Assessment 1: Defining a Gap in Practice: Executive Summary

Name

Capella University

Structure and Process in Care Coordination

Instructor Name

June 27th, 2024

Defining a Gap in Practice: Executive Summary

Coordinated care is an essential aspect of healthcare, focusing on systematically organizing patient care tasks and ensuring that information is effectively communicated among all involved healthcare providers to promote safer and more efficient care delivery (Khanna et al., 2022). This process aims to enhance the overall quality of patient care by facilitating seamless interactions and collaborations among various healthcare professionals. This assessment identifies a gap in current care coordination practices. It formulates a PICOT question to address it, aiming to improve health outcomes for a specific patient population at various levels. The summary provides decision-makers with key information on clinical priorities, available resources, suitable interventions, and expected outcomes, offering a comprehensive plan to enhance care coordination and patient outcomes.

Analyzing Clinical Priorities for Effective Care Coordination

Care coordination is vital for organizing patient care and ensuring effective communication among providers to improve outcomes, particularly for elderly patients with chronic illnesses (Aboumatar et al., 2022). Key priorities include managing multiple medications, preventing readmissions, and addressing comorbid conditions. Proper medication management and monitoring can reduce adverse events and hospitalizations. Improving care coordination involves identifying information gaps, analyzing patient adherence, and comparing care models to find the most effective approach (Wang et al., 2024). Social determinants, patient engagement, and teamwork are crucial for tailored care coordination, ultimately enhancing health outcomes and resource efficiency (Emadi et al., 2022).

Identifying Areas for Improvement with a PICOT Question

The PICOT question designed to tackle discrepancy in care management for senior individuals with long-term health conditions is: In elderly patients with chronic conditions (P), how does a holistic service management initiative (I) compared to conventional care approaches (C) influence hospital readmission rates (O) within six months (T)? Seniors with chronic health issues frequently encounter disjointed treatment, resulting in numerous hospital returns. The lack of integration and coordination among healthcare providers creates a significant gap in current practices, leading to inconsistent chronic conditions and medication management. Research by Jika et al. (2021) found that a comprehensive care coordination program can improve continuity of care, enhance provider communication, and ensure consistent patient monitoring. Aboumatar et al. (2022) indicate that poor care coordination leads to negative patient outcomes and higher healthcare costs due to increased readmission rates. Implementing comprehensive care coordination programs can address these issues by providing structured, integrated care. Research by Khatri et al. (2023) supports this approach, showing significant reductions in readmissions and improvements in medication adherence and patient satisfaction, advocating for such programs to improve patient care and reduce expenses.