurses, patients, and community members, working together to provide integrated care and make shared decisions. Clear and efficient communication between patients and healthcare providers enhances diagnostic accuracy and leads to better treatment outcomes. The interdisciplinary team should embrace straightforward and open dialogue, alongside active listening, to address patients’ concerns. This practice builds patient trust and improves medical results (Zajac et al., 2021). Implementing these strategies fosters greater collaboration, leading to enhanced patient outcomes.

Effect of Change Management on Patient Care

Effective management of care changes resolves various issues affecting patient satisfaction and the delivery of personalized, efficient care. Lewin’s change management model, consisting of three stages: Unfreeze, Change, and Refreeze, provides a structured approach to implementing change in healthcare environments (Stanz et al., 2021). The initial stage, Unfreeze, involves recognizing the need for change and overcoming resistance by educating stakeholders. During the Change phase, new methods, such as the introduction of Electronic Health Records (EHR), are applied to enhance care coordination and patient outcomes.

The final stage, Refreeze, focuses on setting these changes, integrating EHR into existing systems, and assessing the impact through feedback. Healthcare organizations can improve patient satisfaction by adopting new practices by following this model (Stanz et al., 2021). Implementing change using the Lewin Model involves several key strategies. First, engaging in transparent discussions about changes, such as EHR implementation, helps inform patients, which can decrease resistance and foster their involvement in their care process, enhancing trust in healthcare (Benjamins et al., 2024).

Second, providing systematic training for staff on new practices like EHR usage enhances their ability to deliver quality care, which in turn improves patient experiences and satisfaction. Lastly, incorporating patient feedback ensures that changes align with patient needs and preferences, allowing caregivers to address concerns and refine care services (Benjamins et al., 2024). These approaches are essential for successful change management and for improving patient experience and satisfaction.

The patient experience covers all aspects of a patient’s interactions and perceptions through their healthcare journey. This includes the quality of care, engagement with healthcare professionals, and the care process. It represents the patient’s perspective on their experiences within the healthcare system. On the other hand, patient satisfaction measures if medical care meets or exceeds patients’ expectations (Omaghomi et al., 2024). It evaluates patients’ responses to different facets of their care, providing insights into the quality of care. Assessing patient satisfaction is crucial for understanding patient needs and expectations, including aspects related to staff interactions and service quality (Omaghomi et al., 2024).

Rationale for Coordinated Care Plans Based on Ethical Decision-Making

Ethical standards in care planning ensure that medical services are delivered in a manner that respects patients’ beliefs, rights, and dignity. These plans are based on ethical principles such as autonomy, beneficence, nonmaleficence, and justice. Ethical care planning emphasizes patients’ right to make informed choices about their treatment, aligning decisions with their preferences and values, which enhances their satisfaction and engagement (Mittal et al., 2020). Integrated care strategies aim to maximize benefits and minimize harm. Ethical decision-making involves evaluating options to ensure that the care provided yields maximum benefits to patients, avoids unnecessary harm, and promotes their safety and well-being.

The principle of justice ensures that medical services and resources are accessible to all patients, regardless of socioeconomic status or cultural background (Mittal et al., 2020). Interdisciplinary teams, through ethical care plans, work to provide equitable care, address disparities, and ensure appropriate services for every patient. Additionally, ethical decision-making requires open and respectful communication about treatment options, fostering better relationships between patients and healthcare staff, and involving all stakeholders in shared decision-making. Applying these ethical principles allows interdisciplinary teams to deliver personalized and equitable care, improving patient outcomes (Mead, 2024).

A moral framework for CC has significant implications and effects. It fosters greater patient trust and engagement, improves satisfaction and experience, and ensures fair distribution of services and resources. Ethically designed treatment plans that honor patients’ autonomy and prioritize their well-being foster trust, collaboration, and enhanced patient experiences (Mittal et al., 2020). These ethical plans ensure that resources are allocated fairly, helping to reduce health disparities and providing equitable access to essential services.

