Policy Proposal

Policy Proposal

Mercy Medical Center ranks among the best healthcare facilities of Vila Health that provide quality patient center services. However, the evaluation of its benchmark metrics revealed underperformance in the three benchmarks: eye exams, foot exams, and Hgb1Ac tests. Notably, foot exams had the worst performance, followed by eye exams. This paper proposes policy and practice guidelines that facilitate improved quality and performance of the benchmark metrics.

Need for Policy and Practice Guidelines

The evaluation of the benchmark metrics revealed underperformance in the three benchmarks. According to Dashboard Metrics Evaluation Simulation (n.d.), eye exams conducted in 2019 and 2020 are 50, 48, 60, 42, 62, 48, 58, and 64. These figures are lower than the benchmark values of the state of Minnesota and the federal government, which stand at 73.1 and 75.2, respectively (NHQDR, n.d.). Data from the Dashboard metrics indicated 60, 58, 42, 70, 75, 50, 48, and 62-foot exams were conducted in the quarters of 2019 and 2020, respectively (Dashboard Metrics Evaluation Simulation, n.d.). Accordingly, eye exams underperformed because the state of Minnesota and the federal government have their metrics set at 82.9 and 84, respectively (NHQDR, n.d.). According to Dashboard Metrics Evaluation Simulation (n.d.), Mercy Medical Center conducted 60, 48, 60, 42, 72, 58, 78, and 64, Hgb1Ac tests in the quarters of 2019 and 2020, respectively. These metrics ranked lower than the benchmark metrics of the state of Minnesota and the federal government, which are set at 70.4 and 79.5, respectively (NHQDR, n.d.).

The metrics recorded in 2020 reveal that 41.2%, 41.7%, and 48.3% of diabetic patients received eye exams, foot exams, and Hgb1Ac tests, respectively. When compared with the state mentioned above and federal benchmarks, foot exams have the worst performance, followed by eye exams. Hgb1Ac tests attained the best performance at Mercy Medical Center. However, a comparison with the benchmark metrics of the state of Minnesota and the federal government reveals underperformance.

The underperformance of the benchmark metrics implies that the facility does not conduct routine patient screening and follow-ups. This lowers the quality of healthcare services. The underperformance in the number of eye exams implies that diabetic patients at the facility are at risk of developing diabetic retinopathy. This is a microvascular complication that predisposes individuals to blindness (Wang & Lo, 2018). The underperformance in foot examinations implies that diabetic patients at the facility are predisposed to foot complications. According to Monteiro-Soares et al. (2020), this microvascular complication can be classified as ischemic, neuropathic, or neuro-ischemic. Poorly managed diabetic foot complications necessitate amputation (van Netten et al., 2020).

Policy and Practice Guidelines for the Improvement of the Performance Metrics

Policy Statement

Underperformance in the number of foot exams, eye exams, and Hgb1Ac tests is an indicator of reduced quality of healthcare service delivery and predisposes patients to microvascular and macrovascular diabetic complications. This policy is a guide for healthcare providers to enable them to conduct routine tests and exams on diabetic patients. The aim is to improve the performance of the benchmark metrics.

Scope

The policy applies to the members of the hospital administration and the interdisciplinary team of healthcare providers involved in the management of diabetics.

Practice Guidelines

The interprofessional team should embrace routine screening, patient follow-ups, and continuous patient education. Routine screening targets patients’ vitals, such as their random blood sugar levels, fasting blood sugar levels, Hgb1Ac, eye and foot examinations, and renal function tests (Johnson & Carragher, 2018). Diabetics aged 40 years and above and those who have had diabetes for at least seven years should receive more than one foot and eye exam annually (Johnson & Carragher, 2018). Patient education entails the importance of compliance with treatment plans and lifestyle modification (Park et al., 2020). Patient follow-ups enable healthcare providers to contact defaulters and ensure that they comply with medical instructions.

The hospital administration should optimize staff ratios. This will address the problem of understaffing and reduce the burnout and stress experienced by healthcare providers. Consequently, the productivity of staff and quality of service delivery will increase. This is key to enforcing routine screening, patient follow-ups, and continuous patient education. Stakeholders should embrace healthcare ethics and holistic care to ensure ethical and cultural inclusivity. Examples of healthcare ethics are nonmaleficence, justice, autonomy, and beneficence (McDermott-Levy et al., 2018).

