Care coordination is an important determinant of a patient’s health outcomes, as it helps in determining the extent to which patients achieve their prospective outcomes from a health perspective. The primary objective for the adoption of a plan for care and coordination is to maximize overall effectiveness in the quality of care offered for patients as part of their engagement in the health environment. In that view, this care coordination plan will focus on Mrs. Hartley, who is an elderly patient taking medications. The plan will provide an effective approach aimed at enhancing home safety to reduce risk of medication error for the patient.
Patient-Centered Health Intervention
Patient-centered care has become one of the most important approaches that health professionals are considering as part of their delivery of care to patients with different health conditions. The model of patient-centered care focuses on ensuring that all aspects of care focus on the patient with the view being that this would help improve their health outcomes (Levinson, Lesser, & Epstein, 2010). Mrs. Hartley finds herself in a position where she is likely to experience medication error considering her age and the drugs that she is taking. The expectation is that the care coordination plan will help provide an intrinsic approach to improve her health outcomes.
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The patient-centered health intervention that would be most appropriate is the education of Mrs. Hartley on the importance of complying with the drug therapy plan created. Patient education plays a key role in promoting efficiency in care coordination because it ensures that patients are involved in the treatment or care plans developed (Federman et al., 2018). The education of Mrs. Hartley focuses on encouraging her to follow the laid out care plan as a way of minimizing risks of exposure to medication errors. However, the care coordination plan presented brings into question several key issues. The first issue is that Mrs. Hartley is frail, which means that it may be hard or challenging her to follow instructions given. To help deal with this issue, the main area of focus is on the those providing care for Mrs. Hartley, who will be included as part of the education to ensure that they help ensure she takes her medication as prescribed.
The second key issue of concern is that Mrs. Hartley suffers from depression, exposes her to serious medication risks considering that it creates a high possibility of her taking medication against the prescription. When dealing with patients suffering from depression and hopelessness, medication risks often increase significantly considering that these patients are likely to use medications to ensure their relief. That is the case for Mrs. Hartley, who may abuse some of the medications given. Dealing with this issue involves ensuring sufficient partnership in care delivery between safe care services and family members. The third issue is the need for specialized care as she takes medication to help determine her response to the medications provided. The family members would need to ensure that Mrs. Hartley uses necessary community resources as a way of ensuring that she receives proper care, which would help improve her health outcomes significantly.
Community Resources
The following are some of the community resources that Mrs. Hartley and her family may use in ensuring to get necessary information and help as part of reducing risks of medication errors. It is important to note that the resources can be accessed virtually to improve on best possible health outcomes.
SafeCare Services
AHTC, Tower 4C
Paasheuvelweg 25
1105 BP Amsterdam
the Netherlands
(+31) 20 21 039 20
info@safe-care.org
Peak Vista Health Center at International Circle
Community health center in Colorado Springs, Colorado
2828 International Cir #160, Colorado Springs, CO 80910, United States
http://www.peakvista.org/
+1 719 632 5700
Pueblo Community Health Center
Community health center in Pueblo, Colorado
2030 Lake Ave, Pueblo, CO 81004, United States
http://www.pueblochc.org/
+1 719 564 4823
Making Decisions Based on the Code of Ethics of Nursing
Nurses have the responsibility of ensuring their decision align with the provisions of the Code of Ethics of Nursing. The code of ethics plays a central role in determining the basic provisions associated with the quality of care offered by individual patients, which ensures precise care coordination necessities (Tluczek et al., 2019). In the case of Mrs. Hartley, the health intervention considered, which involves patient education, capitalizes on the Code of Ethics of Nursing. The expectation when making decisions from an ethical perspective is to ensure that Mrs. Hartley remains satisfied with the quality of care she receives as part of reducing her risk of medication errors.
Health Policy Implications for the Coordination and Continuum of Care
The precise care coordination varies from one person to another depending on the overall expectations in advancing positive patient outcomes. The implication of health care policies can be seen from the fact that they help shape the design of care created for individual patients. Prokop (2016) indicates that modified care coordination plans, defined based on multiple health policies, help improve the response that patients have towards the specific health issues that they are facing. In the case of Mrs. Hartley, the care coordination plan presented reflects on the need to structure her drug therapy plan in a way that would reduce medication errors. The health policy considered in this case focuses on changing how Mrs. Hartley responds to her taking of different medications while determining how this would change her health behaviors.
