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Introduction
Team-based approaches to health care are central to quality improvement and cost reduction initiatives in the medical field. A well-coordinated group of specialists can quickly and comprehensively respond to surfacing issues and provide a high degree of comfort to the patient through the combination of various specialties and viewpoints. This essay submits an example of the improvements offered by the approach by investigating a hypothetical case and analyzing a team-based treatment strategy.
Case Description
The situation surrounds the case of Mrs. Brown, a 93 years old white woman who has dementia. The primary adverse effect of the condition is memory loss, but the patient is also experiencing the physical symptoms of the disease, such as incontinence issues and weakness in her arms and legs. Mrs. Browns family has decided to move her to an institutional facility where she would receive a higher standard of care than she does at home.
Health Care Delivery Team
The patients issues lie in multiple areas, and an optimal treatment strategy involves addressing them all to the best of the institutions ability. Hughes, Lepore, Wiener, and Gould (2017) suggest the collaboration of an advanced practice nurse with an interdisciplinary care team as a viable approach to dementia care. Since most information about the patients condition is already known from prior examinations, the team does not require a full assortment of specialists that would be present in a hospital. Nevertheless, the quality and cost of care will improve if a group of professionals handles the case.
A nurse, an advanced practice nurse, if possible, should lead the team and administer most of the care procedures to the patient. Ayyoub (2015) suggests the participation of a variety of other medical workers, such as geriatric specialists, physiotherapists, speech pathologists, and occupational therapists. The help of a physiotherapist is particularly relevant in the current situation due to the patients movement issues. On the other hand, dementia-related memory loss is not reversible, and the team can only monitor the progress of the symptom, with the speech pathologists and occupational therapists observing the patients condition and suggesting appropriate treatments when necessary.
Indicators and Determinants of Health
Dementia has numerous variations and symptoms and can express itself significantly differently in various cases. According to Ayyoub (2015), the majority of dementia cases are classified as Alzheimers disease, and vascular dementia is the second most common type. Furthermore, there are sub-classifications within the broader descriptions of the condition, such as mild vascular cognitive impairment and multi-infarct dementia.
Nevertheless, most varieties of the illness have similar symptoms, even if the specific causes for their appearance differ. These signs can be divided into three categories: behavioral, mental, and physical, although specific displays of the symptoms may overlap into multiple types at once.
Behavioral signs manifest themselves as adverse changes in a persons day-to-day activities. According to Ayyoub (2015), they include confusion, speech issues, reduced emotional stability, and difficulty in performing formerly familiar operations. Mental problems adversely affect the brains faculties, such as memory, perception, thought, and navigation ability. Lastly, physical symptoms include tremors, general weakness in arms and legs, balance issues, and incontinence. Although not all of these issues may manifest at once or at all, the care team should monitor their appearance and prevalence to address arising concerns before they significantly reduce the patients well-being.
Management and Line Staff Influence
Management of significant numbers of patients with dementia in long-term care institutions is a prevalent issue that primarily concerns the available line staff. According to Midtbust, Alnes, Gjengedal, and Lykkeslet (2018), the numbers and needs of patients are higher than the staffs capability to administer care. Care institutions often hire temporary staff to fulfill the needs of the residents, which raises concerns over the competence and continuity of care.
However, a team-based approach may help alleviate the issues, particularly those that surround the temporary workers ability to administer care. A team that supports the nurse with relevant guidelines and advice should significantly enhance the quality of work even for less experienced caregivers. Furthermore, a group can examine multiple patients in a short time frame, and provide each worker responsible for the individual treatments a set of suggestions and instructions, improving overall care quality without incurring prohibitive costs.
Financial and Resource Analysis
While a team-based approach would significantly improve the health outcomes in long-term care institutions, particularly for patients with dementia, it may not be as effective at reducing the costs of the treatment for the patient and their family. Wohler and Liaw (2016) note that the implementation of a team-based approach will require the hiring of more primary staff members, which results in higher expenses for both the medical institutions and the patients. However, they also propose multiple potential payment models that would reduce the financial burden on individual families and their insurance providers by sharing the payments with accountable care organizations or the community as a whole.
The implementation of the policy will also require significant investments for the government and the health industry. However, Wohler and Liaw (2016) claim that the finished model would provide improved care at a reduced cost due to the use of less expensive providers without significant loss of quality. The ability to utilize a teams expertise for multiple patients will allow for quicker and less resource-intensive examinations than the use of separate entities, such as hospitals, to assess the patients condition while providing a higher standard of quality than a single general practitioner, such as a nurse.
Team-Based Approach Advantages
A team-based approach has numerous advantages from a leadership viewpoint. The primary benefit is the improved quality of care when compared to the traditional method, where a single caregiver is responsible for a patient. Team members can provide deeper insights into the particulars of a persons condition, discuss the situation, which allows them to spot potential errors and correct them. Furthermore, the division of duties within a team leads to improved productivity as a whole, allowing for faster examinations and care dispensations. Overall, group-based care approaches lead to improvements in most areas of treatment, including speed and quality.
Conclusion
The treatment of dementia has many aspects, as the condition is incurable, may be caused by a variety of factors, and has numerous possible symptoms. A team that consists of professionals such as physiotherapists, speech pathologists, and geriatric specialists would enhance the quality of care for patients while improving the availability and speed of delivery. The implementation of the concept would require a significant initial amount of resources, but the complete model would likely reduce the costs of care for both the patients family or insurance company and the medical institution. It is also preferable to the current model from a leadership perspective.
References
Ayyoub, H. N. (2015). Team assessment and planning of care: Vascular dementia. Middle East Journal of Age and Ageing, 12(2), 18-25.
Hughes, S., Lepore, M. M., Wiener, J. M., & Gould, E. (2017). Research on care coordination for people with dementia and family caregivers.
Midtbust, M. H., Alnes, R. E., Gjengedal, E., & Lykkeslet, E. (2018). Perceived barriers and facilitators in providing palliative care for people with severe dementia: The healthcare professionals experiences. BMC Health Services Research, 18.
Wohler, D. M., & Liaw, W. (2016). Team-based primary care: Opportunities and challenges.
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