Introduction
The modern healthcare sector faces numerous challenges that require effective responses. The COVID-19 pandemic, the increase in the number of chronic diseases, and health disparities complicate the work of care providers. Thus, under these conditions, hospital work is the main factor necessary for supporting stability and improving the nation’s health.
Nowadays, these units’ primary goal is to meet local communities’ needs to ensure the stable development of society. For this reason, every local unit working in a particular area performs a health assessment that outlines the major problems existing at the moment. It helps to understand the current state and introduce appropriate interventions.
Emergency departments play an essential role in responding to today’s challenges. For this reason, it is crucial to select practices to address avoidable or preventable emergency department (ED) visits, thereby reducing pressure on healthcare and helping individuals preserve a high quality of life. Thus, the issue might be addressed by using special ED avoidance tactics available at the moment. Their choice depends on the current community’s needs, social determinants of health, and the goals a particular healthcare facility establishes.
For instance, the New York Presbyterian Hospital is the unit that conducts regular assessments of individuals’ health and the methods that can be employed to enhance it. The unit is chosen for the analysis and discussion of how ED avoidance tactics might be employed to achieve better results. A better understanding of the tactics and how they work in real settings is critical to developing methods to improve care delivery and reduce pressure on the healthcare sector.
Hospital Background and Overview
New York-Presbyterian Hospital (NYPH) is an integral part of the local healthcare system. NYPH is the nation’s comprehensive and academic healthcare delivery system. It offers services to diverse populations living there who have special healthcare needs. The choice of the facility for the investigation is explained by its size and importance. The hospital has around 3,000 beds, 5,700 affiliated physicians, and 34,000 employees necessary for stable work (About Us,” n.d.).
NYPH is critical for maintaining a high quality of life for local community members as it sees over 2 million visits annually (“About Us,” n.d.). The given numbers and statistics show that the unit’s stable operations are critical and, at the same time, demonstrate the scope of challenges the hospital faces every day. For this reason, to better understand current demands, the hospital conducts regular health needs assessments to identify the most pressing issues and address them effectively (“About Us,” n.d.). The assessment results are integrated into the report, which helps to understand the current situation and determine whether special interventions are required.
Priorities and Objectives Pertained to the ED Avoidance Tactic
Based on regular health assessment data, the NYPH establishes a set of incentives and objectives aimed at improving the population’s health and ensuring that individuals can access various services and diversified care. Thus, the NYPH prevention agenda for 2019-2024 is designed based on the recent data collected across communities and the determinants of health (NewYork-Presbyterian, 2020). Thus, the agenda includes the five priority areas that should be addressed to enhance community health. Preventing chronic diseases is the primary goal for population health (NewYork-Presbyterian, 2020).
Second, NYPH focuses on cultivating a healthy and safe environment for all citizens (NewYork-Presbyterian, 2020). Third, the health of women, children, and infants is a priority (NewYork-Presbyterian, 2020). Fourth, the agenda outlines the need to promote well-being and prevent substance use disorders among community members (NewYork-Presbyterian, 2020).
Finally, communicable diseases should be controlled and prevented to protect people (NewYork-Presbyterian, 2020). These core objectives also require educating patients about their current health needs and the conditions for acquiring special care when needed. In such a way, the NYPH’s prevention agenda might be associated with the ED avoidance tactic, which implies acquiring additional information to enhance health outcomes.
Target Demographics
Applying the selected ED avoidance strategy depends on the current understanding of the target demographics and their specific characteristics. The NYPH has a clearer understanding of its clients through regular assessments of local communities. Thus, the target demographics include local community members who lack access to care or experience adverse outcomes due to various factors. Thus, the current NYPH community health needs assessment reports acknowledge the presence of health disparities within the local community (NewYork-Presbyterian, 2020).
The statistics show that the rates of preventable ED use are high, which means that there is room for specific improvement. The hospital also reports higher than the NYC average for all ED visits per 100,000 population, with 55,878 (NewYork-Presbyterian, 2020). The rates are exceptionally high for asthma, diabetes, and hypertension (NewYork-Presbyterian, 2020).
The lack of education, understanding of the current condition, and the absence of access to necessary care are the factors explaining the high rates of avoidable ED visits. Thus, other factors within the community also affect ED use, such as low literacy, inadequate feedback, and limited interaction with care providers (NewYork-Presbyterian, 2020). In such a way, when designing the intervention, it is crucial to consider these peculiarities.
Social Determinants
The hospital’s work and the implementation of practices aimed at improvement also require consideration of the area’s social determinants of health. Thus, the NYPH reports on the economic inequality specific to the community and disparities by race, gender, and social status (NewYork-Presbyterian, 2020). Furthermore, at the moment, individuals suffer from the lack of affordable housing, which impacts their health outcomes and specific disease rates (NewYork-Presbyterian, 2020). Finally, community awareness of current diseases and conditions that might affect their visits to the ED, and of how to manage them, remains low (NewYork-Presbyterian, 2020). As a result, there is a need for specific interventions to address the problem and attain improvement.
ED Avoidance Tactic
In this way, choosing the appropriate ED tactic is critical for aligning the unit’s stable work and achieving better results. Thus, COVID-19 contributed to the initial decline in avoidable ED visits; however, the overall impacts remain unclear (Gottlieb et al., 2023). Under these conditions, ensuring the stable operation of ED departments is critical.
