NHS FPX 6004 Assessment 2 Policy Proposal

Name

Capella university

NHS-FPX 6004 Health Care Law and Policy

Prof. Name

Date

Policy Proposal

Proper diabetes care involves regular monitoring of HbA1c levels, as well as thorough foot and eye examinations, to prevent long-term complications such as peripheral neuropathy and vision loss. At Mercy Medical Center, dashboard metrics have shown that diabetic patients are receiving poor treatment, with late diagnoses and inadequate foot and eye exams, potentially leading to severe conditions like peripheral neuropathy, chronic kidney damage, foot complications, and leg amputations. This policy proposal focuses on improving HbA1c monitoring, as it facilitates early diagnosis and treatment, thereby preventing diabetes-related complications such as kidney damage, neuropathy, and retinopathy.

Need for Policy and Practice Guidelines

According to the dashboard metrics for the last quarter of 2020, MMC’s performance in HbA1c tests, eye exams, and foot exams fell 11% short of the national benchmarks the Agency for Healthcare Research and Quality (AHRQ) set. These benchmarks are 79.5% for HbA1c tests, 75.2% for eye exams, and 84% for foot exams (AHRQ, n.d.). This shortfall highlights the immediate need for MMC to establish policies for regular HbA1c testing and practice guidelines to provide timely and adequate care for diabetic patients.

Failing to meet the HbA1c benchmark has significant health implications that affect the quality of care and the overall functionality of the organization, underscoring the critical need for policy development. Without regular HbA1c testing, there is uncertainty about the glycemic levels in diabetic patients, leading to potential hyperglycemia that can reach life-threatening levels (Kaiafa et al., 2020). Additionally, with adequate HbA1c monitoring, healthcare professionals can develop effective treatment plans, whether they involve lifestyle modifications or pharmacotherapy combined with lifestyle changes (Kaiafa et al., 2020). A policy focused on HbA1c testing would ensure early diagnosis of diabetes in at-risk patients and facilitate effective management through tailored treatment plans based on HbA1c levels.

The repercussions of not taking action include delayed diabetes diagnosis, making it challenging for patients to manage the condition themselves. This directly impacts the quality of care, leading to delayed interventions, prolonged hospital stays, and higher readmission rates. These outcomes affect various stakeholders, including physicians, nurses, patients, and hospital authorities. Furthermore, healthcare organizations may face financial consequences due to increased complications, as preventive measures are less costly than treating advanced complications (Mao et al., 2019). Therefore, MMC must develop policies and practice guidelines to enhance the quality of care and stabilize the organization’s operations, thereby avoiding these potential repercussions.

Proposed Organizational Policy and Practice Guidelines

A new policy proposed for MMC regarding diabetes management is mandating HbA1c testing for all diabetic patients twice yearly to ensure early diagnosis and effective management of diabetes. This policy aims to align MMC’s practices with the benchmarks the Agency for Healthcare Research and Quality (AHRQ) sets, which recommend conducting HbA1c tests at least twice annually for all diabetic patients (Zaslavsky et al., 2021). The practice guidelines will include continuous monitoring and reporting of HbA1c test results, comprehensive patient education on the importance of glycemic control, and establishing a multidisciplinary team to review test results and adjust treatment plans promptly.

Several environmental factors will influence the implementation of these guidelines. Adequate staffing and resources must be allocated to handle the increased frequency of tests and data management, which may require investment in laboratory infrastructure and training for healthcare professionals. Given the diverse patient population in Shakopee City, culturally competent care and communication strategies will be necessary to ensure all patients understand and adhere to the new testing guidelines (Antón-Solanas et al., 2021).

NHS FPX 6004 Assessment 2 Policy Proposal

The policy is expected to have significant cause-and-effect relationships. Regular HbA1c testing will lead to earlier diabetes diagnosis, enabling timely interventions that can prevent complications such as neuropathy, nephropathy, and retinopathy. This, in turn, will enhance patient outcomes, reduce hospital admissions and readmissions, and streamline care processes (Tunsuchart et al., 2020). Implementing this policy will also improve overall operational efficiency, leading to better resource utilization and potentially lowering operational costs by reducing the incidence of severe diabetes-related complications.

