AYM1 — AYM1 TASK 1: SERVICE PLAN LEADERSHIP AND MANAGEMENT IN COMPLEX HEALTHCARE SYSTEMS D030
Diabetes Education Services
Diabetes is a serious and life-threatening disease that poses great challenges to affected individuals and healthcare systems worldwide. The disease is a progressive disorder caused by a combination of insulin resistance and beta-cell dysfunction. Most approaches to the management of the disease involve pharmacological treatment in combination with risk reduction activities. During the last two decades, the interest of healthcare providers towards the importance of education in managing the disease has increased (Nazar et al., 2016). The educational approach aims at accomplishing changes in human behavior through knowledge acquisition and understanding the disease. Diabetes education and coaching are among the strategies for improving the health of the individual upon discharge from healthcare institutions. This service uses a partnership approach with local healthcare facilities, physicians, nurses, community providers, and patients to help reduce the burden of the disease among populations.
Importance
Diabetes self-management training and education play a vital role in the management of diabetes. Although education alone does not help manage the disease, it increases the individual’s awareness of nutrition, physical activities, and other care required when managing the disease. Research establishes that the design of diabetes education should be focused on individual needs to maximize positive outcomes (Powers et al., 2020). Diabetes educational services are designed to provide support and encouragement to the patient. The services also provide a boost to the patient’s self-esteem to promote acceptance and subsequent care upon discharge from the hospital. Lastly, the service plan for diabetes provides a patient care platform that allows communication with primary care providers without visiting the healthcare facility. Through the use of mobile technology and other approaches, the service can enable easy communication, especially during the COVID-19 pandemic.
Market Analysis
Diabetes is a life-threatening disease that causes a significant impact in the US and other nations. According to recent reports, about 34.2 million people have the disease in the US (Centers for Disease Control and Prevention (CDC), 2020). Among these individuals, 26.9 million are already diagnosed with the disease while 7.3 million are undiagnosed. Additionally, most individuals (88 million) have prediabetes that includes 34.6% of the adult US population (CDC, 2020). The diabetes education service plan will target individuals already diagnosed with diabetes and prediabetes in the US. Regarding referral services, a collaborative approach is recommended to ensure patients are referred using the correct criteria. Using the referral forms and EMR systems, primary care physicians will provide referral services during complications or when special care is needed in more advanced facilities. In my region, there are already three institutions providing diabetes education programs to their patients. The facilities use telehealth diabetes education and provide referral services to the local hospital.
SWOT Analysis
| Strengths | Weaknesses |
| Experienced staff to provide comprehensive education to patients e.g Certified diabetes care specialists. | Lack of experience in this market may make it difficult for the facility to adopt. |
| Well-established digital communication systems within the facility to facilitate telehealth. | The COVID-19 restrictions may hinder adequate patient care, especially face-to-face visits. |
| Organizational readiness for change implementation. Financial support is available for the service. | Delayed communication links between the facility and local hospital referral and emergency care. |
| Availability of referral systems to local hospital to facilitate continuity of care. | Problems with insurance reimbursements for out of network patients. |
| Opportunities | Threats |
| Growth and expansion of the facility due to increased demand for the service. | Competition from the neighboring institutions with the same program. |
| Improved patient outcomes regarding the management of diabetes. | Uncertainty on patient participation and compliance. |
| Increased utilization of health information technology systems. | Problems with technology utilization, especially for the older patients that are the majority of the target population. |
| Increased reimbursements from the CMS due to improved patient satisfaction. | Increased number of patients seeking service utilization may impact the financial requirements. |
SWOT Analysis Results
The SWOT analysis results demonstrate that the organization is ready to implement the new strategy for the improvement of quality. The ability of the administration to provide financial support demonstrates the need to improve diabetic patient outcomes while working towards improving reimbursements from the CMS. To maximize opportunities, the service plan must be unique to what the neighboring facilities offer. For example, the plan should involve an online education module for all diabetic patients to ensure they understand the importance of the educational service (CDC, 2021). Secondly, the results indicate that the organization has little experience with the service plan. The use of expert knowledge and experienced external stakeholders can help in improving the quality of the service plan. Using this approach will promote acceptance of the service by patients and other healthcare providers.
