2-Identify a practice issue that would benefit from utilizing a mixed methods approach. Discuss how the quantitative and qualitative data would complement one another and add strength to the study. Discuss the challenges that you might encounter in using a mixed methods approach. Support your discussion using current mixed methods research articles.
Following the financial penalties that are being posted on health facilities with a high rate of readmission, more health facilities are being encouraged to develop efforts which will reduce the rate of hospital readmission. The health facilities are creating different interventions which tend to involve several components such as patient education, medication reconciliation, evaluation of the patient needs as well as planning for timely follow-up and appointments. The Affordable Act of 2010 has continued to hold the health facilities responsible for the rate of readmission, which may be prevented. The NCAL/AHCA Quality Initiative tends to include measurable goals of minimizing the 30day hospital readmission b.y about 15%. This means that the health facilities are under tight pressure to protect their revenue and still be able to provide the patients with quality and satisfactory health care services. In the research conducted it proved that most health care readmissions tend to occur due to the inability to create discharge processes which are of quality standard, minimal preparation of patients and families for the discharge, poor communication and minimum education to he patients in regards to the essentialness of the treatment approach. Several studies tend to link the increasing rate of readmission with inadequate follow up by the primary care providers and other concerned healthcare facilities. The answer to resolving this issue tends to be revolving around predictable steps which may be taken to improve these measures. Every health facility that wants to continue providing health care services to the United States citizens it needs to ensure that it has an approach of minimizing the rate of hospital readmission. This paper will focus on the necessary steps that a health facility may use to ensure that it minimizes the rate of readmission in the future.
Implimenting steps to reduce hospital readmission
1. Tightening the healthcare processes
Most the causes of the preventable readmissions in the health facilities tend to revolve around issues which are predictable and may be understood as well as managed, ranging from the intake process to the discharge process. The healthcare facility needs to engage its team players to be able to identify as well as troubleshoot the segments in the health facility that contribute to readmission (Simorangkir & McGuire, 2017). Some of the areas that most health facilities need to focus on are the preadmission process- this tends to be a kind of readmission that tends to occur because the health facility is not able to effectively care for the patient. The health facility needs to focus on this segment to be able to understand the level of expertise it needs to add in its team to provide quality care. It is essential for the health facility to train its staff to enable them to be able to take higher volumes of specialized diagnoses. The health facility needs to track the outcome and provide a report to the health facility- this provides evidence that the specialties are doing their work effectively.
Advance Directives is another approach that the health facility can tighten its health care processes. This step tends to have a significant implication because it assists in reducing questions from the staff, it mitigates the concerns of the family members, as well as it, prevent hospital readmission by maintaining resident within your building (Nuckols, 2015). The health facility needs to work its workforce to ensure and adjust workflows by collecting advance directives information during the period of admission to be able to develop adequate treatment approach for the patient. The health facility needs to make the collection of advance directives a requirement for every admission will assist it to be able to create a medication approach that is much easier to follow to reduce readmission. Also, it is essential to identify the best storage approach to store the advance directives of every patient.
Evaluating vendor contracts is another way of tightening health care processes. A vendor may contribute to the increase in the rate of readmission if he or she does not deliver the required medical tools or medicine on the required time (Nuckols, 2015). Thus every health facility needs to constantly review the vendor contracts to maintain vendors with a constant supply and do away with those who do not provide the supplies on time. Also, it is essential to challenge vendors to tighten turnaround times for services and make service levels conditions of contracts. And help prevent readmissions by speeding needed services that help stabilize patients conditions.
Nurse Skill Assessment is another step that the health facility may use to tighten the health care process. Generally, in the current era, patients are not only seeking to be provided with health services rather they are seeking for servicing, which satisfy their needs and are of high quality (Nuckols, 2015). It is essential to constantly evaluate the skills of the nurses in the health facility to be able to offer them training where necessary. Evaluation of the skills and qualification will also motivate the nurse to continue improving their knowledge hence reducing the rate of readmission.
2. Improving Patient Care
Several readmission in the health facilities may be prevented following a lower cost intervention, which is often designed to improve the experience of the patient. The health facility needs to maintain close monitoring in their patients to identify changes in the patient’s health.
Monitoring of the ADL score is an excellent method of improving patient care because it tends to track even the minor changes that may occur in the patient’s health status. This means that a reduction in the ADL scores the health care facility and the health providers are provided with the heads up that they need to change on the treatment plan and develop a medication plan that supports the patient’s health (Enos, 2017). Constant monitoring of the ADL scores can assist the health facility in minimizing the rate of unnecessary readmissions.
Creation of alerts is another way that a health facility may improve the care of its patients by developing techniques to monitor the changes in the patient’s condition and follow up treatment (Enos, 2017). When the patient’ condition is more critical, the higher the need for health care to pay close attention to his or her health condition to determine if the condition is improving or deteriorating.
Managing medication is a critical aspect of ensuring that the patients’ care is improved. Several pieces of research have proved that medication adherence reduces the rate of readmission with about 10- 20%. It is essential for the health facility administration to concentrate on identify the trends of refusal of care and also monitor the reasons behind the refusal trends to be able to develop a treatment approach that the patient prefers.
Developing an effective discharge planning is another step that may assist the health facility in improving its patient care as well as reduce the rate of readmission. The health facility needs to develop concise instructions which tend to promote adherence and healing by developing an easy to follow and apply discharge instructions which include medication, side effects of the treatment as well as assistive medical devices.
3. Excellent data management
The effort the health facility makes to reduce the rate of readmission is directly linked to how excellent and effective they collect the patients’ data. Data collection and management is an essential segment in ensuring that any health facility can provide quality care outcome. This step mainly focuses on how data is captured, used, as well as the leverage care data within the health care operation (Askren-Gonzalez & Frater, 2012).
Improving the workflow of data capture is the first step to having excellent data management. When the health facility can collect more data from the patient, it can have a better image of the patient’s health. When data is captured more, it provides room for triggering negative alerts regarding the patient’s health. It is essential to scrutinize every workflow to tighten up the time between interaction and documentationThis enables the health care facility to be able to address issues which trigger a high rate of readmission.
Patient condition Summary is another step that assists the health facility in improving its data management (Askren-Gonzalez & Frater, 2012). This step aids in preventing unnecessary hospital readmission by focusing on the causative aspects and developing a consolidated image of the patient’s health. For instance, the patient may react differently with the treatment provided, and due to the frequent condition summary, the health care can identify the issue and change the medication plan.
Implementing a Quality Assessment, Performance Initiative (QAPI) allows the health care facility to develop new policies which enforce quality and management tracking. This initiative may aid in the reduction of hospital readmission by Pointing out and fixing the risk areas. QAPI enables health care to maintain quality care through the use of patient data.
Askren-Gonzalez, A., & Frater, J. (2012). Case Management Programs for Hospital Readmission Prevention. Professional Case Management, 17(5), 219-226. doi:10.1097/ncm.0b013e318257347d
Enos, G. (2017). Provider team steps in to reduce payer’s hospital readmission rate. Mental Health Weekly, 27(15), 1-7. doi:10.1002/mhw.30999
Nuckols, T. K. (2015). County-Level Variation in Readmission Rates: Implications for the Hospital Readmission Reduction Program’s Potential to Succeed. Health Services Research, 50(1), 12-19. doi:10.1111/1475-6773.12268
Simorangkir, H., & McGuire, S. J. (2017). Training in Readmission Reduction in an Indonesian Hospital. Hospital Topics, 95(2), 40-50. doi:10.1080/00185868.2017.1300477