Advocating for Lasting Change

Hi everyone, my name is Luiz Dias, and today I will be advocating for lasting change to our stakeholders to improve healthcare access through telehealth technology in the Jordan community.

Identification of Stakeholders

The change proposal is being presented to the following stakeholders:

• Project manager 
• Villa health executive leaders 
• Community residents of the Jordan community
• Funding agencies, both Government and Private entities.
• Healthcare experts
• Nurses, including nurse informaticists.

Stakeholders play a crucial role in implementing the change process in the community (Bonawitz et al., 2020), providing the necessary resources, funding, and material for implementing technology.

NURS FPX 6218 Assessment 4 Advocating for Lasting Change

Policy and Financial Support

Jordan is a small town in Minnesota whose community faces numerous problems in getting medical care that affects their mental health and causes several chronic conditions (Capella University, 2023). The proposed change for the Jordan community is implementing telehealth technology within the community center, which needs policy changes and financial support from government and private organizations for a successful implementation. 

Telehealth technology provides cost-effective remote access to medical care for all community members in Jordan, but it needs support and funds for successful implementation (Ganesh et al., 2020). The policies that apply to the proposed change are governmental organizations, such as the Affordable Care Act (ACA), Medicare, and Medicaid policies (Carey et al., 2020). These policies will help provide affordable expansion and insurance programs for the low-socioeconomic group who cannot afford medical care.

Policy Change and Fundings Needed 

Jordan’s community center and healthcare services also need more medical care access resources (Capella University, 2023). As a result, they cannot afford the change proposal and require funding from external government and private sources to manage telehealth technology and healthcare staff for remote care access. The survey results also indicated that the people in the Jordan community belong to a low-socioeconomic group and cannot afford medical care (City of Jordan, 2021). Appropriate funding will assist in implementing telehealth technology that impacts positive results in providing healthcare and overcomes challenges faced by low-income people.

Challenges or Concerns

Several challenges and barriers to the change proposal include resistance to technology acceptance by the community members due to a lack of knowledge and awareness. The chances of data breaches and security or privacy concerns are also barriers to the change process. Other barriers are the need for more technical assistance in using modern telehealth technology by community members and healthcare staff (Mahoney, 2020). If the problems are not addressed, they will result in challenging situations in managing patients’ health conditions. In addition, hospital readmission rates will increase, resulting in burnout and disturbance in work balance. So, the proposed change must be implemented in the community center of Jordan to overcome the problems.

Assumptions

The Windshield survey result evaluated the need to improve healthcare services for the low-economic groups in the Jordan community (Capella University, 2023). The assumptions supporting the rationale for the current policy change by policymakers, members of the community, or health care providers are the need for medical care access to all community members without any social, racial, or economic differences or biases.

Social Determinants of Health 

Social determinants of health are the factors that affect the health and well-being of people (Palmer et al., 2019). These health determinants include living conditions and resources for education and medical care. These factors also include social and physical aspects that affect the health of individuals. The survey results showed that the SDOH for the Jordan community is socioeconomic status, racism, education, and access to medical care services (Capella University, 2023). The differences result in health disparities in getting medical care. These determinants need improvement through telehealth technology to provide equal access to medical care without socio-economic or racial differences.

Windshield Survey and Environmental Analysis Findings

The Windshield survey and environmental analysis help identify the health needs and environmental conditions of the Jordan community that need improvement. The Windshield survey evaluated that the Jordan community has schools, parks, a city council, healthcare services, restaurants, and recreation centers. These are the positive aspects of the Jordan community. However, there are some negative aspects; thus, opportunities exist for improvement. The negative aspects are water quality, air quality, and socioeconomic differences (due to the low income of individuals) (Capella University, 2023). The environmental analysis indicated that water quality is not good and contains contaminants that cause several diseases like cholera, hepatitis, and others (City of Jordan, 2021). These factors affect the health condition and cause health disparities in getting equal medical care access. The change proposal of telehealth technology will help overcome such disparities and cost-effectively provide equal medical care access. Telehealth technology will also help raise awareness among community members about the water quality, air quality, and diseases caused due to contaminations. In addition, there are opportunities for improvement in the available vacant or empty spaces in the community. These spaces can be used for effective business plans that benefit the community.