Cost-Benefit Analysis
| Category | Description of the Service Plan Costs |
| The Organization | 1. Cost of building the new operational structure. |
| 2. Legal services and taxes | |
| 3. Cost of marketing the service. | |
| Operations | 1. Materials for educating patients about the new service. |
| 2. Costs for power/electricity to support technology and other routine operations. | |
| 3. Security cost for monitoring service operations,: installing CCTV and night security services. | |
| The Client/Patient | 1. Patients will incur cost of purchasing drugs and other supplies. |
| 2. Educational materials for the patients. | |
| 3. Cost of the diabetes service program including education. | |
| The Staff | 1. Employee salaries |
| 2. Hiring new specialists for education and setting up the plan. | |
| 3. Cost of training and certification. | |
| Technology | 1. Cost of purchasing the technology; hardware, software |
| 2. Cost of designing the internet for easy access of services. | |
| 3. Maintenance of the technology; internet connection and backups |
| Category | Description of Service Plan Benefits |
| The Organization | 1. Revenue gained from the service plan will help to support other projects in the organization. |
| 2. Educated patients will reduce hospital readmissions and mortality. | |
| 3. Opportunity for expansion and growth due to established connections and more revenue generation. | |
| Operations | 1. Improved care delivery through technology utilization. |
| 2. Providing variety of diabetes services to the community will increase the number of people seeking the services. | |
| 3. Improved communication and access of diabetic patients including timely referrals. | |
| The Client/Patient | 1. Improved knowledge on the disease, management and treatment options. |
| 2. Improved quality of life. | |
| 3. Improved communication with primary care providers and reduced costs. | |
| The Staff | 1. Improved knowledge on diabetes care as a result of educational programs. |
| 2. Improved communication with patients reducing stress and burnout. | |
| 3. Employee satisfaction and improved employee retention due to improved care efficiency. | |
| Technology | 1. Improved program efficiency due to the use of experts. |
| 2. Increased utilization of technology, especially EMR systems. | |
| 3. Opportunity to improve interoperability within the facility and communication with local healthcare facilities. |
Risk Assessment and Strategies
| Risks | Overall Results and Strategies for Minimizing the Risks |
| Patient compliance to the new service. | Most of the patients receiving diabetes care are the elderly aged 65 years and above. Due to the use of technology to support the service, compliance with education may be a problem. To minimize risks, regular assessment of compliance is required including follow-up visits. |
| Technology uncertainty, especially with cybersecurity issues. | The use of HIS is often faced with security issues. To minimize this risk, backup plans must be installed. Experts can also be hired to minimize data breaches. |
| Poor patient turnout due to increased competition. | Already three healthcare institutions are providing the service in the region. The new service might fail to attract many patients during the initial stages. To minimize this risk, marketing the service and reducing costs will be necessary. |
| Lack of significant improvement of patient’s health. | Although educational approaches are observed to improve health outcomes, the new plan might fail to lead to significant outcomes due to compliance issues. Minimizing this risk will involve tracking of patients, regular assessments and vigilance during healthcare service delivery. |
| Minimal revenue from the service | The new service plan might fail to generate significant revenue as a result of patient turnout and insurance issues. Minimizing this risk will require timely review of insurance status of patients and effective management of resources |
Financial projections
Revenue Projections: In recent statistics, the cost of diabetes management in the US has increased to over $237 billion. Based on these statistics, it is expected that a lot of money will be required to sustain the service plan, especially during the first year. Because of the COVID-19 restrictions, not much is expected to be realized due to low patient turnout rates. However, the amount is expected to increase with time as people get to be freer to access healthcare services. In the first quarter, I estimate total revenue of $225 million with an increase of up to $495 million during the fourth quarter.
Methods to Generate Revenue: To generate revenue for the service, the first method will involve increasing the volume of patients through advertisement and other marketing strategies. Secondly, the organization can plan to capitalize on private insurance that is observed to offer more reimbursement.
Financial Payers: Patients will be the first category of individuals paying for the service. Through the fee-for-service strategy, the organization will receive adequate revenue to support the program. The second category will involve funding from the CMS under the Medicare and Medicaid service program. Additional funding from donors and interested third parties will also serve to generate revenue for the program.