How Healthcare Policies Affect Patient-Centered Care
The impacts of health policies n patient-centered care cannot be ignored considering that they help shape how health professionals coordinate care as part of promoting positive health outcomes for their patients. Health professionals often consider the shifts in health care environments resulting from the policies implemented, which change their approach towards the coordinated care plans that they use while handling their patients (Falvo & Holland, 2017). The care coordination plan for Mrs. Hartley has been affected by provisions in the Affordable Care Act (ACA), which is one of the health policies defining provisions of care coordination. Specifically, the policy highlights the need to ensure that Mrs. Hartley receives best quality of care at an affordable cost. Therefore, the plan of care considered reflects on the need to change the approaches considered when receiving best quality of care while shaping the general expectations reflected by her health underlying health needs.
Evaluation in Care Coordination
The care coordination plan is effective because it considers Mrs. Hartley from the perspective of her health need, which involves the risk she faces regarding medication errors. The effectiveness of a care coordination plan is determined based on the plan’s ability to achieve intended objectives within a specific timeline of care (McAllister, Keehn, Rodgers, & Lock, 2018). The overall expectation is to ensure that Mrs. Hartley receives quality education that would reduce her exposure to medication errors taking into account her current medical issues of depression and hopelessness. The plan’s effectiveness can also be seen from the fact that it identifies some of the key issues of concern that are likely to affect the planned approaches for Mrs. Hartley. The identification of these issues is important because it helps create an advanced framework that would guarantee success in service delivery. Therefore, the identification of these issues may serve as a guarantee that the care coordination plan will achieve its intended objectives.
Revision of Plan to Improve Future Outcomes
Revision to the care plan would mean that specific areas of the plan would need to be changed as part of improving its effectiveness. For the changes to be as effective as may be anticipated, they must be focused on the specific areas likely to serve as barriers to effectiveness. For example, the plan may consider a change in the community resources considered with the view being that the current resources do not align with its intended objectives. The consideration of such changes would act as a guarantee for success in promoting success based on Mrs. Hartley’s health outcomes.
Care Coordination and Patient Satisfaction Verses Experience
When creating a care coordination plan, one of the key areas of consideration is patient satisfaction and experience in the quality of care offered. Brooke, Slager, Swords, & Weir (2018) indicate that patient-centered care is reflective of the need to ensure that patients receive best quality of care matching their projected outcomes as a way of improving their health outcomes. For this care coordination plan, Mrs. Hartley’s health outcomes will be guarantee considering that the plan focuses on creating a standard shift towards reducing risk of exposure to possible medical errors.
Aligning Teaching Sessions to the Healthy People 2020 Document
Healthy People 2020 objectives reflect on the importance of reducing medication errors among elderly persons by enhancing their care services to match the quality outcomes. Teaching sessions can only align to the Healthy People 2020 document by endorsing some of the key changes likely to contribute to a change in how the health care plan is coordinated. The latest developments in health care service delivery may also serve as key determinants of advanced learning with the view being that this would guarantee best quality outcomes. The Healthy People 2020 also calls for the full utilization of information technology with the sole objective being to ensure health professionals have access to data that they would utilize as part of their approaches to improved service delivery.
References
Brooke, B. S., Slager, S. L., Swords, D. S., & Weir, C. R. (2018). Patient and caregiver perspectives on care coordination during transitions of surgical care. Translational behavioral medicine , 8 (3), 429-438.
Falvo, D., & Holland, B. E. (2017). Medical and Psychosocial Aspects of Chronic Illness and Disability . Jones & Bartlett Learning.
Federman, A. D., Jandorf, L., DeLuca, J., Gover, M., Munoz, A. S., Chen, L., ... & Kannry, J. (2018). Evaluation of a patient-centered after visit summary in primary care. Patient education and counseling , 101 (8), 1483-1489.
Levinson, W., Lesser, C. S., & Epstein, R. M. (2010). Developing physician communication skills for patient-centered care. Health affairs , 29 (7), 1310-1318.
McAllister, J. W., Keehn, R. M., Rodgers, R., & Lock, T. M. (2018). Care coordination using a shared plan of care approach: From model to practice. Journal of pediatric nursing , 43 , 88-96.
Prokop, J. (2016). Care coordination strategies in reforming health care: a concept analysis. Nursing Forum, 51 (4), 268-274.
Tluczek, A., Twal, M. E., Beamer, L. C., Burton, C. W., Darmofal, L., Kracun, M., ... & Turner, M. (2019). How American Nurses Association Code of Ethics informs genetic/genomic nursing. Nursing ethics , 26 (5), 1505-1517.
