Palliative Care Quality Improvement in Florida

Introduction

Providing palliative care of the required quality, particularly the appropriate management of hospice patients’ information and the provision of prescribed drugs, is a crucial step toward maintaining the quality of the target populations’ lives high (Saad et al., 2016).

The CS/CS/SB 474 Hospice Care policy that has recently been adopted at the state level in Florida is aimed at improving the quality of the data management process and keeping the necessary resources available, at the same time preventing the incidences of prescribed drugs mismanagement, so that the hospice inpatients could enjoy high-quality nursing services (see Appendix A) (Florida Senate, 2017).

The purpose of the analysis is to explore the opportunities that the identified policy offers to the target population. The advantages and disadvantages thereof will be assessed carefully. Seeing that the policy is implemented at the state level, it will be crucial to make sure that it should not affect the rights of any member of the Florida population. The identified policy exists at the level of public health policies and, at the same time, the healthcare systems of Florida.

Indeed, it both defines the way in which essential decisions regarding prescribed drug management should be made in hospices and sheds light on the issues associated with educating people about palliative care as a crucial public health concern. Despite the fact that the issue of palliative care has been explored extensively, some of the associated concerns, such as the mismanagement of prescribed medications, need to be handled accordingly. Therefore, a tighter focus on the disposal of prescribed drugs and a better information management strategy for keeping the patients’ records are a welcome change of pace in the realm of Florida healthcare. Therefore, the policy analysis will seek to address the question of whether the policy allows for an improvement in patient outcomes.

Background

A closer look at the current concerns in the hospice management and palliative care will show that the statistics about palliative care patients and hospice inpatients has been underrepresented over the past few years, mainly, due to the lack of appropriate measurements (Masman, Dijk, Tibboel, Baar, & Mathot, 2015). Therefore, there is a need to develop an appropriate measurement system involving the information provided with the help of both verbal and numerical rating scales (VRS and NRS).

Furthermore, the assistance of the hospice personnel in administering prescribed medications to the target population will have to be considered a necessity to reduce the levels of prescribed drug mismanagement, which has been an issue for years (Masman et al., 2015).

Finally, the process of handling the patient data could use significant improvements so that the essential information should be transferred from one nurse to another successfully, and the crucial problem of contemporary palliative care could be resolved. The scope of the problems listed above may range from a hospice-specific one to a statewide concern since the appropriate regulations have been provided comparatively recently.

The policy, in turn, is likely to create an environment in which the misconceptions associated with patient information management will be avoided successfully. The powerful emphasis that the policy places on the information management allows for more accurate analysis and representation of the patient data. Moreover, the specified step will ostensibly contribute to a rapid drop in the instances of prescribed drugs mismanagement (Pharm, McPherson, & Holmes, 2014).

The policy has its advantages and disadvantages. The strengths of the policy come from its focus on information management. In the context of the contemporary healthcare environment, the emphasis that CS/CS/SB 474 places on the importance of the careful usage of data are a welcome suggestion. Furthermore, the fact that the policy compels nurses to pay attention to the issue of prescribed drug mismanagement makes the new regulation especially important for meeting the needs of palliative care patients.

That being said, CS/CS/SB 474 also has a few flaws. For instance, the lack of clarity concerning the way in which certain hospice staff members will assist in distributing prescribed drugs to the target population needs to be listed among the primary areas of concern. Moreover, the policy could have detailed the process of evaluating patient outcomes, e.g., by mentioning the appropriate measurement tools such as VRS and NRS (Ruskin et al., 2014).

The policy is likely to affect a wide variety of stakeholders as soon as it is implemented in all Florida hospices. The patients that receive palliative care are the most obvious group of stakeholders in the identified scenario since CS/CS/SB 474 will affect the quality of care to a considerable extent. Furthermore, hospice staff members will have to experience vast changes because of the need to accept new responsibilities associated with the management of prescribed drugs.

Analysis

It would be wrong to claim that CS/CS/SB 474 is the only policy that can possibly help improve information management in the realm of palliative care. Other policies, such as the guidelines concerning the use of the Electronic Health Records (EHR) and Health Information Exchange (HIE) tools also contribute to a significant improvement of the data management process in the nursing setting, including hospices (Agency for Healthcare Research and Quality, 2014).

The identified policy also allows for more accurate management of the patient’s data. However, it does not enable the nursing staff to engage in a more efficient process of handling the patients’ personal data, especially with the focus on multidisciplinary collaboration, as CS/CS/SB 474 does (Florida Senate, 2017).

The opportunities for enhancing the quality of information transfer, as well as the reduction in the instances of information mismanagement and the opportunities for providing publicly available statistics, can be viewed as the primary policy assessment criteria. While the alternative policy meets the first requirement, it fails to promote multidisciplinary cooperation and provide public statistics, at the same time keeping the patients’ data safe.

