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NHS FPX 6004 Assessment 2 Policy Proposal

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    NHS FPX 6004 Assessment 2 Policy Proposal

    Student Name

    Capella University

    NHS-FPX 6004 Health Care Law and Policy

    Prof. Name

    Date

    Policy Proposal

    For proper diabetes care, it is important to monitor HbA1c levels regularly along with adequate foot and eye examinations to avoid long-term complications of foot and eyes as a result of untreated diabetes. Lack of early diagnosis of diabetes cause great trouble to diabetic patients impacting their quality of life and patient safety. It is crucial to implement various strategies that ensure early diagnosis to rule out any to prevent future health consequences. In Mercy Medical Center, the dashboard metrics revealed poor treatment of diabetic patients with late diagnosis and inadequate foot and eye examination that might lead to peripheral neuropathy, chronic kidney damage, foot complications, and leg amputations. However, the target of this policy proposal is HbA1c as HbA1c test promotes early diagnosis and treatment, preventing diabetes-associated diseases like kidney damage, neuropathy, and retinopathy, etc. 

    Need for Policy and Practice Guidelines

    At Mercy Medical Center, there is a pressing need for policy development and practice guidelines to ensure the early detection and diagnosis of diabetes in patients. As evident from the dashboard metrics in the last quarter of 2020 presented by MMC, HgbA1c tests, eye exams, and foot exams each fell 11% short of established benchmarks presented by the National Diabetes Benchmark by AHRQ, i.e., HbA1c test 79.5%, eye exams 75.2%, and feet exam 84%. Considering this shortfall from the established benchmarks of diabetes tests, MMC required immediate policy development on regular HbA1c testing and practice guidelines to provide adequate and timely care treatment to diabetic patients.

    The underperformance of the HbA1c benchmark set by national bodies results in various health implications that affect the quality of care and overall organizational functions, requiring the utmost need for policy development. Lack of regular HbA1c testing results in uncertainty about the glycemic levels in the blood of diabetic patients, and hyperglycemia can reach dangerous levels where the patient may die. Moreover, without adequate HgA1c levels, it becomes difficult for healthcare professionals to develop an effective care treatment for diabetic patients which may include only lifestyle modification or pharmacotherapy along with lifestyle changes.

    NHS FPX 6004 Assessment 2 Policy Proposal

    This policy proposal on HbA1c will ensure early diagnosis of diabetes in patients at risk and also manage diabetes through effective planning of care treatment for diabetics based on their HbA1c levels. The potential repercussions of inaction are delayed diagnosis of diabetes, making it difficult for patients to self-manage diabetes. These outcomes directly impact the provision of quality care as delayed interventions may result in delayed recovery, longer hospital stays, and higher hospital readmission rates affecting relevant stakeholders such as physicians, nurses, patients, and hospital authorities (Ali et al., 2022).

    Healthcare organizations may also incur financial implications due to enhanced complications if this policy is not developed timely, as preventive measures cost less than treating complications (Mao et al., 2019).  Therefore, to avoid these potential repercussions, it is highly demanding for MMC to develop policy and practice guidelines to improve the quality of care provided and stabilize organizations’ operations. 

    Proposed Organizational Policy and Practice Guidelines

    Mercy Medical Center needs to develop and implement new organizational policies on diabetes care that promotes regular HbA1c testing to promote quality of care and reduce diabetes-associated complications. Therefore, MMC should encourage regular monitoring of HbA1c levels in diabetic patients or patients who present complaints of diabetes twice a year, as recommended by clinical practice guidelines (Imai et al., 2021). To implement this health policy, several practice guidelines are required to follow to streamline the process and achieve desired goals of achieving benchmarks for diabetes care. 

    Healthcare professionals must identify the patients who have diabetes and are at risk of diabetes. Furthermore, healthcare professionals should educate patients on the effectiveness of these tests and their potential benefits in diabetes care. Likewise, new staff must be educated on the thorough evaluation of diabetes patients and how early diagnosis can promote timely care, leading to enhanced quality of care. Healthcare professionals must schedule regular follow-ups for diabetes patients to provide consistent care treatment. Nurses should be active diabetes educators to patients unaware of the disease and its adequate management, as self-care in diabetes plays a crucial role in controlling the progression of diabetes. 

    NHS FPX 6004 Assessment 2 Policy Proposal

    The recommended policy is impacted by various environmental factors, such as human and financial resources, coordination and collaboration, and the availability of healthcare facilities within the access. With adequate healthcare staffing of physicians and nurses, the HbA1c test can be conducted effortlessly, and the results can be interpreted effectively. Furthermore, sufficient financial resources can enable training and educational programs for healthcare staff and diabetes patients on the significance of HbA1c tests (Ali et al., 2022).

    If the healthcare organization has a collaborative and coordinated system, implementing the practice guidelines and policy will be productive. Lack of interdisciplinary collaboration results in fragmented care and does not bring any fruitful results as desired. Similarly, a healthcare facility within the patients’ access will promote the implementation of the screening testing policy regularly, and the selected benchmark can be achieved timely.

    Ethical Evidence-Based Practice Guidelines

    Implementing ethically correct evidence-based practice guidelines is crucial to improve the targeted benchmark performance on HbA1c tests. The literature supports using healthcare information technologies such as electronic medical records (EMR) to automate reminders for HbA1c tests and disseminate health data among healthcare professionals to facilitate communication and information sharing (Wu et al., 2019). Furthermore, patients’ education through brochures on the significance of HbA1c is another evidence-based strategy that promotes awareness among patients to monitor their HbA1c levels regularly as per the hospital’s policy. This will ultimately lead to controlled and well-managed diabetes with fewer diabetes-associated complications ​​(Thanh & Tien, 2021).

