Student Name
Capella University
NHS-FPX 6004 Health Care Law and Policy
Prof. Name
Date
Policy Proposal
Proper diabetes management requires consistent monitoring of HbA1c levels, alongside regular foot and eye examinations, to prevent long-term complications such as neuropathy, retinopathy, and foot ulcers. Early identification of diabetes is vital, as delayed diagnosis can negatively impact patients’ safety, daily functioning, and overall quality of life. Implementing strategies to ensure timely diagnosis is therefore a key step in mitigating future health risks.
At Mercy Medical Center (MMC), analysis of the clinical dashboard metrics highlighted gaps in diabetic patient care, including delayed diagnoses and insufficient foot and eye examinations. These lapses increase the risk of peripheral neuropathy, chronic kidney disease, and even lower-limb amputations. This policy proposal prioritizes HbA1c testing to facilitate early diagnosis and timely intervention, ultimately preventing severe diabetes-related complications.
Need for Policy and Practice Guidelines
At MMC, there is a critical need to establish policies and practice guidelines aimed at the early detection of diabetes. Dashboard data from the last quarter of 2020 revealed that MMC underperformed by 11% against the national benchmarks set by the Agency for Healthcare Research and Quality (AHRQ) for HbA1c tests, eye exams, and foot exams. The benchmarks are summarized below:
| Test/Examination | National Benchmark (%) | MMC Performance (%) | Gap (%) |
|---|---|---|---|
| HbA1c Tests | 79.5 | 68.5 | 11 |
| Eye Exams | 75.2 | 64.2 | 11 |
| Foot Exams | 84 | 73 | 11 |
Failing to meet these benchmarks has significant health implications. Irregular HbA1c monitoring creates uncertainty about patients’ glycemic control, allowing hyperglycemia to reach dangerous levels, potentially leading to fatal outcomes. Furthermore, without accurate HbA1c data, healthcare providers struggle to formulate effective treatment plans, including lifestyle modifications and pharmacotherapy.
NHS FPX 6004 Assessment 2 Policy Proposal
This policy emphasizes routine HbA1c testing to identify at-risk patients early and guide management plans according to individual HbA1c levels. Failure to implement timely testing can delay diagnosis, making diabetes self-management difficult and reducing the quality of care. Such delays can result in longer hospital stays, higher readmission rates, and increased burden on healthcare staff and hospital operations (Ali et al., 2022).
In addition, healthcare institutions may incur greater financial costs due to complications arising from unmanaged diabetes, as preventive care is significantly more cost-effective than treating advanced complications (Mao et al., 2019). Consequently, MMC must implement clear policies and practice guidelines to optimize patient outcomes and improve organizational performance.
Proposed Organizational Policy and Practice Guidelines
MMC should adopt a structured approach to diabetes care, emphasizing twice-yearly HbA1c monitoring for patients with diagnosed diabetes or those showing early symptoms (Imai et al., 2021). Key practice guidelines include:
- Identification and Education: Screen patients at risk for diabetes and educate them about the significance of HbA1c testing in disease management.
- Staff Training: Train new and existing staff in comprehensive diabetes evaluation and the importance of early intervention.
- Follow-Up Scheduling: Ensure regular follow-ups to maintain consistent monitoring and treatment adherence.
Environmental and Resource Considerations
Effective implementation requires attention to environmental factors such as staffing, financial resources, interdepartmental coordination, and accessibility of healthcare facilities:
| Factor | Recommendation |
|---|---|
| Staffing | Adequate number of physicians and nurses to perform and interpret HbA1c tests efficiently. |
| Financial Resources | Allocate funds for training programs and patient education on HbA1c importance. |
| Collaboration | Foster interdisciplinary teamwork to reduce fragmented care and enhance guideline adherence. |
| Accessibility | Ensure healthcare facilities are easily reachable for regular screenings. |
Nurses play a pivotal role in patient education, particularly for individuals unaware of their condition or management strategies, as self-care is essential in controlling disease progression (Ali et al., 2022).
Ethical Evidence-Based Practice Guidelines
Ethically grounded, evidence-based guidelines are crucial for improving HbA1c test performance. Healthcare information technology, including electronic medical records (EMR), can automate reminders for testing and facilitate data sharing among professionals (Wu et al., 2019). Patient education, using brochures or digital content, reinforces the importance of regular HbA1c monitoring.
