Develop preliminary care coordination plan


Assignment task: Develop a 3-4 page preliminary care coordination plan for a selected health care problem. Include physical, psychosocial, and cultural considerations for this health care problem. Identify and list available community resources for a safe and effective continuum of care.

Scenario:

Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case management staff has been relocated to the inpatient setting. Care coordination is essential to the success of effectively managing patients in the community setting, so you have been asked by your nurse manager to take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to plan effectively in addressing the specific health concerns of community residents.

For this assessment, you will develop a 3-4 page preliminary care coordination plan for a selected health care problem. Include physical, psychosocial, and cultural considerations for this health care problem. Identify and list available community resources for a safe and effective continuum of care.

Before you complete the instructions detailed in the course room, first select one of the following health care problems or issues:

1. Lack of Access to Healthcare Services

  • Physical considerations: Limited transportation options, long wait times for appointments, and lack of insurance coverage can prevent individuals from accessing healthcare services.
  • Psychosocial considerations: Fear of medical procedures, mistrust of healthcare providers, and language barriers can also prevent individuals from accessing healthcare services.
  • Cultural considerations: Cultural beliefs and practices may influence an individual's willingness to seek medical care.
  • Community resources: Community health clinics, mobile health clinics, and telehealth services can provide accessible healthcare services to individuals who may not have access to traditional healthcare settings.

2. Chronic Disease Management

  • Physical considerations: Chronic diseases can cause physical limitations and impairments that can affect an individual's ability to perform daily activities.
  • Psychosocial considerations: Chronic diseases can cause emotional distress, anxiety, and depression.
  • Cultural considerations: Cultural beliefs and practices may influence an individual's willingness to manage their chronic disease.
  • Community resources: Disease management programs, support groups, and community health centers can provide resources and support for individuals with chronic diseases.

After you have selected one of the problems/issues from the list above, return to the detailed instructions in the course room to complete your assessment.

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