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- QUESTION
NEEDS TO BE REVIEWED/Recommendations to make more likely a BCP instead of research paper:
1-PART: GOAL &OBJECTIVES:
The goals illustrate what it is that you want to accomplish. What specifically are you hoping to achieve? Goals are measurable, specific and time sensitive. For example: The Expanded Chronic Care Program will establish weekly community-based education seminars for Diabetic patients within 3 months.
Objectives are actionable strategies to support achievement of the goal. For instance,
Objective: Prior to June 1 meet with diabetes center coordinator to develop educational seminars each week.
Objective: Within 30 days secure conference space at community center for diabetes education
2-PART: IMPLEMENTATION PLAN & TIMELINE:
I was looking for a time line
June 1 Secure conference room space
June 15 Meet with diabetes center coordinator
July 1 Begin media blitz- advertising
Aug 1 First scheduled diabetes education conference
3-PART: FINANCIAL ANALYSIS : There should be a cost associated with advertising, procuring a space, speakers, clinicians, etc unless they are all volunteers and the space donated. There will also be a savings. Estimate the decrease in re-admission rates. How much does it cost to re-admit diabetic patients for complications?Example for finance:
The financial review includes a detailed quantitative analysis of the cost and benefits over the last three calendar years to determine the financial feasibility of a CHF nurse educator. Working beside the ARMC accountant, we found the population over 65 years of age had an increased growth of 2.0 % for 2015, as well as the 2.6 % for 2016 for an increase of over $ 90,000,00. Also, the cost of hospitalization has increased annually from 2014 to current date of the estimated growth in some CHF cases (A. Brown, personal communication, July 1, 2017).The sum of the benefits derived from ED visit reduction, specialist visit reduction, and hospital admission reductions. If the proposed plan meets approval, there will be the cost of one RN FTE and some associated costs to operate the patient registry as well as educate patients. The patient registry will require one FTE secretary. This number will increase to two FTE RN’s within a year of the proposed plan. The benefits include a decrease of 96% reduction in readmission rates the first year of initiation of having a CHF educator. The financial analysis as outlined demonstrates a payback within the first year. The analysis shows that the proposal is worthy of investment.
The true financial rewards will be obvious when the CHF nurse educator is in place. The rewards will occur in the form of higher reimbursements for ARMC. If the readmissions for patients with CHF declines, there will be an indirect saving of money obtained from having to have less staff and fewer resources. Another financial gain is from higher reimbursements. The average cost for a CHF patient admission at ARMC is $11,000 on the initial visit and the readmission cost of $13000. However, the average reimbursement from Medicare is around $10,250 which often does not cover the actual cost of taking care of the patient (A. Brown, personal communication, July 1, 2017). The designated stay is from three to five days per Medicare. If the patient stays longer than the five days, the hospital loses approximately $3200 per patient (A. Brown, personal communication, July 1, 2017). Having the nurse educator will assist in decreasing the length of stay by educating the patient as soon as they arrive. A conservative estimate of the return on the investment is an annual profit of $51,120 in year one.
Projected Percent of Budgeted benefits compared to other hospitals with CHF educator (below is on table, but unable to upload it)
Level of Action
2017
2018
2019
GP visit reduction
0%
6%
15%
Specialist reduction
0%
6%
15%
ED re-admissions
0%
96%
97-98%
ARMC CHF Nurse Educator
Volume Assumption
2000 (based on the 2015 FYTD CHF Admission
Hours of Operation
Monday- Friday
0800-1600 pm
Revenue Case
Dependent on Medicare Payments. If the hospital readmission rate decreases, the current 3% maximum penalty will not occur
Startup Expense
Staffing/FTE
Rate of Pay (entry level)
Unknown operating expense
Room already on site with telephone/desk
$ 5000.00 Additional equipment such as scales, computer, fax machine, copier, chairs, décor, educational pamphlets,
Job Class: Registered Nurse- 1.0 FTE
Unit Secretary- 1.0 FTE
Registered Nurse- $30/hr.
Unit Secretary-$11/hr.