Conversely, poorly designed care coordination plans can harm patients and undermine their autonomy, leading to ethical dilemmas, adverse medical outcomes, increased hospitalizations, and diminished patient satisfaction (Mead, 2024). Significant assumptions behind care coordination include the belief that patients have the right to make informed decisions about their treatment and that healthcare providers must balance patient preferences with effective care and resource management. Open communication between patients and healthcare staff is assumed to facilitate informed decision-making and build trust (Mead, 2024). An ethical framework is essential for improving patient satisfaction and quality care.

Impact of Care Coordination on Health Outcomes

Medical policies are crucial in shaping patient outcomes and experiences by elevating the standards of care and coordination. For instance, the Affordable Care Act (ACA) is instrumental in expanding health coverage and making medical care more affordable. Through its Medicare and Medicaid programs, the ACA has increased the number of insured individuals and improved access to essential services, such as preventive care and medications.

Additionally, the ACA supports integrated care models, like Accountable Care Organizations (ACOs), which help reduce fragmentation in healthcare delivery and foster teamwork, improving care coordination and patient outcomes (Wilson et al., 2020). The ACA’s influence extends to better availability of services and reduced financial barriers for patients, leading to continuous care and increased satisfaction. Similarly, the Health Insurance Portability and Accountability Act (HIPAA) has a profound effect on patient satisfaction and care efficiency by safeguarding clinical information.

HIPAA is critical in maintaining patient trust and engagement by protecting sensitive health data (Williams & Colomb, 2020). This protection enhances patient involvement and adherence to treatment plans, thereby fostering positive relationships between patients and healthcare providers, which contributes to improved care coordination and personalized care. Violations of HIPAA can undesirably impact patient satisfaction and result in legal consequences for healthcare professionals and institutions (Williams & Colomb, 2020). HIPAA and ACA policies enhance patient care by ensuring better service access, equitable treatment, and data security, leading to an improved patient experience.

Nurses Role in Coordination of Care and Continuum

Nurses play a crucial role in care coordination and the continuum of care due to their involvement in managing patient care across various settings. They are pivotal in integrating care, advocating for patients, and ensuring seamless transitions throughout the care process. Nurses use their deep understanding of patient needs and their ability to communicate with patients and their families to deliver personalized and quality care within interdisciplinary teams. Their role helps to address challenges in providing care and maintaining ongoing support, ensuring that patient’s needs are met (Swanson et al., 2020).

Nurses are integral to delivering comprehensive care and improving coordination. They engage with patients and families, coordinate care plans, educate them on medication adherence, and facilitate access to necessary services, which supports the continuity of care. Additionally, nurses assess patient conditions and keep physicians updated on the patient’s status, which enhances coordination and patient satisfaction (Swanson et al., 2020). These functions underscore the significant impact of nurses on care effectiveness and the healthcare environment. Recognizing and supporting the roles of nurses can enhance care coordination and lead to better patient outcomes.

Conclusion

The presentation highlights key strategies for effective Care Coordination (CC), including educational interventions, cultural competence, and interdisciplinary teamwork. It emphasizes the role of ethical decision-making in enhancing patient satisfaction and outcomes. Utilizing Lewin’s change management model, it discusses how adopting new practices like Electronic Health Records (EHR) and adhering to policies like ACA and HIPAA improve patient care. Additionally, the crucial role of nurses in managing patient care and ensuring continuity is underscored.

