NURS FPX 6021 Assessment 2 Change Strategy and Implementation

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Capella university

NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1

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Change Strategy and Implementation

Hospitalization, while essential for medical care, can often evoke feelings of stress, anxiety, and even trauma in patients. Recognizing this, Lakewood Health Center in Minnesota is committed to implementing a change strategy aimed at enhancing coping mechanisms for patients experiencing such emotional challenges during their hospital stay. The experience of hospitalization can be overwhelming for patients, marked by unfamiliar environments, medical procedures, and uncertainty about their health outcomes.

For some individuals, this can trigger traumatic stress responses or exacerbate existing anxiety disorders. Consequently, there is a pressing need to reevaluate and modify the care environment to better support patients’ emotional well-being. This change strategy and implementation plan will explore innovative approaches to transform the care environment at Lakewood Health Center, ensuring it fosters resilience, comfort, and psychological support for patients navigating the challenges of hospitalization.

Data Table of Current and Desired Clinical Outcomes

Clinical Outcomes	Current State	Desired State
Patient Anxiety	Severe anxiety disorder (HADS score showed 15-21 range) reported by patients (About 70% patients were anxious due to hospital readmissions and higher hospitalization rates).	Low levels reported by HADS score of 0-7 (Sivertsen et al., 2023).
Traumatic Stress	Presence reported by patients (60% patients experienced traumatic stress due to frequent hospitalizations).	Absence reported by patients (IES-R score of 0) (Alzahrani, 2021).
Patient Satisfaction	Moderate satisfaction scores (20%) as found by Hospital Consumer Assessment of Healthcare Providers Systems (HCAHPS).	High satisfaction scores above 80 % of HCAHPS (Çamur & Karabudak, 2020)

NURS FPX 6021 Assessment 2 Change Strategy and Implementation

The clinical outcomes related to psychological distress after hospitalization were measured by using the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale-Revised (IES-R), and the Hospital Consumer Assessment of Healthcare Providers Systems (HCAHPS). The information above was obtained from the Lakewood Health Center’s dashboard metrics by the Health Management Information Department. The procedure used to acquire the data is closely aligned with the Health Insurance Portability and Accountability Act’s (HIPAA) mandate to protect individuals’ private health information (Okemiri et al., 2020).

The areas of uncertainty lie under the need further to identify the anxiety and depressive symptoms patients experience. There is still ambiguity on the long-term effects of traumatic stress experienced during hospitalization. There is potential need for persistent symptom monitoring to ensure appropriate identification (Alzahrani, 2021). Moreover, while satisfaction may be assessed through surveys, identifying specific areas contributing to satisfaction (e.g., communication with healthcare providers and comfort of facilities) could provide a clearer picture of improvement opportunities.

Change Strategies for Clinical Outcomes 

To achieve the desired states of reduced anxiety, absence of traumatic stress, and high patient satisfaction, Lakewood Health Center will implement comprehensive change strategies tailored to address each clinical outcome. Firstly, an Anxiety and Traumatic Stress Reduction Program will be established, integrating psychoeducation, coping skills training, and evidence-based therapeutic interventions such as cognitive-behavioral therapy and mindfulness techniques (Murray et al., 2020). Multidisciplinary teams comprising psychiatrists, psychologists, social workers, and nurses will collaborate to provide personalized support to patients. Overcoming potential challenges such as resistance to participation and resource limitations will require proactive education about the benefits of interventions and leveraging community mental health resources (Bonazza et al., 2021). 

Secondly, efforts will focus on enhancing communication and creating a supportive environment throughout the hospitalization process. Healthcare providers will receive training to foster open communication, empathy, and clear explanations of treatment plans. Moreover, facility improvements will be made to ensure physical and emotional safety and comfort for patients (Jamshidi et al., 2020). Addressing challenges such as staff training and infrastructure limitations will involve comprehensive training programs and prioritizing improvements based on patient feedback and available resources. Lastly, Lakewood Health Center will establish a system for continuous quality improvement and feedback collection.

