Hi everyone. My name is (student’s Name), and I will share some information on the fundamental principles of care coordination. I aim to raise awareness of nurses’ vital role in care coordination and the continuum of care using evidence-based information. This presentation contains an outline of the effective strategies for collaborating with patients and their families to achieve desired health outcomes, identifies the aspects of change management that directly affects the element of patient experience in the provision of high-quality patient care, and explains the rationale for coordinated care plans based on ethical decision making. The presentation also identifies the potential impact of specific healthcare provisions on the outcome and patient experiences.
Care Coordination
I will start by elaborating on care coordination and its importance in health care. Care coordination is essential and has a fundamental focus on patients. It involves organizing patients’ care activities and sharing patient information with all interdisciplinary team members (Agency of Healthcare Research and Quality, 2018). It ensures the care provided is safe and high-quality, promoting improved patient outcomes. Care coordination allows nurses to understand patients’ needs on time, delivering high-quality and valuable health care. Nurses understand the importance and effectiveness of care coordination in promoting patient safety and efficiency.
Effective Strategies for Collaborating with Patients and Their Families
Healthcare providers should provide family and patient-centered care, which has proven effective in providing high-quality care, better health outcomes, and lower use of health services. Collaboration between nurses, patients, and their families helps achieve desired health outcomes. Effective strategies to enhance collaboration with patients and their families include
Patients and family engagement. This involves including the patients and their families in active rules in care provision. Patient engagement allows them to understand their health condition and gain knowledge based on their experiences. Involving patients in decision-making has effectively reduced healthcare costs and wastage, enhanced system responsiveness to evolving user needs, and improved quality and transparency (Goodridge et al., 2018). It also improves patient’s experience of care and promotes job satisfaction. Jazieh et al. (2018) state that family involvement enhances the decision-making process, assists the healthcare team in care provision, improves patient safety and quality of care, assists in-home care, and addresses the patient’s family and society’s expectations of care.
Patient and family communication and education. Patient-centered communication is an effective strategy for enhancing patient care and recovery. It ensures optimal health outcomes by reminding nurses that care should be individualized and responsive to patient’s health concerns, beliefs, and values (Kwame & Petrucka, 2021). Patient education promotes patients’ understanding of their health condition and care plan. According to Fereidouni et al. (2019), patient education “incorporates knowledge, skills, values, and attitudes related to specific or general medical topics, preventive services, healthy lifestyles, and correct use of medicine, and the care of disease and injuries at home .”Education techniques appropriate in patient education include teaching back, warm handoff, where nurses share information on diagnosis and treatment, and medication reviews, where nurses discuss the patient’s medication list.
The Aspect of Change Management
Change is inevitable and continues to occur in all areas of care. Healthcare changes aim to improve efficiency, safety, patient-centeredness, effectiveness, timeliness, and accessibility of care and care services. Change management creates awareness of the need for change and the process of implementing the changes and allows the development of skills to implement the change. Change management help organize and disseminate information in the entire organization. The fundamental elements in change management include stakeholder engagement, communication, governance and leadership, monitoring and evaluation, training and education, workflow analysis, and predesign (Pan American Health Organization & WHO, 2019). These aspects of change should be developed and shared among care providers.
Effective communication is central to the change process and facilitates organizational transformation. Communication, stakeholder engagement, and patient education improve patient engagement and are high effectiveness if introduced before the change process. Nurses should communicate more frequently throughout the change process and follow all engagement plans (Pan American Health Organization & WHO, 2019). Additionally, they should review the change process and revise the plans as required. Lastly, nurses should evaluate the entire Working within these aspects enhances quality and patients centered care.
The Rationale for Coordinated Care Based on Ethical Decision-Making
Coordinated care plays a significant role in ethical decision-making. Nurses use ethics and ethical principles to care for and advocate for patients and their families. They must show respect, patient dignity, and compassion throughout care provision. Key ethical principles in nursing include beneficence, justice, autonomy, and non-maleficence. Autonomy ensures that patients’ right to decide based on their beliefs and values is maintained (Haddad & Geiger, 2022). Patients have the right to refuse a treatment intervention, treatment, or benefits regardless of its benefits. The beneficence principle ensures that all interventions are geared towards minimizing harm and promoting good (Haddad & Geiger, 2022). Nurses should offer a balance of benefits against risk, which is achieved by assisting them in meeting their needs. Justice ensures that all patients are treated fairly and equally, while non-maleficence ensures that patients are safe from harm.