Effects of Environmental Factors

The guidelines can be affected by two factors: improper documentation and inadequate financing. Adequate financing is required to ensure that additional healthcare providers are recruited to the task force. This will ensure that the ratios of healthcare providers to patients are optimized and minimize burnout and stress (Marć et al., 2019). Eventually, their productivity is increased. Furthermore, activities such as patient follow-ups require adequate financing because they involve phone calls, emailing, and visiting the patient. Proper documentation enhances the accuracy and reliability of data. This is required during screening, patient education, and follow-ups. The facility should have an accurate record of enrolled diabetic patients, those who have completed their scheduled screening, and defaulters. This avoids confusion and mix-ups by ensuring that the right patient has received the right intervention.

Stakeholder Involvement in Implementing Proposed Strategy

Members of the hospital administration and healthcare providers are key stakeholders in implementing the policy. The hospital administration should ensure that adequate financing is allocated to optimize staff ratios and patient follow-up activities. Furthermore, the hospital administration should collaborate with the directors of various departments to enforce performance evaluation and feedback. Evaluation and feedback will promote accountability because healthcare providers will adhere to the practice guidelines and the policy. Healthcare providers should embrace interdisciplinary collaboration when implementing the proposed policy and practice guidelines (Johnson & Carragher, 2018). Accordingly, this will enhance the clinical decision-making process and ensure that evidence-based practices are used when implementing the policy and practice guidelines.

Conclusion

The underperformance of the benchmark metrics implies that the facility does not conduct routine patient screening and follow-ups. This lowers the quality of healthcare services and can predispose patients to microvascular and macrovascular complications. Policy and practice guidelines that embrace routine screening, patient follow-ups, continuous patient education, and optimization of the ratios of healthcare providers can help improve the performance of the benchmark metrics.

References

Dashboard Metrics Evaluation Simulation.pdf. (n.d.). Dashboard and Healthcare Benchmark Evaluation.

Johnson, J. M., & Carragher, R. (2018). Interprofessional Collaboration and the Care and Management of Type 2 Diabetic Patients in the Middle East: A Systematic Review. Journal of Interprofessional Care, 32(5), 621–628. https://doi.org/10.1080/13561820.2018.1471052

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A Nursing Shortage – A Prospect of Global and Local Policies. International Nursing Review, 66(1), 9–16. https://doi.org/10.1111/inr.12473

McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical Principles and Guidelines of Global Health Nursing Practice. Nursing Outlook, 66(5), 473–481. https://doi.org/10.1016/j.outlook.2018.06.013

Monteiro-Soares, M., Russell, D., Boyko, E. J., Jeffcoate, W., Mills, J. L., Morbach, S., & Game, F. (2020). Guidelines on the Classification of Diabetic Foot Ulcers (IWGDF 2019). Diabetes/Metabolism Research and Reviews, 36(S1), 1–8. https://doi.org/10.1002/dmrr.3273

National Healthcare Quality and Disparities Report. (n.d). Minnesota Diabetes Quality Measures Compared to Achievable Benchmarks. https://nhqrnet.ahrq.gov/inhqrdr/Minnesota/benchmark/table/Diseases_and_Conditions/Diabetes

Park, J. H., Moon, J. H., Kim, H. J., Kong, M. H., & Oh, Y. H. (2020). Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks. Korean Journal of Family Medicine, 41(6), 365–373. https://doi.org/10.4082/KJFM.20.0165

van Netten, J. J., Bus, S. A., Apelqvist, J., Lipsky, B. A., Hinchliffe, R. J., Game, F., Rayman, G., Lazzarini, P. A., Forsythe, R. O., Peters, E. J. G., Senneville, É., Vas, P., Monteiro-Soares, M., & Schaper, N. C. (2020). Definitions and Criteria for Diabetic Foot Disease. Diabetes/Metabolism Research and Reviews, 36(S1), 1–6. https://doi.org/10.1002/dmrr.3268

Wang, W., & Lo, A. C. Y. (2018). Diabetic Retinopathy: Pathophysiology and Treatments. International Journal of Molecular Sciences, 19(6). https://doi.org/10.3390/ijms19061816

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Assessment 2 Instructions: Policy Proposal
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Write a 3-5 page policy proposal and practice guidelines for improving quality and performance associated with the benchmark metric underperformance you advocated for improving in Assessment 1.

