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Assessment 2: Problem Statement (PICOT)

Assessment 2: Problem Statement (PICOT)

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Assessment 2: Problem Statement (PICOT)

Introduction

The general population has the right to access high-quality and safe care. The healthcare system and the government aim to improvise strategies and evidence-based practice essential in enhancing the overall health outcomes of the patients and the population's quality of life. Access to healthcare services is a significant player in determining the quality of life of the people. Various factors hinder access to the recommended quality and timely care. Such health disparities impede the ability of the population to access the different health services, which translates into poor health outcomes for patients who may be in dire need of healthcare services (Ward‐Peterson & Wagner, 2020). Additionally, the healthcare sector continuously experiences various challenges which hinder the delivery of standard healthcare services. 

This also translates into poor health outcomes for the affected population. Some of these challenges include inadequate staffing, inadequate research regarding managing a particular emerging condition, and inadequate funding, which is essential in facilitating research and developing interventions to address the various challenges hindering effective delivery of healthcare services (Oleribe et al., 2019). Various stakeholders have come together and created strategies that have addressed some of these challenges to some extent. One of these strategies is home health care, which is the focus of this discussion. The discussion involves using the PICO (T) framework to assess the effectiveness of various interventions that can be applied in-home health care, to enhance its usefulness in addressing some of the challenges in the healthcare sector. 

Problem Statement

As aforementioned, various issues affect the healthcare system. If not appropriately addressed, these concerns result in poor health outcomes for the patient, which subsequently result in poor quality of life. The population health needs keep changing, thus emphasizing the need to develop different strategies that will effectively address the constantly changing patient needs. Often, health facilities receive an influx of patients seeking medical attention. Due to such influx, some patients do not receive the adequate healthcare services required (Oleribe et al., 2019). This further translates into poor health outcomes. Additionally, some patients, for instance, the elderly and those battling chronic conditions such as late stages of cancer, are too weak to visit hospitals for follow-ups regularly. 

Some also have immune-compromised states, which requires them to limit their hospital visits. These could expose them to other pathogenic microorganisms present in the hospital setting, which can further have detrimental effects on their health status (Oleribe et al., 2019). Besides, some patients require the comfort of their home and family to enhance their recovery. This is, however, limited in a hospital setting where the number of visitors and the duration of visits are limited. The resulting outcome is that such patients do not achieve the best health outcomes as anticipated since all their needs are not addressed. These are a few limitations of hospital care, and if not appropriately addressed, they can negatively affect the patient's health outcomes. A strategy that is useful in handling such a problem include home health care, where health care services are provided to patients and their families in their places of residence, with the primary aim of promoting, maintaining, minimizing the effects of illness or disability, or to generally restore health for the sick individuals (Fathollahi-Fard et al., 2018). Some of the suitable groups of patients for home health care include; patients with fractures, stroke patients, patients with progressive neurological conditions, patients with a high risk of falls, heart failure, COPD patients, and patients with chronic diseases such as cancers. 

However, such an approach of providing care to patients is also faced with several challenges, which hinder its effectiveness in enhancing better patient health outcomes (Fathollahi-Fard et al., 2018). The biggest challenge is experienced in attracting and retaining talented staff, which are critical in driving such a program to success. As the demand for home care health grows, there is also a direct increase in more caregivers to take care of the various patients. Such a challenge requires appropriate interventions, helpful in addressing it to ensure that such patients maximally benefit from such an initiative (Landers et al., 2016). This paper focuses on applying the PICO (T) framework and evidence from peer-reviewed articles to determine how an intervention aimed at addressing this major issue affecting home health care could impact the health outcome of the patients receiving this form of healthcare delivery. 

The challenges affecting home health care affect anyone receiving such care (Landers et al., 2016). Therefore, the population can be anyone receiving home health care, such as those with chronic health conditions, among other notable groups, as previously mentioned. The primary challenge is inadequate caregivers due to difficulties attracting and retaining talented staff (Landers et al., 2016). This culminates in an inability to deliver these healthcare services to the population as required. Staff shortage, especially in the healthcare sector, is associated with work overloads, which lead to burnout among the nurses that result in frustration and low levels of satisfaction for both the healthcare providers and the patients (Fatemi et al., 2019). Therefore, the intervention developed should aim at addressing the current challenge of inadequate staff to drive this process. 

The intervention that this capstone project focused on how technology can be leveraged to improve the program's efficiency, reduce staff turnover, and attract more skilled care providers to enhance the initiative's success (Landers et al., 2016). This intervention is compared with failing to embrace technology and incorporate it into addressing the challenge experienced in-home health care. The intervention, when successfully incorporated, aims at addressing this major challenge by ensuring that the staff issue is addressed, through attracting and retaining more skilled personnel into the program, or providing alternative ways through which the available care providers can be maximally utilized to ensure that the various needs of the patients are adequately addressed. 

