NHS FPX 6004 Assessment 2 Policy Proposal

Name

Capella university

NHS-FPX 6004 Health Care Law and Policy

Prof. Name

Date

Policy Proposal

This assessment is a continuation of assessment one, in which we performed a dashboard metrics analysis for Mercy Medical Center (MMC) against the federal benchmarks. The organization represented a shortfall in diabetes eye screening tests, foot examinations, and HgBA1c tests. This assessment proposes policy and practice guidelines to address organizational underperformance, mainly focusing on comprehensive eye examination. 

Need for Policy and Practice Guidelines

The current benchmark for diabetes eye examinations, as prescribed by the Agency for Healthcare Research and Quality (AHRQ), is 75.2% (AHRQ, n.d.). However, the organization’s performance has significantly lagged, with only 35.5% of patients receiving eye exams in 2019 and 41.2% in 2020. This underperformance highlights a substantial gap in the provision of essential preventive care for diabetes patients.

While this practice gap impacts patients’ health, it also negatively affects the quality of care provided by MMC. With decreased eye examinations, healthcare providers are lacking in early identification of diabetes complications, particularly diabetic retinopathy, a significant cause of vision loss among diabetic patients (Kropp et al., 2023). Ultimately, the organization encounters strain on resources as more advanced and costly treatments are required when complications are not detected early. Moreover, a lack of quality preventative services results in decreased patient trust and satisfaction, potentially leading to a decline in patient retention and influx. 

NHS FPX 6004 Assessment 2 Policy Proposal

The potential repercussions of not addressing this underperformance are severe. Without intervention, the incidence of diabetic retinopathy and associated blindness will likely rise, increasing the health and financial burden on patients, the healthcare system, and the communities. While patients may have to incur additional healthcare costs, the organization may face increased costs due to intensive treatments and potential penalties from insurance payers, as these payments are linked to quality of care and measures that assess this quality (Sarkar et al., 2020).

Additionally, there could be a detrimental impact on MMC’s accreditation, ultimately declining the organization’s reputation among the population served.  Thus, to prevent jeopardizing MMC’s standing in the community and its potential ramifications, there’s a substantial need for comprehensive policy and practice guidelines within the organization. 

Summary of Policies and Practice Guidelines 

The proposed policy and practice guidelines for MMC are grounded in the recommendations of the American Academy of Ophthalmology (AAO) and the American Diabetes Association (ADA). The proposed policy statement is as follows: 

Policy Statement: Mercy Medical Center (MMC) is committed to providing high-quality, comprehensive care for patients with diabetes. The policy includes two postulates – All patients diagnosed with diabetes will receive an annual dilated eye examination, and patients with no signs of retinopathy and well-controlled glycemia, as determined by the healthcare provider, will be screened minimally once every other year (Jotte et al., 2023). 

Practice Guidelines

To implement this policy at MMC, the following practice guidelines are established, involving healthcare providers, administrative leaders, and patient advocates. 

• Healthcare providers, including primary care physicians and nurses, should identify patients with diabetes and ensure they are scheduled for annual or biennial eye examinations. Providers should also practice educating patients on the importance of retinal exams in diabetes, increasing their adherence to screening visits (Moinul et al., 2020). 

• Administrators must make screening resources available for the providers and patients to prevent practice impediments. Additionally, they must conduct follow-up audits to ensure effective implementation of policy and work on areas of improvement. 

• Patient advocates should develop and distribute culturally competent educational materials that explain the importance of regular eye exams. They must advocate and establish telehealth services in partnership with community organizations to address any barriers to accessing care, such as transportation or financial constraints (Dhediya et al., 2022). 

Factors Affecting Policy and Practice Guidelines 

Several environmental factors influence these policy and practice guidelines within the MMC, including the availability of resources, IT infrastructure, and the dynamic nature of healthcare regulations. Adequate financial, human, and logistical resources are necessary for performing comprehensive eye examinations every year (Khanna et al., 2020). Without sufficient funding, these screening tests may remain underperformed, limiting MMC’s ability to meet established benchmarks. Secondly, for accurate health data documentation, follow-up reminders, and telehealth services, a robust IT infrastructure is mandatory.