Therefore, when considering the opportunities for improving the quality of care, one should prefer the CS/CS/SB 474-based approach as the superior one. Indeed, CS/CS/SB 474 offers extensive opportunities for data quality management, its successful transfer, and the options for making the statistical data available to the general public, at the same time keeping the patients’ personal data private. It is likely that the CS/CS/SB 474 policy will trigger a rapid rise in the number of positive patient outcomes. Particularly, the pain experienced by hospice patients will be significantly less severe.

That being said, HER and HIE should also remain part and parcel of nursing so that the overall data management process could remain efficient. Thus, a trade-off can be achieved when balancing the suggested alternatives. Particularly, the policy promoting HER and HIE can be used to reinforce the efficacy of data storage, whereas the CS/CS/SB 474-based approach will help promote communication between a patient and a nurse, as well as among nurses, in the context of hospice.

Recommendations

At present, a combination of the CS/CS/SB 474-based approach and the use of HER and HIE tools as the means of improving the data transfer can be viewed as a necessity. Thus, a comprehensive strategy for managing both the needs of the patients and the information transfer processes between nurses can be built. Herein lies the reason for its selection; it encompasses the needs of all target stakeholders, also providing an opportunity for the further increase in the service quality.

To implement the identified approach, one may consider introducing a change in the value system in the nursing environment, making it more patient-centered and aimed at fast and efficient data management. Kotter’s 8-step model for change implementation can be used to reinforce the process (Saad et al., 2016).

It is expected that nurses will resist the change since it will imply a sharp rise in pressure on the nursing staff. Therefore, the transformational leadership strategy aimed to boost motivation levels among nurses should be selected as the tool for handling the problem. The success of policy implementation can be evaluated by considering the instances of patient data mismanagement and the number of positive patient outcomes (i.e., successful pain reduction).

Discussion

The analysis results and the recommendations serve as the foundation for building a data management framework that will help avoid the incidences of drug mismanagement. Particularly, more careful use of the available data will prevent the identified problems from occurring. Furthermore, the prerequisites for reducing the levels of pain experienced by the target population can be built since the approach implies a more successful transfer of the relevant data and, thus, more efficient management of the patient’s needs.

As a result, both the public health concerns (i.e., the opportunities for educating people about palliative care by providing the relevant statistical and other types of data) and the healthcare system issue (i.e., the management of hospices and meeting the needs of hospice patients) will be handled accordingly.

It should be noted, though, that the analysis has certain limitations. For instance, it does not represent the culture-specific needs of the diverse population of Florida. However, it can be adjusted to meet the needs of the identified population successfully.

Therefore, the implementation of the policy will have a tangible effect on a range of domains. For instance, it will allow improving the quality of palliative care by enhancing the efficacy of bedside handovers and other types of data management. Furthermore, it will affect the levels of education among the general public by offering available data for all those willing to learn more about palliative care. The policy will also leave a mark on the research of the strategies for improving palliative care since it will offer the relevant data to all those concerned. Finally, CS/CS/SB 474 will serve as an impetus for the policy-making process since it implies that improvements must be introduced to the area of healthcare on a regular basis.

Conclusion

The CS/CS/SB 474 policy aimed at addressing the needs of palliative care patients has created the foundation for more successful management of the relevant professes in the context of a hospice environment in Florida. While the framework has its problems, it introduces a range of positive changes, including the opportunities for an enhanced data security. Therefore, it needs to be implemented and used as the tool for improving the quality of patients’ lives. Furthermore, it will contribute to the further study of the subject matter. Particularly, the following questions will have to be addressed using the framework:

  • What tools can be used to enhance the communication process between palliative care hospice patients and the community?
  • What role do nurse educators play in the process of reinforcing the communication between hospice patients and the community?

Appendix A

Florida Senate

References

Agency for Healthcare Research and Quality. (2014). State at a glance: Florida. Web.

Florida Senate. (2017). CS/CS/SB 474: Hospice care. Web.

Masman, A. D., Dijk, M. V., Tibboel, D., Baar, F. P. M., & Mathot, R. A. A. (2015). Medication use during end-of-life care in a palliative care centre. International Journal of Clinical Pharmacy, 37(5), 767-775. Web.

Pharm, L. S., McPherson, M. L., & Holmes, H. M. (2014). Commonly prescribed medications in a population of hospice patients. American Journal of Hospice and Palliative Medicine, 31(2), 126-131. Web.

Ruskin, D., Lalloo, C., Amaria, K., Stinson, J. N., Hon, E. K., Campbell, F., & Brown, S. C. (2014). Assessing pain intensity in children with chronic pain: Convergent and discriminant validity of the 0 to 10 numerical rating scale in clinical practice. Pain Research and Management, 19(3), 141-148. Web.

Saad, A., Der-Nigoghossian, C. A., Njeim, R., Sakr, R., Salameh, P., & Massoud, M. (2016). Prescription errors with chemotherapy: Quality improvement through standardized order templates. Asian Pacific Journal of Cancer Prevention, 17(4), 2329-2236. Web.