Change Strategy and Implementation Essay

Change Strategy and Implementation Essay

Change Strategy and Implementation Essay

Healthcare providers strive to utilize best practices to care for all patients, thus maximizing patient and organizational outcomes. The healthcare field is diverse, and new practice guidelines and best practices are developed occasionally. Therefore, nurses and other healthcare providers must be alert and ready to implement change in their practice settings as a need for change arises. Setting goals for improvement and best practice implementation is also essential in improving patient care outcomes and experience across all departments and units in a practice setting. Identifying a change and implementation strategy helps ease change adoption, plan to address resistance to change, and remain focused on achieving the expected outcomes. This essay presents change strategies and implementation aimed at improving outcomes in diabetes care in an institution. The proposed strategies, their justification, contribution to quality improvement concerning safety and equitable care, and the interprofessional considerations to ensure successful implementation will be discussed.

The reason for focusing on diabetes care is its impact on affected populations and individuals and its contribution to organizational performance. Inefficient diabetes care may drag organizational outcomes and performance down due to related hospitalization issues for diabetes complications, hospital readmissions, and increased operational costs. Additionally, diabetes significantly impacts the mental health of affected individuals due to its relationship to depression and diabetes-related stress. Therefore, diabetes care is a vital issue of consideration.       

Diabetes and Depression

Research shows that depression is two to three times higher among people with diabetes (Chireh et al., 2019). The major reason behind the high prevalence is that diabetes is extremely overwhelming and exhausting since the individual has to keep up with a lifestyle that supports proper diabetes management and care. Many diabetic patients have episodes of feeling low and struggle with their mental well-being. Additionally, the Centers for Disease Control and Prevention (n.d.) note that despite the high prevalence and relationship between diabetes and depression, only 25% -50% of diabetic patients with depression get diagnosed and treated. The others mainly have adverse effects that impact not only the diabetes outcomes but also the overall quality of life. More so, depressed individuals are more likely to develop type 2 diabetes (CDC, n.d.). Diabetes and depression can be treated together, and diabetic patients with any depression symptoms should be assessed, diagnosed, and treated to enhance better care outcomes and improve their quality of life.   

Diabetes-Related Stress

Even though stress does not cause diabetes, research evidence shows a link between stress and the risk for type 2 diabetes. High-stress hormone levels may affect the insulin-producing cells, limiting the insulin produced or stopping them from producing insulin completely. Additionally, Guerrero Fernández de Alba et al. (2020) note that diabetic patients are more likely to develop stress from managing the condition and coping with the demanding lifestyle, especially if they feel there are deficiencies in management, and end up blaming themselves for poor outcomes such as complications (Muktar & Muktar, 2020). These patients require support from support groups, care providers, and family. Therapy should be recommended for diabetic patients experiencing diabetes-related stress. 

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Data Table

Current Outcomes	Change Strategies	Expected Outcomes
Diabetes patients do not readily access mental health care services.  1.      Only 25%- 50% of diabetic patients who suffer from depression are diagnosed and treated. 2.      Patients with diabetes are more likely to suffer stress and depressive symptoms correlated with worsening diabetes outcomes and quality of life.	To ensure diabetic patients get mental health care services and achieve the desired health outcomes, several strategies will be implemented. 1.      Diabetic patients will be encouraged to join anonymous support groups. 2.      Nurses will be trained to offer care that includes mental health wellness to diabetic patients and encourage behavioral management. 3.      Patients will be provided with mental health care services to encourage diagnosis and treatment of depression and diabetes-related distress.	Diabetic patients will have access to the needed mental health care services and be able to avoid the adverse impact of depression and stress on diabetes management and outcomes 1.      Patients will understand the relationship between diabetes and mental health (Guerrero Fernández de Alba et al., 2020) 2.      Diabetes Patients experiencing stress or depression symptoms will seek mental health help 3.      Patients will appreciate the role of support groups and caregiver/family support in preventing diabetes-related mental health issues (Muktar & Muktar, 2020).

