Hospital Corporation of America (HCA) is a leading provider of healthcare services in the United States. The organization was established in 1968 and has quickly grown to serve many communities as it enhances access to healthcare. It operates as an umbrella body of numerous healthcare facilities spanning about 185 hospitals and over 2,000 care centers spread across 21 states in the U.S (HCA, 2019). Most of the facilities are located in Texas and Florida. The organization’s operations span a large area and has a big impact in improving healthcare service delivery. Its key initiatives include providing leadership to expand the capacity of other nonprofit organizations and the community. A project aimed at enhancing Atrial Fibrillation early treatment and prevention will enhance HCA’s influence on the society through better healthcare services and improved outcomes.
Healthcare Need
Atrial fibrillation (AF) is a leading cause of heart failure, stroke, dementia, cardiovascular morbidity, and sudden death globally. According to Bhat et al. (2021), the problems have resulted in increased AF hospital administration across HCA’s facilities while there may be many people suffering from undiagnosed or ‘silent’ AF. The distributing trend impacts on the organization’s spending in treating patients with AF while the resources could be applied to other critical areas, such as research and development. The purpose further entails managing the development of chronic conditions that mainly affect the elderly, especially stroke and heat failure. Therefore, there is the need for HCA to implement a project initiative for AF early treatment and prevention by providing tools to older adults for monitoring key parameters associated with AF.
Evidence
AF is an emerging global health concern across the world. AF affects about 33 million people globally with a projected annual increase of about 5 million new cases (Callanan et al., 2022). Close to half-a-million people are diagnosed with AF every year in the U.S., resulting into deaths of about 158,000 (Bhat, et al., 2021). It remains a key area of target as it increases the risk of stroke and dementia by five and two times, respectively. It is also associated with an increased risk of heart failure and myocardial infarction.
Implementation Plan
Target Area / Intended Population
The project will be centered in the states of Texas and Florida where HCA has a large number of facilities. The target population comprises older adults aged between 60 to 80 years. The targeted population is due to the increase in the incidence and prevalence of AF with age. According to Casajuana et al. (2018), AF prevalence increases by up to three times in the targeted age bracket. The problem is prevalent in industrialized areas the 6th and 8th decade of life. The increasing frequency of AF is particularly notable in industrialized nations more than in the developing parts.
Timeline and Implementation of Milestones
The project is expected to be conducted through a three-year period with key milestones being observed every six months. The aim is to progressively monitor the effectiveness of early treatment and prevention interventions to ensure that the price has an impact in reducing AF morbidity and mortality.
Financial Impact
AF involves huge healthcare spending the would require a budget of about $500 million. The funds will be generated from internal sources and by working with partners through fundraising initiatives. It is expected the through early treatment and prevention, the organization will help to save a portion of Medicare expenses that are about $6 billion in a year (Casajuana et al. 2021). The non-financial gains include reduced AF morbidity and mortality. The project will involve capital expenditures to acquire necessary tools and devices used by physicians, such as Lariat, holter monitor, AtriClip, mobile ECG devices, defibrillator, pacemaker, and Watchman.
Additional Resources
In addition, technology will be a key component of the project especially in the present day as telehealth and telemedicine services grow alongside the increased use of wearable devices. The organization will engage technology experts in developing and monitoring the use of digital health technology to enable medics and patients to improve AF management (Rodriguez et al., 2022). The frontline healthcare professionals will help in supporting decision-making through feedback. Partnership with implementation scientists will help in enhancing the stringency of the project and provide expertise in operations, choosing outcome metrics, and development of effective strategies.
Federal and State Regulations and Ethics Review
The treatment of AF is conducted under guidelines developed by various organizations, including the American Heart Association (AHA) and the American College of Cardiology (ACC). Ethical considerations will be observed as the project involves an interaction with human subjects. The main ethical considerations to be observed in the project include non-maleficence and beneficence, and concerns touching on patient autonomy, such as informed consent (Hamad et al., 2021). Other ethical considerations include the doctor-patient-relationship, justice amid increasing inequalities, and data protection. The organization’s main plan to ensure ethical practices are observed is to create an ethics board that will be mandated with ensuring that applicable procedures and practices are followed.
Evaluation Plan
Specific Goals and Milestones
The specific goals and milestones of the project include;
- Improving control of heart rate among patients. The aim is to attain a normal heart rate of within 60 and 100 beats a minute when resting.
- Enabling patients to regain a normal heart rhythm based on certain observations, including patient symptoms, patient preferences, and exercise tolerance. In specific, the aim is to attain a lenient rate control of between 80 to 110 beats per minute.
- Reducing the risk of having a stroke is a major objective given its close association with AF.
- To enhance management of AF, the project aims to attain a ventricular rate control of less than 100 beats per minute.
Definitions of Measures of Progress
Progress will be assessed by observing various measures to monitor progress, which specifically performing one or more heart or blood tests. The test will be conducted as soon as a patient shows signs of AF. The most common test is called electrocardiogram (ECG) that record the heart’s electrical action using data from an implanted defibrillator or a pacemaker (Hamad et al., 2021). An ultrasound (echocardiography) can be performed to looks at the heart chamber sizes and valves, and the pumping function. Another measure of progress is to conduct blood tests to check the level of various substances in the blood, especially thyroid hormone, sodium, and potassium (Ferguson et al., 2019) states that imaging tests will also be conducted to monitor progress, including cardiac magnetic resonance imaging (MRI) to look at the layout of the left atrium, which is the left upper chamber of the heart, and checking on its performance. Another measure is to track the heart’s electrical activity over a day or two using a holter monitor.