References

Benjamins, J., Vet, E., & Nies, A. (2024). Enhancing interprofessional teamwork between youth care professionals using an electronic health record; A mixed methods intervention study. Journal of Interprofessional Care, 1–11. https://doi.org/10.1080/13561820.2024.2314461

Cusanno, B. R., Dean, M., & Silva, V. T. (2021). “I’m worth saving”: Making sense of medication taking in a care coordination organization. Health Communication, 37(14), 1–14. https://doi.org/10.1080/10410236.2021.1920713

Ho, J. T., See, M. T. A., Tan, A. J. Q., Jones, T., Lau, T. C., Zhou, W., & Liaw, S. Y. (2023). Healthcare professionals’ experiences of interprofessional collaboration in patient education: A systematic review. Patient Education and Counseling, 116, 107965. https://doi.org/10.1016/j.pec.2023.107965

NURS FPX 4050 Assessment 3 Care Coordination Presentation to Colleagues

Kern, L. M., Reshetnyak, E., Colantonio, L. D., Muntner, P. M., Rhodes, J. D., Casalino, L. P., Rajan, M., Pesko, M., Pinheiro, L. C., & Safford, M. M. (2020). Association between patients’ self-reported gaps in care coordination and preventable adverse outcomes: A cross-sectional survey. Journal of General Internal Medicine, 35(12), 3517–3524. https://doi.org/10.1007/s11606-020-06047-y

Kinnaer, L. M., Nelis, M., Hecke, A., & Foulon, V. (2020). Patient-centered care coordination, education and counseling of patients treated with oral anticancer drugs: An importance-performance analysis. European Journal of Oncology Nursing, 47, 101765. https://doi.org/10.1016/j.ejon.2020.101765

Lambert, S., Schaffler, J. L., Brahim, L., Belzile, E., Laizner, A. M., Folch, N., Rosenberg, E., Maheu, C., Ciofani, L., Dubois, S., Phaneuf, E., Drouin, S., Leung, K., Tremblay, S., Clayberg, K., & Ciampi, A. (2021). The effect of culturally- adapted health education interventions among culturally and linguistically diverse (CALD) patients with a chronic illness: A meta-analysis and descriptive systematic review. Patient Education and Counseling, 104(7), 1608–1635. https://doi.org/10.1016/j.pec.2021.01.023

Mead, G. (2024). Shared decision making in older people after severe stroke. Age and Ageing, 53(2). https://doi.org/10.1093/ageing/afae017

Mittal, M. L., Beletsky, L., & Davidson, P. J. (2020). Ethical and legal considerations. Absolute Addiction Psychiatry Review, 363–373.
https://doi.org/10.1007/978-3-030-33404-8_24

NURS FPX 4050 Assessment 3 Care Coordination Presentation to Colleagues

Omaghomi, Akomolafe, Onwumere, Odilibe, P., & Elufioye. (2024). Patient experience and satisfaction in healthcare: A focus on managerial approaches. A review. International Medical Science Research Journal, 4(2), 194–209. https://doi.org/10.51594/imsrj.v4i2.812

Stanz, L., Silverstein, S., Vo, D., & Thompson, J. (2021). Leading through rapid change management. Hospital Pharmacy, 57(4), 422–424. https://doi.org/10.1177/00185787211046855

Stubbe, D. E. (2020). Practicing cultural competence and cultural humility in the care of diverse patients. Focus, 18(1), 49–51. https://doi.org/10.1176/appi.focus.20190041

Swanson, M., Wong, S. T., Misener, R., & Browne, A. J. (2020). The role of registered nurses in primary care and public health collaboration: A scoping review. Nursing Open, 7(4), 1197–1207. https://doi.org/10.1002/nop2.496

Williams, K., & Colomb, P. (2020). Important considerations for the institutional review board when granting Health Insurance Portability and Accountability Act authorization waivers. Ochsner Journal, 20(1), 95–97. https://doi.org/10.31486/toj.19.0083

Wilson, M., Guta, A., Waddell, K., Lavis, J., Reid, R., & Evans, C. (2020). The impacts of accountable care organizations on patient experience, health outcomes and costs: A rapid review. Journal of Health Services Research & Policy, 25(2), 130–138. https://doi.org/10.1177/1355819620913141

Zajac, S., Woods, A., Tannenbaum, S., Salas, E., & Holladay, C. L. (2021). Overcoming challenges to teamwork in healthcare: A team effectiveness framework and evidence-based guidance. Frontiers in Communication, 6(1). https://doi.org/10.3389/fcomm.2021.606445