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Advocating for Lasting Change Scoring Guide CRITERIA NONPERFORMANCE BASIC PROFICIENT DISTINGUISHED Explain why proposed changes to a health care system require policy and financial support to ensure positive, systemic change and to overcome present challenges. Does not explain why proposed changes to a health care system require policy and financial support to ensure positive, systemic change and to overcome present challenges. Describes required policy and financial support for proposed changes but provides little or no justification for policy change or its positive impact on the existing health care system. Explains why proposed changes to a health care system require policy and financial support to ensure positive, systemic change and to overcome present challenges. Explains why proposed changes to a health care system require policy and financial support to ensure positive, systemic change and to overcome present challenges. Makes a well-argued and convincing case and articulates the assumptions that support the rationale for specific policy support. Provide compelling evidence that proposed changes to a health care system will produce the intended outcomes. Does not provide compelling evidence that proposed changes to a health care system will produce the intended outcomes. Provides weak evidence or unsubstantiated claims that proposed changes to a health care system will produce the intended outcomes. Provides compelling evidence that proposed changes to a health care system will produce the intended outcomes. Provides compelling evidence that proposed changes to a health care system will produce the intended outcomes. A perceptive analysis of the evidence and its skillful application effectively strengthens the proposition for achieving the intended outcomes. Provide broad budget estimates to fund specific capital or human resource outlays that are important to the success of a proposed change. Does not provide broad budget estimates to fund specific capital or human resource outlays that are important to the success of a proposed change. Provides broad budget estimates to fund specific capital or human resource outlays, but the estimates do not fall within a reasonable range or the connections between resources and the success of a proposed change are not clear. Provides broad budget estimates to fund specific capital or human resource outlays that are important to the success of a proposed change. Provides broad budget estimates to fund specific capital or human resource outlays that are important to the success of a proposed change. Captures key funding requirements and provides data and information that substantiate the budgetary figures. Outline a plan for leading transformational, evidence-based change in an organization. Does not outline a plan for leading transformational, evidence-based change in an organization. Outlines a plan for leading transformational, evidence-based change in an organization, but overlooks key factors affecting acceptance and sustainability of the change. Outlines a plan for leading transformational, evidence-based change in an organization. Outlines a plan for leading transformational, evidence-based change in an organization. Articulates a clear vision and goals for change and provides a strategy for leading change, supported by applicable change theory and attentive to the effects on the organization. Assess the potential future for wellness, health, and improved Does not assess Assesses the potential the potential future for wellness, future for health, and improved Assesses the potential future for wellness, Assesses the potential future for wellness, health, and improved overall care and the role of overall care and the role of visionary leaders in achieving the desired goals. wellness, health, and improved overall care and the role of visionary leaders in achieving the desired goals. overall care, but the assertions about the role of visionary leaders in achieving the desired goals are unrealistic, inaccurate, or unsubstantiated. health, and improved overall care and the role of visionary leaders in achieving the desired goals. visionary leaders in achieving the desired goals. Acknowledges assumptions underpinning the future vision and justifies a chosen leadership style for driving change. Cultivate stakeholder interest in and support for the proposed changes to a community health care system. Does not cultivate stakeholder interest in and support for the proposed changes to a community health care system. Attempts to cultivate stakeholder interest in and support for the proposed changes to a community health care system, but the approach lacks coherence or is based on assumptions about the stakeholders and their community not supported by the analysis and survey data. Cultivates stakeholder interest in and support for the proposed changes to a community health care system. Cultivates stakeholder interest in and support for the proposed changes to a community health care system. Describes a clear vision for change that anticipates stakeholder concerns and acknowledges potential risks. Provides clear and explicit evidence for claims. Develop slides that augment a multimedia presentation. Does not develop slides that augment a multimedia presentation. Develops slides that add minimal value to a presentation, exhibits poor or inconsistent design, are hard to read, or include distracting slide transitions, animations, or decorative graphics. Develops slides that augment a multimedia presentation. Develops error-free slides that augment a multimedia presentation. The slides effectively support and enhance the presenter’s main points and arguments, are appropriate for the audience, and adhere to visual design best practices. Argue persuasively to obtain policy and financial support from policymakers for a proposed community health care change. Does not solicit policy and financial support from policymakers for a proposed community health care change. Solicits policy and financial support from policymakers for a proposed community health care change, via a multimedia presentation that lacks clear purpose, coherence, or focus, or relies primarily on slide content (reads from the slides) to communicate or argue