NURS-FPX6218 Guiding Questions for Assessment 3 Planning for Community and Organizational Change
Guiding Questions for Assessment 3
Planning for Community and Organizational Change
This document is designed to give you questions to consider and additional guidance to help you successfully complete the Planning for Community and Organizational Change assignment. You may find it useful to use this document as a pre-writing exercise, an outlining tool, or as a final check to ensure that you have sufficiently addressed all the grading criteria for this assignment. This document is a resource to help you complete the assignment. Do not turn in this document as your assignment submission.
Change Proposal
Draft a change proposal to justify your recommendation for improving the health of the community and establish the change as a priority for the next budget cycle.
Identify the benefits of proposed health care system changes and its implications for a community.
What are the direct benefits of your proposed changes?
How will improvements in overall health affect the community?
What evidence supports your claims?
What is the possibility that stakeholders jump to conclusions that are unfounded, given the nature and scope of the change? How would you avoid this risk?
Describe potential barriers to change in an organization or community.
Why do people resist change?
What factors in the organization and community create or contribute to resistance?
What evidence do you have to support your claims?
Develop strategies for changing barriers into opportunities and resolving conflict.
What are the drivers of change in organizations and communities?
What is your vision for change?
What are the expected outcomes and timeline?
How will you communicate with stakeholders and overcome resistance?
How will you resolve conflict among competing interests?
Develop a strategy for helping organizational stakeholders understand and evaluate the proposed changes to an existing health care system.
Who are the key stakeholders in the organization?
What influence do they have on your proposal?
How will your proposed changes affect the organization?
What data and information will you provide to decision makers?
Develop a grant proposal and associated budget for a proposed change to an existing health care system.
Be specific and thorough in identifying budgetary requirements.
Consider how you can present a compelling argument to the funding authority.
Write clearly and concisely in a logically coherent and appropriate form and style.
Write with a specific purpose and audience in mind.
Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
Support assertions, arguments, propositions, and conclusions with relevant and credible evidence.
Integrate relevant and credible evidence from 3–5 peer-reviewed journals or professional industry publications.
Is your supporting evidence clear and explicit?
How or why does particular evidence support a claim?
Will your reader see the connection?
Did you summarize, paraphrase, and quote your sources appropriately?
Submission Reminders
Have you identified the benefits of proposed health care system changes and the implications for the community? Have you provided supporting evidence?
Have you described potential barriers to change in the organization or community and provided supporting evidence?
Have you developed sound strategies for changing barriers into opportunities and resolving conflict?
Is your plan for helping organizational stakeholders understand and evaluate proposed changes to the existing health care system complete?
Is your proposal well-supported by 3–5 sources of relevant and credible evidence?
Is your proposal properly formatted and 3–5 pages in length, not including the title page and references page?
Did you proofread your writing?
NURS-FPX6218 Guiding Questions for Assessment 3 Planning for Community and Organizational Change
**Change Proposal**
**Executive Summary:**
The proposed change aims to implement a community-based mental health program targeting underserved populations in the local area. This program will focus on increasing access to mental health services, improving mental health outcomes, and reducing disparities in care. By integrating evidence-based interventions and leveraging community resources, this initiative seeks to address the growing mental health needs of the community.
**Identification of Benefits:**
– **Direct Benefits:**
– Increased access to mental health services for underserved populations.
– Improved mental health outcomes, including reduced symptoms and improved functioning.
– Enhanced coordination of care between healthcare providers and community organizations.
– Decreased stigma associated with seeking mental health treatment.
– **Impact on the Community:**
– Improved overall community well-being and quality of life.
– Reduced burden on emergency services and healthcare facilities due to proactive mental health management.
– Enhanced social cohesion and support networks within the community.
– **Supporting Evidence:**
– Epidemiological data highlighting the prevalence of mental health disorders in the community.
– Research studies demonstrating the effectiveness of community-based mental health interventions.
– Testimonials and case studies from individuals who have benefited from similar programs in other communities.
