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Discussion Overview: As you reach the endpoint of your small-scale change project, your implementation phase should be close to completion. In this weeks discussion, you will describe how your change strategy was implemented. In addition, you will revisit your data collection plan, created in the week three discussion, to determine the degree to which you have met your desired short-term outcome(s). Then, you will describe your plan for the evaluation phase of your project and the measurement of your long-term outcome.

Discussion Prompt: Restate your projects goal; short-term and long-term outcomes; and your data collection plan. Then, answer the prompt.

Describe the process which was used to implement the change strategy.

Provide a summary of data that you have collected towards the achievement of your short-term outcome.

How do you plan to evaluate the effects of the implementation phase of your change project?

Please be sure to watch all the unit presentations and cite appropriately.

Erika Crystal Herrera

Galen College of Nursing

4850 Capstone Course

Dr. Norman

Week Five Discussion

Hello all,

The proposed change initiative is a small-scale change project aimed at enhancing the follow-up care of patients with chronic conditions at M&B Mobile NP by introducing a well-developed nurse-led protocol in telehealth follow-up. The project’s short-term objective is to enhance the regularity and attainment of the follow-up encounters by nurses within four weeks of the implementation. The short-term objective is that 80 percent of the registered nurses (RNs) and the licensed practical nurses (LPNs) will always employ the telehealth protocol to implement virtual follow-up visits. The long-term effects are better chronic disease surveillance, greater continuity of care, and a decreased risk of disease exacerbation among hypertension, diabetes, and heart failure patients.

A number of interdisciplinary healthcare team members have contributed to the development of the project implementation process. The nurse practitioner owner and the clinical nurse manager, as nursing leadership, were at the center of the workflow change, which was approved and facilitated the use of the available telehealth technology. Their leadership support is approved by the evidence that the interdisciplinary collaboration and leadership engagement enhance the success of care coordination and implementation (Udensi et al., 2025). Also, the interaction with nursing personnel was imperative, and their feedback allowed adapting the protocol to routine working practices and making it viable.

The attainment of both short- and long-term results of the project can enhance holistic and culturally competent care. Telehealth follow-ups decrease the obstacles associated with transport, work hours, and mobility, which are overly impactful on culturally and socioeconomically diverse populations. Culturally sensitive education, individual communication, and better engagement with patients can also be achieved through structured nurse-led assessments. There was an indication that education and organized care models can promote patient-centered and equity-related outcomes due to the development of culturally competent education and care (Lee et al., 2025).

One of the challenges that are likely to be faced in the implementation is the limited time of nurses and the competing workload requirement that can minimize regular use of the telehealth protocol. The barriers that have been well-documented in practice change initiatives are time constraints and disruption of workflow. One of the evidence-based approaches that may be used to address this obstacle is the application of interdisciplinary collaboration and standardized means of communication, including the definition of roles and hierarchical workflow. Leadership support and frequent interdisciplinary check-ins will help to foster accountability, minimize role confusion, and maintain the adoption of the protocols (Udensi et al., 2025). These strategies can be used together to facilitate effective implementation and sustainability of the project.

References:

Lee, Y., Sung, S., & Fan, X. (2025). Cultural competency education for healthcare professionals: an umbrella review. BMC Medical Education, 25(1), 1445. https://doi.org/10.1186/s12909-025-08008-7

Udensi, C. G., Vunnava, R., & Durojaye, T. J. (2025). Interdisciplinary collaboration in healthcare management: Strengthening healthcare deliveryA review. International Journal of Advanced Multidisciplinary Research and Studies, 5(5), 210-216. https://doi.org/10.62225/2583049X.2025.5.5.4881.

Erika Crystal Herrera

Galen College of Nursing

4850- Capstone Course

Dr. Norman

Week Three Discussion

Hello all,

The identified problem in this project is the inconsistent follow up and monitoring of patients with chronic diseases, specifically hypertension, diabetes, and heart failure due to high rates of missed in person appointments. Internal data showing a 32% no show or cancellation rate highlight a significant gap in continuity of care. Based on Week 2 feedback, the shortterm goal is the development and approval of a structured telehealth followup protocol. The shortterm outcome is achieving stakeholder approval of this protocol within a 23week period. The longterm outcome is a measurable reduction in missed followup appointments within the first year of implementation, ideally decreasing the noshow rate from 32% to 20% or lower as telehealth becomes integrated into routine chronic disease management.