The proposed policy addresses the AHRQ’s performance benchmark of 79.5% for HbA1c testing. It aligns with the American Diabetes Association (ADA) recommendations of at least two HbA1c tests per year for diabetic patients  (American Diabetes Association, 2023). By implementing this policy, MMC aims to improve the quality of diabetes care, enhance patient outcomes, and ensure compliance with national healthcare standards.

Ethical Evidence-Based Practice Guidelines

To improve the performance of HbA1c testing at Mercy Medical Center (MMC), ethical and evidence-based practice guidelines must be implemented in alignment with AHRQ’s benchmarks. The guidelines will ensure regular HbA1c testing for all diabetic patients to facilitate early diagnosis and effective management. Evidence-based strategies include scheduling HbA1c tests at least twice yearly for all diabetic patients and adhering to AHRQ’s recommendation of 79.5% compliance. Studies support that consistent monitoring of HbA1c levels significantly reduces complications such as retinopathy, nephropathy, cardiovascular diseases, and neuropathy (Kaiafa et al., 2020). Automated reminders and alerts through electronic health records (EHR) can improve compliance and reduce missed appointments (Schwartz et al., 2022). Additionally, comprehensive patient education programs will inform patients about the importance of regular HbA1c testing and glycemic control, as educated patients are more likely to adhere to testing schedules and treatment plans (Banerjee et al., 2020). 

To ensure these strategies are ethical and culturally inclusive, MMC will prioritize patient-centered care, ensuring patients are fully informed about the benefits and potential risks of regular HbA1c testing and involved in decision-making processes regarding their care (Banerjee et al., 2020). Cultural competence training for healthcare providers will address the diverse needs of MMC’s patient population, including understanding cultural beliefs about health and illness, communication styles, and dietary practices that may affect diabetes management (Antón-Solanas et al., 2021). Ensuring equitable access to HbA1c testing and related care is crucial, which might involve offering sliding scale payment options, transportation assistance, or community outreach programs (Aceves et al., 2022).

NHS FPX 6004 Assessment 2 Policy Proposal

The proposed guidelines will significantly impact stakeholders. Physicians must integrate regular HbA1c testing into their routine practice and collaborate closely with other healthcare team members, involving additional patient education and follow-up time. Pharmacists will play a critical role in educating patients about medication adherence, the importance of regular HbA1c testing, and identifying potential drug interactions that could affect blood glucose levels. Nurses will be essential in coordinating care, conducting tests, and providing patient education, ensuring that patients are scheduled for regular tests, and understanding the importance of maintaining their testing regimen.

Policymakers at MMC must ensure the implementation of the proposed guidelines, allocate sufficient resources, and monitor compliance, addressing any barriers to achieving the targeted benchmarks (Powers et al., 2020). Implementing these evidence-based, ethical guidelines will improve MMC’s performance on HbA1c testing, ensure compliance with AHRQ standards, and provide high-quality, patient-centered care to its diabetic population. This approach addresses current performance gaps and fosters a healthcare environment responsive to the needs of all stakeholders.

Participation of Stakeholders in the Development and Implementation of Proposed Policy

The successful development and implementation of the proposed policy will require the active participation of various stakeholders, including healthcare professionals like physicians, nurses, diabetes educators, and patients, alongside hospital administrators, policymakers, and IT department personnel. Engaging this diverse stakeholder group is essential for several reasons. Healthcare professionals offer valuable insights and expertise in diabetes care, providing the latest research and evidence-based guidelines to inform policy development. Patient involvement in the process ensures their perspectives are considered, empowering them through shared decision-making and increasing their buy-in for the policy. This collaborative approach promotes transparency and builds trust in the policy’s intentions and outcomes (Garritty et al., 2020).