main points. Argues persuasively to obtain policy and financial support from policymakers for a proposed community health care change. Argues persuasively to obtain policy and financial support from policymakers for a proposed community health care change. Delivers a professional, wellorganized, and engaging multimedia presentation. Presents clear and convincing arguments independent of, but well-supported by visual aids. Style, content, and duration are well-suited to the audience and purpose of the presentation. Concludes with a concise summary of key points. Support assertions, arguments, propositions, and conclusions with relevant and credible evidence. Does not support assertions, arguments, propositions, and conclusions with relevant and credible evidence. Sources lack relevance or credibility, or the evidence is not persuasive or explicitly supportive of assertions, arguments, propositions or conclusions. Supports assertions, arguments, propositions, and conclusions with relevant and credible evidence. Supports assertions, arguments, propositions, and conclusions with relevant, credible, and convincing evidence. Skillfully combines errorfree source citations with a perceptive and accurate synthesis of the evidence. Assessment 4 Instructions: Advocating for Lasting Change • • PRINT Develop and record a 10-15 slide, asynchronous, audiovisual presentation for policymakers, soliciting resource and policy support for the community health care system change you proposed in the previous assessment. Introduction Nurse leaders must be able to make effective financial and policy decisions. Equally important is the ability to communicate their vision for change to policymakers and provide objective, evidence-based support for their position with respect to the regulatory, political, social, ethical, legal, and financial aspects of systemic change. This assessment provides an opportunity to develop a presentation aimed at soliciting resource and policy support for the community health care change you proposed in Assessment 3. Preparation The executive leaders at Vila Health accepted your change proposal and would like to move it forward. However, lasting change in a volatile regulatory and policy environment will require adequate funding and support from the applicable governing body or regulatory agency. Consequently, you have been asked to present the proposed change to policymakers to seek their support and funding for the change as an established policy for the organization and community. To prepare for this assessment, you are encouraged to begin thinking about funding and securing policy support for lasting change. In addition, you may wish to: Review the assessment requirements and scoring guide to ensure that you understand the work you will be asked to complete. • Review Guiding Questions: Advocating for Lasting Change [DOCX], which includes questions to consider and additional guidance on how to successfully complete the assessment. • Be sure that your audiovisual equipment works and that you know how to record and upload your presentation. Note: Remember that you can submit all or a portion of your draft presentation to Smarthinking Tutoring for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback. MSN PROGRAM JOURNEY • Please review this guide for your degree program. It can help you stay on track for your practice immersion experience, so you may wish to bookmark it for later reference. • MSN Program Journey. AUDIOVISUAL EQUIPMENT SETUP AND TESTING It is a good idea to check that your recording hardware and software is working properly and that you are familiar with its use as you will make a video recording of your presentation. You may use Kaltura Media or other technology of your choice for your video recording. If using Kaltura Media, refer to the Using Kaltura tutorial for directions on recording and uploading your video in the courseroom. You may use Microsoft PowerPoint or other suitable presentation software to create your slides. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues. • Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@Capella.ed u to request accommodations. Requirements Develop and record a video presentation for policymakers from the appropriate governing body or regulatory agency requesting policy and financial support for your proposed change. Draw on your work in the previous assessments and consolidate lessons learned. The presentation requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. The Guiding Questions: Advocating for Lasting Change document provides additional considerations that may be helpful in completing your assessment. In addition, be sure to note the requirements below for the presentation format, length, and for citing supporting evidence. • • • • Explain why proposed changes to a health care system require policy and financial support to ensure positive, systemic change and to overcome present challenges. Provide compelling evidence that proposed changes to a health care system will produce the intended outcomes. Provide broad budget estimates to fund specific capital or human resource outlays that are important to the success of a proposed change. Outline a plan for leading transformational, evidence- • • • • • based change in an organization. Assess the potential future for wellness, health, and improved overall care and the role of visionary leaders in achieving the desired goals. • As a guide, explore the website of Healthy People 2030. Cultivate stakeholder interest in and support for the proposed changes to a community health care system. Develop slides that augment a multimedia presentation. Argue persuasively to obtain policy and financial support from policymakers for a proposed community health care change. Support assertions, arguments, propositions, and conclusions with relevant and credible evidence. Presentation Format and Length Remember, you may use Microsoft PowerPoint or other suitable presentation software to create your slides. