Capella 4050 Assessment 4

Capella 4050 Assessment 4 Final Care Coordination Plan

Name

Capella University

NURS-FPX 4050 Coord Patient-Centered Care

Prof. Name

Date

Final Care Coordination Plan

Substance abuse is a common healthcare problem in West Virginia. According to the reports by the National Center for Drug Abuse Statistics (n.d.), West Virginia has the highest prevalence of substance abuse, with a 51.5% death rate due to this deadly healthcare issue. For this purpose, as a care coordinator at South Charleston Community Center, I developed a preliminary care coordination plan. This assessment is the evaluation of that care coordination plan, which presents patient-centered health interventions to deal with substance abuse issues. Furthermore, it presents the ethical implications of these interventions and healthcare policies related to the concern. Lastly, the plan evaluates the teaching and learning sessions on evidence-based best practices and Healthy People 2030 objectives.

Health Interventions for Substance Abuse

Several issues are identified in West Virginia communities associated with substance abuse. These include physical damage to body organs, emotional distress that affects psychological well-being, and stigma associated with help-seeking behaviors. To mitigate these issues, the three best practices and patient-centered health interventions are health screening and monitoring programs, collaborative care models, and community education and awareness programs.

Health Screening and Monitoring Programs

According to Woodward et al. (2023), comprehensive health screening and medical intervention programs in community settings are significant in addressing physical health issues and preventing further organ damage through preventive measures. This patient-centered intervention includes patients’ regular checkups, diagnostic testing, and consultations to manage health conditions associated with substance abuse. The timeline to implement this intervention is 10-12 months, including program development, recruitment of trained healthcare professionals, onsite execution, and evaluation of the effectiveness for ongoing improvement. We can utilize community resources such as financial and human resources from the West Virginia Department of Health and Human Resources (WVDHHR), training and technical support from the West Virginia Primary Care Association (WVPCA), and facilitation from local health departments to enhance accessibility.

Collaborative Care Models

Another issue identified is poor psychological well-being. Collaborative care models establish a collaboration among multidisciplinary members such as mental health specialists, healthcare providers, counselors, and social workers to address co-occurring mental health and substance abuse disorders (Fishbein & Sloboda, 2023). Moreover, these models encourage patient engagement to improve health outcomes, eventually improving psychosocial well-being. The timeframe for this intervention is 6-8 months, which includes stages like provider training, implementing integrated behavioral health services in primary care settings, and evaluation for optimal success. Community resources such as the Substance Abuse and Mental Health Services Administration (SAMHSA) will help with funding and technical assistance. Moreover, the West Virginia Psychological Association (WVPA) offers training resources for professionals, and community health centers can be used as spaces for counseling and psychiatric services.

Community Education and Awareness Programs

To mitigate the stigma associated with help-seeking behaviors among substance abusers, educational and awareness campaigns are crucial. Through interactive workshops and peer networking, we can integrate preventive services within the communities (Fishbein & Sloboda, 2023). This patient-centered health intervention will offer culturally sensitive education for patients and their families to reduce stigma and promote help-seeking behaviors. The timeline for this intervention is 7-9 months, including the development of culturally sensitive education materials and media resources and partnering with community organizations to promote anti-stigma campaigns within religious places, schools, and community centers. Moreover, this timeframe includes the implementation of community events, workshops, and support groups and the conducting evaluation of the campaigns. Community resources such as the National Alliance on Mental Illness (NAMI) West Virginia, West Virginia Office of Drug Control Policy (ODCP), and Recovery Community Organizations (RCOs) offer support like advocacy, collaboration, policy development, peer support, and community engagement opportunities.

Ethical Considerations and Patient-centered Health Interventions

In designing patient-centered health interventions, several ethical principles are considered and prioritized to ensure the provision of ethically sound healthcare services. Regular screening and monitoring programs should balance the need for early detection and intervention and patient privacy and autonomy. This ethical consideration is imperative to building patients’ trust in healthcare providers encouraging patients’ participation in screening programs and early intervention (Zhang et al., 2021). Ethical conflicts between patient confidentiality and public health priorities can become a point of uncertainty. Secondly, the collaborative care models should prioritize patient-centeredness, patient autonomy, and patient involvement in decision-making. Inefficient collaboration among healthcare providers can lead to potential uncertainties. Lastly, community education and awareness programs must ensure cultural sensitivity while disseminating information. These awareness programs must respect individuals’ cultural beliefs and practices to mitigate stigmatization and individuals’ attitudes toward substance abuse services (Bo et al., 2023). Uncertainties regarding systemic barriers to healthcare accessibility must be addressed.

Health Policies and Coordination and Continuum of Care

Two relevant health policies that have a significant impact on the coordination and continuum of care for substance abuse issues are the Affordable Care Act (ACA) and the Comprehensive Addiction and Recovery Act (CARA). The ACA has several policy provisions, one of which aims to expand healthcare access for substance abuse treatment and care coordination. Through this policy, low-income individuals are able to access substance abuse treatment and rehabilitation services by Medicaid eligibility (Olfson et al., 2021). This policy provides health insurance coverage without yearly limits. Thus improving care coordination through extensive preventive care and reducing financial barriers.

Similarly, CARA is a federal law that aims to address addiction by promoting preventive and treatment services and rehabilitation for substance abuse-affected individuals. This policy is used to promote evidence-based treatment practices and law enforcement and reduce the stigma associated with substance abuse (Sharp et al., 2023). Both policies emphasize the importance of integrating substance abuse services into mainstream healthcare and fostering partnerships to address the complex needs of individuals with substance abuse disorders, thereby improving the continuum of care and outcomes for affected individuals.