To monitor the progress and effectiveness of the intervention, the study is set to run for 18 months, after which conclusions and further recommendations can be made from the study. With all these factors into consideration, the PICO (T) question is; in patients with chronic conditions and under home health care (P), how does a leverage of technology into the delivery of such services (I) compare to failure to incorporate such technology (C) helps in addressing the staff shortage and ensuring the efficiency of such approach of delivery of healthcare services (O) within 18 months (T)? This discussion highlights various vital elements outlined in various articles supporting the effectiveness of incorporating technology in addressing this issue affecting home health care. 


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Literature Review

Research emphasizes that the population's healthcare needs keep varying, with increasing demands to develop strategies that will be appropriate in addressing the various challenges (Oleribe et al., 2019). Home health care is also an approach in healthcare, although not new, but has undergone a series of transformations to accommodate the population's constantly changing health needs. Currently, many patients, for instance, those with chronic disease conditions such as cancers and diabetes, and other groups of patients as aforementioned, are on home health care, where healthcare providers visit them at their home and deliver appropriate medications and healthcare services (Landers et al., 2016). Despite helping enhance the health outcomes of various groups of patients, home health care has been affected by various conditions that hinder its efficiency and effectiveness. The major challenge affecting home health care is difficulties in attracting and retaining staff, which are critical in the success of such an initiative (Landers et al., 2016). Various other challenges exist, which have also prompted the development of various strategies to address such challenges and facilitate its effectiveness.

Being a significant challenge affecting home health care, various researchers and authors have published articles explaining how the issue of staff shortage can be addressed to enhance the effectiveness of home health care in achieving the diverse health needs of the population. However, the search was limited to only the articles that described how technology helps address this issue. To ensure that the information obtained was reliable and accurate, the sources met specific credibility criteria. Such criteria helped ensure that the information obtained was accurate and dependable in addressing the issue and that the authors had the professional authority to do so. Meeting such criteria is also helpful in avoiding misleading information, which can be more detrimental. 

Technological advancements have facilitated the operations of various sectors, including those of the healthcare sector. Various governments also support their healthcare systems by developing policies that enable operations within this sector. With the current technological revolutions, governments have developed policies that facilitate the incorporation of technology into the delivery of healthcare services to enhance the general population's health status and quality of life. Technology has been continuously applied in the healthcare sector in several ways. However, the main focus for this discussion is on how technology has been applied to enhance the efficiency of home health care by addressing the current major issue affecting this approach of delivery of healthcare services, which is staff shortage. 

Technology can be applied in different ways to address this challenge. This could be through either enhancing the availability of skilled personnel to run the initiative or by providing alternative ways which can be used to facilitate the delivery of these healthcare services efficiently (Liu et al., 2016). Through virtual reality technology, more healthcare providers are trained in even more realistic ways and low-risk environments. Such an initiative increases the availability of skilled medical personnel who can render their services to home health care where the shortage of staff is a significant concern. 

Secondly, electronic visit verification is another way technology can enhance the efficiency of home health care and facilitate the achievement of better patient health outcomes (Landers et al., 2016). This form of technology improves scheduling and confirmation of appointments with care providers, which eliminates incidences of no-show home appointments that hinder the effectiveness of this approach. Additionally, healthcare providers need to be in constant contact with patients on home health care to monitor their progress and advise them appropriately. This, however, becomes difficult, especially when there are inadequate care providers to take care of the increasing number of patients. 

Advancement in technology helps address this issue since there has been the development of various devices and tools that the patients can use to track their well-being (Liu et al., 2016). These include blood pressure measuring devices, glucose levels, and heart monitoring devices, which the patients, after getting educated, can efficiently use to monitor their well-being and progress. This is significant as it reduces the pressure on the available few care providers, given that there is a reduced need to constantly visit the patients to monitor various aspects of their health since they can do this on their own efficiently. 

The other significant way to incorporate technology can help address the issue of staff shortage and, in turn, promote the effectiveness of home health care is through the appropriate application of telehealth. Telehealth is an effective form of technology in healthcare, facilitating constant contact between healthcare providers and patients (Tuckson et al., 2017). This form of technology in healthcare allows the patient and the care providers to use mobile apps and video conferencing to keep in touch, without the need for the patient to be physically present in the health facility or for the healthcare provider to be physically current at the patient's residence (Liu et al., 2016). The healthcare providers can listen to the patient’s concerns, remotely monitor the patient and advise them appropriately on their medications and what is expected of them to achieve better health outcomes. 

This is a more convenient way of delivering care remotely since the healthcare provider does not have to visit the patients in their homes physically. It is, therefore, time-saving, and a single healthcare provider can attend to various patients. Consequently, few healthcare providers are needed to deliver care to the patients when telehealth is used, compared to when such care providers have to visit the patients in their residences physically. The staff shortage can also result in some patients filing to be attended to, thus developing complications or even death. However, this issue is addressed when technology is applied, especially the use of electronic health records. 