Change Proposal 

The health disparities in getting medical care need to be addressed. The existing policies in the Jordan community need to address the problems of remote-care access for low-income individuals. The proposed telehealth technology will help to overcome the problem of remote-care access. The proposed change will also provide cost-effective treatment and reduce the financial burden as it lessens travel costs and expensive insurance plans. This will help low-socioeconomic groups quickly get medical care without social, cultural, or racial differences. The desired outcomes of increased healthcare access, reduced financial burden, and provision of cost-effective care can be achieved through the change process of telehealth technology.

Various studies from the literature support the effectiveness of telehealth technology in providing medical care access to individuals. A study states that telehealth is a cost-effective approach that reduces travel hurdles and expenditures in accessing medical care (Ben-Assuli, 2022). Another study found that during COVID-19, telehealth provided excellent support in orthopedic surgeries (Sprowls et al., 2020). Video conferencing also can help surgeons treat patients effectively by getting expert opinions from other professionals in the field. A study demonstrated the critical role of telehealth in reducing health disparities by providing equal medical care accessible to all people (Hirko et al., 2020). Telehealth technology is a game changer for virtual medical care by experts in the field.

Benefits of the Change for Community and Stakeholders

The proposed change will provide benefits to the community members and stakeholders. The Jordan community will benefit from Telehealth by providing individuals with equal medical care opportunities. It will help the low-socioeconomic group of people get medical care that was previously not affordable. The travel cost will be reduced and help the patients and healthcare organization manage the work balance (Hirko et al., 2020). Burnout among healthcare providers and nurses due to work pressure will be reduced. Moreover, the operating costs of the emergency department will be reduced due to fewer readmissions to the hospital.

Funding

Implementing telehealth technology requires funding and resources from government and private organizations. Funding from organizations, healthcare services, and help from healthcare experts will be needed to implement and sustain the proposed change in telehealth technology. Training healthcare staff will enable them to use technology to provide adequate medical care. The human resource budget includes the salaries of the project manager, healthcare experts, and nurse informaticists. It also has fringe benefits (incentives) and consultation services. In addition, funds are required for the installation costs, such as equipment and maintenance items. 

The basic telehealth costs for implementation will range from about $ 15,000  to $150,000, depending on the features of the technology (Ravitz et al., 2021). The prices depend on the number of participants in the medical team and the resources needed. The cost also covers the salaries of healthcare staff and nurses, the installation of technology, and its initial maintenance. The budget estimate of the proposed change is $35,000, which covers the human resource support, fringe benefits, and equipment installation and maintenance costs. The first-year salary for the project manager, healthcare providers, and nurse informaticists will be $5,000, $10,000, and $4,000, respectively. The estimated amount for fringe benefits, including incentives and consultation services, will be $5,000 and $100, respectively. The equipment cost, including installation, will be $5,000. The material cost for educational purposes will be $5,000. The price for awareness sessions will be $900.  The estimated budget will help provide telehealth services that improve outcomes.

NURS FPX 6218 Assessment 4 Advocating for Lasting Change

Plan for Leading Transformation Change

Vision and Goals for Change

The vision for change is to provide equal healthcare access to all members of the Jordan community without social, cultural, or racial differences. The proposed change will facilitate the individuals of the Jordan community through economic treatments and by providing remote medical access. In addition, the vulnerable community will benefit from the proposed telehealth change.

Evidence-Based Transformational Change

The Awareness, Desire, Knowledge, Ability, and Reinforcement (ADKAR) change management model will address the barriers to change (Wong et al., 2019). This change model will help to bring transformational change in the Jordan community. The first step is creating Awareness (A) among stakeholders regarding the use of telehealth technology. The next step will focus on creating a Desire (D) for change by telling the adverse outcomes if the change is not implemented in Jordan’s community center. In the next step, Knowledge (K) will be provided regarding the use and application of technology. The next step is ensuring the sense of Ability (A) among stakeholders for Reinforcement (R) of the change process in the community center. The stakeholders can use all these steps to implement telehealth technology in the community center by changing the organizational culture of using the community center only for recreational activities. These changes in organizational culture through transformational change can be used for giving culturally appropriate medical care to all the individuals in the community. It will create healthy environments that encourage health and well-being for all individuals.

