EVIDENCE-BASED PROJECT, Part 5: Recommending an Evidence-Based Practice Change

Henry

Walden University

Jan 24, 2020

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Description of the Company

Transitional Care Unit (TCU)- Concerned with transition of the patients from stay in the hospital to home or another level of care.

The management and the subordinates are open to change.

The aim of the unit is to have in place skilled nursing facility to aid the patients transition.

The organization support a culture of intercommunication between individuals within the company.

I work at a Transitional Care Unit (TCU) as a part time job. TCU presents a short term care facility for complex patients moving from hospital to another care setting. At our organization, the employees are advised to maintain the values and culture that defines it and respect and communication between the workers is considered key during the transition process. What defines the growth and effective provision of care within my organization is the willingness of the employees to embrace change and the management have been effective in facilitating this change through effective communication and listening to the perspectives of other individuals in regards to change. The management has a culture of bringing everyone on board and giving them the change for equal contributions on the ways through which the firm can improve its transition process.

Current Opportunity/Problem for Change

Problems

Ensuring continuity of care across health care setting between the care providers and institutions

Enhanced Readmissions

The readmissions are associated with the loss in the resources while in some cases, these problems results in patients’ death due to inadequate care during the transition process.

opportunities

Use of effective provider communication.

Reconciling the patient’s medications upon discharge.

My organization has been impacted by various problems that requires immediate address to improve the care given to the patients in the transition process. For instance, ensuring continuity of care across health setting has been a primary problem to the organization since there has been ineffective communication between the care providers and the health institutions where the patients get transferred (Mansukhani et al., 2015). Also, there has been increased readmissions due to inefficient transitions of care that has cost the firm a burgeoning health care costs. To help counter these inefficiencies in the transition care, there is an opportunity characterized by an evidence based practice to employ the use of an effective provider communication that will help facilitate the communications between the medical providers and the other institutions of transitions or homes. Also, there is a chance to reconcile the patient’s medications upon discharge.

Evidence-Based Idea

One essential proposal in the case is effective provider communication.

It involves direct provider communication to ensure smooth transition between health care settings.

The care provider abilities to access records from the ambulatory care and community pharmacy records has been limited by incomplete health information.

Miscommunication gets perpetuated after the discharge of the patients.

One of the primary proposals for the case is effective provider communication. In the organization, most of the problems that the patients transitioned have faced is lack of effective communication between the care providers and the high level health care centers they are transferred to or their homes. The lack of this communication has limited the acute communication that makes the individuals not to access the patient information and pharmacy records especially if the inpatient care provider is someone other than the main care provider (Mansukhani et al., 2015). . The direct provider communication idea will help prevent the miscommunication perpetuated after discharge from the care setting since the primary care provider may not get the whole documentation of the diagnostic tests, procedures and the changes in medication during hospitalization. The hospital discharge summaries form the primary sources of error in communication and thus the need for direct provider communication.

Evidence-Based Idea Cont’d

Delay in the hospital discharge summaries.

Lack of communication on the identity of the next pharmacists and the initial care provider.

Continuity of care cannot be maintained when there is inadequate information during the transfers/transition.

The National Transitions of Care Coalition (NTOCC) should employ the use of universal transfer tool in the facilitation of the movements of patients between the care settings.

Lack of direct effective communication between the primary care provider and the next level of transition have resulted in numerous problems for the patients that have caused readmissions (Lim et al., 2010). The delays in the hospital summaries have resulted in the patients given wrong treatments that have further worsened their situations causing more readmissions and costing the organization more funds in treating the conditions. From the meta analysis, 12% to 34% of the discharge summaries reach the outpatient teams once the patient has already since the physician (Mansukhani et al., 2015). However, with the idea i place, the community pharmacists will be provided with the data on discharge diagnosis, laboratory results, the changes in medication, the medications that were initially used during hospitalization and the identity of the next medical provider. Such measures will ensure that the patients are given the right medication after the transition and treated based on the discharge diagnosis. Also, it will ensure that the patients meet the right care provider for the appointment and treatment. Moreover, the aspect will guarantee continuity in the provision of care to the patients even after transition. The national Transitions of Care Coalition should ensure that these problems are identified and employ the use of universal transfer tool in the facilitation of the movements of the patients between the care settings.

Plan For Knowledge Transfer

The use of standardized forms will ensure that essential data are relayed to other members of the patient care.

The standard forms can be developed through the use of different technologies such as Continuity Assessment Records and Evaluation (CARE) item set that also gets developed by the CMS (Rodrigue et al., 2011).

The CARE will help offer accurate and up-to date data at the time of discharge from the hospital.

The actualization of this idea can be ensured by using standardized forms that will ensure that essential data get relayed to other members of the patient care where they are getting transferred. The standard forms can get developed through the use of different technologies like the CARE (Continuity Assessment Records and Evaluation) developed by the CMS (Rodrigue et al., 2011). The CARE will ensure that accurate and up-to date information is provided to the pharmacists at the time of discharge from the hospital and that all the details regarding the officials is put in place (Mansukhani et al., 2015). Also, the system will ensure accurate assessment of the patient’s medical, functional, social and cognitive support status across the care settings with the ultimate goal of improving the quality care of the patient that receives the care.