– **Mitigating Unfounded Conclusions:**
– Conducting thorough needs assessments and stakeholder consultations to ensure alignment with community needs and priorities.
– Providing clear and transparent communication about the goals, objectives, and expected outcomes of the program.
– Engaging stakeholders in the planning and implementation process to address concerns and misconceptions.
**Barriers to Change:**
– **Resistance to Change:**
– Fear of the unknown or perceived loss of control.
– Lack of awareness or understanding of the benefits of mental health services.
– Stigma and cultural beliefs surrounding mental illness.
– **Organizational and Community Factors:**
– Limited funding and resources for mental health programs.
– Fragmented healthcare delivery systems and coordination challenges.
– Socioeconomic disparities and access barriers for marginalized populations.
– **Supporting Evidence:**
– Psychological theories of resistance to change, such as loss aversion and status quo bias.
– Community surveys and focus groups highlighting misconceptions and attitudes towards mental health.
– Organizational assessments identifying structural barriers and resource constraints.
**Strategies for Overcoming Barriers:**
– **Drivers of Change:**
– Building a coalition of stakeholders and champions to advocate for mental health initiatives.
– Aligning the program with broader community health goals and strategic priorities.
– Leveraging existing partnerships and collaborations with community organizations and service providers.
– **Vision for Change:**
– Creating a comprehensive and integrated mental health system that addresses the continuum of care.
– Fostering a culture of mental health awareness and destigmatization within the community.
– Establishing sustainable funding mechanisms and resource allocation strategies.
– **Expected Outcomes and Timeline:**
– Increased utilization of mental health services by target populations within the first year of implementation.
– Reduction in mental health disparities and improved outcomes among program participants within three years.
– Long-term sustainability and scalability of the program beyond the initial funding cycle.
– **Communication and Conflict Resolution:**
– Engaging in proactive and transparent communication with stakeholders through regular meetings, newsletters, and community forums.
– Addressing concerns and conflicts through active listening, mediation, and compromise.
– Establishing mechanisms for feedback and evaluation to continuously improve the program and address emerging challenges.
**Strategy for Stakeholder Engagement:**
– **Key Stakeholders:**
– Local healthcare providers, community organizations, government agencies, schools, faith-based groups, and advocacy organizations.
– Patients, families, caregivers, and individuals with lived experience of mental illness.
– **Influence on Proposal:**
– Stakeholders will provide input and feedback on program design, implementation strategies, and evaluation metrics.
– Their support and endorsement are essential for securing funding and resources, as well as mobilizing community support.
– **Impact on Organization:**
– The proposed changes will require collaboration and coordination across multiple sectors and organizations.
– Integration with existing systems and workflows will be critical to ensure seamless delivery of services and optimal patient outcomes.
– **Data and Information:**
– Providing stakeholders with data on the prevalence and impact of mental illness in the community.
– Sharing success stories and best practices from similar programs in other communities.
– Presenting evidence-based research and evaluation findings to demonstrate the effectiveness and cost-effectiveness of the proposed interventions.
**Grant Proposal and Budget:**
– **Budgetary Requirements:**
– Personnel costs for hiring mental health professionals, community health workers, and support staff.
– Training and capacity-building activities for healthcare providers and community partners.
– Technology infrastructure and telehealth equipment for remote service delivery.
– Program evaluation and quality improvement initiatives.
– **Compelling Argument:**
– Emphasizing the high prevalence and significant burden of mental illness on individuals, families, and society.
– Highlighting the cost-effectiveness and return on investment of preventive mental health interventions.
– Demonstrating the potential for long-term savings and improved health outcomes through early intervention and community-based care.
**Conclusion:**
The proposed change represents a proactive and evidence-based approach to addressing the mental health needs of the community. By implementing a comprehensive and integrated mental health program, we can improve access to care, reduce disparities, and promote overall well-being. Through collaboration, innovation, and stakeholder engagement, we can create a healthier and more resilient community for generations to come.
Title of Paper
Note: Delete this note and all instructions from the template before submitting your proposal. Use headings to organize your text, rather than bullets.
