Benchmark – Evidence-Based Practice Proposal

Assessment Description

Throughout this course, you have been developing a formal, evidence-based practice proposal.

The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern with Care Management. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals are submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed, but they should be at least 3,500 words. The cover sheet, abstract, References page, and appendices are not included in the word count.

Section headings and letters for each section component are required. Responses are addressed in narrative form in relation to that number. Evaluation of the proposal in all sections is based upon the extent to which the depth of content reflects graduate-level critical thinking skills.

This project contains six formal sections: Please use the attached sections A-F which has already been written and include it in the final paper

1. Section A: Problem Description

2. Section B: Research Support

3. Section C: Proposed Solution

4. Section D: Change Model

5. Section E: Implementation Plan

6. Section F: Evaluation of Process

The final paper will consist of the completed project, title page, abstract, References list, and appendices. Appendices will include a conceptual model for the project, handouts, data and evaluation collection tools, a budget, a timeline, resource lists, and approval forms.

An abstract is required for the final paper.

Refer to the “EBP Implementation Plan Guide” and the “Evidence-Based Practice Project Proposal Format” as tools for developing your proposal.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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Care Management

Kimberly Boynton

Grand Canyon University

HCA-699- Evidence Based Research Project

Edward Paulch

10/13/2021

Care Management

Care management is a term that refers to the activities carried out to improve patient care and reduce the need for medical services by enhancing care coordination and helping patients and caregivers to manage their healthcare conditions effectively. Care management utilizes several integrated programs which extend beyond current clinical care. Care management consists of several healthcare professionals, such as nurses, social workers, and patent educators. These healthcare management professionals work collaboratively to create a health care plan that will help meet the specific needs. Care management services include patient education, medication management, managing symptoms, and preventative testing. This essay aims to formulate a PICOT question associated with care management, describing the problem’s background and identifying the key stakeholders.

Background of the Problem

The problem that is aimed to be solved in care management is high rehospitalization rates due to poor care management among adults. Older adults are at risk have several complex medical and social needs that are fatal and can result in high increased mortality rates among older adults if care management for these adults is not efficient and effective. These medical conditions and social needs result in rapid hospitalization of older adults, which can be prevented through care management ((Wideman, 2012). Although the united states government has put in place several regulations and policies to ensure that the care management offered to older people is the best, several challenges have made it impossible to meet goals that have been put in place. One of the challenges includes a lack of guidelines to address care transitions between the hospital and the nursing home. Standardized disease management approaches should be introduced in geriatric care management to help lower hospitalization rates of the intended population. One of the ways to improve the quality of geriatric care management is through the use of pay for performance incentives. Pay for performance incentives are offered to healthcare providers if they meet specific performance results instead of their work. This incentive will motivate the healthcare team responsible for geriatric care management to improve the quality of care, efficiency, and the overall care they will be providing for the older adults, resulting in reduced hospitalization rates.

Stakeholders

Several stakeholders are involved in the care management of older persons. These stakeholders are older adults, healthcare providers, the united states government, payers and policymakers, and the Medicare and

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Research Support

Kimberly Boynton

Grand Canyon University

HCA-699-Evidence-Based Research Project

Edward Paluch

10/27/2021

Research Support

Description of Search Method

A total of twelve research articles were selected for this assignment. These articles were obtained from Google Scholar, CINAHL, and the Cochrane Database. The keywords used to identify these articles are care management, social support, pay for performance incentives, and rehospitalization rates of older adults. The first inclusion criteria for the articles for the assignment were that they had to be recent within the past five years, and the articles also had to be peer-reviewed for them to be selected. The third inclusion criteria are that the articles must be relevant to the PICOT question to help inform the evidence-based practice. A total of forty-nine articles were first selected before being excluded based on the year published and relevance to the PICOT question. Thirty-seven articles did not meet the selection criteria and were excluded from the study, and twelve articles met the selection criteria.

Summary of Research Studies

Donelan et al. (2019) conducted a qualitative study to determine how healthcare practices allocate staff for care management activities. The data was collected through questionnaires, and 363 practices that offer geriatric care and 410 were studied. The study determined that when the practices had both registered nurses and a social worker, the role of physicians and NP clinicians differed when it came to chronic care management and care coordination activities. It also found out that registered nurses were more involved in care management and coordination during transitions. There were several limitations that the authors of the article identified. The first limitation is that the data was self-reported in a national random sample, resulting in sampling error and response or non-response errors (Donelan et al., 2019). The second limitation is that data on patient-centered medical home certification was not included in the questionnaires, or the sample frames used by the authors. The data obtained on care management is reliable for patients who are 65 years old or older and might not reflect on younger patients. The group of practices with social workers was small but not compared to registered nurses with the smallest representation. The strength of the study is that it has met its purpose and is relevant to my study.