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues. Your slide deck should consist of 10– 15 slides, not including the title, questions, and references slides. Use the speaker’s notes section of each slide to develop your talking points and cite your sources, as appropriate. Be sure that your slide deck includes the following slides: Note: Your slide titles will depend on your choice of community and the specific content of your change proposal. • Title slide. • Title or name of your project (main focus of your change proposal). • Subtitle (optional), which could include Jordan or Armitage, if not part of the title. • Your name. • Date. • Course number and title. • Introduction. • Identify the stakeholders to whom you are presenting. • Social determinants affecting health in the community (may need more than one slide). • Synopsis of the windshield survey and environmental analysis findings. • Identify the positive aspects of the community. • Identify opportunities for improvement. Although your change proposal addresses these opportunities, avoid phrasing them as negatives. • Your change proposal—briefly outlined (may need more than one slide). • • • • • • • Benefits of the change to the community and stakeholders. Challenges or concerns. • Address the implications for the community and organizational stakeholders, if these opportunities are not addressed. Funding (may need more than one slide). • Include the financial implications for the community and organizational stakeholders. • Specify your funding needs (how much and for what)? Community health implications (may need more than one slide). • Explain how the proposed change will improve the health of the community. • Address both direct or indirect benefits, as applicable. Conclusion. • Summarize key points. • Be sure to thank your audience for their time and consideration of your proposal. Questions. • Add a slide to prompt questions from the audience. References (at the end of your presentation). Supporting Evidence Cite 3–5 credible sources from peerreviewed journals or professional industry publications to support your presentation. Additional Requirements Upload your video presentation and attach the presentation slides, with speaker notes. See Using Kaltura for more information about uploading media. You may submit the assessment only once, so be sure that the assessment deliverables are included before submitting your assessment. Proofread your slides to minimize errors that could distract the audience and make it more difficult to focus on the substance of your presentation. Portfolio Prompt: You may choose to save your presentation to your ePortfolio. Competencies Measured By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: • • • • Competency 1: Identify the challenges and opportunities facing health care. • Explain why proposed changes to a health care system require policy and financial support to ensure positive, systemic change and to overcome present challenges. Competency 2: Compare the effects of different health care finance models and policy frameworks on resources and patient outcomes. • Provide broad budget estimates to fund specific capital or human resource outlays that are important to the success of a proposed change. Competency 3: Evaluate the positive and negative influences of leaders on health care processes and outcomes. • Assess the potential future for wellness, health, and improved overall care and the role of visionary leaders in achieving the desired goals. • Cultivate stakeholder interest in and support for the proposed changes to a community health care system. Competency 4: Develop proactive strategies to change the culture of the organization by incorporating evidencebased practices. Provide compelling evidence that proposed changes to a health care system will produce the intended outcomes. • Outline a plan for leading transformational, evidence-based change in an organization. • Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style consistent with applicable organizational, professional, and scholarly standards. • Develop slides that augment a multimedia presentation. • Argue persuasively to obtain policy and financial support from policymakers for a proposed community health care change. • Support assertions, arguments, propositions, and conclusions with relevant and credible evidence. SCORING GUIDE • • Use the scoring guide to understand how your assessment will be evaluated. NURS-FPX6218 Guiding Questions for Assessment 4 Advocating for Lasting Change This document is designed to give you questions to consider and additional guidance to help you successfully complete the Advocating for Lasting 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 Presentation Develop and record a video presentation to policymakers from the appropriate governing body or regulatory agency requesting policy and financial support for your proposed change. Draw on your work in the previous assignments and consolidate lessons learned. Explain why proposed changes to a health care system require policy support to ensure positive, systemic change and to overcome present challenges. • What types of policies are applicable to the changes you are proposing? For example, federal, state, and municipal governments; community agencies; and service providers, including health care organizations. • Why are specific policy changes and funding needed? • What assumptions held by policymakers, members of the community or health care providers underlie current policy? Provide compelling evidence that proposed changes to a health care system will produce the intended outcomes. • How are existing policies affecting current and future outcomes? • How will your proposed changes bring about the desired change? • What evidence do you have to support your conclusions about the efficacy of the proposed changes? Provide broad budget estimates to fund specific capital or human resource outlays that are important to the success of a proposed change. • What resources are needed to implement and sustain your proposed changes? • What data and information do you have that supports your budget estimates? Outline a plan for leading transformational, evidence-based change in an organization. • What is your vision for change? • How will your proposed changes affect your organization? • How will you address barriers to change? • What changes in organizational culture are needed to support and sustain change? 