An updated and working IT setup is crucial to provide quality care to these patients (Sasaki et al., 2023) and perform regular screenings. Conversely, an outdated or inefficient system can hinder timely patient notifications and follow-up, reducing adherence and interfering with the efficient implementation of the policy and practice recommendations. Finally, evolving healthcare regulations in response to new medical research, technological advancements, and shifts in public health priorities may require constant change in the proposed policy and practice guidelines. 

Ethical and Evidence-Based Practice Strategies

Comprehensive patient education, streamlined follow-up screenings, and expanded access through telehealth are three evidence-based essential strategies to improve eye examination benchmark underperformance in MMC. According to Moinul et al. (2020), well-informed patients have increased compliance with eye tests, enhancing their engagement in healthcare. To make this strategy ethically sound and culturally sensitive, it is crucial to tailor educational materials according to patients’ cultural values and language differences and to respect patient autonomy, needs, and preferences.

Secondly, the reminder system is supported by the literature, highlighting the effectiveness through consistent patient participation in screening tests (Nielsen et al., 2021). Implementing an automated reminder system ensures that patients receive timely notifications about upcoming eye exams, reducing the likelihood of missed appointments. To ensure ethical and culturally inclusive application, reminders should be available in multiple languages and formats, accommodating patients’ preferences and needs. Finally, increasing access to services through telehealth is an effective strategy for overcoming barriers to screening, including financial constraints. It is suggested that telehealth is a cost-effective and accessible method for preventive care, especially in underserved areas (Dhediya et al., 2022). The ethical application involves ensuring telehealth platforms are fair and equitable and protecting patient privacy and confidentiality. Culturally inclusive practices include offering telehealth consultations in multiple languages. 

Effect on Stakeholders’ Work and Job Requirements 

The implementation of these strategies will significantly impact stakeholders’ work settings and job requirements by requiring additional time and resources. All these strategies will necessitate training for frontline workers. Finally, providers may need to adapt their workflows to accommodate patient education sessions and remote patient interactions. These changes aim to enhance patient care and compliance with federal guidelines, ultimately improving diabetes eye examination rates and patient outcomes.

Stakeholders’ Participation in Policies and Guidelines

The stakeholder group is crucial for several reasons. Inayat et al. (2023) elaborate on healthcare providers’ role in policymaking as their feedback can help refine the policy to ensure it is practical and effective in clinical settings. Similarly, administrative leaders are vital for their role in managing resources, implementing technological solutions, and overseeing compliance with the policy. Patient advocacy groups and community organizations are indispensable for outreach and education efforts. They help bridge the gaps between the healthcare system and the patient population, particularly in culturally diverse communities (Chau et al., 2023).

Engaging these stakeholders strengthens the policy by accepting diverse perspectives, promoting buy-in from all stakeholders, and increasing the likelihood of successful implementation and sustained adherence. By leveraging the strengths and expertise of each group, MMC can develop a robust policy that significantly improves diabetes eye examination rates and overall patient outcomes.

Strategies for Collaborating with Stakeholders 

Collaboration with these stakeholder groups is crucial for the successful implementation of the policy and practice guidelines. Establishing shared governance through a multidisciplinary team and establishing regular interdisciplinary team meetings are evidence-based collaboration strategies that can be employed in MMC. Initially, the organization can create a multidisciplinary team that includes representatives of all stakeholder groups. This task force will be led by the concept of shared governance, which enables team members to collaboratively develop detailed action plans, allocate resources, and monitor progress. This strategy fosters a sense of ownership and accountability, enhancing commitment to quality of care (Brennan & Wendt, 2021).

However, possible objections, such as concerns about increased workload for healthcare providers, may arise. These objectives can be addressed through workload distribution and support systems. Secondly, conducting regular interdisciplinary team meetings for updates and feedback keeps all stakeholders informed and engaged (Leykum et al., 2023). This ongoing dialogue allows for real-time problem-solving and continuous improvement. Addressing objections, such as resistance from patient advocacy groups worried about the cultural competence of educational materials, can be managed by involving them in the creation and review process. This ensures materials are tailored to meet the community’s needs and respect cultural differences, thereby enhancing the effectiveness of outreach efforts. 

Conclusion 

In conclusion, the proposed policy and practice guidelines at MMC aim to improve diabetic retinopathy detection and management significantly. By using evidence-based practices and engaging stakeholder groups, the policy ensures culturally competent, effective, and sustainable implementation. These collaborative efforts will enhance compliance with federal guidelines, improve patient outcomes, and strengthen overall healthcare quality. The commitment to continuous evaluation and adaptation will ensure the policy remains effective and relevant, ultimately benefiting both patients and the broader community. 

