Care Coordination Presentation to Colleagues

Care Coordination Presentation to Colleagues

Hello everyone, and welcome to this video presentation. As you already know, my name is Sarah Enow. It is always a pleasure to work with you and learn a new thing every day from every one of you. In this video presentation, I will highlight and help you understand the fundamental principles of care coordination. But first, what do I mean by care coordination? Care coordination, according to the Agency for Healthcare Research and Quality (2018), is the deliberate organization of the activities involved in patient care and the sharing of information necessary for the patient care plan among all of the participants that are involved in the caring of patients with the aim of achieving safer and more effective care. Therefore, it can be viewed as the initiative to bring together the right people at the right time and use the right information to deliver the best care to meet the patient’s needs and preferences. With that, I will introduce to you effective strategies to consider while collaborating with patients and their families to achieve desired health outcomes and how to manage the change that directly affects the elements of the patient experience that define high-quality, patient-centered care. There are many reasons why coordinated care plans should be based on ethical decision-making and healthcare policy provisions during the coordination of care. Therefore, I will clearly explain how and why consideration of ethics and policy provisions are important when coordinating care and how they influence the outcomes of the care and patient experiences. At the end of this video, you will understand why your role is essential in the coordination and continuum of care, especially for high blood pressure care.

First, let me outline the most effective strategies for collaborating with patients and their families to achieve desired health outcomes.

We all must understand that the best care can only be delivered by collaborating with the patient and their families as well as other caregivers of the patient. A major strategy that remains effective in improving collaboration between the patient and their families is being effective in our communication. This means that we need to always provide the right information about the patient, treatment details, and any other care interventions at the right time to the right people in a manner that every member of the care team understands. This includes the patients and their family members. Notably, we are not just required to be effective in our communication. Accordingly, as an effective strategy, we are all expected to consider the individual preferences of the patient and the family members. This, as described by Kokorelias et al. (writing in 2019), is the first step towards the delivery of family-centered care.

Additionally, Brooks et al. (writing in 2019) view culturally sensitive communication as vital in creating an environment in which effective interactions occur even in culturally diverse settings involving difficult situations. In this case, we are expected to improve our cultural knowledge and competence. Additionally, you can educate the patient and their families on their role in the care coordination plan and what is expected of them to achieve the set care goals. The patient and family education can also focus on the medication and care interventions adopted to care for the patient. We always need to help the patient and their caregivers understand the medication, the risks if overdosed, and what to take the medications and when to take them. Evidence presented by Xie et al. (writing in 2020) shows that patient education significantly improves the patient’s adherence to self-management behaviors with an impact on the outcomes of hypertensive patients with comorbid type 2 diabetes. You can employ various resources such as peer support groups and the Internet to support patient education.

Now, I’d like to identify change management aspects that directly affect elements of the patient experience essential to providing high-quality, patient-centered care.

Change is a part of care coordination. Understanding the aspects of change management that directly affect elements of the patient experience essential to providing high-quality, patient-centered care can help you succeed in your care coordination plan. A vital aspect of change management is communication. As noted earlier, we must ensure that we communicate effectively. This involves being clear in our communication regardless of whether we are communicating with the patient, their family members, or health care professionals involved in the care coordination plan. As such, we are supposed to tell them of the planned changes and let them improve on that changes. Therefore, try to be as effective in your communication as possible. Another essential aspect of change is feedback. Always be open to giving and receiving feedback, and do not wait for the members of the coordination plan to give it to you, whether it is about their experiences or what they feel needs to be done; we always need to solicit feedback and give it. This will help you identify achieved successes and what needs to be done to further align the change to the expected care outcomes and goals. And most importantly, train the care team members on what they need to do and when and where they need to do it to facilitate successful change. All of these aspects of change management, effective communication, giving and receiving feedback, and training of care team members significantly impact the patient experience and can help deliver quality patient-centered care.

Before implementing the care coordination plan, let me first explain why it is important to base and design the care coordination plan on ethically made decisions. The first rationale for basing coordinated care plans on ethical decision-making is how ethics in nursing make us accountable for the care and the outcomes of the provided care (Haddad & Geiger, 2022). An ethical approach to patient care will always ensure that the needs and preferences of the patients and their families define how the coordinated care plan is designed. This means that it is possible to provide more patient- and family-centered coordinated care. According to Ko et al. (writing in 2019), this improves the efficiency of the care operations and the outcomes of the care plan.

Now, let’s discuss the potential impact of specific healthcare policy provisions.

As you know, healthcare policy provisions can potentially impact the outcomes of coordinated care and patient experiences. As such, specific healthcare policy provisions potentially impact outcomes and patient experiences. One such specific policy provision is HIPAA’s privacy rule. The provisions of the privacy rule focus on the privacy and confidentiality of personally identifiable healthcare information and the need for patient’s consent in sharing such information. This means that nurses must ensure the highest level of confidentiality when handling and sharing patient information. The provisions guarantee the privacy of patient information. Therefore, the patients get to trust the care professionals with the information they give. This can improve patient care planning or make necessary changes to the coordinated care plan based on the new patient-provided information. In fact, evidence from a study by Miller et al. (writing in 2019) focusing on advance care planning (ACP) notes that assured privacy show that it improves the therapeutic relationship between patients and nurses and helps the openness of the patients in making wishes known. The study further notes that this helped with communication challenges and improved the experiences of the patient and the family members.