 

Change Strategies Proposed to Help Achieve the Desired Clinical Outcomes

Various change strategies can be used to lead to the improvement of clinical outcomes in diabetes care. Offering holistic diabetes care requires the incorporation of efforts from the entire interprofessional team, thus ensuring that all aspects related to diabetes are addressed. Therefore, one of the major change strategies proposed to improve diabetes care outcomes is enhancing interprofessional collaboration among the interprofessional team involved. According to Szafran et al. (2019), the diabetes care interdisciplinary team entails nurses, physicians, nutritionists, endocrinologists, dieticians, social workers, and community health workers.

The other proposed strategy is encouraging and training nurses to monitor behavioral management and include care that entails mental health aspects, such as offering mental wellness support to patients. Diabetes clinical outcomes like preventing diabetes complications, hospitalizations, and hospital readmission highly depend on the patient’s self-management practices and behavior. Thus, nurses need to encourage behavioral management among diabetic patients, hence preparing them to adhere to diabetes management best practices and guidelines. Additionally, deficiencies in diabetes self-management are known to lead to diabetes-related distress and depression (Guerrero Fernández de Alba et al., 2020). Therefore, change can be achieved by training nurses to include mental health wellness care for diabetic patients.

However, potential challenges may be encountered while implementing these strategies. These challenges include role conflicts between the interprofessional team members, slow action-taking following shared decision-making, and the inability of nurses to include mental health care aspects in diabetes care. These challenges will be overcome by enhancing interdisciplinary collaboration through open and free communication, sharing and communicating roles based on specialty areas, and ensuring nurses have the relevant training to include mental wellness in diabetes care.

Change Strategies Justification

The desired outcomes include having diabetic patients with depression diagnosed and treated and patients demonstrating an understanding of the relationship between diabetes and mental health. As mentioned earlier, the strategies that will improve these outcomes are interprofessional collaboration and the inclusion of mental support in diabetes care. According to Guerrero Fernández de Alba et al. (2020), diabetic patients are more likely to seek mental wellness support and care when they understand the relationship between mental health and diabetes and its impact on the overall outcomes and quality of life. Therefore, the change strategy of including mental wellness and support in diabetes nursing care will help achieve the desired outcomes. Some patients may be reluctant to seek support from family members and caregivers. However, Muktar and Muktar (2019) note that diabetic patients who receive adequate support from care providers, caregivers, and family members have better clinical outcomes. Other perspectives on improving diabetes clinical outcomes include Diabetes Self-Management Education and Support (DSME) and diabetes prevention and management programs offered by care institutions.

Proposed Change Strategies and Their Contribution to Quality Improvement with Regards to Safety and Equitable Care

One of the major reasons why healthcare institutions implement change is to ensure quality improvement with patient safety and equitable care. The proposed change strategies aim to promote patient safety and equitable care for diabetes patients. A study by O’Neill et al. (2019) showed that diabetes safety issues such as infections lead to increased diabetes-related costs, which are high and may not be afforded by most diabetic patients, especially the ones from poor socioeconomic backgrounds. Therefore, diabetes-related quality improvement initiatives should focus on the equitability and safety of care. The proposed change strategies will help prevent diabetes-mental illness comorbidities, thus reducing costs and enhancing care equitability. Additionally, the strategies will promote appropriate diabetes self-management behavior, thus improving patient safety.

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Interprofessional Considerations

Implementing change strategies requires all the professionals involved in diabetes care to work together. The interprofessional considerations that will enhance the successful implementation of the change strategies include effective communication, shared decision-making, role clarity and communication, and openness in the interactions between the team. These considerations will help each team member know what is expected of them and the team goals, thus maximizing their contribution.

Conclusion

Diabetes care is one issue that significantly impacts organizational performance and outcomes. Among the clinical outcomes for diabetes patients is reduced risk for complications, achieved through proper diabetes management and preventing the impact of mental illness comorbidities. The proposed strategies to improve this outcome include providing mental health and wellness support, care services, and behavioral management. The discussion above has included the justification and interprofessional considerations to enhance successful implementation.  