1 NURS-FPX6218 • How will you ensure ongoing and effective communication? • Who are the key individuals in your organization who are accountable for implementing and sustaining the change? • What evidence supports your plan? Assess the potential future for wellness, health, and improved overall care and the role of visionary leaders in achieving the desired goals. Note: Explore the website of HealthyPeople.gov. Use it as a guide when examining the potential future for wellness, healthy people, and improved overall care. • What is your vision for a healthy community? • What are the risks and benefits inherent in your vision? • What leadership style will be effective in driving change to accomplish health and wellness goals? Cultivate stakeholder interest in and support for the proposed changes to a community health care system. • Who are your stakeholders? • How might they influence your proposal for change? • Articulate your vision for change clearly and concisely. • Anticipate and address stakeholder concerns and acknowledge potential risks. • What objections might you anticipate and how would you counter them? • What evidence supports your claims? Develop slides that augment a multimedia presentation. • Refer to the presentation design tips below. Argue persuasively to obtain policy and financial support from policymakers for a proposed community health care change. • Express your main points, arguments, and conclusions coherently and convincingly. • Address the anticipated needs and concerns of your audience. • Rehearse your presentation before making your final recording. 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? • o How or why does particular evidence support a claim? o Will your reader see the connection? Did you summarize, paraphrase, and quote your sources appropriately? 2 NURS-FPX6218 Presentation Design Tips Being able to effectively address any audience is a necessary leadership skill. Remember that you are the speaker, not a projectionist. Your purpose is not to present a slide show. Your audience is there to listen to what you have to say, not read your slides—or worse, listen to you read them. Design your presentation slides to compliment and reinforce your message and engage your listeners. The following tips will help you create presentation slides that work to your advantage: • Use a professional presentation template or one used in your organization. • Ensure that your slide background provides sufficient visual contrast for your text and graphics. • Consider your intended audience and how best to communicate effectively with them. • Focus on the content of your presentation and the development of your key points. Remember that your purpose is to garner support for your change proposal. • Create slides that augment your presentation. They should not be your presentation. − Presentation slides are a visual medium. Images are more effective than text at engaging your audience. − Be judicious in your use of bulleted lists. You might even consider a separate slide for some of your key points. • Use speaker notes to record the details you want to communicate to your audience. − Speaker notes can also serve as an audio recording script. • Use images and graphics, when the visual representation of information facilitates understanding or effectively reinforces key points. − Avoid using images that are simply decorative. They can be a visual distraction and do not contribute to your message. • Avoid using flashy slide transitions and animations. They can be both distracting and annoying. Keep your slide transitions consistent throughout the presentation. • Add a slide to the end of your presentation to prompt questions from the audience. • Proofread your slides to minimize errors that could distract the audience and make it more difficult to focus on the substance of your presentation. Submission Reminders • Have you provided adequate justification for why your proposed changes require policy and financial support? • Have you provided compelling evidence that your proposed changes will produce the intended outcomes? • Have you provided broad budget estimates to fund specific capital or human resource outlays that are important to the success of the proposed change? • Have you outlined your change leadership plan? • Have you described your vision for a healthy community and the role of visionary leaders in achieving the desired goals? 3 NURS-FPX6218 • Is your presentation clear, concise, and effective? o Did you address the anticipated needs and concerns of your audience? • Is your presentation well-supported by 3–5 sources of relevant and credible evidence? • Do you have 10–15 slides that effectively support your presentation, without being your presentation? • Did you proofread your slides? 4 1 Opioid Education and Treatment Change Proposal Lizeth Gonzalez Vargas School of Nursing and Health Sciences, Capella University NURS-FPX6218 Leading the Future of Health Care Planning for Community and Organizational Change Whitney Rigdon April 2022 2 Opioid Education and Treatment Change Proposal The previously-conducted community health assessment of Jordan, MN, highlighted many health needs for the community and some priority issues such as opioid use disorder were identified. In the review of interviews with locals, one of the locals identified their scare about the opioid epidemic and how it was affecting the neighborhood. The opioid epidemic is a national pandemic affecting many people and in Jordan, it presents an imminent threat to the health of children and young adults. The proposed policy will be community education and an opioid use disorder (OUD) treatment to be located in the community. This change proposal highlights the benefits, potential barriers, strategies to turn barriers to opportunities, and stakeholder communication for the proposed community education and OUD treatment center for Jordan. Summary Benefits and Implications Community opioid education and establishment of an OUD treatment center has many direct benefits to patients and general community health benefits. One of the benefits is the reduction of overdose deaths through accessible care and naloxone which can reverse overdose. This intervention will save lives. Another direct benefit of the proposed change is improved general health outcomes of the people accessing education and OUD treatment. OUD is associated with general poor