TBD allowing $5000.00 in budget1. Refer to the grading rubric: Executive summary/Introduction 15pts; Proposed solution 10pts; Goals & objectives 10 pts; Cost/benefit Analysis 10pts; Market Analysis 10tps; implementation Plan & Timeline 10pts; Evaluation10tps; Financial10pts; summary 10pts, 10-15 APA/EBP articles 20PTS
BUSINESS CASE PLAN TITLE: Development of a DIABETES Educator OR service…PLEASE Use THE FOLLOWING HEADINGS to help YOU CLEARLY organize your plan paper as APPROPRIATE:
o a)Executive Summary
o b)Introduction that describes the present situation, identifies the problem, and includes a summary of existing conditions
o Presentation/ discussion of viable options to resolve/ address identified problem/ concern
o c)Proposed Solution. Description of the new program/proposed solution
o d)Goals and objectives. What do you plan to accomplish by implementing this new idea/ plan?
o Goals are specific, measurable, and defined by a specific time frame
o Objectives are written to support a goal and are specific, measurable, and time-specific
o e)Cost/Benefit Analysis. Compare and contrast the cost of the new idea versus benefit to company/ organization.
o f)Market Analysis. Consider the timing, location, competition, public interest, etc
o g)Implementation Plan and Timeline. Consider completion dates and how you would implement your new idea.
o h)Evaluation How will you evaluate the success/ failure of program
o i)Financials. Not to be confused with Cost Benefit Analysis.
o J)Summary/conclusion. This is a quick elevator pitch to summarize your idea and the merits for implementation.
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- QUESTION
Discussion: How to Engage All Stakeholders in Program Evaluation
Stakeholder involvement and buy-in is arguably one of the most important aspects of program evaluation. Without it, evaluation efforts will fall short of its goals as comprehensive data collection will be invalid, or even worse, unobtainable.
What can you do as a leader to not only engage all stakeholders, but to help them to understand the importance of their active involvement?
In this Discussion, you revisit the in-service training at Connor Street Early Childhood Program.
The stakeholder discussion had been a lively one, and by the end, Sabrina and her colleagues were able to use the unique traits of each stakeholder to create brief profiles:
Stakeholders Profiles
Teachers New to the formal evaluation process. Children’s academic and social-emotional developments are the primary drivers. Assessments and data collection are already taking up a lot time and there is much fear about how to juggle more evaluations.
Families Family dynamics have changed over the last few years with many new families moving into the area. English is the second language for many heads of the households. Kindergarten readiness and a safe place to play are the primary drivers. Almost all families work long days outside of the home.
Support Staff The home-based manager splits her time with three other programs in the community. She checks in with Connor Street’s home-school liaison once a week. Her primary concerns are the monthly averages of home visit numbers and length of time spent at homes.
________________________________________
The health assistant assumes multiple responsibilities throughout the day. She runs the clinic, tending to hurt or sick children, fills in at the front office when needed, and also counsels children who come to school upset. Once a year, she performs vision and hearing screening on each child who attends the program. Children’s health and well-being are her primary drivers.
Accrediting Agency Holds all programs accountable for achieving quality standards. The provision of educational and developmental services and resources are the primary drivers.
Community The community consists of working class and low-income families. Mainly residential, the community holds a handful of free events throughout the year such as movies on the lawn, fairs, and holiday celebrations. Though the community wants to give more, the lack of established businesses in the area negatively impacts the ability to hold fundraisers or food drives.
To prepare
Watch the media presentations in which presenters share how stakeholders were impacted by accreditation and evaluation processes. Then—with the Connor Street scenario in mind—review “Chapter 36, Section 3” and “Chapter 37, Section 1” of the Community Tool Box series. Though written in a community health context, consider how the interests and needs of all stakeholders are taken into account when designing and implementing evaluations. As an early childhood leader, how can you build upon this best practice to engage early childhood professionals, staff, and families in the evaluation process? Furthermore, how might you ensure that engagement efforts are culturally and linguistically responsive?
By Day 3 of Week 5
Post the following: Briefly explain how you might engage each of the stakeholders presented in the scenario. Then, explain which stakeholders might be the most difficult to engage and why. Support your response by describing potential barriers that might prevent effective engagement.Cite appropriate references in APA format to substantiate your thinking.
