Assignment task:
Assessing the Problem: Quality, Safety and Cost Considerations
Introduction:
Heart disease refers to a range of conditions that impair the heart's ability to function normally, which has a major effect on cardiovascular health. An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke (WHO, 2024). Coronary artery disease (CAD), which is characterized by the buildup of plaque in the coronary arteries and reduces blood flow to the heart muscle while raising the risk of angina and heart attacks, is one of the main causes of heart disease. Another important factor is heart failure, which is the inability of the heart to pump blood effectively, leading to symptoms including fluid retention and dyspnea.
My 64-year-old neighbor Mark is the subject of my practicum, and he has been battling heart disease for a few years; he has a history of unhealthful eating patterns and has trouble following doctor's prescription regimens. He has tried to manage his illness, but persistent lifestyle habits and sporadic noncompliance have made it difficult to keep his blood pressure and cholesterol under control. His continued resistance to following medical advice and leading a heart-healthy lifestyle serves as a stark reminder of the substantial obstacles associated with treating chronic cardiovascular diseases. During this practicum, we will explore the various quality, safety, and cost issues Mark faces as he battles this deadly disease.
Quality of Care:
High-quality care for patients with heart disease is crucial for improving their overall well-being and prognosis. This care involves accurate diagnosis, personalized treatment plans, mental health support, and ongoing management of the condition to minimize readmissions. For instance, approximately one in five patients hospitalized for chronic obstructive pulmonary disease (COPD) or heart failure (HF) are readmitted within 30 days of discharge (Michaels, 2019). Treatment adherence and overall health outcomes can be greatly impacted by the psychological toll that treating a chronic illness can take, thus it is as vital to address the mental health component.
Chronic heart failure (CHF) notably impacts mental health, often leading to increased anxiety and depression due to the persistent stress of managing a debilitating condition. Epidemiological studies reveal that a significant proportion of CHF patients experience depression, which adversely affects their quality of life (QOL), mental health status (MHS), medication adherence, and overall clinical outcomes (Mo, 2021). Additionally, patient education plays a vital role in empowering individuals to take charge of their health, adhere to medical advice, and implement necessary lifestyle changes.
In a recent Tanzanian study, nurses found that when patients received education on self-care management, their quality of life improved. According to participants, the provision of self-care education enabled patients to adhere to medications and proper diet and follow the advice given on lifestyle changes like quitting smoking, exercising, and quitting alcohol (Shirima, 2024).
Effective treatment for heart disease requires both ongoing maintenance and accurate diagnosis. Early and on-time diagnosing of this problem is very essential for preventing patients from more damage and saving their lives (Muhammad, 2020). An accurate diagnosis guarantees that the precise kind and degree of cardiac disease are detected, allowing medical professionals to create individualized treatment regimens that cater to the individual requirements of each patient.
A thorough understanding of the illness is often obtained by a mix of diagnostic testing, imaging examinations, and clinical assessments. A patient's response to therapy and any changes in their condition are considered while adjusting the treatment plan, which is part of ongoing management. This management strategy's key elements include coordinated care with specialists, medication adjustments, lifestyle counseling, and routine follow-up appointments.
During our conversations, Mark had conflicting opinions regarding the standard of the care he got. He respected the expertise and commitment of his healthcare personnel but found it difficult to manage his condition and follow recommended therapies. While Mark acknowledged that the instructional materials were beneficial, he also said that he frequently felt disheartened due to the overwhelming nature of his diagnosis and the expectations of changing his lifestyle. He underlined that in order to successfully incorporate the suggested adjustments into his everyday life, he needed more individualized support and useful direction. This feedback emphasizes how crucial it is to provide patients with high-quality care while also making sure they feel understood and supported during their course of treatment.
Safety:
Since patient safety has a direct impact on treatment outcomes and general health, it is critical to ensure patient safety when managing cardiac disease. Severe complications or worsening of the disease might result from improper or inadequate therapy of heart problems. Patient safety is a key global health priority as health systems have increasing levels of demand for services alongside financial constraints, fragmentation, the changing role of technology in care and information transfer and an increase in long-term condition management (Morris, 2023).
Preventing hospital readmissions is crucial for the safety of patients with heart disease, since it poses a substantial risk of worsening health. The reasons for readmission after an intervention are often not primarily related to the intervention itself, but to the underlying comorbid conditions (Brunner-La Rocca, 2020). Ensuring a safe discharge process is critical; patients must receive clear instructions on medication adherence, dietary restrictions, and lifestyle modifications.
Effective discharge planning should include arranging follow-up appointments and providing resources for continued support. Studies have shown that patients who receive thorough discharge education and have access to post-discharge support are less likely to experience readmissions and complications (Michaels, 2019). A well-coordinated discharge plan helps mitigate risks associated with transitioning from hospital to home care, thereby enhancing patient safety.
