What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?

The advocate is also responsible for liaison between parents and the service providers. They are responsible for ensuring that there is a good relationship between the caregivers and the parents because sometimes it is easier for the two set of individuals to fall into a blame game whenever something is not right. Therefore, it is the advocate’s role to ensure that the disappointments and bureaucracies involved in the program does not impede the relationship between the program managers, caregivers and parents. They are the program’s vision keepers and are responsible for advocating for meeting the kid’s needs regardless of the bureaucracies involved. 

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• What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?

Community health nurses’ role in implementing the program spans from protecting, promoting and preserving the children’s health. As per Barbero et al (2021), their roles are based on various fundamental principles including educating patients on making healthy choices and maintaining healthy lifestyles and providing direct care.  the nurses primarily focus on delivering the children’s health needs. They coordinate with physicians and other health workers to ensure the children receive care that is equally as good as what they would receive in the hospital.

When they make home visits, they assess the children’s health conditions, deliver wound care, check vital signs (e.g. blood pressure) and manage prescription medicine when a child needs it. Furthermore, they are responsible for educating families and other community members on maintaining the children’s health and wellbeing (Assefa et al, 2019). Nurses also act as the gatekeepers for the children’s rights and protection, primarily protecting them from child abuse, sexual harassment, poor nutrition and teen pregnancy. 

These roles are different from their program design roles in many senses. For instance, their program design roles involve identifying when to visit each home and how long they should take in each home. Contrastingly, the implementation role involves determining what they do in every visit, including conducting medical checks on the patients.  In short, program design mainly entails the where, how and when the services are delivered, while program implementation roles entail what services are delivered and by who.

• Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

Medicaid senior leaders are important in the implementation process because they must communicate with the service providers about the program’s success and areas of improvement. According to Schwartz et al (2018), keeping the Medicaid senior leadership will help manage expectations and enhance the leader’s support. Other state agencies may also be important in the implementation process. This is especially for the purpose of gaining feedback and identifying any potential partnership benefits between the care management team and the program (Assefa et al, 2019). For example, the state’s Department of Health Disability Program   might need to partner with the program managers in exploring other opportunities for enhancing the program.

The providers should also be involved in the implementation stage to ensure they buy in the idea. This can be done by forming provider advisory groups or board that provide feedback on the program strategies, guidelines and measures (Barbero et al, 2021). They may also help in developing quality improvement goals based on reported performance. 

References

Assefa, Y., Gelaw, Y. A., Hill, P. S., Taye, B. W., & Van Damme, W. (2019). Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services. Globalization and Health, 15(1), 1-11. https://link.springer.com/article/10.1186/s12992-019-0470-1