Required Readings
Administration for Children and Families. (n.d). Data & ongoing monitoring. Retrieved from https://eclkc.ohs.acf.hhs.gov/data-ongoing-monitoring
Epstein, A. S., Schweinhart, L. J., DeBruin-Parecki, A., & Robin, K. B. (2004). Preschool assessment: A guide to developing a balanced approach (NIEER Policy Brief, Issue 7). New Brunswick, NJ: National Institute for Early Childhood Research. Retrieved from http://www.doe.in.gov/sites/default/files/earlylearning/preschool-assessment-guide-developing-balanced-approach.pdf
National Association for the Education of Young Children. (n.d.). Principles of effective family engagement. Retrieved from https://www.naeyc.org/principles-effective-family-engagement
U.S. Department of Health & Human Services, Early Childhood Learning and Knowledge Center. (n.d.). Measuring what matters: Exercises in data management-Exercise 2: Collect: Collecting data related to family outcomes. Retrieved from https://eclkc.ohs.acf.hhs.gov/sites/default/files/pdf/measuring-what-matters-exercises-02.pdf
U.S. Department of Health & Human Services, Early Childhood Learning and Knowledge Center. (n.d.). Using the Head Start parent, family, and community engagement framework in your program: Markers of progress. Retrieved from https://eclkc.ohs.acf.hhs.gov/sites/default/files/pdf/ncpfce-markers-of-progress.pdf
Work Group for Community Health and Development. (2016d). Chapter 27, Section 10: Understanding culture, social organization, and leadership to enhance engagement. Community Tool Box. Retrieved from http://ctb.ku.edu/en/table-of-contents/culture/cultural-competence/understand-culture-social-organization/main
Work Group for Community Health and Development. (2016c). Chapter 27, Section 7: Building culturally competent organizations. Community Tool Box. Retrieved from http://ctb.ku.edu/en/table-of-contents/culture/cultural-competence/culturally-competent-organizations/main
Work Group for Community Health and Development. (2016f). Chapter 36, Section 3: Understanding community leadership, evaluators, and funders: What are their interests? Community Tool Box. Retrieved from http://ctb.ku.edu/en/table-of-contents/evaluate/evaluation/interests-of-leaders-evaluators-funders/main
Work Group for Community Health and Development. (2015e). Chapter 36, Section 1: A framework for program evaluation: A gateway to tools. Community Tool Box. Retrieved from http://ctb.ku.edu/en/table-of-contents/evaluate/evaluation/framework-for-evaluation/main
Required Media
Laureate Education. (Producer). (2016f). Voices from the field: The accreditation process [Audio file]. Baltimore, MD: Author.
Note: The approximate length of each speaker is as follows:
• Chris Amirault = 2:24
• Christy Opsommer = 0:56
• Crystal Shatara = 2:07
• Lorainne Cooke = 3:04
• Mandy Doy = 0:50
• Mary Graham = 7:15Hopkins, J. (2013, September 11). How to score a classroom using ECERS [Video file]. Retrieved from https://www.youtube.com/watch?v=mGyUpvMYm1w
Note: The approximate length of this media piece is 5 minutes.
| Subject | Business | Pages | 9 | Style | APA |
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Answer
A business case plan on diabetes
Executive summary
Today in America, chronic disease is a leading health endemic that is consuming nearly 70percent of the total health expenditure. The high prevalence of chronic disease is attributed to the absence of continues and complex management initiatives. (Van Oostrom, 2016) confirms that effective chronic disease management has for years been a major challenge among health care providers. A key focus is on diabetes prevalence which has affected more than 100 million Americans, both children and adults (Lin, 2018). Hence, there is an urgent need for diabetes prevention and management initiative. A major issue in the overall diabetes management strategy is associated with poor coordination between health care providers and the services available. Therefore, this paper focuses on analyzing a business case plan for a proposed diabetes management program. This business case plan examines the proposed Expanded Chronic Care Model that included the cost /benefit analysis, market analysis, performance evaluation and finance analysis. As the paper suggest, the Expanded Chronic Care Model promote efforts that help minimize the burden of diabetes through encouraging and supporting healthy living on the general community.
Introduction
For the past several years, the American health system has recognized the need for better approaches to treat and manage chronic disease especially after consuming nearly 70percent of the total health expenditure. The fact that chronic disease brings an irreversible change to a patient’s health means that the illness requires continues and complex management initiatives. Van Oostrom (2016) suggest that decision-makers in the healthcare settings often face challenges related to poor coordination of health services, poor diagnosis approaches, and limited training initiatives for healthcare providers. Also, lack of patient-centered treatment approaches, limited incentives and inadequate disease management protocols often underpin efforts to improve chronic disease management and promote health outcomes among people suffering from chronic illnesses. Recently, the focus in America has been on diabetes management.