Finally, reducing the possibility of mistakes during diagnosis and treatment is another aspect of patient safety. A medication error is a failure to complete a necessary step in the medication use process, or the use of a wrong plan to achieve a medication-related aim (Stipp, 2022). To accurately determine the type and degree of cardiac disease, prompt and accurate diagnostic testing is necessary. Ignorance or postponement of diagnosis may lead to ineffective therapies and potentially dangerous health outcomes.
For patient safety, it is essential to guarantee the precision of diagnostic tests as well as the skill of medical professionals performing these tests to avoid any mistakes. Furthermore, by encouraging openness and patient involvement in their care, a collaborative environment where patients are welcomed to express concerns and ask questions about their treatment can further improve safety.
Cost:
When examining the total cost of medical care for an individual with a heart disease diagnosis, it is crucial to take into account both the direct treatment costs, which include hospital stays, drugs, and surgeries, as well as the indirect costs, which include lost productivity, long-term disability, and a lower quality of life. Annual inflation-adjusted (2022 US dollars) health care costs of cardiovascular risk factors are projected to triple between 2020 and 2050, from $400 billion to $1344 billion (Elkind, 2024).
Therefore, to further reduce the patient's financial burden, the length of stay should be reasonably reduced, and the rational distribution of medical resources should be continuously promoted to ensure equitable access to healthcare services (Zhou, 2024). Expenses for medical treatments such as hospital stays, doctor consultations, diagnostic testing, prescription drugs, and surgical procedures are considered direct costs. These expenses can add up quickly for patients with long-term cardiac issues, particularly if the illness necessitates repeated hospital stays or intricate procedures. Even if they are less obvious right away, indirect expenses can nevertheless have a big influence. These expenses include diminished quality of life, missed work because of illness or disability, and the long-term financial consequences of having a chronic ailment. Patients might not be able to work as much or could need to take longer leaves, which would result in lost wages and more financial strain. Moreover, the psychological and emotional burden of treating a chronic illness can make it difficult for patients to continue working or carry out daily tasks.
Discussion with Mark:
My conversations with Mark gave me important new perspectives on the practical aspects of heart disease management, especially as they relate to quality, safety, and cost. Mark's experiences demonstrated how difficult it may be to follow doctor's orders in the complex world of heart illness. He brought out the challenge of managing lifestyle modifications and consistent medication adherence, for example, both of which are essential for high-quality care but are frequently difficult to put into practice. Evidence-based strategies that emphasize the value of patient education and support in enhancing treatment adherence and results are in line with this.
Personalized care plans and thorough patient education are essential for effectively addressing these difficulties, according to a review of relevant EBP protocols and resources. Mark had trouble adhering to his medicine regimen and changing his lifestyle due to a number of obstacles, such as a lack of individualized assistance and trouble comprehending safety procedures. Even while he understood how important these factors were, he thought the typical information was too much and frequently unsuited to his needs. This feedback draws attention to a widespread problem that is backed by research, which shows that safety procedures and general education do not always adequately address the concerns of specific patients . The obstacles were acknowledged by Mark's family as well, and they all agreed that improved adherence and general condition management required more tailored help.
I used a number of crucial abilities, such as teamwork, leadership, and communication, to overcome these barriers. By providing information on the possible repercussions of non-adherence and highlighting the significance of individualized support, I tried to instill a sense of urgency. I was able to help overcome some of the initial resistance by working directly with Mark and his family to provide clearer explanations and more helpful guidance. This strategy not only addressed Mark's immediate worries but also made it easier to see how serious the issue was. Consequently, I revised my problem statement to incorporate the requirement for more customized and understandable safety and quality controls.
Looking back on the process, I see that the intervention may have been even more successful if Mark and his family had provided more frequent and proactive input. Regular check-ins and more flexible treatment plan modifications may have resolved problems faster and increased adherence.
Conclusion:
This practicum offered insightful information about the complex issues associated with heart disease management from the perspectives of cost, safety, and quality. Mark's experience made clear how important it is to receive individualized, high-quality care that takes into account both the physical and mental components of treating a chronic illness. His challenges with changing his lifestyle and adhering to his medicine regimen brought to light the significance of patient-centered strategies that go beyond general education and accepted practices. Mark's feedback on safety showed important obstacles pertaining to the application and clarity of safety procedures. In terms of cost, Mark's condition clearly showed both direct and indirect costs associated with controlling heart disease. The cost of ongoing care, prescription drugs, and missed work puts a strain on finances that makes cost-control measures necessary to maintain good standards of care. In summary, this practicum highlights the significance of managing cardiac disease holistically, incorporating safety, cost considerations, and tailored care to improve patient outcomes and quality of life.