Introduction
Understanding the cultural diversity in depression for the delivery of mental health care is a core quality data that requires more research because of the limited study. The phenomenon is a dynamic and complex procedure and encompasses delivery of essential security services for patient safety. In this regard, such factors as clinical collaboration, patient-centered care therapy, and multidisciplinary teamwork are critical concepts in cultural diversity as provided in the patient protection act especially in mental health care. According to Bailey et al. (2018), there are approximately 18 million people who suffer mental health conditions such as mood disorder disease. According to Bailey et al (2018), about 10 million people experience clinical depression as a result of mental health conditions in the U.S. Therefore, there is a need to acknowledge the importance of identifying early on-set symptoms for mental health diseases and their co-morbidities. To satisfactory identify such systems, nurses and other health care providers require appropriate training that is coordinated through collaborative working. As such, collaborative decision-making in mental health diagnosis, treatment, and management are important for quality and effective patient care.
Problem and Needs
One of the major mental health condition affecting health care systems at Desert Parkway Behavioral Healthcare Hospital is depression. According to Desert Parkway as at 2018, approximately 1 in 10 adults suffer from symptoms of depression or depression related conditions (Desert Parkway Behavioral Healthcare Hospital, n.d.). In the U.S., about 10 million people are diagnosed with depression or other symptoms related to depression (Bailey et al., 2018). In this regard, nurses are mandated to deliver clinical judgement based on Mental health Act, 2017. Despite the condition encompassing several related policies, clinical expertise should use the guidelines as depicted in Mental health Act policy to provide appropriate care.
Proposed Solution
Desert Parkway Behavioral Healthcare Hospital recounts three common types of depression in their treatment formulary, which include such conditions as persistent depressive disorder (PDD), bipolar disorder, and major depression. From this analysis, it is evident that there are diverse quality indicators for the treatment and management of depression, including diagnosis, assessment, and nursing observations. This forms the basis of this proposal whose main objective will aim to study the association between the illustrated indicators for the provision of QI improvements in a mental health care. The proposed strategy will also aim to analyze the outline and design of relationship between the indicators and the data to be obtained. Succinctly, the data will be used to ascertain the presence of various assumptions with regards to quality care and nursing practices in mental health facility, the case of Desert Parkway Behavioral Hospital. The proposal will further, explore the provision of evidence-based practices (EBP) and ascertain the validity of the indicators for feasibility analysis and their role in monitoring, promoting, and assessing the quality of care for depression. Through the implementation of instruments, the proposal will also analyze the set of identified quality indicators for provision of strategic solution.
Analysis of Dashboard Metrics to Identify Quality Issues
Desert Parkway Behavioral Healthcare Hospital is considered as one of the bests in behavioral and mental health care treatment after the closer of the then Monte vista hospital in Las Vegas since 2016. The hospital offer psychiatric care with state-of-the-art care facilities that provide more than 152 beds, focusing on delivering quality mental health and behavioral changes (Desert Parkway Behavioral Healthcare Hospital, n.d.). The available resources at the facility ensure mental health promotion that is structured on care for both the patient and their families in the greater Las Vegas region. To ensure the provision of accountability of health care services, improved healthcare outcomes amongst depressed patients, reduce the cost of mental care treatments, and low medical errors, it is imperative to monitor and appraise quality care for quality mental health care systems.
From the above illustration, the critical assessment and appraisal of health care systems delivery is based on the care standards provided by the mental health facility and the available evidence from the quality indicators identified on the facility. Therefore, in the planning of QI initiative, it is important to recognize sub-optimal practices, and assess the past and the present performance indicators, and use the accessible data. Using such qualitative data metrics as treatment results, methods, and frameworks, it is also essential to characterize the appraisal based on context. According to Blischke et al. (2011), one should only use data from literature material that guarantee the provision of quality metrics and facts. Otherwise, according to Blischke et al. (2011), experts should implore quality indicators using consensus strategies based on how they are familiar to a particular set of quality indicators. Therefore, one of the best strategies to determine quality metrics in a mental health care facility is through classifying systematic judgment and evidence analysis.
