Patients not returning to their follow-up appointments is a critical clinical practice issue that decreases the quality of services and must be included in the East Orange Hospital Clinic systematic agenda. Indeed, many of my practicum site’s beneficiaries represent the impoverished population and, therefore, experience difficulties following their physicians’ recommendations (Dantas et al., 2018). The issue is urgent because skipped appointments lead to severe patient outcomes, damage the hospital’s performance and affect chronic diseases and mortality rates of New Jersey. This paper aims to discuss the strategies for stakeholders’ persuasion of the importance of the no-return to follow-up visits and identify how the issue can be included in agenda-setting and policy-making processes.
As an AGNP, I can collaborate with my preceptor to investigate and develop strategies to address the issue during the practicum hours completion. The stakeholders who influence agenda setting at the East Orange Hospital Clinic are the executives’ board, the union of physicians, and the quality-improvement team containing all departments’ workers. A vital aspect of persuading them is formulating the issue, offering the action plan in the correct language, and including all the outcomes. Consequently, the policy proposal must contain problem identification, adoption, alternative frameworks, implementation tools, and evaluation measures (Laureate Education, 2011). The issue described with these precise details will move from simple discussion to policy development because of the sufficient scope of evidence supporting the urgency of change implementation.
Research, literature review, and feedback gathering revealed that administrators and physicians could address the issue of missing appointments at the organizational level. The policy can be formulated as the demand for including the patient education protocol in a primary visit scenario. Several types of conversations can be developed and adapted to the practice, and, based on their effectiveness, the optimal variant would be created (Hyder et al., 2010). Implementation requires the clinic to consider beneficiaries’ needs, and socioeconomic status and use the relevant arguments to convince them to attend the follow-up visit (Laureate Education, 2011). Evaluation is necessary to prove the solution’s efficiency and establish it as an obligatory health care policy in the future. Periodically measuring the number of non-attendants after the visits where the new protocol was applied is the appropriate way of retrieving the data to assess.
Stakeholders interested in the follow-up appointment policy integration are primarily the physicians whose patients refuse to attend the clinic. Furthermore, the clinic’s quality improvement team may find the initiative worth adding to the practices. Indeed, the policy that influences attendance will positively impact treatment outcomes and decrease the number of worsened chronic disease conditions (Hyder et al., 2010). The stakeholders can provide the initiative with additional support by assisting in passing it to the administrative boards and setting the issue on the clinic’s agenda. The policy can be addressed through the changes in protocols given to the physicians during their education, and reaching out to the institutions would be beneficial for taking the issue to the statewide and nationwide levels (Votruba et al., 2020). The increasing number of missed appointments noticed by a practitioner and developed into a significant change in treatment is an example of how evidence-based initiatives can impact healthcare.
Agenda-setting capabilities enable practitioners to be actively involved in health care quality improvement and can help them move a simple discussion question to massive policy change. For instance, the problem of patients not returning to their follow-up appointments is a critical clinical practice issue in my setting. As an AGNP, I can take action to develop and implement the solution and persuade the stakeholders to support the initiative. Executive board representatives, physicians, and the quality improvement team can be convinced to participate by providing them with a detailed policy outline.
Dantas, L. F., Fleck, J. L., Oliveira, F. L. C., & Hamacher, S. (2018). No-shows in appointment scheduling–a systematic literature review. Health Policy, 122(4), 412-421. Web.
Hyder, A., Syed, S., Puvanachandra, P., Bloom, G., Sundaram, S., Mahmood, S., & Peters, D. (2010). Stakeholder analysis for health research: Case studies from low-and middle-income countries. Public Health, 124(3), 159-166. Web.
Laureate Education, Inc. (2011). Healthcare policy and advocacy: Agenda setting and the policy process [Video]. Baltimore.
Votruba, N., Grant, J., & Thornicroft, G. (2020). The EVITA framework for evidence-based mental health policy agenda setting in low-and middle-income countries. Health Policy and Planning, 35(4), 424-439. Web.