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Care Processes Construct of the McCormack and McCance Person Centred Framework

Focusing on the Care Processes Construct of the McCormack and McCance Person Centred Framework (2010, 2017), critically analyse the care delivered to a patient you have nursed and the impact this care had on the achievement of Person-Centred Outcomes.

The services offered in most of the health care organizations across the world are riddled with delays. According to Marsha and Handel (2011) it is observed that almost every person has waited for a longer period to schedule a certain medical procedure or get an appointment with a doctor. It is not uncommon to find a higher number of patients backlogged in the reception rooms waiting to be assessed by the physicians. The delays are even worse in the emergency rooms where the patients that need immediate care are forced to queue for longer period before receiving the medical that they need (Tones, Robinson &Tilford, 2013). It is observed that these delays in the emergency room are likely to lead to advancement into the poor health condition of the individual. Any delays in the provision of services to the patients are likely to result into more serious health complications as well as patients’ dissatisfaction.

The mobile application software is a technology that is being implemented to reduce the patient wait time.  According to Ozdalga, Ozdalga & Ahuja (2012) the application can assist the patient choose a health care facility that will reduce their wait time. Moreover the mobile apps is also essential in reducing the perceived versus the actual patient wait time. As such it is expected that the use of the application in any health care setting is likely to reduce significantly the patient wait time (Marsha & Handel, 2011). It is however, important that the cost effectiveness of implementing the app be determined. As much as its application is likely to ensure that the patients are satisfied it is vital that its economic importance in the management of the patient be determined. Based on the two papers by West and Kropf the current paper presents and evaluation of the social and economic benefits of adopting the mobile apps in the management of the patient wait time. The paper begins with the analysis of the selected papers and an evaluation of their suitability in economic evaluation of the chosen technology. The social and economic benefit of the technology in addressing the delays in patient admission observed in the emergency room is also provided.

Analysis of the Papers Chosen

The paper entitled “mobile solutions for improving the patient experience” looks at the significance of the mobile applications in the management of the patient wait time. The paper looks at the influence of the mobile apps on the improved satisfaction of the patients with the wait time that they experience (Kropf, 2014). The author has identified two major apps, the HealthONE and the Detroit Medical Centre that are used in the management of the patient wait time. The paper has present comprehensive information on the economic significance of the mobile apps in the management of patient wait time. The apps do not only inform the patients on when they are likely to meet the physician, but also enhances their satisfaction levels with the services provided since there are made aware of the exact time that they are likely to meet the doctor. The paper has also clearly indicated that the app is effective in assisting the patient save on the cost involved in health management. According to Marsha and Handel (2011) the longer the wait time for the patients, the higher the possibility of them developing more complications that will require additional resources to be manage the condition. In some cases, excessive wait in the emergency rooms might lead to death. According to the author, the app therefore have the economic benefits of ensuring that the patient uses minimal costs in their treatment process and also enhances their satisfaction with the services offered so that they do not move from one health care facility to the next that may require additional costs.

As much as the paper is effective in presented the effectiveness of the mobile applications in the management of patient wait time, the authors have failed to clearly identified the research question that is to be answered. The author has just presented general information on the research topic without clearly stating the objectives to be accomplished as well as the research methods that have been adopted to attain the findings stated. As Husereau et al (2013) stated, it is vital that an economic health evaluation research have clear objectives to be attained as well as the research methods that are adopted to come with the research findings.

In his article entitled ‘How Mobile Devices are Transforming Healthcare’, West (2013) has also focused on the analysis of mHealth. The author has presented general information on the importance of the mobile applications in the management of various health outcomes, such as the effects of chronic diseases, management of pregnancies, enhancing rural access to the services offered by various health care practitioners and management of patient wait time. The author has also presented comprehensive information on the economic impacts of the application of the mobile apps in the management of health (West, 2013). Reduction in the cost of health as well as positive impacts on the economic growth and development of the nation has been reported. The paper however, does not have a clear statement of the objective as well as a description of the methods that have been adopted to obtain the information presented as required of the medical evaluations (Senn, et al., 2013). Nevertheless, the information provided is sufficient in communicating the different health outcomes that are managed using the mobile apps as well as the economic impacts observed.