health including higher risk of contracting sexually transmitted diseases increased risk of mental illness (Hooker et al., 2021). Providing OUD treatment and education, therefore, improves the overall health of the people accessing these services. In the community, the proposed change will increase productivity and reduce crime rates. A healthier 3 community is more productive which promotes the local businesses and economy. Similarly, reduced opioid use reduces crime rates because drug abuse is associated with criminal activity. Potential Barriers to Change There are two main potential barriers to change and they can be transformed into opportunities. One potential barrier is the source of funding. Establishing an OUD treatment center will require some significant investment by the healthcare organization. The financial challenge can be turned into an opportunity by developing a grant proposal and searching for alternative sources of funding. While searching for grants, this is an opportunity to partner with other community organizations and partners to address the opioid pandemic in Jordan. The second main potential barrier is stakeholder buy-in and the lack of unity of support from various community stakeholders. This challenge presents an opportunity of educating stakeholders to emphasize the challenge of opioid abuse in the community and the need to make changes (Parmar et al., 2021). Stakeholder education is essential for achieving buy-in because it not only increases their awareness but also communicates the urgency of the issue to elicit support. Stakeholder Communications The OUD treatment and education project has several stakeholders including the health organization, community members, the Scott County health department, and project sponsors. The health organization nurses and other professionals will need information specific on the interventions needed to be implemented with the target population to achieve project goals. Community members will need to be educated to create awareness and reduce stigma while improving their help-seeking behavior (Stone et al., 2021). The support of the county health department and sponsors is needed. The main decision-makers are executives in this health organization. Communication on the strategic plan of the program and how it fits in the overall 4 strategy of the organization will be provided in a detailed proposal. Financial details including an assessment of cost-effectiveness of the program and expected sources of financing will also be provided to the executives and sponsors. Sponsors whose interests are in reducing opioid and substance abuse will be approached and a grant proposal prepared for effective communication and support for the program. 5 References Hooker, S. A., Lonergan-Cullum, M., Levy, R., Nissly, T., & Sherman, M. D. (2021). Longitudinal assessment of mental health and well-being in patients being treated with medications for opioid use disorder in primary care. Addictive Behaviors Reports, 13, 100348. https://doi.org/10.1016/j.abrep.2021.100348 Parmar, J., Sacrey, L. A., Anderson, S., Charles, L., Dobbs, B., McGhan, G., & Triscott, J. (2021). Facilitators, barriers and considerations for the implementation of healthcare innovation: A qualitative rapid systematic review. Health & Social Care in the Community. https://doi.org/10.1111/hsc.13578 Stone, E. M., Kennedy-Hendricks, A., Barry, C. L., Bachhuber, M. A., & McGinty, E. E. (2021). The role of stigma in US primary care physicians’ treatment of opioid use disorder. Drug and Alcohol Dependence, 221, 108627. US Census Bureau. (n.d.). QuickFacts: Jordan City, Minnesota. https://www.census.gov/quickfacts/fact/table/jordancityminnesota/PST045221 6 Appendix A: Grant Proposal Need Statement The opioid epidemic has troubled the United States for more than two decades now and it remains to be ever relevant to the entire nation and especially Jordan community. Although Jordan is a generally healthy community, opioid use disorder is increasingly evident in some of the neighborhoods. This problem especially affects teenagers and young adults and hence is relevant to close to 2,500 people based on the latest census statistics (US Census Bureau, n.d.). We conducted a community health assessment of Jordan and established priority needs. Many of the residents identified their worries about their teenage children and young adults using and abusing opioids. The main challenge for many people is that they have no access to educational material and accessible care for treating opioid use disorder (OUD). This challenge presents a huge threat in the future opioid addiction prevention and treatment at Jordan. Program Description Our proposed program is a public education campaign and establishing a small OUD treatment center at Jordan. The public education intervention will target the general population and it aims to increase their awareness of opioid use, risks, and prevention strategies. The campaign will be carried out by our organization and will include community meetings and a media campaign. The establishment of an OUD treatment center will require the recruitment of an addiction specialist and nurse therapists. The center will also need a facility to where Jordan residents can visit and the equipment and medical supplies needed for a health center. Combining the education program and a health center will enhance access to OUD information and treatment. Goals and Objectives 7 The main goal for the proposed program is to provide accessible and affordable OUD education and healthcare to the people of Jordan. This goal can be achieved by pursuing the following objectives: 1. To increase community awareness of OUD by 50% in one month. 