Summary
Benefits and Implications
Identify the benefits of proposed health care system changes and its implications for a community.
Consider the goals and potential outcomes of the proposed changes.
What are the direct benefits of your proposed changes?
How will improvements in overall health affect the community?
Potential Barriers to Change
Describe potential barriers to change in an organization or community.
What factors in an organization and community create or contribute to resistance to changes?
What other factors can create barriers to change?
Articulate strategies for changing barriers into opportunities and resolving conflict.
What are the drivers of change in organizations and communities?
How will you communicate with stakeholders and overcome resistance?
How will you resolve conflict among competing interests?
Stakeholder Communications
Articulate a strategy for helping organizational stakeholders understand and evaluate proposed changes to the existing health care system.
Who are the key stakeholders in the organization?
What influence do they have on your proposal?
Consider the effects of these changes on the organization and the specific information needs of decision makers.
References
List your APA-formatted references here.
Appendix A: Grant Proposal
Need Statement
Define the problem that this change is addressing.
Describe the scope of the problem.
Who is affected? How will you describe this population?
How many people does this problem affect?
Identify the barriers you are likely to encounter when implementing this change?
Identify the sources of information you used to define the need for change.
Identify any other change initiatives or studies that are addressing this problem.
Program Description
Describe the proposed change initiative and how you plan to implement it. Address the basic questions of who, what, when, where, why, and how.
Goals and Objectives
Describe the goals and objectives of the change initiative.
Program Evaluation
Explain how this change initiative will be evaluated.
Who will have oversight responsibilities?
How and how often, will this initiative be evaluated?
Who is the recipient of the evaluation reports?
What is the extent of stakeholder involvement in evaluation?
Summary
Explain why this change is important to the community.
Explain how the goals and objectives of this change initiative align with those of the funding organization and why their financial support is vital to the success of this initiative.
Be sure to thank the funding agency for considering and supporting this initiative.
Appendix B: Project Budget
Table directions:
Add table rows, as needed, for each budget category.
Enter the information (startup, first-year budget figures, other sources of revenue, and justification) for each budget category line item in columns 2–5.
Categories
Startup
1st Year
Other Sources
of Revenue
Justification
Salary and Wages
· Project Manager
· Support Staff
· Other
·
·
Fringe Benefits
·
·
·
Consultation or Contract Services
·
·
·
Equipment
·
·
·
Materials
·
·
·
Travel
·
·
·
Miscellaneous or Other
·
·
·
Total Expenses
Proposing Evidence-based Change
Executive Summary
Proposed Change
Opioid prescription for pain management is responsible for an estimated eighty-five percent of the cases of misuse and overdose in the United States. A study by Pierce et al. (2021) found that the 15 per 100,000 population per year opioid-related death rate in 2018 was due to the influence of the inclusion of pain as one of the core vital signs for chronic disease on the increased rate of misleading marketing of its benefits by drugs companies and changes to the prescribing laws for opioid medications. While several legislative actions were taken to tackle the opioid epidemic since 2016, mortality rates have remained unchanged due to the lack of a comprehensive policy on opioid prescriptions. This proposal aims to implement an opioid harm reduction program that curtails opioids prescription and establishes supervised drug consumption centers across the United States. Therefore, the restriction on access to opioid medications and availability of treatment centers would reduce the high mortality rates from illicit use and overdose and other associated burden on the healthcare system.
Desired Outcomes
The expected outcome from this program is the reduction of opioid-related mortality rates from drug misuse across the United States. Aside from this main goal of the program, it is projected that it would strengthen efforts to restrict opioid prescription by increasing the number of states with restrictive prescribing laws from 15 to 52. Also, another desired outcome is increased adoption of the Center for Disease Prevention and Control’s(CDC) guidelines for alternative pain treatment methods. The outcome is the implementation of the Prescription Drug Monitoring Program (PDMP) in the United States to strengthen the prohibition against unnecessary prescriptions that lead to opioid abuse, overdose, and death (Meisenberg, Grover, Campbell, & Korpon, 2018). In summary, the proposed changes to the harm reduction strategies of the United States should prevent indiscriminate opioid prescriptions, misuse, and deaths, and increase treatment and rehabilitation of substance use disorder patients.