References

AHRQ. (n.d.). National Healthcare Quality and Disparities Reports (NHQDR). datatools.ahrq.gov. https://datatools.ahrq.gov/nhqdr/?tab=national&dash=282

Brennan, D., & Wendt, L. (2021). Increasing quality and patient outcomes with staff engagement and shared governance. OJIN: The Online Journal of Issues in Nursing, 26(2). https://doi.org/10.3912/ojin.vol26no02ppt23 

NHS FPX 6004 Assessment 2 Policy Proposal

Chau, M. M., Nadeem, A., Pillai, S., Telzak, R., Fraser, M., & Islam, N. (2023). Community‐based organizations as trusted messengers in health. Hastings Center Report, 53(S2). https://doi.org/10.1002/hast.1529 

Dhediya, R., Chadha, M., Bhattacharya, A. D., Godbole, S., & Godbole, S. (2022). Role of telemedicine in diabetes management. Journal of Diabetes Science and Technology, 17(3), 193229682210811. https://doi.org/10.1177/19322968221081133 

Inayat, S., Younas, A., Andleeb, S., Rasheed, S. P., & Ali, P. (2023). Enhancing nurses’ involvement in policymaking: A qualitative study of nurse leaders. International Nursing Review, 70(3), 297–306. https://doi.org/10.1111/inr.12828 

Jotte, A., Vander Kooi, W., & French, D. D. (2023). Factors associated with annual vision screening in diabetic adults: Analysis of the 2019 National Health Interview Survey. Clinical Ophthalmology, 17, 613–621. https://doi.org/10.2147/opth.s402082

Khanna, R., Cicinelli, M., & Marmamula, S. (2020). Comprehensive eye care – Issues, challenges, and way forward. Indian Journal of Ophthalmology, 68(2), 316. https://doi.org/10.4103/ijo.ijo_17_19 

Kropp, M., Golubnitschaja, O., Mazurakova, A., Koklesova, L., Sargheini, N., Steve, K., de Clerck, E., Polivka, J., Potuznik, P., Polivka, J., Stetkarova, I., Kubatka, P., & Thumann, G. (2023). Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications—risks and mitigation. EPMA JOURNAL, 14(1), 21–42. https://doi.org/10.1007/s13167-023-00314-8

Leykum, L. K., Noël, P. H., Penney, L. S., Mader, M., Lanham, H. J., Finley, E. P., & Pugh, J. A. (2023). Interdisciplinary team meetings in practice: An observational study of IDTS, sensemaking around care transitions, and readmission rates. Journal of General Internal Medicine, 38(2), 324–331. https://doi.org/10.1007/s11606-022-07744-6 

Moinul, P., Barbosa, J., Qian, J., Chen, M. L., Mohaghegh, M., Kaur, H., Holmes, J., Radman, H., Robinson, T., & Chaudhary, V. (2020). Does patient education improve compliance to routine diabetic retinopathy screening? Journal of Telemedicine and Telecare, 26(3), 161–173. https://doi.org/10.1177/1357633×18804749

NHS FPX 6004 Assessment 2 Policy Proposal

Nielsen, J. H., Melendez-Torres, G. J., Rotevatn, T. A., Peven, K., Fonager, K., & Overgaard, C. (2021). How do reminder systems in follow-up screening for women with previous gestational diabetes work? – a realist review. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06569-z 

Sarkar, R. R., Courtney, P. T., Bachand, K., Sheridan, P. E., Riviere, P. J., Guss, Z. D., Lopez, C. R., Brandel, M. G., Banegas, M. P., & Murphy, J. D. (2020). Quality of care at safety‐net hospitals and the impact on pay‐for‐performance reimbursement. Cancer, 126(20), 4584–4592. https://doi.org/10.1002/cncr.33137

Sasaki, N., Yamaguchi, N., Okumura, A., Yoshida, M., Sugawara, H., & Imanaka, Y. (2023). Does hospital information technology infrastructure promote the implementation of clinical practice guidelines? A multicentre observational study of Japanese hospitals. BMJ Open, 9(6), e024700. https://doi.org/10.1136/bmjopen-2018-024700