Speech Presentation: Remote Collaboration and Evidence-Based Care
Hello, My name is _ and today I want us to talk about collaboration and the use of evidence-based care in remote areas. Remote areas are often faced with challenges that hinder access and delivery of healthcare services including poor funding by the government, lack of skilled personnel, and issues with accessing healthcare facilities. Challenges such as lack of enough education, shortage of healthcare providers, social stigma, lack of health insurance, and transportation issues require evidence-based interventions to ensure rural communities get the best care possible. As explained by Rojas et al (2018), collaborative care involves the working together of primary care teams and coordination with managers and specialists to reduce healthcare costs while improving quality care. In this video, I will discuss collaborative care and the use of evidence-based practices to realize better patient outcomes for Caitlynn, a pediatric patient diagnosed with cystic fibrosis.
Caitlynn is a two-year-old patient admitted to the facility for pneumonia following complaints of breathing difficulties. Her past medical history reveals that this is her second admission with the same problem and she had a meconium ileus at birth. Further examination revealed decreased breath sounds, scattered Ronchi in the upper lobes, and an elevated temp of 101°F. Detailed examination revealed that she had decreased subcutaneous tissue in her extremities and her sweat chloride tests were high. Eventually, a diagnosis of cystic fibrosis was made and the patient started on treatment.
Caitlynn stays with her parents in McHenry which is an hour away from Valley city. As the healthcare providers debate about the treatment of the patient, it is realized that day-to-day treatment will be a challenge due to the distance and complications that might arise during the long drives. Rebecca Helgo, her respiratory specialist states “I am concerned about her day-to-day treatment, though. She’ll be back here with pneumonia if the parents can’t stay on top of that.” Because of this challenge, the healthcare providers decide to use an educational approach before discharge and Skype consult to maintain care delivery at the patient’s comfort. Additionally, the pediatrician at Valley city proposes the use of telemedicine for consults in case complications arise at home. During routine communication, the healthcare providers use emails, phone calls, and Skype to monitor the progress of the patient.
Evidence-based Practice model
From the above scenario, an evidence-based practice model was used to help develop the care plan for Caitlynn. Olade (2004) defines the evidence-based practice as a process that uses well-researched interventions with clinical experience and ethics, and client preferences and culture to guide and inform the delivery of treatments and services. The above case scenario demonstrates the use of the Tyler collaborative Model which acknowledges the role of collaborative care in improving patient outcomes. The Tyler model allows for a step-by-step change process that presents providers with an opportunity to integrate previously available methods of critical appraisal to determine the best evidence for practice (olade, 2004).
The first step of using evidence-based practice involves breaking the ice. A healthcare problem must be identified and the forces that affect change should be determined during this step. The second approach involves the building of collaborative relationships among healthcare teams to appropriately diagnose problems. Following the diagnosis, the collaborative teams should identify areas to implement and acquire resources for the process. The collaborative process should then involve other nursing teams to identify solutions for the identified problem. Other activities using this model involve a review of literature, conducting pilot studies, and evaluation of results.
The above case scenario demonstrates the use of Tyler’s evidence-based practice model fr collaborative care. Firstly, Dr.Copeland and Virginia Anderson work together to identify the health problems faced by the patient. The two then collaborate with Rebecca Helgon the respiratory therapist to help identify gaps in continuing patient care upon discharge from the facility. Through collaborative practice, it is realized that Caitlynn will be receiving treatment from home due to the long distance to the facility. Further consultation with Caitlynn’s pediatrician reveals that telemedicine will be the most appropriate way to provide care to the patient. Later we observe that the healthcare team guides the mother in providing chest physiotherapy through Skype and checking for signs of respiratory distress.
Most Relevant and Useful Evidence
The most relevant and useful evidence observed in this case scenario involves the use of telemedicine to coordinate care. Telehealth connects rural providers and their patients to services at a distant site. Evidently, telehealth functions to ensure healthcare services are available to rural communities given the shortage of medical specialties. Using telehealth, the primary care provider can be able to leverage telecommunication technologies to connect the patient with specialists instead of traveling to the facility. The Centers for Disease Control and Prevention (CDC) (2020) support the use of telehealth today because it promotes patient-centered care. The technology allows patients and families to take part in designing the type of healthcare required by the patient. In the above case scenario, the healthcare providers used strategies such as phone calls, video calls (Skype), and the internet through email to communicate patient care. These communication approaches were used in this scenario because of the long distance between the patient’s home and the healthcare facility. Additionally, telehealth was the best option for the nurse, pediatrician, and social worker to communicate while providing care to Caitlynn from different locations
Benefits and Strategies
The last part I want to focus on is the benefits and strategies to mitigate the challenges of interdisciplinary collaboration. The first benefit of interdisciplinary collaboration is that t improves patient care and outcomes. Rojas et al (2018) explain that collaborative practice reduces medical errors, improves staff relationships, and reduces inefficiencies in healthcare. Collaboration displayed in the above scenario helped the patient to lower costs of treatment and she was able to receive ongoing and consistent care in the physical absence of the medical providers. Strategies that can be used to mitigate challenges of interprofessional collaboration include the use of EHRs that are compatible to record and monitor patient data from different locations. Secondly, healthcare facilities should consider the availability of free internet to promote communication using Skype and other video recording platforms.
Centers for Disease Control and Prevention. (2020) Preventing chronic disease: The influence of telehealth for better health across communities. https://www.cdc.gov/pcd/issues/2020/20_0254.htm
Olade, R. A. (2004). Strategic collaborative model for evidence‐based nursing practice. Worldviews on Evidence‐Based Nursing, 1(1), 60-68. https://doi.org/10.1111/j.1741-6787.2004.04003.x
Rojas, G., Guajardo, V., Martínez, P., Castro, A., Fritsch, R., Moessner, M., & Bauer, S. (2018). A Remote Collaborative Care Program for Patients with Depression Living in Rural Areas: Open-Label Trial. Journal of Medical Internet Research, 20(4), e158. https://doi.org/10.2196/jmir.8803
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