Evaluation of Telephone follow up call with Patients Diagnosed with COPD

Economically, annual health system incur billions of expenses due to readmissions. The issue of readmissions is propelling among individuals who suffer from cardiovascular health problems, diabetes and chronic respiratory diseases. Furthermore the patients that experience chronic heart failure form the most significant percentage of readmissions in health centers. Additionally, people with the chronic obstructive pulmonary disease (COPD) are about 22% (Health Quality Ontario, 2017). These patients with chronic conditions require complete treatment process because if they are discharged early, it can be challenging to them and those who take care of them. Practice focused question What is the effectiveness of the use of Case management model for telephone follow-up on discharged patients with COPD, within the first 30 days after discharge from health care center, in comparison to the late monitoring or no follow-up, in the reduction of unplanned readmissions, mortality or emergency department visits that are non-elective? Or, Does the use of the case management model of education during telephone follow-up by the nurses taking care of patients with more than 65 years of age, diagnosed with COPD improve the education within thirty days? Social change Due to the unsustainable levels of healthcare spending concerning the chronic disease, there is a need for a program that can help in reducing unnecessary expenses.

The program used should achieve this objective while improving the quality of health and life thus a significant consequence. Using a technique that guides nursing practitioners to provide health care services efficiently will aid in achieving patients satisfaction. The quality of care will be improved for the patients diagnosed with COPD since will be possible to assess the efforts of the primary consideration. A standardized method which will be used in this project is a case management model with the intervention of telephone follow-up. The patients are connected to the formal resources and are encouraged to communicate with informal ones such as friends and families. By having this collaboration, the patients' ability and willingness to follow through the services is increased.

It is a model that creates opportunities for patients to grow personally, develop their skills in regards to their health issues and gain insights on how to manage themselves as well as their families while in their situation (Aorn, 2014). It recognizes community, family and cross-agency partnership. This project aims at finding a way to improve patients' health while reducing health care expenditures at the same time concerning COPD. This includes both obstructive and restrictive pulmonary disease. The wellness program aims at improving patients' quality of life, increase physical endurance, personal education and family about pulmonary conditions of patients and to teach patients how to cope with and control breath shortness. Furthermore, telephone follows up call has been used to ensure that patients discharged are progressing well and that they are responding well to medical aid issued to them.

By being concerned about their patients helps them to monitor and decrease admissions and readmissions especially those with chronic conditions. According to Burke et al. (2015) say that adoption of the telephone call as a mean to follow-up their patients after discharge has been effective in minimizing the rate of readmissions while at the same time cutting expenses and achieving clients’ satisfaction. Case management model, on the other hand, serves as a platform where interaction between patients and nursing practitioners is enabled. This environment makes it easy for the patient to interact with the primary care, and in return, they receive adequate services that are relevant to their health conditions. Similarly, a case management system helps the COPD patients to relate well to the community around them.

They get to understand that the society is not there to judge or discriminate them it to support them. This system facilitates supportive, practical and is population-based. It offers a platform which is evidence-based giving prepared, activated and informed patients a chance to interact with practice, proactive team. Firstly, the model associates patients with the community, from their interaction information can be gathered concerning their response and behavior. Secondly, patients are given a chance to manage their conditions, in case of challenges they report to the primary care and assistance, is offered. Thirdly, telephone follow-up is implemented to ensure patients are in good condition. Therefore the evaluation of the program aims to regulate and enhance the current system and operations in the ORMC.

Nursing care, on the other hand, will be improved via the COPD telephone discharge follow-up intervention. Case management similarly will enhance and facilitate improvement in the communication and interaction between primary care providers and patients. Also, a sense of belonging and recognition will be instilled in the patients' perceptions. Made to feel important will positively impact their health and understanding of themselves and others. Y. The Impact of Postdischarge Telephonic Follow Up on Hospital Readmissions Burke, R. E. , Kripalani, S. , Vasilevskis, E. -J. The care transitions intervention results of a randomized controlled trial. Arch International Medicine. Health Quality Ontario, (2017). Effect of early follow-up after hospital discharge on outcomes in patients with heart failure or chronic obstructive pulmonary disease: a systematic review.