Real-time patient feedback will inform targeted interventions, fostering a culture of continuous improvement where changes are made in response to patient needs and preferences (Chessell et al., 2022). Overcoming challenges related to data collection, analysis, and resistance to change will require investment in user-friendly data collection tools, staff training, and effective change management strategies. By implementing these change strategies, Lakewood Health Center aims to improve patient experiences and outcomes during hospitalization significantly.

Change Strategies Justification

The chosen change strategies are justified based on their evidence-based effectiveness in addressing the targeted clinical outcomes. Research supports the effectiveness of psychoeducation, coping skills training, and therapeutic interventions like CBT and mindfulness in reducing anxiety and traumatic stress (Murray et al., 2020). By implementing a comprehensive program, Lakewood Health Center can offer patients evidence-based interventions tailored to their needs, potentially leading to significant improvements in mental well-being. While these interventions have shown efficacy, it is essential to acknowledge that individual responses may vary, and some patients may not find them helpful. Offering alternative approaches could accommodate diverse patient needs and preferences. Clear communication and a supportive environment are fundamental in reducing patient anxiety and enhancing satisfaction.

Empathetic communication and improvements in the physical environment can foster feelings of safety and comfort, contributing to overall patient well-being (Jamshidi et al., 2020). While enhancing communication and the environment are generally beneficial, some patients may prefer minimal interaction or have specific environmental sensitivities. Providing options for personalized care experiences could accommodate these preferences. Establishing mechanisms for collecting real-time patient feedback and implementing continuous quality improvement processes allow for the timely identification of areas for enhancement (Chessell et al., 2022). It is important to acknowledge potential challenges such as feedback bias or unrealistic patient expectations. Balancing patient feedback with clinical expertise and organizational constraints ensures that changes are beneficial and feasible.

Quality Improvement by Change Strategies

Improving communication and fostering a supportive environment can significantly contribute to quality improvements in patient safety. Clear and effective communication among healthcare providers reduces the risk of errors, miscommunication, and adverse events. By enhancing communication channels, such as standardized protocols, handoff procedures, and team huddles, Lakewood Health Center can ensure that critical information is conveyed accurately and efficiently, minimizing the likelihood of safety incidents. Additionally, creating a supportive environment promotes a culture of safety where staff feel empowered to speak up about safety concerns or near misses. This open communication fosters a proactive approach to identifying and addressing potential hazards, ultimately reducing the occurrence of adverse events.

Furthermore, improvements in the physical environment, such as reducing noise levels, improving signage, and enhancing patient room layouts, can mitigate the risk of falls, infections, and other safety-related incidents.  By reducing the occurrence of safety incidents, such as medication errors, falls, and infections, the enhanced communication and supportive environment strategy directly contributes to improvements in patient safety. The assumption underlying this explanation is that communication breakdowns and environmental factors significantly contribute to patient safety incidents within healthcare settings. It is assumed that by addressing these factors through enhanced communication and a supportive environment, Lakewood Health Center can effectively mitigate risks and enhance patient safety outcomes.

NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Implementing a continuous quality improvement (QI) process coupled with a robust feedback loop can lead to quality improvements in equitable care delivery. Through ongoing data collection and analysis, Lakewood Health Center can identify disparities in care outcomes among different patient populations, including marginalized or underserved groups. By disaggregating data by demographic factors such as race, ethnicity, socioeconomic status, and language preference, the organization can pinpoint areas where inequities exist and develop targeted interventions to address them. Furthermore, by actively soliciting and incorporating patient feedback, Lakewood Health Center can identify and rectify instances of bias, discrimination, or cultural insensitivity that may contribute to inequities in care. Additionally, engaging with community stakeholders and partnering with local organizations serving vulnerable populations can inform culturally competent care practices and enhance access to services for marginalized groups. 

