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MDC Care Coordination Discussion

MDC Care Coordination Discussion

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Two Replies:

Gelila TilahunYesterdayAug 21 at 10:34am

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Hello class and professor,

It is my belief that care coordination is a vital component of today’s healthcare system and a strong influence on the quality of care. Care coordination refers to the deliberate, systematic process of organizing the patient’s healthcare across multiple providers, specialists, and organizations (Anderson & Hewner, 2021). The purpose of care coordination is to ensure that care does not take place in a silo, and that efforts are not duplicated, as well as to ensure that important issues are not overlooked. Interprofessional communication and shared goals for the patient and their health are essential for effective care coordination (Anderson & Hewner, 2021). It has been demonstrated that when care is coordinated appropriately, quality outcomes may be improved, such as readmissions, hospital-acquired infections, complications, and costs. By communicating with healthcare organizations and providers, waste can be reduced, efficiency can be improved, and patient goals can remain at the forefront of treatment decisions.

For example, patients with schizophrenia can benefit from care coordination. In addition to severe functional impairment caused by psychiatric symptoms, schizophrenia is associated with homelessness and housing instability, as well as comorbid substance use disorders, cardiometabolic illnesses, involvement in the criminal justice system, violence victimization and perpetration, dysfunctional family relationships, and adverse health and social outcomes (Patel et al., 2014To ensure effective nursing care for individuals with schizophrenia, the coordination of care among various specialists and providers within and beyond the healthcare sector is crucial. Research underscores that such coordination can significantly enhance health outcomes, minimize psychiatric hospitalizations, and reduce visits to the emergency department for those diagnosed with schizophrenia (Roach et al., 2021). Despite these benefits, these programs are often underutilized or not consistently accessible to all eligible patients (Roach et al., 2021).

P.S. I would also like to express my heartfelt gratitude to my classmates for their unwavering support and encouragement throughout this journey. Your belief in me has been truly motivating. And to Professor Kue, your willingness to address my challenges and endless questions has been a cornerstone of my learning experience. Thank you all for making this class such a remarkable chapter in my academic life.

References:

Anderson, A., & Hewner, S. (2021). Care Coordination: A Concept Analysis. AJN The American Journal of Nursing, 121(12), 30-38.

Patel, K. R., Cherian, J., Gohil, K., & Atkinson, D. (2014). Schizophrenia: overview and treatment options. Pharmacy and Therapeutics, 39(9), 638.

Roach, M., Lin, D., Graf, M., Pednekar, P., Chou, J. W., Benson, C., & Doshi, J. A. (2021). Schizophrenia population health management: perspectives of and lessons 

Laura Limon8:36amAug 22 at 8:36am

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Hello everyone! Wishing everyone who has to re-take APEA (myself included) good luck! May you get plenty of time to review and study!

Yes, care coordination affects the quality of the patient care delivered. Personally, it is the person working that piece of coordination that affects the quality of patient care. In the CCCR model there are talking tools for the collaborative team addressing all health concerns related to the patient. Working with caring and motivated experts adds value to the network experience and process. When the coordinators are motivated, so is the environment aura to do better for the patients. This makes me think of the nursing theorist Jane Watson as an example. The human caring theory by Jane Watson explains the mystery between human caring and healing. Jane Watson fully believed that a nurse could change the environment of a patient’s room by the presence of genuine caring and positive energy. The human caring theory states that caring for patients promotes growth. Her theory can expand to all areas of care coordination. When the interdisciplinary team genuinely cares and demonstrates to the patient the caring energy, the quality of patient care is changed in a positive way.

Proper care coordination can reduce hospital readmissions. It is interesting that I can answer this question this week because I have a related story. Earlier in the week a patient we had for a while was discharged home with a PICC line for home IV antibiotic infusion. Two days later the patient was readmitted with fever. It was discovered that home health infusion did not show up to administer the IV antibiotics to the patient. Then it was discovered that the home infusion received the patient’s address, but the patient was staying with a relative for the time being. Everyone makes mistakes, I understand, but there was failure to communicate with the patient about where he was going to go after the hospital. This is one that could have been avoided if there was a better relationship with the patient. Rammohan (2023), states that 79 % of readmission after discharge can be avoided. I think my example is one that could have been avoided.

References

ANEF, R.K.P.R. C., FAAN, D.J.P.P.R. P., & DNP, T.E. A. (2016). Clinical Reasoning and Care Coordination in Advanced Practice Nursing. Springer Publishing LLC. https://online.vitalsource.com/books/9780826131843

Rammohan, R., Joy, M., Magam, S. G., Natt, D., Patel, A., Akande, O., Yost, R. M., Bunting, S., Anand, P., & Mustacchia, P. (2023). The Path to Sustainable Healthcare: Implementing Care Transition Teams to Mitigate Hospital Readmissions and Improve Patient Outcomes. Cureus, 15(5), e39022. Links to an external site.“>https://doi.org/10.7759/cureus.39022Links to an external site.

Nursing Theory (n.d).https://nursing-theory.org/nursing-theorists/Jean-… 

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