To measure the shortterm outcome with minimal disruption, data collection over 23 weeks will focus on tracking protocol development milestones, stakeholder engagement, and approval status. This can be accomplished through brief weekly surveys, meeting attendance logs, and documentation reviews that require no additional burden on clinical staff. Because the target population for this phase is the clinical team not patients the workflow impact remains minimal. This approach aligns with evidence showing that streamlined data collection processes support staff engagement and reduce resistance during early implementation phases (Berg & Aase, 2023). Once the protocol is approved, the organization will be positioned to transition into piloting telehealth followups without delaying routine patient care.

The longterm outcome of reducing missed followup appointments within one year reflects meaningful improvement in chronic disease management and can be measured using internal scheduling and attendance data. Achieving this outcome has broader implications for other healthcare settings, as improved appointment adherence is associated with better disease control, fewer hospitalizations, and enhanced patient satisfaction. Research demonstrates that telehealth expansion can significantly improve access for vulnerable populations, including rural patients and those with mobility limitations (Rodriguez et al., 2023). Therefore, meeting the longterm outcome in this project could serve as a model for other clinics seeking to strengthen chronic disease monitoring, reduce acute care utilization, and promote equitable access to followup care.

References:

Berg, S. H., & Aase, K. (2023). Facilitators and barriers to successful implementation of digital health interventions in clinical practice. Journal of Healthcare Management, 68(2), 112121.

Rodriguez, J., Clark, C., & Patel, V. (2023). Telehealth utilization and chronic disease outcomes in underserved populations: A longitudinal analysis. Journal of Telemedicine and Digital Health, 11(3), 201210.

Instructions for the assignment are attached as a pdf. Please ensure to use a scholarly article as a resource.

Drawing on your learning and feedback from your placement, provide

a critical reflection of your strengths and areas for development as a

mental health nurse

You should:

Draw specifically on your own experiences and learning from the

placement.

Make use of one reflective model of your choosing (e.g., Gibbs,

Driscoll, Rolfe, Johns) and signpost where/how youre using it.

Engage with feedback you received on your performance from your

PS/PA or other registered health professionals, or service

user/relative/carerwhat it was, how you interpreted it, and what

you did/will do with it.

Identify strengths and areas for development, with concrete

examples from practice.

Show critical thinking: compare and contrast relevant evidence

(e.g., guidelines, research, professional standards) to support your

pointsnote similarities/differences and what this means for your

practice.

Support your discussion with recent, good-quality literature (cite

appropriately using your programmes referencing style).

Clearly state how you will use this learning in your future

development (e.g., a brief action plan).

Demonstrate ongoing commitment to learning, growth, and safe,

person-centred care.

Be well structured, clear, and coherent, explicitly showing your use

of the reflective model.

Are there any additional

materials?

Please Note:

My placement location is at Ward 1 (Carseview centre) and learning environment type is Mental health , service type and field of practice: In Patient adult.

Common Conditions: Adult Acute Psychiatry

Practice Learning Opportunities – Opportunity for nurses to learn about all aspects of mental health issues: illnesses, treatments, including ECT and advance intervention service – Patient journey from admission to discharge – Liaison with other agencies – Students in 3rd year are given the opportunity to manage the ward -Involvement in creating and updating care and risk plans -Medication administration (dependent on placement) –Time with other services may also be available e.g. OT, depot clinics, physiotherapy

Associated Learning Opportunities Particular opportunity to work with service users within the AIS remit which consists of caring for: Treatment resistive depression OCD Singleotomy VNS

uggested Reading Knowledge of acute psychiatry – Knowledge of drug administration – Knowledge about recovery for the mental health patient – Admission and discharge procedure – www.mwcscot.org.uk/the-law/mental-health-act/ -Trauma informed care IOP Improving observational practice Seclusion Policy Locked Dorr Policy Care Planning Standards for LD and MH