Introduction
Nowadays, much attention is paid to healthcare services and the systems under which numerous people have to work and cooperate. The peculiar feature of any healthcare system is the possibility to unite people who have different professions and background knowledge and offer them an appropriate working environment, fair attitudes, and reasonable promotions. To make sure that all professionals are satisfied with the healthcare system and aware of how to treat patients, special practice guidelines are created. As a rule, these guidelines are available to employees and remain unknown to ordinary users of healthcare services. Still, evidence-based practice promotes the integration of research evidence or scientific rationality and clinical experience, also known as practitioner behavior (Hamer & Collinson, 2014). In this paper, evidence-based practice will be used to discuss the healthcare system practice guideline of one of the local organizations, Florida Hospital Medical Group, in terms of its creation, definition, adoption, and effectiveness for the center’s workers, as well as for their visitors.
Healthcare System Practice Guideline
My past and current practices are closely connected to the development of internal medicine and the promotion of effective primary care to all patients in the United States. There are many healthcare facilities I can work with, and each of them has to own a list of requirements, standards, and rules to be followed by all employees. However, the success of any medical center or hospital depends not only on the presence or absence of specific guidelines but also on the way employees and leaders understand its meaning and follow it. In this paper, I would like to evaluate the effectiveness of the guidelines offered to the workers of Florida Hospital Medical Group.
There are several reasons why this organization is chosen for the analysis, including its history and patients’ feedback. Florida Hospital Medical Group was founded in 1994 and was introduced as a common healthcare facility where people could come and ask for help (“About Florida Hospital Medical Group,” n.d.). Today, it is a well-known organization with 500 licensed physicians and about 2,000 clinical staff who are ready to offer their compassionate and professional care to a million patients each year (“About Florida Hospital Medical Group,” n.d.). There are more than one hundred offices located in the United States, and each of them has programs focused on behavioral health, oncology, primary care, women’s care, pediatrics, urology, etc. Regarding a variety of healthcare services, this facility uses different guidelines in order to make sure that each patient receives enough care and appropriate interventions.
This paper aims at discussing the guidelines that are offered to care for patients with diabetes. Diabetes is one of the most complex illnesses in the world. More than 400 million people live with diabetes, and more than one million deaths because of diabetes are reported annually (American Diabetes Association, 2017). Management of diabetes plays an important role because this disease can hardly be treated. Therefore, people should learn how to live with it, avoid complications, and check its possible progress. The guideline of Florida Hospital Medical Group for diabetes care includes the necessity to inform patients about the peculiarities of this disease, define the type of diabetes, evaluate all symptoms and possible causes, and follow all significant modifications. Screening, counseling, and management are the three main issues in the guidelines. In addition, the practitioners of the chosen facility have to consider all accompanying diseases, health changes, and the complications and inform patients about them at the initial stages of treatment.
It is expected that all professionals pay their attention to such aspects of primary care for diabetic patients as screening, diagnosis, glycemic targets, pharmacological approaches, lifestyle management, risk factors, and in-/out-patient care (American Diabetes Association, 2017). This guideline mentions that risk factors like high blood pressure, a sedentary style of life, or family history cannot be ignored even if patients give negative answers. Each intervention has to be taken only after a number of tests are taken, and the levels of glucose and hemoglobin are defined. A plan of care depends on patients, their family involvement, and their readiness to cooperate with healthcare professionals. It is not enough to take regular tests and check the level of sugar in the blood. Diabetes is a disease with a number of peculiarities, and patient-doctor communication is a step forward to managing this condition in a proper way. At the same time, the patient’s understanding of the disease is usually determined by the way how employees hold to the guideline.
Healthcare Professionals and the Guideline
It is necessary to admit that even if each hospital or other healthcare facility is able to develop its own guidelines for each disease and the type of care that should be offered, many things also depend on how well different people in this healthcare system comprehend and follow these rules. Florida Hospital Medical Group is the place where many nurses, pharmacists, physicians, dietitians, and care coordinators work. Each group of professionals has its own responsibilities and tasks. The guideline binds all these groups and offers recommendations on care for diabetic patients.
Nurses are employees who frequently communicate with patients. They have to explain the peculiarities of this disease and prepare patients and their families for some changes and interventions that have to become an integral part of their lives from the moment diabetes being diagnosed. At the same time, nurses should never say more than physicians or other doctors might say. Nurses have to support and make sure that all information is clear to a person who has not been aware of diabetes earlier. In addition, nurses are responsible for taking blood tests and blood pressure according to the prescriptions of a doctor (Bodenheimer & Bauer, 2016). The guideline underlines the necessity for a nurse to cooperate with all inhabitants (visitors) of the center because this person is the only credible and available source of information.
Physicians usually define themselves as the core employees of the hospital or other facilities. The guideline under analysis can be used to determine the responsibilities of this group of people and make sure they perform all the necessary work. Their primary goal is to measure, treat, and prevent pain, as well as to optimize the glucose level and avoid the development of neuropathy (American Diabetes Association, 2017). Doctors should also guide nurses and patients: the former have to know how to support the latter, and the latter should understand what kind of help they may ask from the former. Diagnosis, treatment, education, decision-making, and life support are the main responsibilities of doctors.
