D055 Evidenced-Based Practice for Care Coordination

D055 Evidenced -Based Practice for Care Coordination A care coach is another name for this role - Care coordinator A care coach is another name for care coordinator. A care coordinator is planning for a patient's upcoming surgery and postoperative needs. During a planning session, the surgeon states, "The patient is from Mexico so home care visits will be needed to ensure compliance with post -op care." The primary care physician (PCP) immediately responds, "What makes you think my patient will not comply? What a racist thing to say!" Which statement by the care coordinator attempts to foster collaboration among the healthcare team? - "We have a misunderstanding. Please explain again so everyone understands." This statement shows reflection and allows for restatement and correction if n ecessary. A care coordinator is working with a client who is a recent immigrant. The coordinator is discussing a culturally competent care plan and wants to hold a conversation about the client's perceptions of the treatment options. Which question is app ropriate to ask this client? - "What do you call your health problem?" This will help generate a conversation about the client's perceptions and help develop a culturally sensitive care plan. This gives the client an opportunity to use his own terminology to talk about his health history. A case manager is arranging discharge plans for an older adult who requires continuous tube feedings. The patient will be discharged home within 24 hours to the care of a family member. What is the appropriate referral pr ocess in preparing this patient for discharge? - Consult a dual medical supply company to furnish the needed supplies and equipment This company will supply the needed supplies and equipment for someone being discharged to home as well as the tube -related supply support. A case manager is concerned that discharge instructions provided to patients have been incomplete and patient outcomes are being impacted. The case manager performs a literature review on evidence -based practice (EBP) related to the issue. Which action should the case manager take to improve these outcomes now that the literature review is completed? - Conduct a focus group with nurses The case manager requires deeper understanding of the problem related to care transitions. Focus groups ar e a way to get a selected group of people together to discuss a topic. Clear understanding of the problem will support evidence -based practices designed to address the problem. A culturally diverse interprofessional healthcare team is working with a healt hcare coordinator to prepare a care plan for a patient with mental and physical illnesses. What action will promote successful interprofessional collaboration among the team members? - Aligning values to meet the patient's needs. A healthcare coordinator w orks with a variety of healthcare professionals as a liaison, or coordinator, of patient care. This requires the healthcare professionals to collaborate and work together as a team. A discharge planner is reviewing a patient's needs after leaving the hosp ital. The patient has been discharged after abdominal surgery, is ambulatory, and remains on narcotics for pain control. Which situation should the planner address? - The patient will be unable to drive after discharge. This situation is directly related t o the discharge plan itself and must be addressed by the planner. A diverse healthcare employee population promotes what for diverse clients? - Better outcomes A diverse healthcare employee population promotes better outcomes for diverse clients. A healt h services coordinator is engaging a patient in developing a plan of care for smoking cessation. Which technique would involve positive engagement? - Using active listening Using active listening helps to build a stronger, more open and honest relationship with the patient and helps the patient work toward smoking cessation goals with positive engagement. Active listening allows open discussion between the coordinator and patient as to which strategies and techniques would best work for the patient to achie ve this goal. A healthcare coordinator arranges an appointment at a specialist physician's office that the patient has been referred to by a primary care physician. The healthcare coordinator sends an electronic referral to the specialist's office. How can the healthcar e coordinator prevent any delay in the patient's consultation or treatment? - Track the referral electronically to verify that it was sent and received. It is the healthcare coordinator's responsibility to send clinical information to the specialty physici an's office and follow up to ensure it was received. This is done easily using software that tracks the process. A healthcare coordinator at a clinic observes that patient who is older is missing appointments for follow -up care after a surgery. The patien t tells the healthcare coordinator that is difficult to drive into the city to get to the appointments. What can the healthcare coordinator do to encourage patient adherence to the treatment plan? - Discuss other transportation options with the patient. By helping the patient to seek assistance from resources, such as family, friends, or community organizations, the healthcare coordinator can present transportation options to the patient that remove the barrier of not feeling comfortable driving in the city . By removing this barrier, the patient will be more likely to adhere to the treatment plan by coming to scheduled appointments. A healthcare coordinator at a community clinic is arranging for care for a patient in a long-term nursing facility. The patien t is low -income and does not have insurance, but will require skilled nursing care. How can the healthcare coordinator meet the patient's care needs using critical thinking skills? - Arrange for a social worker to assist the patient in applying for financi al assistance. The healthcare coordinator should collaborate with a social worker to assist the patient in applying for financial benefits for necessary rehabilitation care. This collaboration will assist in meeting the patient's financial needs. A health care coordinator at a community health clinic is discussing care with a patient who has type 2 diabetes mellitus. The patient wants to get the disease under control with a care plan and knows that some lifestyle changes are needed, but has struggled to mak e healthy decisions. Which would be appropriate short - and long -term goals for the healthcare coordinator to suggest to the patient? - "Keep a diet diary, and gradually work to modify your diet to be healthier." A healthcare coordinator should use critical thinking skills to assist a patient in setting realistic long - and short -term healthcare goals. By keeping a diet diary, the patient will be able to critically evaluate what changes are needed, then slowly implement those changes in a practical way. A healthcare coordinator at a community public health clinic is discussing a care plan with a patient who lives in a rural area. The care plan includes taking a medication available from a specialty pharmacy. Which would be an appropriate action to increase the likelihood that the patient will follow through with taking prescribed medication? - Ask if the patient knows of a pharmacy that is able to fill the prescription for the medication. Appropriate questions to gather information allow the healthcare coordin ator to improve the patient's outcome. To increase the likelihood that the patient will follow through with taking the medication, the healthcare coordinator can help the patient find a pharmacy where the prescription can be filled or suggest an alternate resource, such as a mail -
away pharmacy. A healthcare coordinator at a correction facility healthcare clinic is seeking to improve inmate health outcomes. How can the healthcare coordinator apply the Calian Group model of care? - Contract physicians to pro vide inmate care onsite The Calian Group developed a care model for correctional facilities that provides greater access to services through contracting local physicians. The model decreases the need to transport prisoners to the hospital for care, which s aves time, money, and resources. A healthcare coordinator at a hospital is coordinating care for a patient who has Medicare and pays a monthly premium for Part B coverage. The patient is receiving