The rate of diabetes prevalence in America is at a rise attributed to the aging population and lifestyles such as lack of physical exercises. With more than 80,000 diabetes-related deaths, the American health system saw the urgent need for improving treatment and management of diabetes (Lin, 2018). Up-to-date, diabetes cure has not been discovered which leaves patient to rely on close blood sugar level monitoring, insulin injections and regular check-ups so as to maintain and improve health outcomes. According to Davy (2015), Chronic Care Model (CCM) has been a major high-quality diabetes management approach that involves integration of five key systems in the treatment and decision making process. These systems include: the community, decision support system; self- management support; health care system and the delivery system. The success of the Chronic Care Model relies on support for patient-centered care through the self-management system (Shin, 2015). A major issue in the overall diabetes management strategy is associated with poor coordination between health care providers and the services available.
Proposed Solution
While the Chronic Care Model (CCM) is considered an effective method in promoting diabetes care and management, it exhibits some limitations that calls for the need of an improved approach. Anderson (2018) argues that the current Chronic Care Model is designed for clinically oriented systems hence, it fails to incorporate prevention and health promotion among practitioners. Therefore, the proposed solution would be to implement the Expanded Chronic Care Model which adds features of prevent and health promotion (Gee, 2015). Unlike the current Chronic Care Model that focus reducing the impacts on diabetics, the Expanded Chronic Care Model will further promote efforts that help minimize the burden of diabetes through encouraging and supporting healthy living on the general community. Powers (2017) suggests that the Expanded Chronic Care Model simplifies health care initiatives by being a single model for disease prevention and management. Adopting the Expanded Chronic Care Model broadens the center of healthcare practice to work towards promoting health outcomes for populations.
The Expanded Chronic Care Model outcomes are much more improved in the sense that it improves a population health and facilitate productive relationships among individuals, community groups, healthcare providers and healthcare systems (Beck, 2018).
Goals and objectives
The goal of the proposed Expanded Chronic Care Model is to establish weekly community-based education conferences within three months.
The general objectives of the Expanded Chronic Care Model include:
- Preceding to June 1 meet with the diabetes coordinator to develop educational conferences for each week.
- Within 10 days, select and prepare the diabetes educators that will conduct the community-based seminar
- Prior July 1 secure conference rooms at the community area for diabetes education
- As from July 1 , commence media advertising of the community-based diabetes education program
- The first diabetes education conference commences at the beginning of August.
Cost/ benefit analysis
Hirsch (2017) confirms that a major concern linked to cost/benefit analysis of chronic diseases initiatives is that returns of investments cannot be measured immediately. Therefore, benefits are measured based on the outcomes accomplished through money spent on care for diabetes patients as their conditions progress over years. Further if benefits based on improved consumer satisfaction rates, enriched quality of life, enhanced productivity, and limited or delayed disabilities are identified within the first few years, then the Expanded Chronic Care Model will be said to be cost beneficial (Hirsch, 2017). On the other hand, the cost analysis will start by examining on how the initial investment has been applied in primary and community care, in drug management and diabetes education. Months later will determine the cost benefits that are basically measured through avoidance or minimized in-patient or hospital admission to acute or chronic care among diabetes patients.
Market analysis
The success of the Expanded Chronic Care Model highly depends on the awareness of the services offered by the various stakeholders that include the patients, health care providers, health care systems and the Ministry of Health Management. Hence, in order to outdo the existing diabetes programs, this initiative will focus on marketing and communication strategies (Hirsch, 2017). These strategies take place as follows: building a strong brand for the self-management education initiative; organize a big media event and enacting a brand spokesperson to build a strong media personality; create awareness to the keys stakeholders through the media and social media platforms and build a website for the initiative and establish a firm public and community relation.
Implementation plan and timeline
Expanded Chronic Care Model implementation is within a timeframe of three months. The implementation time line will be as follows:
- June 1: meet with the diabetes center coordinator
- June 10: selected and address the diabetes educator team on plans and activities at hand
- July 1: secure conference rooms for the seminars
- July 15: Start media announcements and advertising of the program
- August 1: commence the diabetes education seminar.