Training healthcare staff to deliver patient-centered care ensures ethically responsible practice, emphasizing compassion, beneficence, and informed decision-making (Robinson et al., 2019). These practices not only enhance clinical performance but also strengthen patient-provider relationships, fostering transparency, engagement, and trust. Improved HbA1c assessment directly enhances patient quality of life and staff job satisfaction (Thanh & Tien, 2021).
Participation of Stakeholders in the Development and Implementation of Proposed Policy
Stakeholder engagement is essential for creating policies that address patient needs effectively. Key stakeholders include:
- Physicians, nurses, and diabetes educators
- Patients living with diabetes
- Hospital administrators and policymakers
- IT department personnel
Healthcare professionals contribute expertise and evidence-based insights, while involving patients encourages shared decision-making and policy adherence. Engaging a broad stakeholder base promotes transparency, builds trust, and supports interprofessional collaboration, enhancing policy acceptance and effectiveness (Garritty et al., 2020; Bachynsky, 2019).
Strategies for Collaborating with a Stakeholder Group
To ensure successful policy development and implementation, the following strategies are recommended:
- Collaborative Meetings and Workshops: Facilitate in-person or virtual discussions for open communication and role clarification (Walker & Daniels, 2019).
- Digital Collaboration Tools: Use online platforms, webinars, and educational videos to reach remote stakeholders.
- Relationship Building: Foster mutual respect and celebrate stakeholder contributions to increase buy-in and engagement.
These strategies strengthen cooperation and communication, ensuring effective execution of policy initiatives.
Conclusion
The underperformance of diabetes care at MMC, relative to AHRQ benchmarks, underscores the need for a comprehensive policy targeting HbA1c monitoring. Twice-yearly HbA1c testing, supported by structured follow-ups, staff training, and patient education, forms the foundation of this policy. Engaging a multi-disciplinary stakeholder group and implementing evidence-based ethical practices will improve health outcomes, patient quality of life, and organizational efficiency.
References
Ali, M., Nadeem Ahmad Khan, M., & Junaid Patel, M. (2022). Pattern and knowledge of HbA1C testing among diabetic patients at the Indus Hospital (TIH), Karachi. Liaquat National Journal of Primary Care, 4. https://doi.org/10.37184/lnjpc.2707-3521.4.19
American Diabetes Association Professional Practice Committee. (2021). 12. Retinopathy, neuropathy, and foot care: Standards of medical care in diabetes—2022. Diabetes Care, 45. https://doi.org/10.2337/dc22-s012
Bachynsky, N. (2019). Implications for policy: The triple aim, quadruple aim, and interprofessional collaboration. Nursing Forum, 55(1), 54–64. https://doi.org/10.1111/nuf.12382
Garritty, C., Hamel, C., Hersi, M., Butler, C., Monfaredi, Z., Stevens, A., Nussbaumer-Streit, B., Cheng, W., & Moher, D. (2020). Assessing how information is packaged in rapid reviews for policy-makers and other stakeholders: A cross-sectional study. Health Research Policy and Systems, 18(1). https://doi.org/10.1186/s12961-020-00624-7
Imai, C., Li, L., Hardie, R.-A., & Georgiou, A. (2021). Adherence to guideline-recommended HbA1c testing frequency and better outcomes in patients with type 2 diabetes: A 5-year retrospective cohort study in Australian general practice. BMJ Quality & Safety, 30(9), bmjqs-2020-012026. https://doi.org/10.1136/bmjqs-2020-012026
NHS FPX 6004 Assessment 2 Policy Proposal
Mao, W., Yip, C.-M. W., & Chen, W. (2019). Complications of diabetes in China: Health system and economic implications. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-6569-8
Robinson, J., Lang, B., & Clippinger, D. (2019). Impact of the Alphabet strategy on improving diabetes care at a free health clinic. Journal of Community Health Nursing, 36(4), 157–164. https://doi.org/10.1080/07370016.2019.1665323
Thanh, H. T. K., & Tien, T. M. (2021). Effect of group patient education on glycemic control among people living with type 2 diabetes in Vietnam: A randomized controlled single-center trial. Diabetes Therapy. https://doi.org/10.1007/s13300-021-01052-8
Walker, G. B., & Daniels, S. E. (2019). Collaboration in environmental conflict management and decision-making: Comparing best practices with insights from collaborative learning work. Frontiers in Communication, 4. https://doi.org/10.3389/fcomm.2019.00002
Wu, S. S., Chan, K. S., Bae, J., & Ford, E. W. (2019). Electronic clinical reminder and quality of primary diabetes care. Primary Care Diabetes, 13(2), 150–157. https://doi.org/10.1016/j.pcd.2018.08.007