Involving stakeholders raises awareness of the targeted benchmarks’ underperformance, fostering a collective effort to achieve desired goals in HbA1c testing for diabetic patients. Interprofessional collaboration in policy development fosters inclusivity and equity while facilitating the attainment of established goals. Additionally, engaging a wider stakeholder group aids in disseminating information and garnering support for the policy among broader networks, leading to greater acceptance and implementation  (Bachynsky, 2019). Ultimately, the involvement of stakeholders strengthens policy development, facilitates practice guidelines, and drives improvements in health outcomes for patients with diabetes.

Strategies for Collaborating with a Stakeholder Group

Identifying pertinent stakeholders and employing effective collaboration methods are pivotal in policy development and implementation. One such approach involves arranging collaborative meetings and workshops and facilitating transparent communication among stakeholders to exchange ideas openly (Walker & Daniels, 2019). These gatherings clarify each stakeholder’s roles and responsibilities, ensuring seamless policy implementation.

Additionally, utilizing technology, like digital platforms and collaboration tools, aids in remote collaboration by offering access to online educational materials and virtual meetings to educate stakeholders on proposed policies (Senbekov et al., 2020). Furthermore, nurturing relationships with stakeholder groups grounded in mutual respect and trust is vital for garnering support and enhancing collaboration. Acknowledging and celebrating the contributions of all stakeholders throughout the process reinforces their significance and fosters a sense of ownership in achieving milestones (Walker & Daniels, 2019). 

The importance of stakeholder collaboration cannot be overstated, as it ensures that policies are grounded in diverse perspectives and experiences. Collaborating with stakeholders allows for identifying potential objections or concerns, which can be addressed proactively. For example, healthcare professionals may have concerns about increased workload or resource allocation, while patients may worry about access to care or the impact on their treatment plans.

By actively engaging stakeholders and considering their perspectives, these objections can be addressed, fostering a sense of inclusivity and ownership in the policy implementation. Furthermore, stakeholder collaboration promotes transparency and accountability, as stakeholders are involved in decision-making processes and have a stake in the policy’s success. This transparency builds trust among stakeholders and increases buy-in, making it more likely that the policy will be effectively implemented and sustained over time. Ultimately, stakeholder collaboration ensures that policies are responsive to the needs of those they affect and are more likely to result in positive outcomes for all involved parties.

Conclusion

In conclusion, the proposed policy and practice guidelines aimed at improving HbA1c testing at Mercy Medical Center represent a significant step towards enhancing diabetes care and patient outcomes. By addressing performance gaps and ensuring compliance with national benchmarks, MMC is poised to provide more effective and timely treatment for diabetic patients, thereby reducing the risk of complications and improving overall healthcare quality. The involvement of stakeholders in the development and implementation process is essential for fostering transparency, accountability, and inclusivity, ultimately leading to a more successful and sustainable healthcare policy. Through collaborative efforts and ethical practice guidelines, MMC can achieve its goal of delivering high-quality, patient-centered diabetes care while promoting positive health outcomes for all stakeholders involved.

References

Aceves, B., Ezekiel-Herrera, D., Marino, M., Datta, R., Lucas, J., Giebultowicz, S., & Heintzman, J. (2022). Disparities in hba1c testing between aging US Latino and non-Latino White primary care patients. Preventive Medicine Reports, 26, 101739–101739. https://doi.org/10.1016/j.pmedr.2022.101739

AHRQ. (n.d.). NHQDR data tools – national healthcare quality and disparities reports (NHQDR). https://datatools.ahrq.gov/nhqdr/

American Diabetes Association. (2023). Diagnosis | ADA. Diabetes.org. https://diabetes.org/about-diabetes/diagnosis 