Priorities of a Care Coordinator and Evidence-based Practices

While discussing this final care coordination plan with the patients and their family members, the care coordinator must set some priorities to ensure the plan is tailored to patients’ needs. Moreover, changes in the care plan should be based on Evidence-Based Practices (EBP), providing the care plans are based on the latest and justified evidence. Priorities for plan discussion include:

Clear communication channels must be established to facilitate shared decision-making and address patients’ and their family members’ concerns regarding the effectiveness of the plan. Open communication between providers and patients fosters trust and collaboration, enhancing patient engagement and adherence to the care plan (Kwame & Petrucka, 2021).
Secondly, the care coordinator would prioritize personalized goal-setting based on evidence-based interventions. By aligning treatment goals with the patient’s preferences, values, and unique circumstances, the care plan becomes more meaningful and achievable.
Lastly, they should prioritize patients’ understanding of the plan, which requires clear and easy-to-comprehend language. Using non-medical terms and culturally sensitive concepts is essential to discuss the plan with the clients and their families, guaranteeing their engagement in the healthcare journey (Ranjan et al., 2020).

Need for the Changes in the Plan

Incorporating EBP into the care plan is essential to ensure the plan is effective, safe, and aligned with the best available scientific knowledge. In the preliminary care coordination plan, we only added best practices like collaborative care models and community education. However, the final care coordination plan includes health screening and monitoring programs along with two other patient-centered interventions. This change to the plan is based on EBP to optimize outcomes by integrating interventions that have been rigorously evaluated and shown to produce positive results in substance abuse patients.

Alignment of Learning Sessions

While evaluating the learning sessions’ content against the best practices, it is imperative to prepare the evidence-based content, ensuring its accuracy and effectiveness. For example, the education and awareness sessions for the communities must include evidence-based coping strategies for substance abuse survivors to provide appropriate and established guidelines (Fishbein & Sloboda, 2023). Moreover, the content should be learner-centered, taking into account the diverse needs, preferences, and learning styles of affected individuals in the West Virginia community. These learner-centric sessions enhance engagement and knowledge retention among participants (Bo et al., 2023).

Incorporating Healthy People 2030 objectives into the outline of teaching sessions will help align these sessions with Healthy People 2030. For example, the learning session with a focus on substance abuse prevention should address specific objectives related to reducing substance abuse prevalence, promoting healthy behaviors, and improving access to treatment and recovery services as outlined in Healthy People 2030 (U.S. Department of Health and Human Services, n.d.). The need for revisions lies in the constantly updating scientific knowledge. As evidence advances, it is imperative to update teaching materials to ensure accuracy and relevance. Moreover, revisions are needed to incorporate feedback from learners and evaluations of previous sessions. By soliciting input from participants and systematically assessing the impact of the learning sessions, educators can identify areas of improvement in the existing content and make targeted revisions to enhance the overall learning experience.

References

Bo, A., Goings, T. C., Evans, C. B. R., Sharma, A., Jennings, Z., Durand, B., Bardeen, A., & Murray-Lichtman, A. (2023). Culturally sensitive prevention programs for substance use among adolescents of color: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology Review, 99, 102233. https://doi.org/10.1016/j.cpr.2022.102233

Fishbein, D. H., & Sloboda, Z. (2023). A national strategy for preventing substance and opioid use disorders through evidence-based prevention programming that fosters healthy outcomes in our youth. Clinical Child and Family Psychology Review, 26(1), 1–16. https://doi.org/10.1007/s10567-022-00420-5

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(1), 158. https://doi.org/10.1186/s12912-021-00684-2

Capella 4050 Assessment 4

NCDAS. (n.d.). Drug abuse statistics. https://drugabusestatistics.org/

Olfson, M., Wall, M., Barry, C. L., Mauro, C., Choi, C. J., & Mojtabai, R. (2021). Effects of the ACA on health care coverage for adults with substance use disorders. Psychiatric Services (Washington, D.C.), 72(8), 905–911. https://doi.org/10.1176/appi.ps.202000377

Ranjan, P., Kumari, A., & Arora, C. (2020). The value of communicating with patients in their first language. Expert Review of Pharmacoeconomics & Outcomes Research, 20(6), 559–561. https://doi.org/10.1080/14737167.2020.1835474

Sharp, N., Fuchs, J., & Drake, A. (2023). An implementation evaluation of the Comprehensive Addiction Recovery Act (CARA) policy in New Mexico. Maternal and Child Health Journal, 27(1), 113–121. https://doi.org/10.1007/s10995-023-03787-1

Capella 4050 Assessment 4

U.S. Department of Health and Human Services. (n.d.). Addiction—Healthy People 2030 | health.gov. https://health.gov/healthypeople/objectives-and-data/browse-objectives/addiction

Woodward, D., Wilens, T. E., Glantz, M., Rao, V., Burke, C., & Yule, A. M. (2023). A systematic review of substance use screening in outpatient behavioral health settings. Addiction Science & Clinical Practice, 18, 18. https://doi.org/10.1186/s13722-023-00376-z

Zhang, H., Zhang, H., Zhang, Z., & Wang, Y. (2021). Patient privacy and autonomy: A comparative analysis of cases of ethical dilemmas in China and the United States. BMC Medical Ethics, 22(1), 8. https://doi.org/10.1186/s12910-021-00579-6