You will collaborate with two of your classmates to share ideas and offer feedback and suggestions to one another in an informal setting. This collaboration within your group will assist you in further developing your Change Proposal to be submitted for feedback from your instructor next week.

You will collaborate with two of your classmates to share ideas and offer feedback and suggestions to one another in an informal setting. This collaboration within your group will assist you in further developing your Change Proposal to be submitted for feedback from your instructor next week.

Peers submission attached below.. please provide feedback and suggestions individually!!

Peer 1:

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Victoria Lyons posted

IV. Implementation Plan

Assess the factors that are likely to affect the implementation of your recommended activities

Many stroke patients require rehabilitation after their hospitalization and many patients get readmitted from post-acute care facilities, educating these facilities could decrease the readmission rate however rehabilitation facilities are often short-staffed and may not have money for education amongst the staff

 

Identify evidence-based rationales to propose how you will address them, incorporating your identified change theory. Your plan should encompass the following with evidence to support your rationale:

Technological challenges

Stroke patients require adequate follow-up care with their health provider team, tele-health is a great way to provide these follow-up appointments however stroke patients may not be able to navigate computers to be able to do these appointments as they frequently have deficits.

Stroke health care providers would have to learn how to use tele-health and there may be push back to using it due to health care providers typically using hands on assessment skills, they may not find assessing patients this way adequate. Finding a group of health care providers that are willing to start treating patients this way is the first step.

 

Institutional structures

Changes in hospitals do not happen overnight. At my state run hospital it seems to take forever to get any changes made. Implementing education regarding how to reduce stroke readmissions would require research and then approval from many different committees to even be approved for implementation. Once approved then it has to be sent all to all hospital staff involved. Examples of committees that a hospital will have and that any changes would have to go through are finance, safety and quality, strategic planning, and audit and compliance committee (Price, 2018).

Strategies for building buy-in-among different stakeholders, including nursing

Doctors, nurse practitioners, physician assistants, physical therapists, social workers, and case managers will need to be on board with the change process. Historically nurses have a hard time with change.

Financial trends and anticipation of the availability of human resource and project funding

Implementing tele-health and training to decrease stroke readmission, mostly education and new ways to check that everything a patient needs, will cost money which the institution will have to be prepared to put into their budget. Institutions get penalized financially for readmissions so increasing efforts to decrease these would be a financial benefit (Kripalani, Theobald, Anctil, & Vasilevskis, 2015).

Hospital or governmental policy constraints

It may be tricky for patients that have strokes that are on Medicaid or Medicare and    working around their insurance policies. Within hospitals it takes time to get a policy

set into place.

Regulatory requirements

Some regulatory acts that would have to be taken into consideration would be The Health Information Technology for Economic and Clinical Health Act (HITECH) (Maryville University, 2020) and the Medicare Access and CHIP Reauthorization Act of 2015 (Maryville University, 2020). The MARCA works with a payment model for quality of care, reducing readmissions would help with reimbursements (Maryville University, 2020).

Patient diversity

Educating patients on ways to decrease their admission will have many different considerations. Reading levels, language spoken, family support, use of technology, what disability they have after their stroke. Understanding why groups of people tend to get readmitted over others is an important way to decrease admissions. Individuals less than 80 years of age had a less chance of being readmitted over individuals over 80, this was related to statin use (Poston, 2018).

 

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