Comparison of Health Care System
Germany and United Kingdom have similar opioid consumption rates, demographics, and economic systems as the United States which is useful for comparing the issues regarding the opioid epidemic and strategies to address them. In this regard, the consumption rates would be used to evaluate the overdose and opioid-related death rates for these countries before justifying the harm reduction strategies that are used by their public health system to achieve the outcomes. Hence, these countries provide evidence of the best practices for addressing the opioid epidemic in the United States.
Opioid prescription for non-cancer pain treatment in Germany is the second-highest in the world. According to Pierce et al. (2021), 29,000 daily doses per 1,000,000 inhabitants were prescribed in 2018 despite the existence of tight restrictions on opioid prescription for non-cancer pain and guidelines on the indications and contraindications for the medication. While Germany’s opioid prescription rate is close to the 40,000 daily doses per 1,000,000 inhabitants in the United States, its 166,300 opioid addiction rate is lower than the 2.1million full addiction cases that were recorded in the United States in 2016 (Rosner, Neicun, Yang, & Roman-Urrestarazu, 2019). Similarly, studies show that despite the high opioid addiction rate in Germany, the 21 per million mortality rate from opioid overdose was much lower than the 198 per million that was recorded in the United States in 2016 (Pierce et al., 2021). Aside from the influence of the restrictions on opioid prescription on the lower addiction and opioid-related death rates in Germany, alternative treatments for chronic non-cancer pain are covered by the universal health insurance system. Also, the nation’s harm reduction strategy is effective because it includes free treatment services for addicted persons, behavioral counseling, and the establishment of safe-injection sites which are unavailable and controversial in the United States.
Furthermore, the United Kingdom provides another piece of evidence on the positive impacts of harm-reduction strategies on efforts to lower opioid addiction and mortality rates. According to Pierce et al. (2021), consumption of prescription opioids in the United Kingdom is higher than in the United States because its daily dose of 58,088 per 1,000,000 inhabitants in 2018 was higher. The analysis of the factors that contributed to the lower addiction and opioid-related death rates in the United Kingdom highlighted the critical role of rescribing laws and the universal healthcare system in restricting access and providing treatment for addicts. While the country does not use safe-injection sites as part of its harm reduction strategies like its German counterpart, it has a strong regulatory system and promotes the use of alternatives and mental health interventions for long-term pain management (Suda et al., 2019). As a result of these harm-reduction practices, the country has reduced its consumption rates from the 2018 value and prevented misuse and abuse from leading to high mortality rates.
In summary, these two countries provide the framework that the United States can use to prevent the change in the unnecessary use of opioid prescriptions in the country. Also, their interventions are effective in preventing the diversion to other illicit forms of opioid medications that can result in the same challenges for the public health system. Therefore, the proposed harm-reduction program for the United States is supported by evidence from the literature that justifies its adoption.
The rationale for the Proposed Change
Multiple studies support the use of harm-reduction programs that include access to treatment, regulated prescriptions, alternative methods for pain management, and safe injection sites to reduce opioid misuse and deaths. Meyer, LeClair, and McDonald (2020) found that the strong regulatory oversight over opioid prescriptions in Germany and the United Kingdom and the promotion of nonsteroidal anti-inflammatory drugs (NSAIDs) for chronic non-cancer pain management helped them to avoid the American opioid crisis. For example, national formularies restrict UK dentists from prescribing a high potent opioid for postoperative pain management. Similarly, the importance of lowering the misuse and overdose of opioid medications during medical to the quality of life and care provided by the US public health means that mental health interventions should be integrated as part of initial pain treatment. As the outcome of the study by Zgierska et al. (2018) revealed, cognitive-behavior therapy is an effective pain management intervention that can reduce opioid prescription by half without increasing the cost of service delivery. Finally, the safe-injection sites are considered an effective strategy for tackling opioid addiction and reducing the role of unsafe needle use in infectious disease transmission. Overall, the proposed changes to the strategies for managing the opioid epidemic in the United States are justified by evidence from different parts of the world on its positive impacts on the population.