Success/failure evaluation
Evaluating the success of the program will best be achieved by assessing whether the program has managed to improved consumer satisfaction rates, enriched quality of life, enhanced productivity, and limited or delayed disabilities are identified (Schmittdiel, 2017). The failure of the program may be evaluated by looking at the annual national survey reports and analyzing on the diabetes prevalence to see if the change is positive or negative.
Financial analysis
The financial analysis will include costs incurred in acquiring seminar rooms, media advertisements, hiring professional speakers or diabetes educators, transportation and communication costs. The Cost/ benefit analysis will provide the approximate cost incurred to implement the programs which will be used to measure the financial benefits. The savings or benefits will be derived from the visitation reductions, decrease in hospital admissions and the specialist visitation reduction among diabetic patients. If the proposed Expanded Chronic Care Model plan meets approval, there will be costs incurred related to educating patients, and functioning the patients’ registry. The benefits expectations include a 15% reduction in readmissions rates within the first year of implementation. Hence, the financial analysis indicates a payback within the first year.
Conclusion
Diabetes remains to be a costly chronic disease which is comparatively well-understood to be effectively managed. The lack of patient-centered treatment approaches, limited incentives and inadequate disease management protocols often underpin efforts to improve chronic disease management and promote health outcomes among people suffering from chronic illnesses. The fact that diabetes is a national issue, there is need for a population health approach with a broader perspective such as the Expanded Chronic Care Model. In case all impediments of diabetes are avoided, the Expanded Chronic Care Model is expected to show evidence of its success in a time span of within 18 months.
References
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Anderson, E. W., Frazer, M. S., & Schellinger, S. E. (2018). Expanding the palliative care domains to meet the needs of a community-based supportive care model. American Journal of Hospice and Palliative Medicine®, 35(2), 258-265. Beck, J., Greenwood, D. A., Blanton, L., Bollinger, S. T., Butcher, M. K., Condon, J. E., ... & Kolb, L. E. (2018). 2017 National standards for diabetes self-management education and support. The Diabetes Educator, 44(1), 35-50. Davy, C., Bleasel, J., Liu, H., Tchan, M., Ponniah, S., & Brown, A. (2015). Effectiveness of chronic care models: opportunities for improving healthcare practice and health outcomes: a systematic review. BMC health services research, 15(1), 194. Gee, P. M., Greenwood, D. A., Paterniti, D. A., Ward, D., & Miller, L. M. S. (2015). The eHealth enhanced chronic care model: a theory derivation approach. Journal of medical Internet research, 17(4), e86. Hirsch, J. D., Bounthavong, M., Arjmand, A., Ha, D. R., Cadiz, C. L., Zimmerman, A., ... & Morello, C. M. (2017). Estimated cost-effectiveness, cost benefit, and risk reduction associated with an endocrinologist-pharmacist diabetes intense medical management “tune-up” clinic. Journal of managed care & specialty pharmacy, 23(3), 318-326. Lin, J., Thompson, T. J., Cheng, Y. J., Zhuo, X., Zhang, P., Gregg, E., & Rolka, D. B. (2018). Projection of the future diabetes burden in the United States through 2060. Population health metrics, 16(1), 9. Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., ... & Vivian, E. (2017). Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. The Diabetes Educator,43(1), 40-53. Schmittdiel, J. A., Gopalan, A., Lin, M. W., Banerjee, S., Chau, C. V., & Adams, A. S. (2017). Population health management for diabetes: health care system-level approaches for improving quality and addressing disparities.Current diabetes reports, 17(5), 31. Shin, S., Kim, H., Lee, K., Lin, V., Liu, G., & Shin, E. (2015). Effects of diabetic case management on knowledge, self-management abilities, health behaviors, and health service utilization for diabetes in Korea. Yonsei medical journal, 56(1), 244-252. van Oostrom, S. H., Gijsen, R., Stirbu, I., Korevaar, J. C., Schellevis, F. G., Picavet, H. S. J., & Hoeymans, N. (2016). Time trends in prevalence of chronic diseases and multimorbidity not only due to aging: data from general practices and health surveys. PloS one, 11(8), e0160264.
Appendix
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