Pharmacists play an important role in treating diabetic patients, as well. These people promote the effective processing of medications and check all drugs’ administration and effects. Many patients, especially older adults, have to take several medications at the same time to deal with several diseases or health problems. Such polypharmacy increases the impact of pharmacists on diabetes treatment. Therefore, the chosen guideline discusses the role of this group of people because some drugs, while interacting with each other, may lead to unpredictable side effects that should result in choosing another treatment plan. Metformin, inhibitors, and receptor agonists have to be properly chosen to decrease the incidence of diabetes complications and control the prediabetes condition (American Diabetes Association, 2017). Pharmacists of this center have to be confident that each patient receives enough attention and is educated on how to take drugs and ask for new prescriptions.
The work of technicians is poorly defined in the guideline. Still, special attention is paid to care offered to diabetic patients by dietitians. Nutrition and dietary changes have to be discussed with each patient. Sometimes, nurses or doctors can perform this function and give enough information about this point. However, in this center, dietitians are hired to discuss nutrition peculiarities with patients. They have to cooperate with nurses to find some details about patients, their families, and preferences (e.g., religion, culture, family involvement, or already followed diets) and with doctors to learn the type of disease, its level, and possible prognoses.
Finally, care coordinators work at Florida Hospital Medical Group to make sure that all patients, despite their diseases, the level of income, and background knowledge, can obtain help and care. They usually participate in all treatment activities and observe the results of the work done by other employees. It is necessary not to confuse this profession with nursing because care coordinators also aim at evaluating the work of doctors, pharmacists, and nurses and improve the quality of care.
Research to Adopt the Guideline
Specific research is used to adopt the guideline. First, the parameters of research have to be defined. The decision to use several online libraries is made. PubMed, EBSCO, and JSTOR help to get an idea of what diabetes guidelines can be used, and if there are some standards to be followed. The investigations of the American Diabetes Association are usually used to define the guideline. The guidelines of this organization serve as the basis for the development of local guidelines and suggestions for doctors and nurses to treat and help patients.
Qualitative research methods, like observations and interviews, can also be helpful in adopting the guideline. The point is that first, it is important to understand what people expect when they address a hospital or medical center. Sometimes, it is not enough to admit that health improvement is the goal. Many patients want to talk to doctors in order to prevent the growth of a complication or eliminate the risks of having a disease. Counseling and communication help patients and cannot be neglected (Bodenheimer & Bauer, 2016). In addition, observations of how care is offered, how patients are treated, and how prepared the medical staff are are necessary. These sources of information should be prejudiced. Therefore, it is better to make records and discuss all confidentiality issues before screening is chosen and diagnosis is offered.
Evidence to Define the Guideline
Each guideline has its background that is usually chosen by its developers and meets the expectations of potential users. Clinicians and policymakers find it necessary to apply evidence to clinical and medical practice because such type of medicine can have a variety of forms that may be analyzed, criticized, and improved. As a rule, evidence focuses on specific diagnostic strategies, treatment, and management, the task of every user is to consider the needs and demands of every patient and make a care plan individualized. Each intervention has to be supported with strong and clear evidence, and systematic reviews remain one of the most credible and frequently followed strategies with the help of which it is possible to identify evidence.
The creation of the chosen guideline for a particular healthcare facility is closely connected with systematic reviews and the opinions of authorities like the American Diabetes Association, establishing the level of evidence between V and VII. Meta-synthesis of qualitative studies and the reports of an expert committee are the basis for the guideline on how to manage patients who have diabetes. The treatment and management of diabetes through the offered guideline introduce a unique combination of ideas in order not only to reduce the level of pain or control the impact of this health condition but also to support patients and make it easier for them to accept lifestyle changes and new routine activities.
Opinion on Following the Guideline
The promotion of the guideline is a serious step for every organization. It is a list of definite rules that have to be followed when treating and diagnosing patients, as well as developing professional relationships in the setting. Regarding the results of the work done and the information obtained from the literature analysis, my personal opinion about the guideline and its role for the chosen healthcare organization can be formulated. Each professional, despite their fields of work, knowledge, and the level of cooperation with patients has to be aware of the guideline and follow a plan of work. Such attention can help to avoid misunderstandings and provide each employer with a clear plan of work.
The guideline has to be followed by all representatives of the system within which it is developed because of two main reasons. First, in case a patient or the members of a family complain about something, the development of the events can be easily restored, and each step may be properly described and explained. Second, this guideline helps to control each professional and improve the quality of work of the whole organization. Healthcare leaders should not think about some new obligations and standards. It is enough for them to add the guideline to a list of the documents that have to be followed and check how all employees understand the rules.
Conclusion
In general, the role of evidence cannot be ignored in the work of healthcare facilities and the guidelines these facilities create to treat and manage each disease. The work of the Florida Hospital Medical Group may become a good example for other clinics and individual professionals who aim at helping people improve their health, prevent diseases, and control possible complications. Diabetic patients deserve special attention in terms of treatment and management, and the representatives of the Florida Hospital Medical Group show how this chronic disease should be managed. The recommendations and the rules supported by the American Diabetes Association turn out to be the best evidence that can be used to define the guideline and improve the evidence-based practice.
References
About Florida Hospital Medical Group. (n.d.). Web.
American Diabetes Association. (2017). Standards of medical care in diabetes – 2017. Diabetes Care, 40(1). Web.
Bodenheimer, T., & Bauer, L. (2016). Rethinking the primary care workforce – An expanded role for nurses. The New England Journal of Medicine, 375(11), 1015-1017.
Hamer, S., & Collinson, G. (Eds.). (2014). Achieving evidence-based practice: A handbook for practitioners (2nd ed.). St. Louis, MO: Elsevier.