Sadness and stress in one of the factors that trigger depression in most people. These factors seem to vary based on gender, age, and ethnicity across the U.S. For instance, in terms of ethnicity, depression amongst the Caucasians was 17.9% as divergent to African Americans, whose prevalence approximation was only 10.4%. The variance between African Americans and Caucasians lies in the element of disease being chronic and higher for African Americans (56%) than it was for Caucasian patients (38.6%) (Bailey et al., 2018). According to the National Institute of Mental Health [NIH] (2021), In terms of age, age 18-25- 13.1%, age 26-49- 7.7%, and age 50 and above- 4.7% (NIH, 2019).On the other hand, in 2017, gender analyses comprised of Male-5.3% and Female-8.7% (NIH, 2019). Moreover, the highest percentage in terms of depression in ethnicity category is occupied by the native White Americans 7.9%, with Hispanic AND African American constituting 5.4% of the population, and Asian Americans comprising of 4.4% (NIH, 2019). In the age category, the highest age group with the number of most people with depression is the age of 18-25 years old, comprising of 13.1%. Finally, in terms of gender specific analysis of depression, females were more diagnosed with depression symptoms compared to men. According to this data, is imperative to suggest that women are more affected with depressive symptoms because men have the capacity to seek for assistance compared to females (Kuehner, 2017). Therefore, the above analysis is essential in the formulation of a care plan that meets the QI initiatives merits.
One way of optimizing the management of depression at a high risk population is through the awareness of the patient health information as a function of healing and control of underlying health conditions in the standard procedures for quality outcomes. As such, the concepts should be converted into workable clinical judgments through nursing skill’s identification, allowing the nurses to identify the at risk populations. In this case, the longitudinal association between functional limits and depression is vital aspect of the study.
As a comparison, due to their health vulnerability, depression in the elderly remains undertreated. For instance, adults depression are compounded by the adverseness in medical errors, poor coping skills, lack of treatment controls specific to their population, worsening physical fitness, aging, and sedentary lifestyle. Although elderly depression can be managed in its entirety, the implementation of such psychoactive proxies as adverse measures and risk of falls because of hazards involvements with somatic medication can generate and improve substitute therapies, particularly in aging populations. For the aging group, most challenges can represent a gap in the mental health resource utilization. However, such obstacles can be achieved through successful psychoanalytic therapy, an approach which factors in the pain that the elderly do though during their presence at the mental care facilities.
Reasons why women are more depressed than men has brought controversial findings. In the U.S., more women than men were indicated to have been diagnosed with depression than men (NIH, 2019). However, at some instance, study indicates that men were more depressed than women (NIH, 2019). In this regard, depression among the gender patterns is understudied (Mojtabai et al., 2016). In the diagnosis of depression, several clinical tests have been explored. Many are lengthy and inappropriate, but others are suitable to use, shorter and patient-centered. Conversely, other procedures pertinent to clinical practice include the health of the country’s outcome scales, individual handler coupled with their career expectations of services, motivation, discourse, and Warwick-Edinburgh mental well-being scale. In general, the measures of depression offer brief account of each extent, with clinician rating scales, self-reports devices, designed diagnostic interviews, and overall illness ratings.
Another challenge of understanding depression in term of ethnicity and communication barrier is through the use of improved language and comprehension of symptoms. Practically, language barrier in mental health care system especially in depression management is a cause of concern. Interestingly, experts augment the use of computerized text analysis and machine learning to sense a multiplicity of disorders in mental health using natural languages such as blog posts. However, machine learning cataloging will only be operational if more data is expounded and necessary algorithms are industrialized. In this case, the wide outlines of pronouns, negative, and already well-defined totalitarianism go beyond this view.
Outline for the QI Initiative Proposal
Nurses play an integral role in the manipulation of patient care in a health care system. They are accountable for the assessment and synchronization of tasks related to various mental health issues, depression being a part of them (Angerer et al., 2017). The nurses in the Desert Parkway Hospital are fully equipped with mental health management and skills necessary for the diagnosis, appraisal, management, and treating of several mental health conditions. The facility offers a continuous personal and professional development programs to nurses that strengthen their abilities in terms of providing quality treatment, modalities within the hospital. However, due to recent noticeable burnouts and reduced state turnover, understaffing has caused emergence of conflicts and completions amongst the nurses with increased lack of communications.