The success of the project will mainly be evaluated through benchmarking, which involves the use of comparative data to analyze and measure the processes of a project. The data will be derived from other sources outside the organization, including the state and federal databases that track the industry and marketplace studies. The aim will be to identify areas for improvement, such as improving on quality. Observable deviations and adjustments will be handled by adjusting the approach and intervention based on patient reaction and patterns observed in the project.
Collecting and Analyzing Information to Ascertain Stakeholder Satisfaction
Stakeholder satisfaction is important in the project as it helps to indicate that the organization has an impact in improving the health of the community. The process involves enhancing with the stakeholders directly and in the process collecting data through interviews, focus groups, and conducting surveys. The data can be analyzed using qualitative and quantitative approaches, including content analysis and description. The project will involve many stakeholders categorized into different groups. These are primary stakeholders, secondary stakeholders, and policymakers.
Communication and Management Plan
Progress Communication
Progress communication is vital for the organization as it involves a way of reporting to the management, the board of directors, and other stakeholders. The communication further ensures the stakeholders are involved at each stage of the project through which they can provide support, suggestions, and take part in project evaluation for continuous quality improvement. The key strategies entail using emails and newsletters for immediate delivery of information, easy management of communications, and monitoring engagement. The stakeholders can also be engaged using virtual or online presentations after which the slides can be sent to the stakeholders for further reference (Elwy et al., 2022). Tailored communication will be provides using continuous project summary reports that are more helpful and provide unique information.
Change Management Plan
The healthcare industry is multifaceted, and can be challenging to introduce changes. However, changes are unavoidable and the organization will be sensitive to ensure the employees, patients, clients, departments, and outside stakeholders are involved in the project. Tampio et al (2022) state that healthcare involves handling people who are exposed to vulnerabilities and may have varied and fixed views on specific practices, cultures, and standards.
Change will be handled by impacting its need and impact and identifying as well as addressing any resistance. Changes will be introduced using the ADKAR model as it focuses more on human psychology and on appreciating the feelings and thinking of the people affected by the change. The model can potentially help to gather feedback and use it to see how different stakeholders are impacted. The model comprises five main steps of implementing a change, including creating awareness, creating a desire to support the change, providing knowledge so that there is more support for the change, enhancing their ability to participate, and reinforcing the change.
Post-Implementation Communication
After the project has been implemented, post-implementation communication is essential to report on results and provide ongoing exchange. The main audiences are the internal and external players involved in the project. The internal players will be addressed using conference calls, face-to-face meetings, instant messaging, email, and videoconferencing (Elwy et al., 2022). The external audiences can be communicated to though the website and using media. Social media can be used to reach a wider audience as it has become a part of everyday engagement. The organization can use its verified social media platforms, including LinkedIn, Facebook, Twitter, and blogs. The organization will be ensure shared information has been evaluated for correctness to avoid providing erroneous results of wrong messages.
References
Bhat, A., Khanna, S., Chen, H. H. L., Gupta, A., Gan, G. C. H., Denniss, A. R., MacIntyre, C. R., & Tan, T. C. (2021). Integrated care in atrial fibrillation. Circulation: Cardiovascular Quality and Outcomes, 14(3). Web.
Callanan, A., Quinlan, D., O’Sullivan, S., Bradley, C. P., Kearney, P. M., Murphy, A., & Buckley, C. M. (2022). Atrial fibrillation (AF) pilot screening programme in primary care in Ireland: an implementation study protocol. BMJ Open, 12(2). Web.
Casajuana, M., Giner-Soriano, M., Roso-Llorach, A., Vedia, C., Violan, C., & Morros, R. (2018). Annual costs attributed to atrial fibrillation management: cross-sectional study of primary healthcare electronic records. The European Journal of Health Economics, 19(8), 1129–1136. Web.
Elwy, A. R., Maguire, E. M., Kim, B., & West, G. S. (2022). Involving stakeholders as communication partners in research dissemination Efforts. Journal of General Internal Medicine, 37(S1), 123–127. Web.
Ferguson, C., Hendriks, J., Gallagher, C., Bajorek, B., & Inglis, S. C. (2019). Clinical service organization for adults with atrial fibrillation. The Cochrane Database of Systematic Reviews, 2019(8). Web.
Hamad, A. K. (2021). New technologies for detection and management of atrial fibrillation. Journal of the Saudi Heart Association, 33(2), 169–176. Web.
HCA. (2019). HCA Healthcare. Web.
Rawson, J. V., & Davis, M. A. (2023). Change management: A framework for adaptation of the change management model. IISE Transactions on Healthcare Systems Engineering, 1–12. Web.
Rodriguez, J. F., Berenfeld, O., Loewe, A., Corino, V., & Juan Pablo Martínez. (2022). Atrial fibrillation: Technology for diagnosis, monitoring, and treatment. Frontiers Media SA.
Tampio, K.-P., Haapasalo, H., & Ali, F. (2022). Stakeholder analysis and landscape in a hospital project – elements and implications for value creation. International Journal of Managing Projects in Business, 15(8), 48–76. Web.