References

Centers for Disease Control and Prevention (n.d.). Diabetes and Mental Health. Accessed 21^st April 2023 from  https://www.cdc.gov/diabetes/managing/mental-health.html

Chireh, B., Li, M., & D’Arcy, C. (2019). Diabetes increases the risk of depression: A systematic review, meta-analysis and estimates of population attributable fractions based on prospective studies. Preventive Medicine Reports, 14, 100822. https://doi.org/10.1016/j.pmedr.2019.100822 

Guerrero Fernández de Alba, I., Gimeno-Miguel, A., Poblador-Plou, B., Gimeno-Feliu, L. A., Ioakeim-Skoufa, I., Rojo-Martínez, G., Forjaz, M. J., & Prados-Torres, A. (2020). Association between mental health comorbidity and health outcomes in type 2 diabetes mellitus patients. Scientific Reports, 10(1), 19583. https://doi.org/10.1038/s41598-020-76546-9

Mukhtar, S., & Mukhtar, S. (2020). Letter to the Editor: Mental Health and Psychological Distress in People with Diabetes during COVID-19. Metabolism: Clinical And Experimental, 108, 154248. https://doi.org/10.1016/j.metabol.2020.154248 

O’Neill, K. N., McHugh, S. M., & Kearney, P. M. (2019). Cycle of Care for People with Diabetes: an equitable initiative? HRB Open Research, 2(3), 3. https://doi.org/10.12688/hrbopenres.12890.1

Szafran, O., Kennett, S. L., Bell, N. R., & Torti, J. M. I. (2019). Interprofessional collaboration in diabetes care: perceptions of family physicians practicing in or not in a primary health care team. BMC Family Practice, 20(1), 44. https://doi.org/10.1186/s12875-019-0932-9

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Guiding Questions: Change Strategy and Implementation
This document is designed to give you questions to consider and additional guidance to help you successfully complete the Change Strategy and Implementation assessment. You may find it useful to use this document as a pre-writing exercise, as an outlining tool, or as a final check to ensure that you have sufficiently addressed all the grading criteria for this assessment. This document is a resource to help you complete the assessment. Do not turn in this document as your assessment submission.
Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.
• Does your data table clearly and accurately reflect the current state of one or more clinical outcomes?
o If applicable, have you appropriately citied the source for this data?
o Is your data HIPAA compliant?
• Does your data table clearly and accurately reflect the desired state of one or more clinical outcomes?
o Have you based your desired state on best practices, guidelines, or regulations?
 Have you cited the relevant sources of evidence that you used to set your desired outcome state?
 Is your data HIPAA compliant?
• Are the data and outcomes in your table relevant to a specific care setting, case study, or other clearly defined condition or issue?
• Are the data and the outcomes relevant and appropriate for the change strategy you will be proposing?
Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.
• What change strategies do you propose implementing to help achieve your desired outcomes?
• How will you implement the change strategies to help achieve your desired outcomes in the context of the care setting or case study you are using for this assessment?
o What other implementation considerations do you need to take into account to ensure that the change strategy is successful?
o What implementation challenges or hurdles might exist and how might you deal with them?
• How could the efficiency and effectiveness of the care system be evaluated to see if the desired outcomes are met?
Justify the specific change strategies used to achieve desired outcomes.
• Why is each change strategy you have chosen to implement relevant and appropriate for achieving one or more of your desired outcomes?
o What evidence (literature, best practices, professional guidelines, et cetera) supports your reasoning for implementing a chosen change strategy in the context of the care setting, case study, or desired outcomes you are considering for this assessment?
 How does the evidence support your reasoning and proposed implementation? Be specific.
Explain how change strategies will lead to quality improvement with regard to safety and equitable care.
• Which change strategy (or strategies) will most likely lead to quality improvements in the area of patient safety?
o How will it contribute to quality improvements in this area?
• Which change strategy (or strategies) will most likely lead to quality improvements in the area of equitable care?
o How will it contribute to quality improvements in this area?
• How might the strategy (or strategies) lead to other improvements related to the Quadruple Aim?
Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.
• Which proposed change strategy (or strategies) will best leverage interprofessional considerations and strategies?
o How will it help ensure successful implementation across interprofessional or multidisciplinary teams?
o How does your change strategy address the well-being of health care professionals?
Communicate a change plan in a way that makes the data and rationale easily understood and compelling.
• Is your data table clearly presented?
• Are the links between your data table, desired outcomes, and change strategy and implementation clear and justified?
• Is your writing clear and professional?
• Is your writing free from errors?
• Is your submission 3–5 pages (not including the title page and reference list)?
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
• Did you use 3–5 sources in your assessment?
o Are the sources you used no more than five years old?
• Are your sources cited in APA format throughout the assessment?
• Have you included an attached reference list?
• Did you use the APA Paper Template for the proper formatting and to include a running head and title page?
o No abstract is needed for this assessment.

