Introduction
Quality is one of the basic priorities of healthcare centers that try to ensure the best patient outcomes. It has been acknowledged that quality is not confined to addressing specific health issues and conducting a set of clinical procedures. Patient satisfaction, readmission rates, and the cost-effectiveness of the provided services are also important quality measures to consider when evaluating healthcare interventions (Sherwood, 2017). This paper includes a brief evaluation of the quality of services provided at the cardiovascular surgery department of a medical center.
The Medical Center, Its Success, and Failures
The cardiovascular surgery department of the medical center Avicenna’s Center addresses the needs of a wide audience, but the majority of patients are people aged 60 or older. The department is quite understaffed as the nurse-patient ratio is 1:3, which is associated with a high turnover of nurses. The major successes of the department include the high quality of the provided services that are related to patient outcomes.
The vast majority of surgical operations are successful and characterized by no or limited complications. A low rate of medical error can also be seen as a sign of the high quality of services. It is noteworthy that post-discharge telephone calls are becoming more common, but their use is a matter of the personal choice of the medical staff. No policy or standard exists in the facility to regulate the use of this quality measure.
Among the most apparent failures of the facility is the overall level of patient satisfaction, which is rather low. The recent survey implemented at the medical center shows that patients are often dissatisfied with the need to arrange appointments due to the deterioration of their health within a month after their discharge. Patients also expressed their discontent with the way nurses treated them. Finally, the lack of funding makes the administration of the healthcare entity reconsider its fund allocation policies.
Possible Impact of Nursing Science
It is clear that thorough nursing research may be instrumental in identifying the most burning issues to address. Thompson, Fahs, and Kell (2016) claim that readmission is a common issue involving patients who have undergone cardiovascular surgery, especially the elderly population. Readmission is also associated with adverse health outcomes for patients and a considerable financial burden for the facility and the entire healthcare system. It is necessary to identify the current readmission rate in the department to understand the severity of the problem. Healthcare professionals should also participate in the research as their views on the reasons for the readmission can help in developing an effective intervention to address the issue.
Patient satisfaction should also be researched in more detail in order to improve the quality of the provided services. Such aspects as clinical procedures, relationships with the medical staff, and clinical experiences should be analyzed. Apart from contributing to the development of effective intervention, nursing science will be helpful in evaluating their effectiveness. Such variables as cost-effectiveness, patient satisfaction, readmission rates before and after the implementation of the intervention
Follow-Up Calls Project in the Facility Under Consideration
The establishment of specific standards concerning follow-up calls to patients who have undergone cardiovascular surgery can address some of the major issues the department faces. The intervention aimed at assessing the effectiveness of such calls will include nursing professionals and physicians’ calls to the target population. Lee, Yang, Hernandez, Steimle, and Go (2016) note that follow-up calls are associated with a lower readmission rate within 30 days after patients’ discharge. Such areas as medication and lifestyle are major topics to address (Liu et al., 2018). However, the healthcare staff should also ask patients about their overall health condition. The aspects that will be covered during the calls will be developed on the basis of the research involving the medical staff mentioned above.
Thompson et al. (2016) state that the involvement of community partners enhances the positive outcomes of the intervention. The project in question should also encompass some elements of this strategy. The nursing practitioners of the medical center should notify community healthcare entities (for example, home health agencies) about patients’ discharge with some central information about their condition and needs. Community healthcare professionals will develop the corresponding strategies to ensure that patients follow the given recommendations and have no complications or related health issues. After the evaluation of the intervention and its effectiveness, the corresponding policies and standards should be established.
Challenges and Ways to Address Them
Some of the challenges related to the successful implementation of the intervention and the establishment of standards are the inappropriate performance of the healthcare professionals, understaffing, funds scarcity, and the overall resistance to changes. The effectiveness of projects involving follow-up calls often depends on the fact whether these calls have been received (Tang, Fujimoto, & Karliner, 2014; Harrison, Auerbach, Quinn, Kynoch, & Mourad, 2014).
Hence, it is essential to make sure that healthcare practitioners will reach the patients. The performance of the medical staff, as well as the acceptance of changes, is closely related to the understaffing problem. Therefore, the administration of the medical center in question should ensure the development of the corresponding culture. Healthcare professionals involved in the project should be informed about its benefits for patients and the medical staff. It can be necessary to introduce certain perks for high-performers. As far as the lack of funds, the administration can compare the costs associated with readmissions and the funds they will allocate to implement the intervention.
Collaboration
In order to implement the intervention and transform it into a policy, the collaboration of certain groups is necessary. It is essential to ensure the support of the administration as the project needs some funding. It is also critical to communicate with nursing professionals to become active participants in the program. Since the intervention will involve community health entities, it is critical to collaborate with their professionals, including the provision of some training or guidance.
Conclusion
In conclusion, quality in healthcare is one of the priorities to focus on. The medical staff should pay attention to different aspects of quality, including clinical procedures, patient satisfaction, project cost-effectiveness, practitioners’ performance, and other areas. One of the ways to improve the quality of the services provided at the cardiovascular department of the medical center understudy is to implement the post-discharge calls intervention. The project will be developed and implemented based on the empirical data concerning patients’ readmission rates and their satisfaction.
The evaluation of the intervention will be related to such areas as readmission rates, patient satisfaction, and the cost-effectiveness of the project. The collaboration of the administration, the medical staff of the department, and the practitioners of community health facilities will be needed. The intervention can become the basis for the development of standards that will ensure the provision of high-quality care.
References
Harrison, J. D., Auerbach, A. D., Quinn, K., Kynoch, E., & Mourad, M. (2014). Assessing the impact of nurse post-discharge telephone calls on 30-day hospital readmission rates. Journal of General Internal Medicine, 29(11), 1519-1525. Web.
Lee, K., Yang, J., Hernandez, A., Steimle, A., & Go, A. (2016). Post-discharge follow-up characteristics associated with 30-day readmission after heart failure hospitalization. Medical Care, 54(4), 365-372. Web.
Liu, V. C., Mohammad, I., Deol, B. B., Balarezo, A., Deng, L., & Garwood, C. L. (2018). Post-discharge medication reconciliation: Reduction in readmissions in a geriatric primary care clinic. Journal of Aging and Health, 1-16. Web.
Sherwood, G. (2017). Driving forces for quality and safety: Changing mindsets to improve health care. In G. Sherwood & J. Barnsteiner (Eds.), Quality and safety in nursing: A competency approach to improving outcomes (pp. 3-20). Hoboken, NJ: John Wiley & Sons.
Tang, N., Fujimoto, J., & Karliner, L. (2014). Evaluation of a primary care-based post-discharge phone call program: Keeping the primary care practice at the center of post-hospitalization care transition. Journal of General Internal Medicine, 29(11), 1513-1518. Web.
Thompson, C., Fahs, B., & Kell, C. (2016). A nurse-led collaborative linking medical center with community partners transforms patient care and reduces readmissions. Heart & Lung: The Journal of Acute and Critical Care, 45(4), 381. Web.