EVIDENCE-BASED PROJECT, Part 5: Recommending an Evidence-Based Practice Change

Plan Cont’d

The plan will also include the development of Universal Transfer Form.

The form will facilitate the passage of the necessary patient information from one setting to another.

The plan will also ensure that the information is availed to the physicians before they begin treatment on the transferred patients.

The idea will include the establishment of Universal Transfer Form. The form will be integral in ensuring the pharmacist get the message about their patients in time before they attend to them and provide an appropriate information regarding diagnosis, treatment and care for the transferred patients Flynn, & Dupuis, 2003). Also, the plan will ensure that before the physicians begin treatment, they have all the information on the transferred patients.

Outcomes

The idea will provide a more seamless and timely transfer of the information.

It will increase access of health information by the providers

Reduce redundancies in diagnostics and in the history of the patient’s health.

Improve provider-to-provider communication and relations while also enhancing the learning process.

The idea of effective provider communication will be of great benefit to the organization because it will help offer a more seamless and timely transfer of the information to the medical providers or care givers. This will help enhance the treatment process as it will enhance the access of the health information by the providers (Schroy III, Mylvaganam, & Davidson, 2014). Also, the idea will help eliminate redundancies in the diagnostics and in the history of the patient’s health and this will also help in the provision of effective care and reduce the readmissions due to wrong care provision or drug use.

Outcomes

The direct communication amongst the providers will also ensure that there is continuity in care provision because of the consistence in the provision of the report.

Movements of the patients will be facilitated universal transfer forms.

Readmission rates will be reduced.

The standard forms will ensure effective evaluation of the data and accurate measurements taken to deliver the desired care.

The idea will ensure that the readmission rates are reduced because of the continuity in the provision of care. The idea is characterized by consistency in the provision of the information. Also, through universal transfer form, the movements of the patients can be facilitated to the needed healthcare systems and attended to in a timely manner. The standard forms enable appropriate evaluation of the patient data and the result is better and improved treatment. The system will enable my organization deliver better and desired care to the patients and avert the problems of continuity in care provision and reduce readmissions that are costly to the organization.

Critical Appraisal Tool Summary

The Critical Appraisal tool offered guidelines for the treatment of various disease conditions.

The evidence based practice were identified as effective in the molecular analysis of the lung cancer required in guiding ALK and EGFR.

The information provided to the physicians was established as essential in the treatment process especially with regard to the use of external beam radiotherapy.

The critical Appraisal Tools were effective in the illustration of various aspects of Evidence based practice. The CAT illustrated various methods of evidence practice such as molecular analysis, external beam radiotherapy, palliative treatment and even chemotherapy (Azzoli, Temin, & Giaccone, 2012. The CAT was also effective in the illustration of the communication of the patient data that is effective in the treatment of the patients especially to prevent the problems such as readmissions and reduce the chances of ineffectiveness during the transition process (Lindeman et al., 2013). The evidence based practice got identified as effective in the molecular analysis of the lung cancer and other sensitive conditions that require careful address.

Evaluation Table Summary

The various methods of evidence based practiced were discussed in the tables including palliative and radioactivity methods.

I learned that communication between the caregivers is essential in the improvement of health of the patients and especially in the transition process.

The tables illustrated the various levels of research based on the theoretical concepts used in the research.

Most of the research done were associated with the analysis of the literature review especially on the peer reviewed articles that support the various treatment methods of disease conditions especially the lung cancer (Rodrigue et al., 2011).

References

Azzoli, C. G., Temin, S., & Giaccone, G. (January 01, 2012). 2011 Focused Update of 2009 American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer. Journal of Oncology Practice, 8, 1, 63-6.

Flynn, G., & Dupuis, S. (2003). EASING THE TRASITION FROM COMMUNITY CARE TO LONG-TERM CARE.

Lindeman, N. I., Cagle, P. T., Beasley, M. B., Chitale, D. A., Dacic, S., Giaccone, G., Jenkins, R. B., …College, . A. P. I. A. S. L. C. A. M. P. (January 01, 2013). Molecular testing guideline for selection of lung cancer patients for EGFR and ALK tyrosine kinase inhibitors: guideline from the College of American Pathologists, International Association for the Study of Lung Cancer, and Association forMolecular Pathology. The Journal of Molecular Diagnostics : Jmd, 15, 4, 415-53.

References

Lim, E., Baldwin, D., Beckles, M., Duffy, J., Entwisle, J., Faivre-Finn, C., Kerr, K., … Win, T. (October 01, 2010). Guidelines on the radical management of patients with lung cancer. Thorax, 65.

Mansukhani, R. P., Bridgeman, M. B., Candelario, D., & Eckert, L. J. (2015). Exploring transitional care: evidence-based strategies for improving provider communication and reducing readmissions. Pharmacy and Therapeutics, 40(10), 690.

Rodrigues, G., Videtic, G. M., Sur, R., Bezjak, A., Bradley, J., Hahn, C. A., Langer, C., … Movsas, B. (January 01, 2011). Palliative thoracic radiotherapy in lung cancer: An American Society for Radiation Oncology evidence-based clinical practice guideline. Practical Radiation Oncology, 1, 2.)

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References

Schroy III, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27-35.