2. To provide OUD prevention and treatment services and information to approximately 2500 residents of Jordan annually. Program Evaluation The program will be evaluated by the county health department and the executive leadership of the organization. Quarterly evaluations will be conducted by the program director to determine the progress of the program, any new needs to be attended, and evaluate the program’s attendance of set goals and objectives. Quarterly reports will be produced by the program director and submitted to the executive leadership, sponsors, and the county health department. Stakeholder feedback about program progress and evaluation of both fiscal and project performance will be used as the main sources of evaluation information. Summary Jordan community is a thriving community with an imminent threat in OUD. The proposed program will help save lives in the community, improve safety, and enhance productivity in the community. Funding this program will provide affordable and accessible healthcare services to the people and improve their wellbeing. As an opioid-focused program, the proposed change aligns with your strategic plan of making Jordan a drug-free community. Thank you for your consideration and we are looking forward for your support and collaborating with you in improving the well-being of people in Jordan City. 8 Appendix B: Project Budget Categories Startup 1st Year Other Sources of Revenue Justification Salary and Wages • Program director $7,000 $84,000 Board salaries Salary • 2 Support Staff $10,000 $120,000 None Salary • 2 Therapists $16,000 $192,000 None Salary Fringe Benefits • Program director $10,000 $10,000 None Car and health insurance • Therapists $20,000 $20,000 None Car and health insurance Equipment • Office supplies $10,000 $30,000 None • Furniture $50,000 $50,000 None • Healthcare information tech $60,000 $60,000 None Miscellaneous or Other $5,000 $30,000 Total Expenses $188,000 $596,000 1 Community Health Assessment Lizeth Gonzalez Vargas School of Nursing and Health Sciences, Capella University NURS-FPX6218 Leading the Future of Health Care Assessing Community Health Care Needs Dr. Whitney Rigdon April 2022 2 Community Health Assessment Jordan is a rural area in Scott County, Minnesota. It is one of the communities served by Vila Health System and this community healthcare needs presents an opportunity to understand the priority health services needed. A windshield survey and healthcare community needs assessment was conducted at Jordan and this summary highlights the general conditions and environmental factors to consider in this community. Executive Summary General Condition and Public Health Needs The people of Jordan City are healthy and the city’s general condition is favorable for the people’s health outcomes. Overall, St. Francis Health Services provides a range of health services which are important to the people of Jordan. During the windshield survey, there were no obvious health hazards or conditions observed among the residents of Jordan. The population is generally young and vibrant and there are signs of economic activity in the city. The public also has access to public services as seen by the presence of a city hall and fire services. Access to education is adequate through the Jordan public school system. The presence of a supermarket and food shelf provide food access to the people. Although the windshield survey identified that Jordan is generally a healthy place, there are some opportunities for improvement. First, St. Francis is the only health center and this may be overwhelmed in the case of emergencies or high disease burden. For instance, a recent community health assessment estimates Scott County has a 915:1 patient to mental health provider ratio compared to 430:1 the Minnesota average (St. Francis Regional Medical Center, 2020). Therefore, there is a chance to increase access to health services. Food insecurity is yet another issue in this city. Specifically, there are no restaurants offering healthy food options 3 although there is a grocery store. Access to healthy food options is a public health need for this community. Environmental Analysis Moreover, the environmental analysis showed a healthy environment although there are some negative aspects of the community. The community has green spaces which are important for recreation and active living. These include a park, baseball grounds, and an education and recreation center near Jordan Middle School (Vila Health, n.d.). These support an active lifestyle which is important in healthy living. The conditions of the roads and public facilities are good. This supports healthy living while reducing safety risks. The rural landscape of Jordan maintains minimal pollution which also reduces the health risks for the residents of the town. The environment of Jordan supports healthy living. Several social determinants of health have to be considered for Jordan as well. The physical environment including the roads and parks encourage healthy living as reviewed in the environmental analysis. Access to health care is another social determinant and in Jordan, it needs to be improved. Despite the presence of a health care facility the community has inadequate access to health services which could lead to poor health outcomes (Vila Health, n.d.). The neighborhood and housing conditions at Jordan are varied and they also affect health outcomes. On the one hand, the neighborhood to the southwest of the city in Timber Ridge Court has well-maintained homes. On the other hand, the downtown area neighborhood has poor quality of housing which could also affect health negatively. The average household income at Jordan is $87,606 which is higher than the average US rates (World Population Review, 2022). A high average income is a positive determinant of health. 4 Conclusion Jordan is a healthy community but has opportunities for health improvement. The main identified issues are adequate access to healthcare services and access to healthy food options. Although there is a healthcare provider in the city, they cannot meet the health needs of the population. Similarly, although there is a grocery shop at Jordan, there is also food insecurity in the city, threatening the health outcomes of the residents. Vila Health can extend health services to Jordan and collaborate with community resources in enhancing access to health food options in the area. 5 References St. Francis Regional Medical Center. (2020). Community Health Needs Assessment and Implementation Plan. Community Health Needs Assessment and Implementation Plan US Census Bureau. (n.d.). QuickFacts: Jordan City, Minnesota. https://www.census.gov/quickfacts/fact/table/jordancityminnesota/PST045221 Vila Health: Environmental Analysis and Windshield Survey simulation. https://media.capella.edu/CourseMedia/msn6218element238562/wrapper.asp World Population Review. (2022). Jordan, Minnesota Population 2022. https://worldpopulationreview.com/us-cities/jordan-mn-population 6 Appendix Table 1: Windshield Survey and Environmental Analysis Category Questions Observations and Impressions SWOT Category References Community Size What is the area of Jordan? Around 3 square miles Opportunity for growth into a city. World Population Review Population What is the population of Jordan? 