An ethical approach’s logical positive implications and consequences on care provision promote patient outcomes (Lantos, 2018). Understanding these ethical principles promotes the decision-making process. It enhances care coordination as decisions are made when patients are willing and well-informed, and judgments are based on values and in line with government rules and regulations. Ethical decisions promote trust, respect, responsibility, fairness, and caring, essential in care. Violating these ethical principles negatively impacts the continuum of care and patient outcome.
Underlying assumptions that guide decision-making are patient and physician or nurse based. Nurses should understand their client’s cultures and backgrounds to avoid unconscious bias in care provision. They should engage patients in the decision process and listen to their worries and fears (Lantos, 2018). This ensures they understand what the patients or their families fear or believe in enhancing patient-centered care.
Potential Impact of Specific Health Care Policy Provision On Outcomes and Patient Experiences
Policies, procedures, rules, and regulations affect patient care. For example, the affordable care act (ACA) improved patients’ experiences and access to care and decreased out-of-pocket expenditures. Millions of people are covered under this insurance act, and it has proven effective in access, affordability, and increase in outpatient utilization, especially among individuals in low-income populations. Ercia et al. (2021) noted that 10.8 million uninsured individuals enrolled in Medicaid by 2014, and the number continued to increase. The number of uninsured people has continued to decrease since the establishment of this program. ACA expands Medicaid to the less fortunate and the elderly (Ercia, 2021). However, the program continues to face diverse challenges, especially for newly insured individuals. It will enhance its effectiveness by understanding the coverage, access, utilization, and expected health outcomes.
Nurse’s Vital Role in Care Coordination
Nurses have significant responsibilities in care coordination and the continuum of care. Their role in care coordination includes establishing a trusting and respectful relationship with patients and their families, providing emotional support, offering education and support in self-management care, assisting the patients and their families in navigating through the healthcare process, and facilitating access to care services and healthcare centers (Karam et al., 2021). They also help the patient manage care and assist them in the transition process.
Nurses communicate patients’ needs to the other interdisciplinary tea members. Communication ensures that every member understands their responsibilities and impact on the patient’s recovery. Additionally, communication fosters collaboration and teamwork and reduces medical errors. Effective communication is ongoing, regular, and constant in the entire care provision. Their role is essential from diagnosis, treatment, recovery, and other life stages.
References
Agency for Healthcare Research and Quality. (2018). Care coordination. https://www.ahrq.gov/ncepcr/care/coordination.html
Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California, and Texas. BMC Health Services Research, pp. 21, 1–9. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06961-9
Fereidouni, Z., Sarvestani, R. S., Hariri, G., Kuhpaye, S. A., Amirkhani, M., & Kalyani, M. N. (2019). Moving into action: The master key to patient education. The journal of nursing research, 27(1), 1. https://journals.lww.com/jnr-twna/fulltext/2019/02000/moving_into_action__the_master_key_to_patient.7.aspx
Goodridge, D., McDonald, M., New, L., Scharf, M., Harrison, E., Rotter, T., … & Penz, E. D. (2019). Building patient capacity to participate in care during hospitalization: a scoping review. BMJ open, 9(7), e026551. https://bmjopen.bmj.com/content/9/7/e026551
Haddad, L. M., & Geiger, R. A. (2018). Nursing ethical considerations. https://www.ncbi.nlm.nih.gov/books/NBK526054/
Karam, M., Chouinard, M. C., Poitras, M. E., Couturier, Y., Vedel, I., Grgurevic, N., & Hudon, C. (2021). Nursing care coordination for patients with complex needs in primary healthcare: A scoping review. International Journal of Integrated Care, 21(1). https://doi.org/10.5334%2Fijic.5518
Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20(1), 1-10. https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-021-00684-2
Jazieh, A. R., Volker, S., & Taher, S. (2018). Involving the family in patient care: a culturally tailored communication model. Global Journal on Quality and Safety in Healthcare, 1(2), 33-37. https://doi.org/10.4103/JQSH.JQSH_3_18
Lantos, J. D. (2018). Ethical problems in decision making in the neonatal ICU. The New England Journal of Medicine, 379(19), 1851-1860. https://www.nejm.org/doi/10.1056/NEJMra1801063
Pan American Health Organization, & World Health Organization. (2019). Change Management in Public Health. https://www3.paho.org/ish/images/toolkit/IS4H-KCCM-EN.pdf
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