Assessing the Strengths of the Economic Evidence

An economic evaluation on health care focuses on the evaluation of the costs and consequences of a health intervention. The effectiveness of the economic evaluation on health is determined based on its ability to address and compare the costs and consequences of the health intervention, validity of the evaluation as well as the ability of the results to assist in the procurement of the intervention or the service to the local people (Tones, Robinson & Tilford, 2013). The validity of the economic evaluation is based on the clarity of what the authors are trying to accomplish and the provision of a suitable competing alternative to the service being evaluated.

Focusing on the two papers chosen, it is observed that the economic evaluations are valid.  Kropf in his paper has clearly stated his objective of determining the effectiveness of the mobile app in enhancing the patients’ experience and satisfaction with the wait times. The author has also mentioned the lean management process as an alternative approach in the management of the patient wait time. This therefore justifies the validity of the evaluation (Tones, Robinson & Tilford, 2013). The costs involved in the adoption of the mobile app have also been mentioned in the paper. However, the author has failed to offer comprehensive description on the costs involved indicating one of its major weakness (Ozdalga, Ozdalga & Ahuja, 2012). The paper contains comprehensive information on the consequences of adopting the mobile applications in the management of the patient wait time. Patient satisfaction through offering better services, employee satisfaction following the proper redistribution of work and saving on medical costs by the patients are the consequences of the service (Weinstein et al., 2014). It is also observed that the need for adopting the mobile apps has also been clearly mentioned. The increase in competition within the health care sector and the need to ensure that the patients receive quality and satisfactory health care services requires that all the organizations adopts the use of mobile application in the management of the patient wait time (Kropf, 2014).

To some extent, the evaluation is effective in identifying the effectiveness and the cost effectiveness of adopting the mobile apps in the management of the patient wait time. However, the authors have not effectively discussed the significance of the mobile app in comparison with the lean management approach that they pointed out. According to Husereau et al (2013) an effective and suitable economic evaluation on health does not only provide the economic benefits and the cost effectiveness of the health services but also does the comparison of the effectiveness of the service to other alternative services that can be adopted in the management of the same health outcome. This is important in the justification of the suitability of the chosen service.

The second paper is also a valid economic evaluation owing to the clarity of the authors in mentioning the objective of the study. However, the comparison of the effectiveness and cost effectiveness of the mobile application in the management of various health outcomes has not been clearly discussed. Moreover, the paper does not provide alternative methods that can be adopted in the management of the various health outcomes that have been discussed. According to Senn et al (2013) it is vital that an economic evaluation on health carries out a comparative analysis of the costs and cost effectiveness of the service being promoted and an alternative service that can be adopted in the management of the same health outcome. This is effective in ensuring that the most suitable service is recommended for the management of the health outcome after the evaluation of the costs and consequences of each of the service (Husereau et al, 2013). The inability of the author to offer the comparative analysis in terms of the cost and effectiveness of the service therefore makes the paper weak in offering and appropriate health economic evaluation (Senn et al, 2013). Nevertheless, the author has provided the economic impacts of the implementation of the services that is important in analyzing and evaluating its economic significance thus justifying the need for the technology to be adopted in the health care sector. As much as the two papers have availed information on the cost and effectiveness of the mobile app in the management of various health outcomes, especially, the patient wait-time, it is observed that the paper by Kropf is more effective in economic evaluation than the second paper by West.

Effectiveness and Cost Effectiveness

The mobile application software can be developed by a number of health care practitioners. According to Torous, Friedman and Keshavan (2014) the adoption of the app in the management of the patient wait time will ensure that they are no delays in the process of offering services to the patients. The health care practitioners will not only manage effectively the waiting period in the emergency department, but will also ensure that the patients are satisfied with the services they receive. Moreover, the mobile applications allow the patient to check-in through the internet and only report physically to the hospital when their reporting time reaches (Ozdalga, Ozdalga & Ahuja, 2012). As such, the patients are presented with an opportunity to relax at home rather than wait at the hospital benches that are always uncomfortable. It is also important to note that the mobile application provides an opportunity to select the hospital where they are likely to have the shortest waiting time. The implementation of the mobile apps in the management of the patient waiting time will therefore ensure that they have the shortest possible waiting time. 7

According to Steinhubl, Muse and Topol (2013) the increase in the waiting- time results into development of more serious complications by the patients. Several cases of deaths have been reported in the emergency department following the delays in having the patients see the physician. In addition, some patients have developed more complications that could have been easily handled if they were treated on time. The adoption of the mobile app will allow for communication between the patients and the physicians in a way that that only those cases that can be handled in time will be allowed to check (Torous, Friedman & Keshavan, 2014). This does not only improve the quality of the services being offered but also ensures that cases of patients developing serious complications are reduced to the minimum levels. The adoption of the mobile application app in the management of the patient wait-time is therefore likely to lead to the attainment of positive results.