6,656 (2020) Opportunity for population and economic growth. U.S Census Bureau Age What is the median age? 31.6 years Opportunity as most of the community members are young and productive. U.S Census Bureau Ethnicity How ethnically diverse is the community? White majority 90.7% Weakness as the city is not ethnically diverse. U.S Census Bureau Health Issues Obvious community health issues observed? None Strength in no evident health issues. Vila Health: Environmental Analysis and Windshield Survey simulation. Health Care Services Is there a health center providing appropriate general health services? Yes. St. Francis Health Services provide “full range of inpatient, outpatient, and emergency care.” Strength in access to health services. Vila Health: Environmental Analysis and Windshield Survey simulation. Churches Are there churches? Yes. Immanuel Methodist and St. John the Baptist Church Strength as faith and religion are coping mechanisms for healthy living. Vila Health: Environmental Analysis and Windshield Survey simulation. 7 Category Questions Observations and Impressions SWOT Category References Schools Are there public schools? Yes. Jordan elementary, middle, and high school. Strength in access to education improving health outcomes. Vila Health: Environmental Analysis and Windshield Survey simulation. Businesses What is the condition of businesses in the city? Business seems to be thriving but there are some empty buildings. Opportunity to set up more businesses. Vila Health: Environmental Analysis and Windshield Survey simulation. Buildings What is the quality of housing? Housing is in mixed conditions with newer houses in the outskirts and rundown houses in the downtown area. Threat in the impact of poor housing on health outcomes. Vila Health: Environmental Analysis and Windshield Survey simulation. Restaurants Are there healthy food restaurants in Jordan? No restaurants but a fast food shop at the shopping plaza. Weakness in lack of access to healthy food restaurants. Vila Health: Environmental Analysis and Windshield Survey simulation. 1 Proposing Evidence-Based Change Lizeth Gonzalez Vargas Capella University Leading the Future of Health Care Dr. Whitney Rigdon April 2022 . 2 Proposing Evidence-Based Change The healthcare system of a country is critical since it determines the health condition of the people within the nation. There are different types of healthcare systems utilized in different countries, including multiple-payer systems and single-payer systems (Cai et al., 2020). In this case, a multiple payer healthcare systems refers to a system whereby there is more than one entity that finances healthcare practices, whereby one of the entities is the government. On the other hand, a single-payer system refers to a healthcare system whereby the payment and the funding of healthcare practices are funded by a single entity, particularly the government (Cai et al., 2020). Though each of these systems has its benefits and challenges, a single-payer system is considered more beneficial than a multiple-payer system based on its outcomes. A single-payer system’s outcomes are better than those of a multiple-payer system. Therefore, the U.S. healthcare system has been compared with that of Canada and Sierra Leone to support a proposed change. Executive Summary Proposed Change Though the United States is among the most developed countries globally, its healthcare system is considered to be among the most expensive ones based on the costs of various services to the patients (Cai et al., 2020). Despite the expensiveness of the healthcare services in the country, the quality of care delivered to the patients is relatively lower compared to other developed nations. This aspect has significantly affected the residents in the U.S. to the extent that most people with severe illnesses seek healthcare services from other countries. This is because such people consider other countries less expensive than the U.S. and give high-quality care. One of the reasons the cost of healthcare services in the U.S. is extremely high is that the 3 country practices a multiple payer system whereby different entities change various services based on the type of care offered. Therefore, if the payer system can be changed, the healthcare costs can be lower, thus improving access to healthcare services within the country. Based on such understanding, the proposed change involves transforming the U.S. healthcare system from a multiple-payer to a single-payer system. Desired Outcomes There are three major desired outcomes that need to be achieved through the proposed change developed. One of the desired outcomes involves reducing the healthcare cost in the U.S. Reduced healthcare costs will improve access to healthcare services within the country has, enabling more people to receive care. Besides, the reduced healthcare costs in the country will reduce the number of U.S. residents who go to seek healthcare services from other countries. The metrics on the number of people who access care from various healthcare facilities can be used to measure this outcome. The second outcome that would be achieved through the proposed change involves decreasing the mortality rates experienced in the U.S. There is a high mortality rate in the U.S. This is because some residents with severe illnesses cannot afford the cost of healthcare services. Therefore, they prefer remaining in their residences rather than visiting various healthcare facilities because they cannot afford the costs (Hsiao et al., 2019). This later contributes to their deteriorated health conditions leading to death. However, if the country adopts a single-payer system, such deaths can be avoided due to increased access to care services. Comparing mortality rates can be one of the ways of measuring this outcome. The