Nurses have a vital role in the coordination and continuum of care.

So far, you have noted that the nurse is the master planner of the care delivered to patients based on the considerations of the needs and preferences of the patient and their families. At all levels of the delivery of coordinated care, the nurse sets care goals for the patient, educates the patient and their family members, identifies the needed resources for the care plan, organizes the resources, and helps identify and manage needed care changes. The nurses must ensure that the patient and their families receive the best care and treatment regardless of whether they are within the facility settings or receiving care from home. Therefore, as a nurse, you are a vital element in the coordination of care and throughout the entire continuum of care.

As I conclude, let me remind you that care coordination goes beyond just bringing the needed resources to care for the patient. Therefore, we should all know how to make the different resources work together effectively. The coordinated care plan should be modeled around the patient and family’s needs and preferences. All care decisions must be guided by the existing ethical codes as well as policy provisions with regard to care coordination. Finally, as a nurse, always remember that you have a duty to the patient. Therefore, we should ensure we achieve the best possible patient experiences and care outcomes.

Thank you!

References

Agency for Healthcare Research and Quality. (2018). Care Coordination. AHRQ. https://www.ahrq.gov/ncepcr/care/coordination.html

Brooks, L. A., Bloomer, M. J., & Manias, E. (2019). Culturally sensitive communication at the end-of-life in the intensive care unit: A systematic review. In Australian Critical Care (Vol. 32, Issue 6). https://doi.org/10.1016/j.aucc.2018.07.003

Haddad, L. M., & Geiger, R. A. (2022). Nursing Ethical Considerations. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK526054/

Ko, D. G., Mai, F., Shan, Z., & Zhang, D. (2019). Operational efficiency and patient-centered health care: A view from online physician reviews. Journal of Operations Management, 65(4), 353–379. https://doi.org/10.1002/JOOM.1028

Kokorelias, K. M., Gignac, M. A. M., Naglie, G., & Cameron, J. I. (2019). Towards a universal model of family-centered care: A scoping review. BMC Health Services Research, 19(1), 1–11. https://doi.org/10.1186/S12913-019-4394-5/FIGURES/2

Miller, H., Tan, J., Clayton, J. M., Meller, A., Hermiz, O., Zwar, N., & Rhee, J. (2019). Patient experiences of nurse-facilitated advance care planning in a general practice setting: A qualitative study. BMC Palliative Care, 18(1), 1–8. https://doi.org/10.1186/S12904-019-0411-Z/PEER-REVIEW

Xie, Z., Liu, K., Or, C., Chen, J., Yan, M., & Wang, H. (2020). An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. BMC Public Health, 20(1), 1–13. https://doi.org/10.1186/S12889-020-09274-4/TABLES/6

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Develop a 20-minute presentation for nursing colleagues highlighting the fundamental principles of care coordination. Create a detailed narrative script for your presentation, approximately 4-5 pages in length, and record a video of your presentation.

Care Coordination Presentation to Colleaguess

Introduction
Nurses have a powerful role in the coordination and continuum of care. All nurses must be cognizant of the care coordination process and how safety, ethics, policy, physiological, and cultural needs affect care and patient outcomes. As a nurse, care coordination is something that should always be considered. Nurses must be aware of factors that impact care coordination and of a continuum of care that utilizes community resources effectively and is part of an ethical framework that represents the professionalism of nurses. Understanding policy elements helps nurses coordinate care effectively.

This assessment provides an opportunity for you to educate your peers on the care coordination process. The assessment also requires you to address change management issues. You are encouraged to complete the Managing Change activity.

Completing course activities before submitting your first attempt has been shown to make the difference between basic and proficient assessment.

Preparation
Your nurse manager has been observing your effectiveness as a care coordinator and recognizes the importance of educating other staff nurses in care coordination. Consequently, she has asked you to develop a presentation for your colleagues on care coordination basics. By providing them with basic information about the care coordination process, you will assist them in taking on an expanded role in helping to manage the care coordination process and improve patient outcomes in your community care center.

To prepare for this assessment, identify key factors nurses must consider to effectively participate in the care coordination process.

You may also wish to:

Review the assessment instructions and scoring guide to ensure you understand the work you will be asked to complete.
Allow plenty of time to rehearse your presentation.
Recording Equipment Setup and Testing
Check that your recording equipment and software are working properly and that you know how to record and upload your presentation. You may use Kaltura (recommended) or similar software for your audio recording. A reference page is required. However, no PowerPoint presentation is required for this assessment.

If using Kaltura, refer to the Using Kaltura tutorial for directions on recording and uploading your video in the courseroom.
Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@capella.edu to request accommodations.

Instructions
Complete the following:

Develop a video presentation for nursing colleagues highlighting the fundamental principles of care coordination. Include community resources, ethical issues, and policy issues that affect the coordination of care. To prepare, develop a detailed narrative script. The script will be submitted along with the video.
Note: You are not required to deliver your presentation.

Presentation Format and Length
Create a detailed narrative script for your video presentation, approximately 4–5 pages in length. Include a reference list at the end of the script.

Supporting Evidence
Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your video. Include your source citations on a references page appended to your narrative script. Explore the resources about effective presentations as you prepare your assessment.