Population health-based projects|Essay pro
Posted: February 18th, 2023
Aims and Objectives: To identify structure, process, and outcomes associated with the implementation of transitional community-based management of hospital readmission rates.
Background: Population health-based projects have previously been described (Chapters 10 and 13). Using a transitional community-based readmissions plan for patients with heart failure, categorize quality metrics into structure, process, and outcomes.
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Questions/comments to be considered are as follows:
- What are your data input, output, and measures of success?
Suggested response: The data input would be community health workers and patients with heart failure, the output would be readmission plans, and the measure of success would be surveying patient responses.
2, Explain how your devised model incorporates social context.
- The community-based management program will ensure that social contexts such as social or familial support, income, or cultural norms are incorporated.
- Patients will be treated within their social context and communities.
3.How will you assess your population or community?
Suggested response: The patient assessment instrument in Centers for Medicare & Medicaid Services (CMS) measure management programs can be used to assess the population or community.
SOLUTION
Aims and Objectives: The aim of this project is to identify the structure, process, and outcomes associated with the implementation of transitional community-based management of hospital readmission rates for patients with heart failure. Specifically, the objectives are:
- To describe the structure of the transitional community-based management program, including its components, resources, and staffing.
- To identify the key processes involved in the program, including patient identification, referral, enrollment, and intervention.
- To measure the outcomes of the program, including hospital readmission rates, length of stay, and patient satisfaction.
Background: Hospital readmissions are a major issue in healthcare, particularly for patients with heart failure. Transitional community-based management programs have been shown to be effective in reducing hospital readmission rates for these patients. These programs involve a coordinated effort between hospitals, healthcare providers, and community resources to provide ongoing support and care to patients after discharge.
Quality metrics can be categorized into three domains: structure, process, and outcomes. Structure metrics refer to the resources and infrastructure in place to support the program. Process metrics measure the activities and interventions that occur during the program. Outcome metrics evaluate the results of the program.
In this project, we will use these quality metrics to evaluate the implementation of a transitional community-based management program for patients with heart failure. By categorizing these metrics into structure, process, and outcomes, we can gain a comprehensive understanding of the program’s effectiveness and identify areas for improvement.
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