Antón-Solanas, I., Tambo-Lizalde, E., Hamam-Alcober, N., Vanceulebroeck, V., Dehaes, S., Kalkan, I., Kömürcü, N., Coelho, M., Coelho, T., Casa Nova, A., Cordeiro, R., Sagarra-Romero, L., Subirón-Valera, A. B., & Huércanos-Esparza, I. (2021). Nursing students’ experience of learning cultural competence. Plos One, 16(12). https://doi.org/10.1371/journal.pone.0259802

Bachynsky, N. (2019). Implications for policy: The triple aim, quadruple aim, and interprofessional collaboration. Nursing Forum, 55(1), 54–64. https://doi.org/10.1111/nuf.12382

NHS FPX 6004 Assessment 2 Policy Proposal

Banerjee, M., Chakraborty, S., & Pal, R. (2020). Diabetes self-management amid COVID-19 pandemic. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(4), 351–354. https://doi.org/10.1016/j.dsx.2020.04.013

Garritty, C., Hamel, C., Hersi, M., Butler, C., Monfaredi, Z., Stevens, A., Nussbaumer-Streit, B., Cheng, W., & Moher, D. (2020). Assessing how information is packaged in rapid reviews for policy-makers and other stakeholders: A cross-sectional study. Health Research Policy and Systems, 18(1). https://doi.org/10.1186/s12961-020-00624-7 

Kaiafa, G., Veneti, S., Polychronopoulos, G., Pilalas, D., Daios, S., Kanellos, I., Didangelos, T., Pagoni, S., & Savopoulos, C. (2020). Is hba1c an ideal biomarker of well-controlled diabetes? Postgraduate Medical Journal, 97(1148). https://doi.org/10.1136/postgradmedj-2020-138756

Mao, W., Yip, C.-M. W., & Chen, W. (2019). Complications of diabetes in China: Health system and economic implications. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-6569-8  

Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M., & Uelmen, S. (2020). Diabetes self-management education and support in adults with type 2 diabetes: A consensus report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAS, the American Association of Nurse Practitioners, and the American Pharmacists Association. Journal of the American Pharmacists Association, 60(6), 1–18. https://doi.org/10.1016/j.japh.2020.04.018 

NHS FPX 6004 Assessment 2 Policy Proposal

Schwartz, J. L., Duan, D., Maruthur, N. M., & Pitts, S. I. (2022). Utility of an electronic health record report to identify patients with delays in testing for poorly controlled diabetes. The Joint Commission Journal on Quality and Patient Safety, 48(6), 335–342. https://doi.org/10.1016/j.jcjq.2022.03.002 

Senbekov, M., Saliev, T., Bukeyeva, Z., Almabayeva, A., Zhanaliyeva, M., Aitenova, N., Toishibekov, Y., & Fakhradiyev, I. (2020). The recent progress and applications of digital technologies in healthcare: A review. International Journal of Telemedicine and Applications. 2020. https://doi.org/10.1155/2020/8830200 

Tunsuchart, K., Lerttrakarnnon, P., Srithanaviboonchai, K., Likhitsathian, S., & Skulphan, S. (2020). Benefits of brief group cognitive behavioral therapy in reducing diabetes-related distress and hba1c in uncontrolled type 2 diabetes mellitus patients in Thailand. International Journal of Environmental Research and Public Health, 17(15), 5564. https://doi.org/10.3390/ijerph17155564

Walker, G. B., & Daniels, S. E. (2019). Collaboration in environmental conflict management and decision-making: Comparing best practices with insights from collaborative learning work. Frontiers in Communication, 4. https://doi.org/10.3389/fcomm.2019.00002 

Zaslavsky, O., Yu, O., Walker, R. L., Crane, P. K., Gray, S. L., Sadak, T., Borson, S., & Larson, E. B. (2021). Incident dementia, glycated hemoglobin (hba1c) levels, and potentially preventable hospitalizations in people aged 65 and older with diabetes. The Journals of Gerontology: Series A, 76(11), 2054–2061. https://doi.org/10.1093/gerona/glab119