Graph
Operational Expense budget
| Category | Description and Cost ($) of Each Type of Expense |
| Personnel Expenses | Personnel expenses for the program will include salary costs for healthcare workers and other hired groups, health insurance for staff working in the unit, and costs for purchasing uniforms. |
| Other-than-Personnel
(OTP) Expenses |
Other costs that are expected include payment of the electrical bill, water and tax. The technology costs will include maintenance of an internet connection and regular maintenance costs including checkups. Additionally, educational materials will be required. |
Pie Chart
Key performance Indicators (KPIs)
|
Service Plan KPIs |
Measurement and Frequency |
| Structure: Treatment costs | The costs for patient care will be assessed monthly alongside the revenue generated. This will help determine if the service is running at a profit or loss. |
| Process: Productivity | The productivity of the service plan will be measured using the amount of revenue generated monthly. A quarterly analysis of the revenue will be done to ascertain improvements. |
| Outcome: Patient satisfaction | The patient satisfaction scores will be used to measure the level at which the new program is meeting the expectations of the patients. The surveys will be administered at the end of each visit and analysis conducted monthly. |
Future Decisions
Upon measurement of the KPIs, the organization will be able to determine if the service plan is meeting the patient’s expectations while generating revenue. The KPIs will help the organization in adjusting treatment costs to realize a profit or reduce the costs to the patients. More funding will be requested to support the service plan in case the revenue generated is minimal. Regarding patient satisfaction, poor scores will translate to re-assessment of the initial plan, assessment of employees, and setting up more strict policies to guide the educational service.
Improvement Strategy
The first strategy will involve using supportive tools like TeamSTEPPS to enhance performance and patient safety and to improve communication. According to the Agency for Healthcare Research and Quality (AHRQ) (2019), TeamSTEPPS is a strategy that can be used to improve the integration of teamwork skills among healthcare professionals. The second approach to improve performance will involve the use of rewards and incentive programs for staff or teams that demonstrate high-quality care. Metrics for rewarding can include aspects of the number of patients who returned for subsequent care, Utilization of technology to communicate, and timely referral that led to better patient outcomes.
Tasks and Timelines
| Task | Task owner Title | Timeline |
| Conceptualization of the service line | Project manager | Two weeks |
| Creation of the service plan | Project manager and administration | Two months |
| Market analysis | Chief marketing officer (CMO) | Three weeks |
| Estimation of costs | Chief financial officer (CFO) | Two weeks |
| Creation of operational budget | Chief financial officer (CFO) | One month |
| Risk assessment | Chief marketing officer (CMO) | One month |
| Advertisement and marketing | Director of marketing services | Three months |
| Recruitment of staff | Director of human resource services | Three weeks |
| Education and training of staff | Director of education services | Two months |
| Review of the whole plan/budget | Project manager/CFO | Two weeks |
Executive Summary
Service Idea
Diabetes is a serious and life-threatening disease that poses great challenges to affected individuals and healthcare systems worldwide. To ensure effective management of the disease, and education approach is often used alongside pharmacological interventions. Diabetes education and coaching service are designed to provide continuity of care to patients upon discharge. This strategy will be implemented to ensure effective control and management of the disease among the affected individuals.
Results of Market Analysis
The market analysis results indicate that diabetes is a chronic disease that affects many people in the region. Individuals who are 65 years and old are at greater risks for complications and will benefit the most from the service line. Although three other facilities have implemented the service in the region, an additional diabetes education service line can improve the accessibility of educational services to many.
Results of SWOT Analysis
The SWOT analysis results indicate that the diabetes education service line can be of great benefit to the patients and the healthcare organization. The new program will greatly improve the health of populations while generating extra revenue for the facility. The plan presents an opportunity to utilize technology in promoting population health while improving collaborative services with other institutions through referral services.
Feasibility of Service Idea
The benefits that the new diabetes education service line will provide to the patients and the organization outweigh the risks and associated costs. Patients are the category that is more likely to benefit through the service with improved quality of life, acquisition of knowledge, and utilization of resources to inform their health. Although the initial costs will be high for the organization, the long-term benefits are worth the risk of starting the diabetes education service.
References
Agency for Healthcare Research and Quality. (2019). About TeamSTEPPS. https://www.ahrq.gov/teamstepps/about-teamstepps/index.html
Centers for Disease Control and Prevention. (2020). Diabetes: National diabetes statisctics report. https://www.cdc.gov/diabetes/data/statistics-report/index.html
Centers for Disease Control and Prevention. (2021). Diabetes self-management education and support (DSMES) toolkit. https://www.cdc.gov/diabetes/dsmes-toolkit/referrals-participation/referral-process.html
Nazar, C. M., Bojerenu, M. M., Safdar, M., & Marwat, J. (2016). Effectiveness of diabetes education and awareness of diabetes mellitus in combating diabetes in the United Kigdom; A literature review. Journal of Nephropharmacology, 5(2), 110–115. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297564/
Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M., & Uelmen, S. (2020). Diabetes self-management education and support in adults with type 2 diabetes: A consensus report of the American Diabetes Association, the Association of Diabetes Care and Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. JAAPA : Official Journal of the American Academy of Physician Assistants, 33(7), 1–20. https://doi.org/10.1097/01.JAA.0000668828.47294.2a