Bookey et al. (2017) conduct a systematic qualitative review of studies on how interprofessional collaborations impact care management in adults with chronic conditions. The authors determined that interprofessional collaborations are important to ensure proper care management of adults with chronic diseases. The study’s limitations are

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Proposed Solution

Kimberly Boynton

Grand Canyon University

HCA699-Evidence-Based Research Project

Edward Paluch

11/3/2021

Health care is one of the critical aspects of our daily lives. It helps the patients to recover from their illness, thereby contributing to the sustainability of society (Peckham and Wallace, 2018). However, there is a gap in the daily management of hospitals, clinics, and other health care environments. Low quality of services from health care providers has diminished the rate at which patients, especially the older ones, recover from their illness. To improve the quality of service, the pay for performance is the ideal solution that can improve the morale and motivation among the health care providers (Brunn, 2017). The pay for performance arouses the interests of nurses since they feel a sense of belonging at their respective solutions. Additionally, it also increases coordination among the health care professionals that helps to improve the competency levels of the nurses and the doctors. In our health care setting, this solution might be realistic since the hospital management can reduce other unnecessary expenses and use the excess income to introduce the pay for performance initiative (Antoñanzas, Rodríguez-Ibeas, and Juárez-Castelló, 2018). However, cost leadership would be highly required in this case. The hospital management can reduce the number of suppliers and concentrate on the most critical aspect of the health care facility, such as drug availability. This would help them save excess funds for this initiative. In UK and Canada, this concept has gained popularity due to the effectiveness of the leaders (Mathes et al., 2019). The government and the leaders have co-operated to ensure health care professionals are paid according to their performance. In the last two years, both countries have recorded a 5% increase in the quality of services provided at health care facilities (Kovacs et al., 2020). Therefore, in our health care setting, it is possible to introduce this strategy to enhance the competency of health care services provided.

The organizational culture is very crucial in a health care setting. It dictates the daily operations of any health care facility. The proposed solution is consistent with the operations of the organizational culture since it leads to improved performance in the health care facility. One of the objectives of the organizational culture is to set standards for improved per

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Pay for Performance Initiative Implementation Model

Kimberly Boynton

Grand Canyon University

HCA699- Evidence-Based Research Project

Edward Paluch

11/10/2021

Part D – Change Model

Roger’s diffusion of innovation theory

Implementing pay for performance for nurses on improving care management and reducing re-hospitalization rates among the aging population can be done using Roger’s diffusion of innovation theory. Diffusion of Innovation (DOI) is used to explain how an idea gains momentum and spreads through a particular population over time. According to DOI theory, the spread’s result is that people adopt innovative ideas or behavior. Adoption means that there will be a meaningful change in the way people do things. In my organization, the implementation of pay for performance initiative will motivate nurses (García‐Avilés, 2020). It is also associated with low re-hospitalization rates among people with acute conditions, ensuring proper care management. The use of the DOI model to implement this initiative implies that after a short while, nurses and physicians who are the main stakeholders in the implementation of this initiative would start performing their roles differently than how they have been doing it previously.

The adoption of an idea and innovation does not happen simultaneously in a healthcare organization. Instead, it is a process where some nurses and physicians are more apt to adopt the innovation than others. The model asserts that people who adopt an idea earlier have distinct features than those who embrace an idea later. There are five adopter categories proposed in DOI. They include innovators, early adopters, early majority, late majority, and laggards (Mohammadi et al., 2018). These adopter categories are used to appeal to the target population when promoting an innovation.

Innovators: Innovators are a set of customers that use new products as soon as they are launched, that is are the first set of customers of any new technology or new products it count for 2.5% and product example of Innovation model is Foldable Phones, Foldable phones are very few in few in numbers and is a very new product, one will hardly find people using it. There is extraordinarily little that needs to be done to the initiative to appeal to these people.

Early adopters: These are people who represent opinion leaders. These are people who embrace change opportunities in an organization and enjoy leadership roles. These people are aware that an organization needs change, and therefore they are comfortable adopting innovative ideas, and they do not need the information to convince them to change.

Early Majority: These are the set of customers those who widely adopt an innovative new product and are accepted by th

Dissemination of Evidence

Care Management Proposal

Kimberly Boynton

Introduction

Care management is a term that refers to the activities carried out to improve patient care and reduce the need for medical services

Care management consists of several healthcare professionals, such as nurses, social workers, and patent educators (Wideman, 2012).

Care management services include patient education, medication management, managing symptoms, and preventative testing

The problem that is aimed to be solved in care management is high rehospitalization rates due to poor care management among adults.

One of the ways to improve the quality of geriatric care management is through the use of pay for performance incentives

Care management is a term that refers to the activities carried out to improve patient care and reduce the need for medical services by enhancing care coordination and helping patients and caregivers to manage their healthcare conditions effectively. Care management utilizes several integrated programs which extend beyond current clinical care. Care management consists of several healthcare professionals, such as nurses, social workers, and patent educators. These healthcare management professionals work collaboratively to create a health care plan that will help meet the specific needs (Wideman, 2012). Care management services include patient education, medication management, managing symptoms, and preventative testing.

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The PICOT Question

In older patients (P), what is the effect of pay for performance incentives for nurses (I) on improving care management and reducing rehospitalization rates (O) compared with the use of social support (C) within six months?

P-Elderly patients

I-Effect of pay performance incentives for nurses

O-Improving care management and reducing rehospitalization rates

C-Compared with the use of social support

T-Within six months

One of the ways to improve the quality of geriatric care management is through the use of pay for performance incentives. Pay for performance incentives are offered to healthcare providers if they meet specific performance results instead of their work. This incentive will motivate the healthcare team responsible for geriatric care management to improve the quality of care, efficiency, and the overall care they will be providing for the older adults, resulting in reduced hospitalization rates.

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The benefits of care management

Health care providers and social caregivers would improve the quality of performance of the elders by providing both physical and social support

Pay for performance is expected to improve the level of competency among the health caregivers since they would improve their services and attrac

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