    Furthermore, healthcare staff training on ethical care treatment for people with diabetes for conducting and evaluating the HbA1c measurements is imperative. This is followed by further care treatment plans based on a patient-centered approach, kindness, and beneficence to help improve targeted benchmark performance (Robinson et al., 2019). These practice changes greatly impact relevant stakeholders, such as patients, as their quality of life is enhanced through better assessment of the HbA1c levels. Moreover, the healthcare staff will experience job satisfaction through better performance based on clinical guidelines and ethical care delivery. These ethical evidence-based practice changes will create an engaging care-provider and patient relationship that promotes transparent and open communication, and fosters shared decision-making culture.

    Participation of Stakeholders in the Development and Implementation of Proposed Policy 

    In further development and implementation of the proposed policy, several stakeholders’ participation will be required to ensure that policies align with the patient’s health needs and diverse perspectives. These stakeholders include healthcare professionals such as physicians, nurses, diabetes educators, diabetes patients, hospital administrators, policymakers, and IT department personnel. This stakeholder group is essential for several reasons, such as healthcare professionals providing valuable insights and expertise on diabetes care. They can provide the latest research and evidence-based guidelines that can be included in policy development.

    Furthermore, patients should be actively involved in policy development procedures to increase their buy-in by empowering them through shared-decision making. This will promote the easy implementation of the developed policy (Garritty et al., 2020). Moreover, stakeholder participation will promote transparency and build trust in the developed policy’s intentions and outcomes. The rationale for involving this group in the policy development and implementation process is to raise awareness of targeted benchmarks underperformance and how they can collaboratively achieve the desired goals of HbA1c tests for diabetics.

    Interprofessional collaboration in policy development and implementation results in attaining established goals and gives a feeling of inclusivity while promoting equity in policy development and implementation (Bachynsky, 2019). Through wider stakeholder groups, disseminating information among other networks becomes easier as these stakeholders act as communicators and advocators for change resulting in broader acceptance of developed policy and its implementation. Hence, this stakeholder group strengthens policy development and facilitates practice guidelines and changes in improving health outcomes in patients with diabetes.

    Strategies for Collaborating with a Stakeholder Group

    To develop and implement a policy, it is essential to identify the relevant stakeholders and employ various strategies to collaborate with them. Some of the collaborative strategies that promote effective collaboration and communication with a stakeholder group are as follows:

    • Organizing collaborative meetings and workshops to bring all the relevant stakeholders together and share ideas through open and transparent communication (Walker & Daniels, 2019). Through collaborative meetings with stakeholder groups, the roles and responsibilities of every stakeholder will be clear. This will facilitate the effective implementation of developed policy without turbulence in the actual policy implementation process. 
    • Leverage technology, including digital platforms, online educational videos, and collaboration tools, to educate stakeholders on proposed policies to facilitate virtual collaboration remotely.
    • Foster a relationship with stakeholder groups based on mutual respect and trust to increase buy-in and improve collaboration. This is accomplished by acknowledging and celebrating the contributions of all stakeholders in achieving any milestone throughout the procedure.

     Conclusion

    The underperformance of diabetes care benchmarks in Mercy Medical Care established by the National body AHRQ advocated the need for policy proposals for adequate testing of HbA1c levels in patients with diabetes. The proposed policy demands HbA1c-level testing twice a year. For this purpose, practice guidelines on scheduling follow-ups and patient and staff education are proposed. Moreover, the stakeholder group of healthcare professionals is necessary for the effective development of policy and its implementation through various collaborative strategies.

    References

    Ali, M., Nadeem Ahmad Khan, M., & Junaid Patel, M. (2022). Pattern and knowledge of hbA1C testing among diabetic patients at the indus hospital (TIH), Karachi. Liaquat National Journal of Primary Care, 4. https://doi.org/10.37184/lnjpc.2707-3521.4.19 

    American Diabetes Association Professional Practice Committee. (2021). 12. retinopathy, neuropathy, and foot care: Standards of medical care in diabetes—2022. Diabetes Care, 45. https://doi.org/10.2337/dc22-s012 

    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

    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  

    NHS FPX 6004 Assessment 2 Policy Proposal

    Imai, C., Li, L., Hardie, R.-A., & Georgiou, A. (2021). Adherence to guideline-recommended hba1c testing frequency and better outcomes in patients with type 2 diabetes: A 5-year retrospective cohort study in Australian general practice. BMJ Quality & Safety, 30(9), bmjqs-2020-012026. https://doi.org/10.1136/bmjqs-2020-012026 

    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 

    Robinson, J., Lang, B., & Clippinger, D. (2019). Impact of the Alphabet strategy on improving diabetes care at a free health clinic. Journal of Community Health Nursing, 36(4), 157–164. https://doi.org/10.1080/07370016.2019.1665323

    Thanh, H. T. K., & Tien, T. M. (2021). Effect of group patient education on glycemic control among people living with type 2 diabetes in vietnam: A randomized controlled single-center trial. Diabetes Therapy. https://doi.org/10.1007/s13300-021-01052-8  

    NHS FPX 6004 Assessment 2 Policy Proposal

    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 

    Wu, S. S., Chan, K. S., Bae, J., & Ford, E. W. (2019). Electronic clinical reminder and quality of primary diabetes care. Primary Care Diabetes, 13(2), 150–157. https://doi.org/10.1016/j.pcd.2018.08.007