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Change Strategy and Implementation Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.	Does not develop a data table.	Develops a data table, but the table is either not accurate or does not reflect the current or desired states of one or more clinical outcomes.	Develops a data table that accurately reflects the current and desired states of one or more clinical outcomes.	Develops a data table that accurately reflects the current and desired states of one or more clinical outcomes. Identifies areas of ambiguity or uncertainty where additional data could help to improve clarity.
Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.	Does not describe change strategies.	Describes change strategies, but does not fully relate how the strategies will help to achieve the desired state of one or more clinical outcomes.	Proposes change strategies that will help to achieve the desired state of one or more clinical outcomes.	Proposes change strategies that will help to achieve the desired state of one or more clinical outcomes. Acknowledges potential difficulties and discusses how those challenges will be met.
Justify the specific change strategies used to achieve desired outcomes.	Does not justify the specific change strategies used to achieve desired outcomes.	Provides a weak or flawed justification of how the specific change strategies will help achieve desired outcomes.	Justifies the specific change strategies used to achieve desired outcomes.	Justifies the specific change strategies used to achieve desired outcomes. Impartially considers other perspectives.
Explain how change strategies will lead to quality improvement with regard to safety and equitable care.	Does not explain how change strategies will lead to quality improvement with regard to safety and equitable care.	Explains change strategies used, but the rationale for how they will lead to quality improvement with regard to safety and equitable care is unclear or missing.	Explains how change strategies will lead to quality improvement with regard to safety and equitable care.	Explains how change strategies will lead to quality improvement with regard to safety and equitable care. Identifies assumptions upon which the explanation is based.
Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.	Does not explain how change strategies will utilize interprofessional considerations to ensure successful implementation.	Explains change strategies used, but the rationale for how they will utilize interprofessional considerations to ensure successful implementation is unclear or missing.	Explains how change strategies will utilize interprofessional considerations to ensure successful implementation.	Explains how change strategies will utilize interprofessional considerations to ensure successful implementation. Identifies assumptions upon which the explanation is based.
Convey purpose of the assessment narrative in an appropriate tone and style, incorporating supporting evidence, and adhering to organizational, professional, and scholarly communication standards.	Does not convey purpose of the assessment narrative, in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and communication scholarly standards.	Conveys purpose of the assessment narrative, in an appropriate tone or style. Clear, effective communication is inhibited by insufficient supporting evidence and minimal adherence to applicable communication standards.	Conveys purpose of the assessment narrative in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly communication standards. Uses APA style and formatting.	Conveys clear purpose of the assessment narrative, in a tone and style well-suited to the intended audience. Supports assertions, arguments, and conclusions with relevant, credible, and convincing evidence. Exhibits strict and nearly flawless adherence to organizational, professional, and scholarly communication standards, including APA style and formatting.