Financial and Health Implications
The potential to minimize the adverse economic and public health consequences of the opioid epidemic are the underlying financial and health implications for the proposed changes. First, the reduction in the prevalence and incidence of opioid misuse and overdose-related deaths would save the US public health system the estimated $70 billion annual cost of treatment, crime prevention, and loss of productivity due to the problem (Meisenberg et al., 2018). Second, the long-term financial impact of the savings from the reduction of the economic burden of the opioid crisis in the United States would occur in other aspects of society. Third, the increased utilization of the PDMPs to restrict unnecessary opioid prescriptions would have huge implications for the public health system as providers can use the database to screen patients for opioid addiction and recommend alternative methods of treatment without subjecting their practice to medical malpractice lawsuits. Similarly, PDMP would strengthen other harm reduction strategies such as the treatment of opioid addicts and the prevention of overdose-related deaths. Finally, the population health implications include the elimination of the physical and psychological distress from the addiction and the prevention of other chronic diseases such as kidney and liver failure. Therefore, the proposed changes to the prescribing practices for opioid medications in the United States have a positive impact on the nation’s finances, population, and socioeconomic system.
Conclusion
The opioid epidemic remained one of the leading causes of untimely deaths, lost productivity, and high healthcare expenditure in the United States. While the problem is severe and it can be prevented through harm reduction programs that strengthen the regulatory oversight of overprescribing practices of healthcare providers. Also, the focus on increased access to free addiction treatment services, use of alternatives such as NSAIDS, mental health interventions for chronic pain, and safe injection sites would reduce the curb the current rate of misuse and overdose-related death drastically. Finally, these proposed changes to the opioid management practices of the country are supported by evidence from other developed nations with similar pain intolerance levels.
References
Meisenberg, B. R., Grover, J., Campbell, C., & Korpon, D. (2018). Assessment of opioid prescribing practices before and after implementation of a health system intervention to reduce opioid overprescribing. JAMA network open, 1(5), e182908-e182908. doi:10.1001/jamanetworkopen.2018.2908
Meyer, A., LeClair, C., & McDonald, J. V. (2020). Prescription opioid prescribing in Western Europe and the United States. Rhode Island Medical Journal, 103(2), 45-48. http://www.rimed.org/rimedicaljournal/2020/03/2020-03-45-contribution-meyer.pdf
Pierce, M., van Amsterdam, J., Kalkman, G. A., Schellekens, A., & van den Brink, W. (2021). Is Europe facing an opioid crisis like the United States? An analysis of opioid use and related adverse effects in 19 European countries between 2010 and 2018. European Psychiatry, 64(1), e47, 1-18. https://doi.org/10.1192/j.eurpsy.2021.2219
Rosner, B., Neicun, J., Yang, J. C., & Roman-Urrestarazu, A. (2019). Opioid prescription patterns in Germany and the global opioid epidemic: systematic review of available evidence. PLoS One, 14(8), e0221153. https://doi.org/10.1371/journal.pone.0221153
Suda, K. J., Durkin, M. J., Calip, G. S., Gellad, W. F., Kim, H., Lockhart, P. B., … & Thornhill, M. H. (2019). Comparison of opioid prescribing by dentists in the United States and England. JAMA Network Open, 2(5), e194303-e194303. doi:10.1001/jamanetworkopen.2019.4303
Zgierska, A. E., Vidaver, R. M., Smith, P., Ales, M. W., Nisbet, K., Boss, D., … & Hahn, D. L. (2018). Enhancing system-wide implementation of opioid prescribing guidelines in primary care: Protocol for a stepped-wedge quality improvement project. BMC Health Services Research, 18(1), 1-8. https://doi.org/10.1186/s12913-018-3227-2
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