Ensuring Ongoing and Effective Communication

Effective verbal and open communication methods can ensure ongoing and effective communication among the stakeholder team. The key individuals accountable for implementing the change are community residents of Jordan, the project manager, nurses, healthcare care experts, and members of funding agencies. All the team members need to follow the steps of change management theory to implement the change process. One study demonstrated that the ADKAR change management model is helpful for project management evaluation in a pediatric healthcare center (Glegg et al., 2019).

Community Health Implications

The goals of Healthy People are to provide health treatments for all individuals on, equality, and the promotion of healthy beings of people by 2030 (Healthy People 2030, 2023). Healthy People also focuses on the effective leadership style (visionary) for creating health and wellness among individuals in the community. The visionary leadership style focuses on the equal provision of medical care for all individuals. Healthy People also focuses on enhancing medical care through information health technology through telehealth by 2030. All these goals are aligned with the proposed telehealth technology change for equal medical care provision.

Vision for Healthy Community

The vision for the health community is to promote awareness among community members regarding disease management through telehealth technology. The community members will be given the education to consider the resources that are available to increase outcomes. The benefits are cost-effective treatment and improved healthcare access for all individuals. The risks are the chances of a data breach that result in privacy and security concerns among community members (Zhou et al., 2019). The patient’s medical information is at risk of being attacked by hackers.

Leadership Style

Transformational and collaborative leadership styles will be used to effectively implement the change for achieving health and wellness goals. The transformational leadership style creates an environment where all the team members are responsible for their duties, resulting in positive outcomes. On the other hand, collaborative leadership helps improve communication among stakeholders so that all members share their ideas and actively participate in the decision-making process to improve outcomes (Hansen & Pihl-Thingvad, 2018). Thus it is justified that both leadership styles will help to implement and sustain the change process in the community center of Jordan.

Stakeholder Support for the Proposed Change

Stakeholder interest and support will be cultivated by offering them incentives. This approach of offering incentives will increase the interest of stakeholders in the change proposal for community healthcare. Stakeholders are the essential aspects of the change proposal method. The stakeholders for the proposed change are project managers, nurses, healthcare professionals, community residents of Jordan, and funding organizations. The stakeholders influence the change proposed in the following ways:

• The project manager will manage all the responsibilities of the change proposal by collaborating with all other stakeholders.
• Nurse informaticists will educate and guide healthcare experts and community residents about technology usage.
• Healthcare providers will treat patients remotely by providing clinical decision support.
• Funding agencies will provide funds for the implementation of the new technology.
• Residents will use the technology.

The vision of change is to provide equal and affordable healthcare access to all individuals in the Jordan community. However, there are some concerns of stakeholders regarding the work distribution and preferences of patients who need to treat first. In addition, there can be objections regarding security and privacy concerns that result in data breaches and the loss of confidential patient information to hackers and unauthorized personnel. These issues can be addressed by following the security and privacy rules of HIPAA. These rules will help in securing patient information through the use of individual login systems. One study demonstrated the importance of following HIPAA rules for securing patient information in hospitals’ electronic health records (Shuaib et al., 2021). 

Conclusion  

The presentation focuses on advocating lasting change for using telehealth technology in the Jordan community. First, the presentation identified the stakeholders and explained the need for policy and financial support to implement the change process successfully. Next, the presentation focused on SDOH for the community and the findings of the Windshield survey and environmental analysis. Next, the presentation explained the plan’s change proposal and funding resources. Next, the presentation explained the plan for leading transformational change and community health implications. Finally, the presentation explained the role of stakeholder support for the change proposal.