third desired outcome involves providing health insurance coverage to all U.S. residents. Currently, not all U.S. residents are insured regardless of the adoption of the affordable 4 care act. However, by transforming the U.S. healthcare system into a single-payer, all residents can be ensured regardless of their socioeconomic status. A population analysis can be applied in measuring this outcome. By transforming the U.S. care system from a multiple-payer to a single-payer, the government would be responsible for paying for the services of the country’s residents. Such funds can be obtained from different sources such as taxation. However, it may be challenging for the proposed change to be achieved in the U.S. due to various factors. One of the limiting factors is the existence of several private healthcare organizations within the country, such as pharmaceutical companies, insurance agencies, and hospitals (Hsiao et al., 2019). The other limiting factor involves the increased number of citizens who needs to be covered under health insurance. Health Care System Comparative Analysis The two non-U.S. healthcare systems that are being compared with the U.S. healthcare systems are the Canadian system and the Sierra Leone system. Canada practices a decentralized, publicly funded, universal healthcare system known as Canadian Medicare (Woolhandler & Himmelstein, 2019). Healthcare in Canada is administered and funded mainly by the territories and provinces within the country, whereby the money used is obtained from the government. This is considered to be a single-payer system with various outcomes such as reduced costs of special health procedures and tests, high life expectancy among the residents, and health insurance coverage among all the residents within the country. Besides, the Sierra Leone Government adopted a Free Healthcare Initiative (FHCI) in the country in 2010 to improve access to the nation’s residents (Woolhandler & Himmelstein, 2019). The initiative adopted ensures that children under the age of five years, lactating mothers, and 5 pregnant women receive healthcare services for free. Other populations within the country are only required to pay little for their healthcare services. The initiative has significantly improved the condition of the country’s residents in different ways. Some of the outcomes that have been experienced in the country due to the adopted initiative include increased access to healthcare services, improved life expectancy, and improved healthcare insurance coverage. The Rationale for the Proposed Change U.S. residents have been experiencing several challenges associated with access to healthcare services. The access to care services among the country’s residents is uneven since some citizens have improved access to healthcare services while others are not. This has contributed to significant healthcare disparities in the country, creating a boundary between the upper and the lower socioeconomic classes. Therefore, the U.S. needs to adopt a single-payer system to eliminate such health disparities. The increased cost of healthcare in the U.S. has not only reduced access of the country residents to healthcare services but also contributed to poor health conditions and low life expectancy among the citizens (Jackson, 2019). The U.S. healthcare system is more of a business rather than catering to the health condition of the people. As other countries continue to lower the healthcare costs of their citizens, the cost of care services in the U.S. continues to rise. The cost of some care services and drugs is twice as much compared to the care in other developed countries. This shows a great need to introduce a single-payer system in the country. Financial and Health Implications For the U.S. to successfully adopt a single-payer system, the government needs to develop an equalized way of obtaining funds from the citizens. The government can develop the means of taxing people based on their earnings. This implies that the people who earn more have 6 to pay more taxes, and those who do not earn anything will not be taxed at all. This strategy can enable the government to get sufficient revenue to fund the healthcare system. There are several implications associated with adopting the proposed change and failing to adopt it. Some of the implications associated with adopting the strategy include improved access to healthcare services among the country residents, reduced mortality rate within the nation, and improved health conditions among people. On the other hand, some of the implications of failing to adopt the proposed change involve low access to care services, high mortality rates among the residents, and poor health conditions (Jackson, 2019). By comparing the implications of adopting the change and the facility to introduce it, it is more beneficial for the country to adopt a single-payer system. Conclusion The healthcare cost in the U.S. is extremely high regardless of the country’s development. The increased healthcare costs in the country have contributed to much suffering among the residents due to reduced access to care services. When comparing the healthcare system of the U.S. and other countries such as Sierra Leone and Canada, it can be evident that there are more improved health conditions in the two non-U.S. countries. This is because they have adopted a healthcare system that reduces healthcare costs, thus improving the residents’ healthcare conditions. 7 References Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., … & Kahn, J. G. (2020). Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. PLoS medicine, 17(1), e1003013. https://doi.org/10.1371/journal.pmed.1003013 Jackson, E. A. (2019). Systemic healthcare failure as a symptom of market failure in Sierra Leone. Southern African Journal of Public Health, 3(4), 72-78. https://hdl.handle.net/10520/EJC-1dc525aeaf Hsiao, W. C., Cheng, S. H., & Yip, W. (2019). What can be achieved with a single-payer NHI system: The case of Taiwan. Social Science & Medicine, 233, 265-271. https://doi.org/10.1016/j.socscimed.2016.12.006 Woolhandler, S., & Himmelstein, D. U. (2019). Single-payer reform—“Medicare for All”. JAMA, 321(24), 2399-2400. 10.1001/jama.2019.7031
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