This enables the healthcare provider to understand the very critical patients who require immediate attention and attend to them promptly, thus eliminating the risks which could pose a significant threat to their lives (Landers et al., 2016). Home visits by healthcare providers can be halted, especially when some patients are out of their designated location. This could pose a significant threat to their lives, especially when no one knows their whereabouts. Through the use of GPS, healthcare providers and even families can track the location of their patients and even identify emergencies that are also fatal (Megges et al., 2017). Through this, the healthcare providers can determine where to find these patients and attend to them, thereby reducing the inconveniences caused when such a technology is not applied. 

Incorporating technology in healthcare is beneficial, especially in enhancing home health care in situations where there are staff shortage challenges, as outlined above. However, the application of technology in such scenarios also has some barriers, hindering its effectiveness. These include; user unfriendliness, challenges of interoperability, and challenges of asset tracing among the healthcare providers (Landers et al., 2016). These issues can interfere with the effectiveness of technology in enhancing home health care. Therefore, it is essential to develop strategies that will help address these issues to enable the patients to benefit maximally from the application of technology in-home health care, despite the shortage of staff. 

Conclusion

In summary, the healthcare sector is essential in ensuring a healthy nation and a productive economy. The various challenges affecting the healthcare sector require appropriate interventions to minimize the devastating impacts of these challenges on the health outcomes of the population. Home health care is an essential approach in addressing some challenges affecting the healthcare system, such as the influx of patients in hospitals and enhancing patients' health outcomes requiring regular follow-up and close monitoring to achieve better health outcomes. However, home health care can only be efficient and effective if adequate staff ensures that the necessary operations are appropriately done. This, however, remains a significant challenge since the overall health sector globally experiences a shortage of healthcare providers. This, therefore, when left unaddressed, can interfere with the effectiveness of home health care, which will subsequently compromise the health and safety of the groups of individuals who rely on such services. 

This paper focused on how technology can be leveraged to address the issue of staff shortage and enhance the efficiency and effectiveness of home health care in managing the health needs of certain groups of patients. Through support from literature and other sources, evidence suggests that incorporating various forms of technology helps address the issue of staff shortage and subsequently enhances the efficiency of home health care. The article also outlines the various barriers that may hinder the effectiveness of technology in addressing this issue, further emphasizing the need to develop strategies to address those challenges. In general, applying various forms of technology effectively addresses challenges caused by the shortage of staff, thus ensuring that home health care is done efficiently. Multiple stakeholders should collaborate and embrace technology in their health facilities if such facilities still lack a proper way of addressing staff shortages concerning home health care. 

References

Fatemi, N. L., Moonaghi, H. K., & Heydari, A. (2019). Perceived challenges faced by nurses in home health care setting: A qualitative study. International journal of community-based nursing and midwifery, 7(2), 118. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456761/ 

Fathollahi-Fard, A. M., Hajiaghaei-Keshteli, M., & Tavakkoli-Moghaddam, R. (2018). A bi-objective green home health care routing problem. Journal of Cleaner Production, 200, 423-443. https://www.sciencedirect.com/science/article/pii/S0959652618322479?casa_token=_dFjpt-yxm0AAAAA:OiLF_OfOanolj87nqET1AkUh-Dwf-d6ZZvB1sHSfpDa1e5Ug5tiXEaVHIVaYlHbG6kgBEnDnUhzGBw 

Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., ... & Breese, E. (2016). The future of home health care: a strategic framework for optimizing value. Home health care management & practice, 28(4), 262-278. https://journals.sagepub.com/doi/abs/10.1177/1084822316666368 

Liu, L., Stroulia, E., Nikolaidis, I., Miguel-Cruz, A., & Rincon, A. R. (2016). Smart homes and home health monitoring technologies for older adults: A systematic review. International journal of medical informatics, 91, 44-59. https://www.sciencedirect.com/science/article/pii/S1386505616300648 

Megges, H., Freiesleben, S. D., Jankowski, N., Haas, B., & Peters, O. (2017). Technology for home dementia care: A prototype locating system put to the test. Alzheimer's & Dementia: Translational Research & Clinical Interventions, 3(3), 332-338. https://www.sciencedirect.com/science/article/pii/S2352873717300306 

Oleribe, O. O., Momoh, J., Uzochukwu, B. S., Mbofana, F., Adebiyi, A., Barbera, T., ... & Taylor-Robinson, S. D. (2019). Identifying key challenges facing healthcare systems in Africa and potential solutions. International journal of general medicine, 12, 395. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6844097/ 

Tuckson, R. V., Edmunds, M., & Hodgkins, M. L. (2017). Telehealth. New England Journal of Medicine, 377(16), 1585-1592. https://www.nejm.org/doi/full/10.1056/nejmsr1503323 

Ward‐Peterson, M., & Wagner, E. F. (2020). Health Disparities. The Wiley Encyclopedia of Health Psychology, 51-59. https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119057840.ch188