Introduction
In advocating for institutional policy changes related to local, state, or federal health care laws or policies, health leaders must be able to develop and present clear and well-written policy and practice guideline proposals that will enable a team, a unit, or an organization as a whole to resolve relevant performance issues and bring about improvements in the quality and safety of health care. This assessment offers you an opportunity to take the lead in proposing such changes.

As a master’s-level health care practitioner, you have a valuable viewpoint and voice to bring to discussions about policy development, both inside and outside your care setting. Developing policy for internal purposes can be a valuable process toward quality and safety improvement, as well as ensuring compliance with various health care regulatory pressures. This assessment offers you an opportunity to take the lead in proposing such changes.

Propose organizational policy and practice guidelines that you believe will lead to an improvement in quality and performance associated with the benchmark underperformance you advocated for improving in Assessment 1. Be precise, professional, and persuasive in demonstrating the merit of your proposed actions.

Note: Remember that you can submit all, or a portion of, your draft policy proposal to Smarthinking for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Requirements
The policy proposal requirements outlined below correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.

Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
What is the current benchmark for the organization and the numeric score for the underperformance?
How is the benchmark underperformance potentially affecting the provision of quality care or the operations of the organization?
What are the potential repercussions of not making any changes?
What evidence supports your conclusions?
Recommend ethical, evidence-based practice guidelines to improve targeted benchmark performance prescribed by applicable local, state, or federal health care policy or law.
What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark?
How would these strategies ensure performance improvement or compliance with applicable local, state, or federal health care policy or law?
How would you propose to apply these strategies in the context of Eagle Creek Hospital or your own practice setting?
How can you ensure these strategies are ethical and culturally inclusive in their application?
Analyze the potential effects of environmental factors on your recommended practice guidelines.
What regulatory considerations could affect your recommended guidelines?
What resources could affect your recommended guidelines (staffing, financial, and logistical considerations, or support services)?
Explain why particular stakeholders and groups must be involved in further development and implementation of your proposed policy and practice guidelines.
Why is it important to engage these stakeholders and groups?
How can their participation produce a stronger policy and facilitate its implementation?
Organize content so ideas flow logically with smooth transitions.
Proofread your proposal, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.
Use paraphrasing and summarization to represent ideas from external sources.
Be sure to apply correct APA formatting to source citations and references.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 2 Example [PDF].
Policy Proposal Format and Length
It may be helpful to use a template or format for your proposal that is used in your current organization. The risk management or quality department could be a good resource for finding an appropriate template or format. If you are not currently in practice, or your organization does not have these resources, many appropriate templates are freely available on the Internet.

Your policy should be succinct (about one paragraph). Overall, your proposal should be 3-5 pages in length.

Supporting Evidence
Cite 3–5 references to relevant research, case studies, or best practices to support your analysis and recommendations.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.

Portfolio Prompt: You may choose to save your policy proposal to your ePortfolio.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Analyze relevant health care laws, policies, and regulations; their application; and their effects on organizations, interprofessional teams, and professional practice.
Analyze the potential effects of environmental factors on recommended practice guidelines.
Competency 2: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.
Recommend ethical, evidence-based practice guidelines to improve targeted benchmark performance prescribed by applicable local, state, or federal health care policies or laws.
Competency 3: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, to inform health care laws and policies for patients, organizations, and populations.
Explain the need for creating a policy to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws.
Competency 4: Develop strategies to work collaboratively with policy makers, stakeholders, and colleagues to address environmental (governmental and regulatory) forces.
Explain why particular stakeholders and groups must be involved in further development and implementation of a proposed policy and practice guidelines.
Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella’s writing standards.
Organize content so ideas flow logically with smooth transitions.
Use paraphrasing and summarization to represent ideas from external sources.