The teach-back method is one way to address avoidable visits. Following the method, patients or care providers should repeat what they understand to professionals to confirm their comprehension and avoid misunderstandings (Hesselink et al., 2022). Most patients have difficulty recalling information provided by nurses or other clinicians, suggesting that the method can effectively improve their knowledge (Talevski et al., 2020). It is a potent tool for reinforcing patient education and addressing knowledge gaps about their health care plans after discharge from the ED (Yen & Leasure, 2019). It means that the choice of the ED avoidance strategy is explained by its effectiveness and its ability to achieve positive results across diverse population groups.
The choice of the strategy is also explained by its nature and applicability to the discussed setting. First, it is a relatively simple and feasible method that can be used in almost all healthcare units globally (Hesselink et al., 2022). Patients discharged from the ED departments can receive standard discharge care; however, implementing the teach-back method improves the expected outcomes (Hesselink et al., 2022).
Furthermore, the approach’s effectiveness has consistently been underestimated. However, it remains one of the best practices for working with elderly patients, which is vital for communities such as the one discussed (Hesselink et al., 2022). Teach-back helps increase patients’ retention of instructions, which is critical to achieving desired goals (Hesselink et al., 2022).
Additionally, the selected tactic demonstrates increased effectiveness for specific populations. For instance, for individuals with diabetes, teach-back promotes better interactions between patients and providers, which is critical for managing their conditions (Hong et al., 2022). The given factors demonstrate the benefits of the chosen tactic and its importance to the NYPH.
Another essential advantage of the selected tactics is the absence of specialized equipment or costly training requirements. Thus, teach-back training can be part of the curriculum to train nurses to improve outcomes and reduce avoidable ED visits (Holcomb et al., 2022). As a result, health workers will be able to provide necessary instructions and monitor comprehension without additional cost, which is critical for specific communities.
Regular training can lead to better results and reduce hospitals’ financial burden, making it cost-effective. Which is more important, it is not a time-consuming method of educating patients, meaning that both nurses and clients can accept it as a beneficial framework for interaction (Mahajan et al., 2020). In this way, numerous advantages of the teach-back tactic justify its implementation in the selected settings.
Application of the Tactic to the Hospital
Therefore, the selected ED avoidance tactics can be applied to the NYPH to achieve better outcomes and ensure the unit can effectively provide care to local populations. The existing research indicates that the burden of ED overutilization can be reduced by educating at-risk patients about the appropriate use of the ED (Williams & Haffizulla, 2021). Additionally, inappropriate ED use is related to the socioeconomic vulnerability of populations (Naouri et al., 2020). This means that patients who lack shelter or have limited sources of income may belong to a risk group with higher rates of ED visits. Under these conditions, the teach-back method can be an effective way to engage NYPH patients from the outlined groups.
Patients with asthma, diabetes, and cardiovascular conditions can be provided with additional instructions after discharge from NYPH to improve outcomes. The investigation shows that patients with two or more previous inappropriate ED visits are more likely to use the same pattern in the future (Miyazawa et al., 2019). It means that using the method will lead to addressing the issue across different client groups and to establishing a framework for better ED utilization.
The simplicity of the approach and its low cost are the central factors justifying its selection for the communities served by the NYPH. Using the teach-back method, the hospital will address the high rate of avoidable visits, establish a basis for improvement, and increase patient awareness. A better understanding of current conditions is vital for clients’ ability to self-manage and assess, as well as for healthcare providers to provide timely attention.
Metrics for Outcomes
Implementing the ED avoidance tactics requires introducing specific measures to monitor progress and determine whether changes to the approach are required. Thus, for the NYPH, the positive change in the rate of avoidable ED visits can be considered the central determinant of the selected intervention’s success. According to current research, the teach-back method reduces the burden of inappropriate ED use. For this reason, the statistics before and after the implementation should be compared to determine whether a positive dynamic emerges.
The rise in the patients’ overall satisfaction levels can be viewed as another important metric. Numerous visits to the ED might lead to deterioration in people’s quality of life and undesired outcomes. The implementation of the tactic is expected to address the problem and create the basis for improvement. For this reason, it is possible to compare the clients’ satisfaction before and after the measure is used to determine whether it remains effective within the selected setting.
Priorities
The application of the teach-back method to the NYPH has a specific goal: to manage avoidable ED visits. At the same time, a specific priority should be established when the intervention is used. Thus, it is critical to ensure patients can achieve better outcomes when seeking care and enhance the quality of their lives without visiting the ED. It means the priorities are linked to people’s well-being and health, which aligns with the NYPH’s agenda. The teach-back method can cultivate better health knowledge, which is central to maintaining the nation’s health at a high level and to ensuring individuals can engage in self-care activities to reduce the burden on the healthcare sector.
Conclusion
Altogether, the population’s health is a critical concern for the modern healthcare sector. The work of various hospitals should be aligned to ensure that clients acquire the best care and enjoy a high quality of life. The delivery of care should also be aligned with the social determinants of health and local communities’ needs.
The NYPH conducts regular assessments of the current state of populations to guarantee that the most effective models of care are selected. The unit reports a problem of avoidable ED visits, suggesting that applying the teach-back method could be a beneficial solution. The advantages of the approach, such as low cost, simplicity, and ease of use, justify the choice of the intervention and its ability to promote positive change within the selected population group. In general, it is expected that the ED avoidance tactic will help achieve positive results and address current community health needs.
References
About Us. (n.d.). NewYork-Presbyterian.
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