ASSESSMENT PROJECT – READMISSION OF PATIENT WITH CHF IN A SKILLED NURSING FACILITY ESSAY

ASSESSMENT PROJECT – READMISSION OF PATIENT WITH CHF IN A SKILLED NURSING FACILITY ESSAY

ASSESSMENT PROJECT – READMISSION OF PATIENT WITH CHF IN A SKILLED NURSING FACILITY ESSAY

Assessment Project

Hospital readmission refers to an admission that happens within a particular period after a patient is discharged. A hospital’s readmission rates are regarded as a measure of healthcare quality and reflect elements of quality of patient care (Upadhyay et al., 2019). This paper will discuss my leadership project on reducing readmission of patients with congestive heart failure (CHF) in a skilled nursing facility.

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Focus, Goals, and Competencies

The focus of the leadership project was to reduce the readmission of patients diagnosed with congestive heart failure (CHF). The project focused on establishing factors that increase readmission rates among patients diagnosed with CHF and identifying interventions that can be employed to mitigate or eliminate these factors.  Frequent readmissions put patients at a high risk of nosocomial infections, lower their quality of life, and increase healthcare costs.

The goals I developed during the practicum include refining my leadership skills. I sought to improve communication, decisiveness, problem-solving, and team-building skills. Besides, I set a goal to improve my ability to identify loopholes in the delivery of patient care and develop sustainable solutions to addressing them. Another goal was to improve the health outcomes of patients at the practicum site, which I aimed to achieve through the practicum project.

The AONE competencies I hoped to attain during the practicum include those in the domains of Communication, Healthcare Environment Knowledge, and Leadership. Under Communication and Relationship Building, I hoped to develop effective communication skills and establish collaborative relationships (Waxman et al., 2017). I also hoped to collaborate with other healthcare professionals in identifying priority patient care needs. In the domain of knowledge of the healthcare environment, I hoped to utilize EBP to develop patient care standards and practices in the facility (Waxman et al., 2017). Under the leadership domain, I hoped to apply knowledge in decision-making and problem-solving and employ visionary thinking on matters impacting the skilled nursing facility.

Project Needs

The project was informed by the increasing healthcare burden of CHF in the skilled nursing facility and the larger healthcare system. CHF is one of the major causes of hospitalizations and readmissions in hospitals and skilled nursing facilities (Lee et al., 2020). The CHF readmissions are usually caused by poor quality of health care and result in excessive healthcare spending (Lee et al., 2020). I, therefore, saw the need to identify and implement an intervention to prevent readmissions of CHF patients. Besides, reducing readmission rates was a priority to enhance quality of life and decrease healthcare costs associated with CHF.

Castle Manor Skilled Nursing was my leadership practicum site. It is a skilled nursing facility that focuses primarily on post-discharge transitional care. The facility’s mission is to assist patients in recovering and discharge them back home or to a lower level of care. The philosophy states that every patient in the facility’s care is unique. The project fits into the facility’s philosophy and mission since it seeks to promote better health outcomes for CHF patients in the post-discharge phase. Interventions to improve the recovery of CHF patients and reduce readmission rates align with the facility’s mission to help patients in the recovery process and discharge them back with minimal chances of developing complications (Warchol et al., 2019). Furthermore, the project supports the facility’s goal of maximizing the comfort and recovery potential of patients.

Barriers

No barriers were encountered in developing and implementing the project. The project development was swift, owing to the overwhelming support from my preceptor and nurses at Castle Manor. The preceptor and the nursing staff assisted in identifying factors that worsen the health outcomes of CHF patients. They also took part in developing interventions to mitigate and eliminate the factors.

Outcomes

The outcomes of the project will be measured by reviewing the number of readmissions of CHF patients 12 months after initiation of the project. Data will be collected from patients’ health records and the facility’s database. The data will comprise patients’ age, comorbidities, current treatments, and the number of days post-discharge.  The number of readmissions during the first 12 months will be compared to readmissions in the 12 months before project initiation (Warchol et al., 2019). The project is sustainable since it seeks to mitigate factors worsening health outcomes for each CHF patient admitted at Castle Manor Skilled Nursing Center. Every CHF patient admitted to the facility will be enlightened on the factors that worsen health outcomes and educated on measures to mitigate them and lower the chances of readmission.

Project Success

The CHF project was executed successfully with the help of my preceptor and nursing staff at the skilled nursing facility. We successfully identified factors worsening health outcomes in CHF patients and provided health education on measures to reduce them in order to reduce the chances of readmission. The next steps will be to disseminate the project’s findings to health professionals in other organizations to influence them to implement the project to reduce CHF readmission rates.

Conclusion

The leadership project focused on reducing the readmission of patients with CHF in a skilled nursing facility. It was informed by the high readmission rates, poor health outcomes, and high healthcare costs of CHF patients.  The project seeks to improve health outcomes and decrease healthcare expenditures for CHF patients. Its outcomes will be measured by comparing readmission of CHF patients 12 months before and after initiation of the project.

References

Lee, K. K., Thomas, R. C., Tan, T. C., Leong, T. K., Steimle, A., & Go, A. S. (2020). The heart failure readmission intervention by variable early follow-up (THRIVE) study: a pragmatic randomized trial. Circulation: Cardiovascular Quality and Outcomes, 13(10), e006553. https://doi.org/10.1161/CIRCOUTCOMES.120.006553

Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission Rates and Their Impact on Hospital Financial Performance: A Study of Washington Hospitals. Inquiry: a journal of medical care organization, provision, and financing, 56, 46958019860386. https://doi.org/10.1177/0046958019860386

Warchol, S. J., Monestime, J. P., Mayer, R. W., & Chien, W. W. (2019). Strategies to Reduce Hospital Readmission Rates in a Non-Medicaid-Expansion State. Perspectives in health information management, 16(Summer), 1a.

Waxman, K. T., Roussel, L., Herrin-Griffith, D., & D’Alfonso, J. (2017). The AONE nurse executive competencies: 12 years later. Nurse Leader, 15(2), 120-126. https://doi.org/10.1016/j.mnl.2016.11.012

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ASSESSMENT PROJECT

PROJECT – READMISSION OF PATIENT WITH CHF IN A SKILLED NURSING FACILITY

Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 850-1000 word document, discuss the following topics:
1. What was the focus of your leadership project, the goals you set for yourself, and the AONE competencies you hoped to achieve?
2. How did you discover the need for this project, and how did it fit into the organization’s philosophy and mission?
3. Did you encounter any real or potential barriers during your practicum experience related to your project?
4. Discuss how the outcomes of your project will be measured? Is your project one that is sustainable or is it designed to be a single occurrence?
5. Evaluate the success of your project. If you were not able to implement your project, discuss why. What are the next steps for the project?