NURS FPX 4900 Assessment 3 Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations

Care Coordination and Utilization of Community Resources

Numerous community-based programs that use characteristics in line with the Chronic Care Model have achieved and demonstrated usefulness in enhancing outcomes specific to diabetes. The previous study shows that the care coordination model and clinical management processes are components of the Chronic Care Model (Tauschmann & Hovorka, 2018). These approaches’ crucial elements include patient self-management, the advanced drug delivery system, care coordination which includes information systems and decision support, and community resources. Self-management education is one of the core tenets of the Chronic Care Model and is linked to better clinical outcomes for people with diabetes, including reduced self-reported weight, a better quality of life, healthy coping, and lower expenses. It also improves knowledge and self-care behavior (De Groot et al., 2020).

The American Diabetes Association’s recommendations for providing the fundamental standards of care for diabetic patients. It is a great way for patients to get in touch with community resources and would be through diabetes support. The main objective of the ADA is to reduce costs for the healthcare organization and the patient while enhancing patient health outcomes. It also helps to maximize nursing personnel usage in a way that lessens duplication and improves overall organizational efficiency (Wherry et al., 2021). Several great methods have been developed and evaluated that show promise in preventing diabetes or lowering readmission rates in patients with diabetes who are hospitalized. To deliver the programs, these procedures frequently used intense interventions carried out by highly qualified nurses, dietitians, and psychologists. It is appropriate to find strategies for adapting and effectively providing interventions in patient-centered, community-based formats in the era of cost containment in the delivery of health care services. The ADA also helps professional practice in healthcare management. These are meant to guide physicians and patients based on evidence or expert opinion (De Groot et al., 2020).

System-level reorganizations have been started by organizational experts in the healthcare industry to enhance the coordination of diabetes treatment. To set patient-centered goals, track patient progress, and spot treatment gaps, clinical decision support, and electronic medical data are used. Transparent communication with patients put a positive influence on care coordination. My patient Anne also can get help from ADA to manage her diabetes treatment costs (Saeedi et al., 2019). 

Barriers 

Lack of patient trust, poor understanding of the care coordinator’s responsibilities, and reluctance to take leadership of patients’ chronic disease treatment have a bad impact on care coordination. Numerous barriers frequently prohibit needy families and children from receiving community support. Many people, those who are minorities or come from low-income families, in particular, hold the stigmatized belief that seeking public assistance will result in persecution or criticism, or that using community resources diminishes their worth (Wherry et al., 2021).