Based on the above analysis, the best suitable QI initiative model for dealing with depression in the Desert Parkway Hospital is the collaborative care strategy known as Partners-in-Care (PIC) model. The approach include such activities as, an institutional obligation to the QI initiative, clinician instruction, teaching of local experts, and training nurses for patient evaluation, as well as tutoring. The model is not population-specific as it targets a general population including both the young and the old who have been diagnosed with depression. Additionally, the PIC approach facilitates the availability of psychoanalysis treatment and a regular family physician visits. Nurses’ realization towards patient care and depression requires a collaborative and partnership work processes amongst the nurses, the patients, and the families members who act as proxy to medical emergencies. Despite the PIC model’s efficiency and efficacy, there are still some knowledge gaps with regards to the information that can disturb the QI processes in the overall health care change. Therefore, it is challenging to obtain cooperation and teamwork from the patients and their families as most of them believe that the mental assessment is the sole responsibility of nurses only.
Integration of Interprofessional Perspectives
Curricula reforms is necessary for the clinical and mental health care nurses that ensures that they are educated on the current trends in mental health illness, with incorporation of community and multidisciplinary teams for workforce and policy changes. To this effect, promotion of role and role managers in mental health control ensures provision of safe and quality care. Moreover, the nursing practice being a complex and demanding profession, there is a need to transform the key areas of clinical practice such as leadership, practice, and education. Through nursing curricula reforms, the future nurse leader will have the ability to syndicate administrative consciousness and clinical acumen. Through such trainings, the nurses will be able to form a concerted interprofessional partnership and inform complex changes that transform the team roles, thus promoting interprofessional cooperation and innovative ideas in leadership style.
The proposed model adopted for QI initiative is based on the doctrines of increasing productivity and reducing the cost of medical health care by offering competitive and evidence-based practice (EBP) in the treatment of depression (Petrosyan et al., 2017). The approach also focuses classifying elimination of wastes by rationalization the processes in hospital services to generate better outcomes. The objective of QI in healthcare is to improve on such general results as the length of stay, re-admission, medication, and morbidity. In each profession, new collective personalities, capability, and proficiency need to be familiarized to advance patient care; however, some barriers prevent the healthcare system. These challenges include industrial role models, assumed control discrepancies, and the absence of ethnic evaluation skills. However, these challenges are necessary to integrate the key competencies built upon through interprofessional collaboration, including obligation, effort, inspiration, harmonization, decision-making, and accountability to enhance patient care. To reduce cost of management, such non-nursing concept as Pharmacist-led medication therapy (PLMT) can be incorporated into the QI initiative. For instance, According to Erku et al. (2017), the use of PLMT was indicated to lead a cost-effective healthcare in terms of medication for type 2 diabetic patients. Therefore, it is equally vital to integrate the method in the above QI initiative.
The impact of change behavior in the nursing profession with regard to new skills acquisition, knowledge impact, and nursing practice decrease with time. Based on the present analysis, mental health care interprofessional role play require effective communication to ascertain improvements in clinical outcomes for depressed persons, positive changes in behavior in nursing in terms of attitudes and character. Furthermore, the available researches only formulated empirical analysis without regard to post-interventions for the care of depression in patients. Therefore, for the proposed PIC intervention, it is vital to scrutinize the best time, format, content, and timing for PIC interventions to achieve the longest impact.
References
Angerer, P., Schmook, R., Elfantel, I., & Li, J. (2017). Night work and the risk of depression: A systematic review. Deutsches Ă„rzteblatt International, 114(24), 404-411.
Bailey, R. K., Mokonogho, J., & Kumar, A. (2019). Racial and ethnic differences in depression: Current perspectives. Neuropsychiatric Disease and Treatment, 15(1), 603-609.
Desert Parkway Behavioral Healthcare Hospital, n.d. About our mental health programs in Las Vegas, NV.
Erku, D. A., Ayele, A. A., Mekuria, A. B., Belachew, S. A., Hailemeskel, B., & Tegegn, H. G. (2017). The impact of pharmacist-led medication therapy management on medication adherence in patients with type 2 diabetes mellitus: A randomized controlled study. Pharmacy Practice (Granada), 15(3). 1-7.
Kuehner, C. (2017). Why is depression more common among women than among men? The Lancet Psychiatry, 4(2), 146-158.
Mojtabai, R., Olfson, M., & Han, B. (2016). National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics, 138(6). 1-12.
National Institute of Mental Health. (2019). Major depression. NIH.
National Institute of Mental Health (2021). Mental illness. NIH.
Petrosyan, Y., Sahakyan, Y., Barnsley, J. M., Kuluski, K., Liu, B., & Wodchis, W. P. (2017). Quality indicators for care of depression in primary care settings: A systematic review. Systematic Reviews, 6(1), 1-14.