There are certain challenges that might arise following the adoption of the technology. According to Tones, Robinson and Tilford (2013) miss-interpretation of the information communicated through the app may contribute to dissatisfaction of the patients. One may assume that the allocated time to see a nurse meant seeing the doctor leading to arguments with the employees. In addition, there are average period of time that are specified for certain diagnosis processes. However, there are certain unique cases that will take longer time, as such, leading to delays. The health care practitioners should be careful in their bookings to ensure that they give suitable allowances so that every patient has an opportunity to meet the physician or the nurse within the specified period. The cost that comes along with the development of the apps should also be taken into consideration. The selected studies have not indicted a comprehensive discussion on the costs involved, however, as Marsha and Handel (2011) noted the cost involved in the adoption of the mobile app is the initial cost required in its development. According to Husereau, et al., (2013), the initial costs is however, negligible in comparison with the benefits in health that are observed. The mobile app should therefore be adopted in the management of the patient wait-time for the identified benefits to be realized.

Conclusion

From the analysis of the selected two papers, it is observed that mobile applications can be adopted in the management of the patient wait-time in the emergency department as well as in the management of other health outcomes. The economic evaluation papers are valid based on the clear statement of the objectives that is to be accomplished. The paper by Kropf is suitable in the economic evaluation process since the author has managed to properly discuss the cost and effectiveness of the technology in the management of the patient wait time. However, the article by West has mainly focused on the economic impacts of the technology without much emphasis on the costs involved. It is important that these research papers apart from focusing on the cost effectiveness of the technology in question should also provide a comprehensive discussion on the alternative technology that can be adopted to justify the suitability of the one being promoted. It is observed that the mobile application software is cost effective since it has immense benefits that outweighs the cost of development, as such, should be encouraged as a suitable technology for the management of the patients’ wait time.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Husereau, D, Drummond, M, Petrou, S, Carswell, C, Moher, D,  Greenberg, D & Loder, E, 2013, ‘Consolidated health economic evaluation reporting standards (CHEERS) statement’, BMC medicine, vol.11, no.1, p.1

Kropf, R, 2014, ‘Mobile Solutions for Improving the Patient Experience Managing Wait Times’, journal of health care management,  vol. 28, no. 3, 18-19http://www.chartis.com/resources/files/whitepapers/Mobile_Solutions_Improve_Patient_Experience_Kropf_Scalzi.pdf

Marsha J. & Handel, J, 2011, ‘mHealth (Mobile Health)—Using Apps for Health and Wellness,’ the journal of science and healing, vol. 7, no. 4, 256-261

Ozdalga, E,  Ozdalga, A & Ahuja, N, 2012, The smartphone in medicine: a review of current and potential use among physicians and students, Journal of medical Internet research, vol.14. no.5, p. 128.

Senn, B, Kirsch, M, Sanz, C C, Karlou, C,  Tulus, K,  De Leeuw, J, & Ringner, A, 2013, ‘Developing and evaluating complex interventions: the new Medical Research Council guidance’, Studies, vol.59, pp.587-592.

Steinhubl, S R, Muse, E D & Topol, E J, 2013, ‘ Can mobile health technologies transform health care’, Jama, vol. 310, no.22, pp. 2395-2396

Tones, K, Robinson, Y K & Tilford, S, 2013, Health education: effectiveness and efficiency. Springer.

Torous, J, Friedman, R & Keshavan, M, 2014, ‘Smartphone ownership and interest in mobile applications to monitor symptoms of mental health conditions,’ JMIR mHealth and uHealth, vol.2, no.1, pp. 12-16.

Weinstein, R S, Lopez, A M, Joseph, B A, Erps, K A,  Holcomb, M, Barker, G P & Krupinski, E. A, 2014, ‘Telemedicine, telehealth, and mobile health applications that work: opportunities and barriers,’ The American journal of medicine, vol.127.no.3, pp. 183-187.

West, D, 2013, ‘How Mobile Devices are Transforming Healthcare’, Issues in Technology Innovations, pp. 19-21http://www.insidepolitics.org/brookingsreports/mobile_health_52212.pdf