Interprofessional Perspectives of Change Strategies

Interprofessional considerations ensure that diverse perspectives, expertise, and roles within the healthcare team are leveraged effectively to drive change and achieve desired outcomes. This strategy involves collaboration among various healthcare professionals, including physicians, nurses, pharmacists, social workers, and allied health professionals. Each member brings unique insights and skills to the table, contributing to a comprehensive approach to patient care. Interprofessional teams can be formed to develop and implement communication protocols, standardized procedures, and environmental and overall quality improvements.

These teams facilitate cross-disciplinary communication and decision-making, ensuring that all perspectives are considered in the design and implementation of safety initiatives (Wijnen et al., 2023). This explanation assumes that effective communication and collaboration among diverse healthcare professionals are essential for addressing the complex factors contributing to patient safety and creating a supportive care environment. It also assumes that interprofessional teams can effectively coordinate efforts and implement changes to improve patient safety outcomes. By incorporating patient feedback into improvement efforts, the organization can enhance patient-centeredness and responsiveness to the needs of diverse patient populations, contributing to a more inclusive and equitable healthcare environment (Chessell et al., 2022). 

Conclusion

In conclusion, Lakewood Health Center’s pursuit of improved patient safety and equitable care underscores its commitment to enhancing healthcare quality. Through evidence-based interventions targeting anxiety, traumatic stress, and patient satisfaction, coupled with strategies like enhanced communication and continuous quality improvement, the organization aims to achieve the Quadruple Aim. Interprofessional collaboration serves as a cornerstone for successful implementation, leveraging diverse expertise to drive meaningful change. By fostering a culture of teamwork, open communication, and ongoing learning, Lakewood Health Center endeavors to create an environment where patient safety and equitable care are paramount. With a dedication to continuous evaluation and refinement, the organization strives to ensure that patients receive the highest standard of care, tailored to their individual needs and preferences.

References

Alzahrani, N. (2021). The effect of hospitalization on patients’ emotional and psychological well-being among adult patients: An integrative review. Applied Nursing Research, 61(61), 151488. https://doi.org/10.1016/j.apnr.2021.151488 

Bonazza, F., Borghi, L., di San Marco, E. C., Piscopo, K., Bai, F., Monforte, A. d’Arminio, & Vegni, E. (2021). Psychological outcomes after hospitalization for COVID-19: Data from a multidisciplinary follow-up screening program for recovered patients. Research in Psychotherapy: Psychopathology, Process, and Outcome, 23(3). https://doi.org/10.4081/ripppo.2020.491 

Çamur, Z., & Karabudak, S. S. (2020). The effect of parental participation in the care of hospitalized children on parent satisfaction and parent and child anxiety: Randomized controlled trial. International Journal of Nursing Practice, 27(5). https://doi.org/10.1111/ijn.12910 

Chessell, S., Courtiour, S., Colman, A., Porter, S., & Heaslip, V. (2022). Staff perspectives of a near-real time feedback intervention to improve patient experiences. British Journal of Healthcare Management, 28(9), 245–252. https://doi.org/10.12968/bjhc.2022.0056 

Jamshidi, S., Parker, J. S., & Hashemi, S. (2020). The effects of environmental factors on the patient outcomes in hospital environments: A review of literature. Frontiers of Architectural Research, 9(2). https://doi.org/10.1016/j.foar.2019.10.001 

NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Murray, H., Grey, N., Wild, J., Warnock-Parkes, E., Kerr, A., Clark, D. M., & Ehlers, A. (2020). Cognitive therapy for post-traumatic stress disorder following critical illness and intensive care unit admission. The Cognitive Behaviour Therapist, 13(13), 1–36. https://doi.org/10.1017/s1754470x2000015x 

Sivertsen, H. E., Helvik, A.-S., Gjøra, L., & Haugan, G. (2023). Psychometric validation of the hospital anxiety and depression scale (HADS) in community-dwelling older adults. BMC Psychiatry, 23(1). https://doi.org/10.1186/s12888-023-05407-2

Wijnen, J., Gordon, N. L., Hullenaar , G. van ’t , Pont, M. L., Henricus, W., Oosterwijck, J. V., & Jong, J. de . (2023). An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1113356  

NURS FPX 6021 Assessment 2 Change Strategy and Implementation