NURS FPX 6218 Assessment 4 Advocating for Lasting Change

References

Ben-Assuli, O. (2022). Measuring the cost-effectiveness of using telehealth for diabetes management: A narrative review of methods and findings. International Journal of Medical Informatics, 163, 104764. https://doi.org/10.1016/j.ijmedinf.2022.104764

Bonawitz, K., Wetmore, M., Heisler, M., Dalton, V. K., Damschroder, L. J., Forman, J., Allan, K. R., & Moniz, M. H. (2020). Champions in context: Which attributes matter for change efforts in healthcare? Implementation Science, 15(1). https://doi.org/10.1186/s13012-020-01024-9

Capella University. (2023). Vila health: Environmental analysis and windshield survey transcript. https://media.capella.edu/coursemedia/MSN6218/vilahealthenvironmentalanalysiswindshieldsurvey/transcript.asp

Carey, C. M., Miller, S., & Wherry, L. R. (2020). The impact of insurance expansions on the already insured: The affordable care act and medicare. American Economic Journal: Applied Economics, 12(4), 288–318. https://doi.org/10.1257/app.20190176

City of Jordan. (2021). Jordan-2021-drinking-water-report [PDF]. jordanmn.gov. https://jordanmn.gov/wp-content/uploads/2022/04/Jordan-2021-Drinking-Water-Report.pdf

Ganesh, D., Seshadri, G., Sokkanarayanan, S., Bose, P., Rajan, S., & Sathiyanarayanan, M. (2020, October). Autoimpilo: Smart automated health machine using iot to improve telemedicine and telehealth. IEEExplore. https://doi.org/10.1109/ICSTCEE49637.2020.9277223

Glegg, S. M., Ryce, A., & Brownlee, K. (2019). A visual management tool for program planning, project management and evaluation in paediatric health care. Evaluation and Program Planning, 72, 16–23. https://doi.org/10.1016/j.evalprogplan.2018.09.005

Hansen, J., & Pihl-Thingvad, S. (2018). Managing employee innovative behaviour through transformational and transactional leadership styles. Public Management Review, 21(6), 918–944. https://doi.org/10.1080/14719037.2018.1544272

Healthy People 2030. (2023). Healthy People 2030. health.gov. https://health.gov/healthypeople

Hirko, K. A., Kerver, J. M., Ford, S., Szafranski, C., Beckett, J., Kitchen, C., & Wendling, A. L. (2020). Telehealth in response to the covid-19 pandemic: Implications for rural health disparities. Journal of the American Medical Informatics Association, 27(11), 1816–1818. https://doi.org/10.1093/jamia/ocaa156

Mahoney, M. F. (2020). Telehealth, telemedicine, and related technologic platforms. Journal of Wound, Ostomy & Continence Nursing, 47(5), 439–444. https://doi.org/10.1097/won.0000000000000694

Palmer, R. C., Ismond, D., Rodriquez, E. J., & Kaufman, J. S. (2019). Social determinants of health: Future directions for health disparities research. American Journal of Public Health, 109(S1), S70–S71. https://doi.org/10.2105/ajph.2019.304964

Ravitz, N., Looby, S., Jordan, C., & Kanoff, A. (2021, December 9). The economics of a telehealth visit: A time-based study at penn medicine. HFMA. https://www.hfma.org/technology/telemedicine/the-economics-of-a-telehealth-visit-a-time-based-study-at-penn/

Shuaib, M., Alam, S., Shabbir Alam, M., & Shahnawaz Nasir, M. (2021). Compliance with hipaa and gdpr in the blockchain-based electronic health record. Materials Today: Proceedings. https://doi.org/10.1016/j.matpr.2021.03.059

Sprowls, G. R., Brown, J. C., & Robin, B. N. (2020). The shoulder telehealth assessment tool in transition to distance orthopedics. Arthroscopy Techniques, 9(11), e1673–e1681. https://doi.org/10.1016/j.eats.2020.07.008

Wong, Q., Lacombe, M., Keller, R., Joyce, T., & O’Malley, K. (2019). Leading change with Dakar. Nursing Management, 50(4), 28–35. https://doi.org/10.1097/01.numa.0000554341.70508.75

Zhou, L., Thieret, R., Watzlaf, V., DeAlmeida, D., & Parmanto, B. (2019). A telehealth privacy and security self-assessment questionnaire for telehealth providers: Development and validation. International Journal of Telerehabilitation, 11(1), 3–14. https://doi.org/10.5195/ijt.2019.6276

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